What is the nurses responsibility to ensure that the task was completed as assigned?
Significant changes in health care over the past century have included implementation of a universal health care system, a rapidly aging population, technological advances, and scientific discoveries, and have culminated in increased stress upon the system and rapidly escalating costs. Health care leaders searched for ways to meet the increasing demands placed on the system. One solution that has been successfully implemented over the past 20 to 30 years, in response to
these pressures on health care, is delegation of care. Delegation of care refers to “the transfer of responsibility for a task when it is not part of the scope of practice or scope of employment of the care provider” (SRNA, 2015, p. 8). Delegation of care most often occurs between an RN and an unregulated care provider or between a physician and an RN. Guidelines have been established to ensure the quality of patient care throughout the delegation process. The RN is
responsible for the coordination of patient care, which may include assessment, assignment, care planning, supervision, ongoing monitoring, decision making, and evaluation of care (SRNA, 2015). The RN assigns provision of the client’s care to the most appropriate care provider based on the previously completed RN assessment. Assignment occurs when the required care falls within the scope of practice (i.e., LPN [licensed practical nurse], RN, RPN [registered psychiatric nurse])
or the job description (i.e., UCP [unregulated care provider]) of the care provider who accepts the assignment from the RN. . . . The RN at the point of care retains the overall accountability for the appropriate assignment and oversight of client care. This responsibility cannot be delegated. (SRNA, 2015, p. 8) DelegationDelegation of nursing care is different than assignment since it refers to “the transfer of responsibility for a task when it is not part of the scope of practice or scope of employment of the care provider” (SRNA, 2015, p. 8). It is important to remember that only the task can be delegated; the RN retains the responsibility for coordination of patient care. Nurse leaders must ensure the following delegation principles (SRNA, 2015, p. 9) are present in their organization before delegation takes place:
This accountability requires the RN to monitor the performance and completion of the delegated tasks by the unregulated care provider. Regular communication with the unregulated care provider is required during the initial delegation of the task, throughout the performance of the task, and when the delegated task is completed. Essential Learning Activity 5.4.1The five rights of delegation provide an excellent mental checklist for RN delegation of patient care. They include right task, right circumstances, right person, right direction/communication, and right supervision/evaluation. Read more about the five rights of delegation on pages 21–23 of the “SRNA Interpretation of the RN Scope of Practice.” Delegation by Physician to RNIn September 2014, The Medical Profession Act, 1981, was amended to give the College of Physicians and Surgeons of Saskatchewan (CPSS) “the authority to adopt bylaws that can allow physicians to delegate activities described in the College bylaw to other health care professionals” (CPSS, 2015, p. 7). Consequently, the CPSS bylaws were changed to allow physicians to delegate certain activities to RNs. The transfer of medical function (TMF) allows RNs “to perform complex, highly-skilled activities which are outside the scope of registered nursing and within the scope of the practice of medicine” (SRNA, 2016, p. 1). CPSS principles for delegation include the following:
Essential Learning Activity 5.4.2RN Evolving Scope of Practice Read pages 9–13 of the “SRNA Interpretation of the RN Scope of Practice,” then answer the following questions:
Collaboration between RNs, RPNs, and LPNs in Saskatchewan Read “Collaborative Decision-Making Framework: Quality Nursing Practice” (approved by the Saskatchewan Association of Licensed Practical Nurses, SRNA, and the Registered Psychiatric Nurses Association of Saskatchewan on September 9, 2017), then answer the following questions:
What is the nurse's responsibility to ensure that the task was completed as assigned?The nurse who assigns the tasks and jobs must then communicate with and direct the person doing the task or job. The nurse supervises the person and determines whether or not the job was done in the correct, appropriate, safe and competent manner.
What are the nurse's responsibilities when delegating tasks?the nurse assigned to the clients is responsible for the delegation process of communication, supervision/monitoring, and evaluation of the performance of the task/activities. the nurse also maintains accountability for the decision to delegate and the provision of safe nursing care.
Why is the responsibility retained by nurses when tasks are delegated?RNs are accountable for the decision to delegate and for the adequacy of nursing care provided to the healthcare consumer. The delegating RN retains accountability for the patient outcomes associated with nurse delegation, provided the person to whom the task was delegated performed it as instructed.
What are a nurse's responsibilities?Key Responsibilities. Perform physical exams and health histories before making critical decisions.. Provide health promotion, counseling and education.. Administer medications and other personalized interventions.. Coordinate care, in collaboration with a wide array of health care professionals.. |