WYSK WK1 Class 2 - All the study guides for Adult Health2 and some for Leadership and Management PDF

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All the study guides for Adult Health2 and some for Leadership and Management...

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Class 2 Week 1: What You Should Know 1. Identify specific strategies for successful delegation Some specific strategies for successful delegation are identifying necessary skill and education levels to complete the delegated task, planning ahead, selecting and empowering capable personnel, communicating goals clearly, empowering the delegate, setting deadlines and monitoring progress, monitoring the role and providing guidance, evaluating performance, and rewarding accomplishments (Marquis & Huston, 2021). 2. What does the NPA (Nurse practice act) contain as the essential elements regarding delegation (as in ATI) Essential elements regarding delegation contained in the nurse practice act are the definition of delegation, items that cannot be delegated, items that cannot be routinely delegated, guidelines for RN’s about tasks that can be delegated, description of professional nursing practice, description of LVN/LPN nursing practice and unlicensed nursing roles, degree of supervision required to complete a task, the guidelines for lowering delegation risks, warnings about inappropriate delegation, and if there is a restricted use of the word nurse to licensed staff (Wolters Kluwer, 2021). 3. Describe the 5 rights of delegation—name them and define them The five rights of delegation are right task, right circumstances, right person, right direction/communication, and right level of supervision. Right

task refers to a task that is delegable for a specific patient (Marquis & Huston, 2021). A right task it is repetitive, requires little supervision, and is relatively noninvasive for the client (ATI testing, 2019). Right circumstances refer to an appropriate patient setting, available resources, and other relevant factors considered (Marquis & Huston, 2021). Right circumstances match the complexity of care demands to the skill level of the health care team member factoring in their workload (ATI testing, 2019). Right person refers to delegating the right task to the right person to be performed on the right person (Marquis & Huston, 2021). For the right person the task has to be within the team members scope of practice, and they must be competent with the necessary level of training required to complete said task. Right direction/communication refers to clear, concise description of the task including its objectives, limits, and expectations (Marquis & Huston, 2021). Right direction/communication can be done in writing or orally regarding data that needs to be collected, method and timeline for reporting concerns/findings, specific tasks to be performed, client specific instructions, expected results, timelines, and expectations for follow up communication (ATI testing, 2019). Right level of supervision refers to appropriate monitoring, evaluation, intervention, as needed and feedback (Marquis & Huston, 2021). Right level of supervision requires the delegating nurse to provide supervision (directly or indirectly), clear directions and expectations of the task, monitor performance, provide feedback, intervene if necessary,

and evaluate client and whether or not outcomes were met (ATI testing, 2019). 4. Provide an example of each of the 5 rights of delegation An example of a right task is delegating assisting a patient with a bedpan to an AP. An example of right circumstance is delegating taking stable patients vitals to an AP. An example of right person is delegating performing tracheostomy care to a PN. An example of right direction/communication is delegating assisting patient in room 200 with getting dressed before 1200 to an AP. An example of right level of supervision is delegating inserting a urinary catheter to a PN and observing to ensure it was inserted properly using aseptic technique and providing positive feedback to the PN. 5. Describe the criteria for delegation to an unlicensed assisted personnel (UAP) The criteria for delegation to an unlicensed assisted personnel (UAP) is being aware of the job description, knowledge base, and demonstrated skills of each person and understanding UAP’s cannot exceed their scope of practice because no scope of practice exists for UAP’s (Wolters Kluwer, 2021). 6. Name 5 tasks that are generally considered appropriate for delegation to UAPs Tasks that are generally considered appropriate for delegation to UAP’s are basic activities of daily living such as bathing, feeding, ambulation, vitals,

weight, assistance with elimination, and maintaining a safe environment (Marquis & Huston, 2021). 7. Describe the reasons nurses will under delegate tasks. Reasons nurses will under delegate tasks are the assumption that delegating could be interpreted as a lack of ability on the nurses part, the individuals desire to complete the task personally due to lack of trust in subordinates, people new to delegation who feel it requires them to give up control, fear of letting someone else complete a task they are ultimately responsible for, lack of time to delegate, lack of experience in the job or delegation itself, failure to anticipate the help they need, and finding difficulty in assuming the manager role (Marquis & Huston, 2021). 8. Describe the situations in which nurses will over delegate tasks Situations in which nurses will over delegate tasks are when they are poor managers of time, disorganized, or they feel insecure in their own ability to perform a task. 9. Draw the decision tree created by the National Council of State Boards of Nursing (NCSBN) that is used to determine appropriate tasks for UAPs—(apply the example of obtaining a blood sugar value to this model to determine if that would be an appropriate task to delegate

DECISION TREE FOR DELEGATION TO UAP

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Is the task within the scope of practice for UAP?  NO STOP! Do not delegate to UAP. ↓ Yes ↓

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Is the activity allowed by the Nursing Practice Act, Board Rules, Statements, or by any other law, rule or policy?  NO  STOP! Do not delegate to UAP. ↓ Yes ↓

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Is RN assessment of client’s nursing care needs complete?  NO  STOP! Do not delegate to UAP. ↓ Yes ↓

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Is the RN/LPN competent to make delegation decisions?  NO  STOP! Do not delegate to UAP. ↓ Yes ↓

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Is the task consistent with the rules for delegation to UAP? Must meet all the following criteria: -Frequently recurs in the daily care of a client or group of clients -Is performed according to an established sequence of steps -Involves little to no modification from one client care situation to another -May be performed with a predictable outcome

-Does not inherently involve ongoing assessment, interpretation, or decision making which cannot be logically separated from the procedure(s) itself; and -Does not endanger the client’s life or wellbeing  NO  STOP! Do not delegate to UAP. ↓ Yes ↓ 

Is the UAP properly trained and validated as competent by an RN to accept the delegation?  NO  STOP! Do not delegate to UAP. ↓ Yes ↓

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Does the capability of UAP match the care needs of the client?  NO  STOP! Do not delegate to UAP. ↓ Yes ↓



Are there written agency policies, procedures, and/or protocols in place for this task?  NO  STOP! Do not delegate to UAP. ↓ Yes ↓

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Is appropriate supervision available?  NO  STOP! Do not delegate to UAP. ↓ Yes ↓



Proceed with delegation

Based on the decision tree obtaining a blood sugar value is an appropriate task to delegate to a UAP. A UAP can take a patient’s blood glucose if they have the knowledge/competency to do so, if agency/hospital protocols allow for it, and if the nurse has assessed the patient’s needs and is competent to make delegation decisions. 10.

Name the key differences between what roles and

responsibilities exist for RNs and contrast that with those of LPNs The key differences between what roles and responsibilities exist for RN’s in contrast with those of LPN’s largely depends upon state regulations. In some states LPN’s have a larger scope of practice and are responsible for much of what RN’s are typically responsible for. RN’s have the knowledge and competence to utilize the nursing process, create care plans, and administer IV medications whereas for LPN’s this is not typically in their scope of practice. LPN’s are responsible for basic nursing care including monitoring findings, reinforcing client teaching from a standard care plan, performing tracheostomy care, suctioning, checking NG tube patency, administering enteral feedings, inserting a urinary catheter, administering medication (excluding IV in some states) (ATI testing, 2019).

References ATI Testing. (2019). Nursing Leadership and Management Review Module Edition 8.0. ATI Testing. https://student.atitesting.com/Home

Marquis, B. L., & Huston, C. J. (2021). Leadership roles and management functions in nursing: theory and application (10th ed.). Wolters Kluwer. Wolters Kluwer. (2021). Chapter 9 Time Management. [PowerPoint slides]. https://resu.brightspace.com/d2l/le/content/14005/viewContent/24456 3/View...