Which tasks should the registered nurse delegate to the licensed practical nurse?
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What is delegation in nursing? It’s where a licensed nurse (RN) transfers responsibility to a person, who is competent, to perform a certain task. What’s the overall purpose of delegation in nursing? It frees up the RN to care for a more critical patient or complete other necessary tasks that only the registered nurse can
perform. REMEMBER: The RN is ACCOUNTABLE (liable or responsible) for the delegated task getting done even though they are not the one doing the task. So, in other words, the accountability is NOT transferred to that person completing the task. ***However, not all tasks can be delegated to other nursing staff, such as the LPN/LVN or UAP (nursing assistant) because some tasks can only be done by the registered nurse. This is where you need to know what factors determine delegation in nursing. Video on Nursing Delegation for NCLEXWhen you start practicing nursing, it’s very important that you are always familiar with your facilities and state’s nursing protocols. For example, in some states LPNs are allowed to give IV medications and start IVs if they have completed a certification course. While in some states this is prohibited. In addition, in some states certified nursing assistants (CNAs) can draw blood, obtain EKGs, or check blood glucose levels if they have completed a certification course. Therefore, as you can see delegated tasks can vary depending on where the RN works. What tasks can NOT be delegated by the RN? Remember these categories for when you are answering those NCLEX style questions!
An easy way I remember it: Don’t delegate a task to the LPN or UAP if the task requires TAPE!! Some factors that you need to keep in mind before delegating a task as a registered nurse:
5 Rights of Nursing Delegation
Source for 5 Rights: (National Guidlelines for Nursing Delegation, 2016) Other important details: the person who received the delegated task can NOT go and delegate it to someone else. UAP can NOT delegate. Only RNs can delegate. Please note that in most states LPNs can delegate to UAP, but this may NOT be the case in all states (always check your state board of nursing’s rules for this). RN vs LPN vs UAP RolesBelow are the “most common” duties each position can perform. This is not a complete list, but the list will give you an idea of the differences between each profession when you are studying for the NCLEX exam. UAP (unlicensed assistive personnel)
Duties:
Don’t delegate tasks for unstable patients (ex: patient has a new ostomy…RN needs to be assessing and monitoring/measuring stool rather than delegating this task or if patient is post-opt from open heart surgery….the RN should be getting the patient out of bed to ambulate the first time due to the unforeseen complications that can arise. LPN (licensed practical nurse)
Duties:
RN (registered nurse)
Never delegate: avoid options on exams that deal with assessment, critical patient cases (requires you to understand the disease process), education, or evaluation of patient care Delegation NCLEX Practice Questions1. You’re making the patient assignments for the next shift. On your unit there are three LPNs, two RNs, and two nursing assistants. Which patients will you assign to the LPNs? A. A 68 year-old male patient who is expected to be discharged home with IV antibiotic therapy. B. A 25 year-old female patient newly admitted with diabetic ketoacidosis. C. A 75 year-old male patient with dementia who has an ileostomy and scheduled tube feedings. D. A 65 year-old female patient who has an order to remove a Foley catheter. Answers are C and D. Option A: An RN is the best for this patient because the patient will need discharge teaching AND the nurse will need to teach the patient how to self-administer antibiotics. Option B: This is a new admission and the patient is UNSTABLE. Most patients with DKA (diabetic ketoacidosis) require insulin drips along with close monitoring of the blood glucose levels, which requires critical thinking and interpretation. Options C and D are best for the LPNs: these are standard routine procedures the LPN can perform and these patient cases are stable. 2. As the registered nurse, which tasks below should you NOT delegate to the LPN? A. Performing an assessment on a new admission B. Collecting a urine sample from an indwelling Foley catheter C. Developing a plan of care for a patient who is admitted with Guillain-Barré Syndrome D. Educating a patient about how to monitor for side effects associated with Warfarin E. Auscultating lung and bowel sounds F. Starting a blood transfusion G. Administering IV Morphine 2 mg for pain H. Providing wound care to a stage 3 pressure injury Answers are A, C, D, F, G….these are all out of the scope of practice for an LPN. Remember anything that deals with assessments, educating, evaluating, developing a plan of care, IV medications, unstable patients, or invasive/complex procedures where there is unpredictability the RN is responsible for doing it, and these tasks can’t be delegated. An LPN can perform a focused assessment by listening to lung or bowel sounds and report the findings to the RN but a comprehensive assessment is done by the RN. In addition, the LPN can perform standard procedures that are predictable on stable patients like wound care for a pressure injury, Foley catheter insertion, obtaining an EKG, obtaining blood glucose level etc. More delegation NCLEX questions References: Journal of Nursing Regulation. (2016). National Guidlelines for Nursing Delegation[Ebook] (p. 8). Retrieved from https://www.ncsbn.org/NCSBN_Delegation_Guidelines.pdf What can the RN delegate to the LPN?Nurses may also delegate tasks to those with a more narrow scope of practice. For example, an RN might delegate PO med passes to the LPN. An LPN may delegate tasks such as ambulating or feeding a patient to the CNA. The question of when a nurse should delegate is dependent on many factors.
What are three tasks that a registered nurse may assign to a licensed practical?Initiate, administer, and titrate both routine and complex medications. Perform education with patients about the plan of care. Admit, discharge and refer patients to other providers.
What tasks can an RN delegate to an LPN ATI?Related Studylists. complete a task while retaining the accountability is called. ... . a nurse may delegate an LPN to: ... . perform tracheostomy care, suctioning, ... . admin enteral feedings, ... . administer medications (except IVs meds) ... . ADLs, bathing, grooming, dressing, toileting, ambulating, feeding (w/o swallowing precautions),. What tasks can be assigned to an LPN?What are some common LPN duties?. Monitoring basic patient health such as vital signs and overall condition.. Changing dressings or inserting catheters.. Taking patient histories and maintaining documentation.. Assisting with tests or procedures.. Providing personal care, such as helping with bathing and toileting.. Which tasks should the RN delegate to the UAP?Routine tasks, such as taking vital signs, supervising ambulation, bed making, assisting with hygiene, and activities of daily living, can be delegated to an experienced UAP. The charge nurse appropriately delegates the routine task of feeding to the UAP.
Which tasks can the registered nurse safely delegate to unlicensed assistive personnel?In general, simple, routine tasks such as making unoccupied beds, supervising patient ambulation, assisting with hygiene, and feeding meals can be delegated. But if the patient is morbidly obese, recovering from surgery, or frail, work closely with the UAP or perform the care yourself.
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