Delegation to Improve Patient Care and Patient Safety Essay
Delegation to Improve Patient Care and Patient Safety Essay
Scenario: A medical-surgical RN delegated emptying of the JP drain to the unlicensed assistive personnel (UAP) on a new postoperative patient. At the end of the shift, the UAP reported 2,000 mL bloody JP output. There had been no communication about the drainage during the shift. The RN immediately called the surgeon and the patient returned emergently to the OR for postoperative hemorrhaging.
Assignment: 1) Define and describe delegation by RNs to UAPs based upon the CA BRN Nurse Practice Act and The RN as Supervisor. 2) Analyze and evaluate what went wrong with the delegation. Determine who is responsible for the failure to recognize and respond to the postoperative hemorrhage in a timely manner. 3) As the nurse manager, identify actions that you will take to prevent future occurrences.
Delegation to Improve Patient Care and Patient Safety Essay
1) Define and describe delegation by RNs to UAPs based upon the CA BRN Nurse Practice Act and The RN as Supervisor.
RN delegation involves assigning the performance of patient care tasks and activities to UAPs while retaining accountability for the outcome. The RN is not permitted to delegate the responsibilities related to nursing judgments. It involves transferring responsibility for performing nursing tasks from the RN to the UAP while the RN retains accountability for the outcome. In delegating a task to a UAP, the RN transfers the responsibility for the performance of the task to the UAP but retains the professional responsibility for overall care. Some of the nursing activities that a RN may not delegate to a UAP include assessing and evaluating the impact of care intervention provided to the patient (Weiss et al., 2023).
ORDER HUMAN-WRITTEN PAPER HERE
The CA BRN Nurse Practice Act outlines the tasks that a RN can and cannot delegate to a UAP. The tasks that can be delegated include those supported by the Nurse Practice Act provisions, within the scope of practice of the RN and UAP, after an assessment of the patient’s needs, tasks performed without critical nursing judgment, repeated without nursing assessment, and appropriate supervision availed. Tasks that cannot be delegated to UAP include assessment, diagnosis, planning and evaluation tasks, nursing functions in lieu of the RN, functions requiring substantial technical skills and knowledge even under supervision, and activities not allowed by the scope of practice (Zheng, 2024).
2) Analyze and evaluate what went wrong with the delegation. Determine who is responsible for the failure to recognize and respond to the postoperative hemorrhage in a timely manner.
The RN is responsible for failing to recognize and respond to the post-operative hemorrhage promptly. The activity involved in the JP drain involves making nursing judgments, as it requires continuous assessment and evaluation of the patient. The task requires critical nursing judgment and cannot be repeated without a nursing assessment. Consequently, the RN should not have delegated the JP drainage task to the UAP (California Board of Registered Nursing, 2024).
3) As the nurse manager, identify actions that you will take to prevent future occurrences.
As a nurse manager, it is important to provide regular staff training to ensure the RNs and UAPs stay informed. The training should reflect pertinent changes affecting task delegation and the performance of nursing duties. This would ensure that the nursing staff work within their scope of practice and do not compromise patient safety. In addition, it is important to ensure that the facility nursing delegation protocols are regularly updated to reflect any changes made to the state NPA. Keeping track of changes and updates made to the NPA ensures the facility can retire outdated practices and provides timely training to the nursing staff (Weiss et al., 2023).
References
California Board of Registered Nursing (2024). The RN as Supervisor. https://www.rn.ca.gov/pdfs/regulations/npr-i-12.pdf
Weiss, S., Tappen, R., & Grimley, K. (2023). Essentials of Nursing Leadership & Management (8th ed.). F.A. Davis.
Zheng, K. (2024). California Nurse Practice Act: Facility Guide. https://www.intelycare.com/facilities/resources/california-nurse-practice-act-facility-guide/#:~:text=California%20Nurse%20Practice%20Act%20Delegation,explicitly%20supported%20by%20NPA%20provisions.
