Delegation is when a Registered Nurse (RN) directs another person to perform tasks and transfers responsibility but maintains accountability for the patient. Assignment is when a nurse directs a person to perform tasks that are already within that person’s scope of practice, such as making patient assignments (ANA & NCSBN, 2019).
In Oklahoma, APRNs, RNs, and LPNs within their scope of practice are responsible for patient care that is received under their supervision. Tasks that are approved for delegation are tasks that do not require nursing assessment, judgment, or teaching during implementation (Oklahoma Board of Nursing, 2020). The nurse must first assess each patient before delegating nursing tasks to ensure that the UAP is competent in performing the task (Oklahoma Board of Nursing, 2020).
Proper delegation can improve patient care and the efficiency of the healthcare team. Three strategies that nurse managers can use to reduce risks and strengthen efficiency of unit workflow are to communicate goals clearly, identify necessary skills and education levels, and rewarding accomplishments (Marquis & Huston, 2021). Purpose and goals of the task as well as a timeline and expectations for reporting should be clearly discussed with everyone participating in the patient care. A general suggestion for identifying necessary skills and education levels is to place RN, LPN, and UAP scope of practice in a common area for staff to review. Scope of practice for UAP and LPNs differ from state to state and even facility to facility. At a previous facility that I worked at, LPN’s were able to administer IV medications with a certification offered through the hospital. The majority of LPNs obtained the certification so this was extremely helpful to patient care and assignments. The facility I currently work at does not offer and has no desire to offer IV medication administration certifications for LPN. This places more responsibility on the nurse and time taken from their assigned patients to administer medications to other patients. People work more efficiently and are happier to work when they feel appreciated. A way to achieve this as well as strengthen efficiency in unit work flow is to reward accomplishments. “No one likes to be assigned more work only to be ignored for his or her labor” (Marquis & Huston, 2021). Something as simple as thanking and recognizing an employee for their hard work makes a huge difference in morale and a sense of appreciation.
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