20 Feb Delegation, Prioritization, and Scope of Practice in Nursing
Delegation. Prioritization, and Scope of Practice: Examine the principles of delegation and prioritization in client care. Clearly delineate the scope of practice for Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and Unlicensed Assistive Personnel (UAPs) within the context of safe and effective delegation
Discuss delegation and prioritization of clients and scope of practice for RN, LPN, and UAP
Introduction
Safe and effective nursing practice requires clear principles of delegation and prioritization, alongside a thorough understanding of the scope of practice for different nursing roles. Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and Unlicensed Assistive Personnel (UAPs) each have distinct responsibilities. Proper delegation ensures patient safety, maximizes efficiency, and empowers the healthcare team.
Principles of Delegation
Delegation is the process of transferring responsibility for a task to another person while maintaining accountability for the outcome. According to national guidelines:
The RN remains accountable for the overall patient care plan.
Delegation must consider the task, the patient’s condition, and the competence of the delegatee.
The “Five Rights of Delegation” are often emphasized:
Right task – Is the task appropriate to delegate?
Right circumstance – Is the patient stable enough for delegation?
Right person – Does the delegatee have the skills and training?
Right direction/communication – Are instructions clear and specific?
Right supervision/evaluation – Is follow-up and oversight provided?
Principles of Prioritization
Nurses must prioritize care to address the most urgent needs first. Common frameworks include:
Maslow’s Hierarchy of Needs – Physiological needs (airway, breathing, circulation) take precedence.
ABC Model (Airway, Breathing, Circulation) – Guides immediate interventions in emergencies.
Safety First – Tasks that prevent harm (fall prevention, medication administration) are prioritized.
Time-Sensitive Care – Tasks with deadlines, such as scheduled medications, are prioritized over routine activities.
Scope of Practice
1. Registered Nurses (RNs)
Responsibilities: Comprehensive patient assessment, care planning, administering medications (including IV), patient education, and supervising LPNs and UAPs.
Delegation Role: RNs delegate tasks but retain accountability for patient outcomes.
Decision-Making: RNs use critical thinking to determine what can safely be delegated.
2. Licensed Practical Nurses (LPNs)
Responsibilities: Provide basic nursing care, administer certain medications (depending on state regulations), monitor patient status, and report changes to RNs.
Limitations: LPNs cannot perform complex assessments or create independent care plans.
Delegation Role: LPNs may delegate tasks to UAPs but remain accountable for supervision.
3. Unlicensed Assistive Personnel (UAPs)
Responsibilities: Perform non-clinical, supportive tasks such as bathing, feeding, ambulation, vital signs collection, and basic hygiene.
Limitations: UAPs cannot administer medications, perform invasive procedures, or make clinical judgments.
Delegation Role: UAPs carry out tasks assigned by RNs or LPNs but do not independently decide patient care.
Comparative Table
Role Scope of Practice Delegation Authority Examples of Tasks
RN Full patient assessment, care planning, medication administration, supervision Delegates to LPNs & UAPs IV meds, care plans, patient education
LPN Basic nursing care, limited medication administration, monitoring Delegates to UAPs Oral meds, wound care, vital signs monitoring
UAP Supportive, non-clinical tasks Cannot delegate Bathing, feeding, ambulation, vital signs collection
Conclusion
Delegation and prioritization are essential for safe, efficient nursing practice. RNs, LPNs, and UAPs each have defined scopes of practice that ensure tasks are performed by the appropriate personnel. By adhering to the principles of delegation and prioritization, nurse leaders can optimize patient care, empower their workforce, and maintain high standards of safety and effectiveness.
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