Nurse delegation is a critical process in the provision of nursing care. Delegation is the process by which nurses assign tasks to other persons to conduct nursing activities and tasks. Registered nurses (RNs) and licensed practical nurses (LPNs) have to delegate tasks at various career stages. Some nursing facilities lack clear policies on the delegation roles of LPNs; therefore, it is essential to develop a new policy that establishes the responsibilities of LPNs in assigning tasks to other medical personnel.
LPNs have to utilize their nursing judgment to evaluate the suitability of task delegation. When selecting what task to assign to unlicensed assistive personnel (UAP), LPNs should consider the probability for patient harm, task complexity, predictability of medical outcomes, personnel and equipment resources available, and the level of communication required (Toney-Butler & Martin, 2018). Additionally, when delegating to a specific UAP, LPNs consider the UAP’s regular assignments and verify their training and education.
The delegation process must include constant communication with the UAP, which specifies the expectations of the assigned roles. For instance, communication identifies the authority limits, desired outcomes, the delegation’s time frame, verification of supervision and monitoring, and the delegate’s assignment understanding. LPNs should also understand that the original allocation of a task to a delegate and the inspection of the assigned activity remains their responsibility (Toney-Butler & Martin, 2018). LPNs usually delegate their tasks to the assistive personnel, who include the certified nursing assistant (CNA), home health aide, certified medication aide (CMA), and a patient care technician.
The licensed practical nurse can delegate various duties, which include the following:
- Assisting a patient with the aspects of their daily living like hygiene, bathing, grooming, dressing, and ambulation.
- Gaging and recording fluid output and intake, vital signs, weight, and height.
- Provision of nonmedical pain relief and comfort interventions like creating and sustaining a conducive and comfortable environment and providing a patient with a therapeutic and soothing back rub.
- Observing and reporting changes and current patient status in regards to their condition and responses to care.
- Assistance with feeding, making beds, bladder and bowel functions, transfers, and motion exercises.
- Transport of patients, specimens, and other tasks like stocking supplies.
The LPNs must understand which tasks to assign or when they are not supposed to delegate activities required by Florida’s Nurse Practice Act. The licensed practical nurse shall not delegate the original or subsequent nursing assessments and the activities that are not within the LPN’s scope of practice. Furthermore, LPNs should not assign tasks that the UAP has shown no competence or nursing activities that require special knowledge and skills of the practical or registered nurse (Nurse Practice Act, 2020). Roles that require determination or interpretations of diagnosis and assessments should not be assigned to the UAP.
The rationale behind the LPN’s role in delegation is related to healthcare. Delegation is a critical skill that LPNs can perform safely and effectively to provide quality and affordable care through the utilization of resources. The current healthcare industry necessitates the need to delegate certain nursing functions to multiple personnel with different knowledge, training, cultural competence, and educational preparation. All delegation-related decisions are founded and based on protecting the public’s safety, welfare, and health. LPNs take accountability and responsibility for the provision of nursing care (Nurse Practice Act, 2020). As a result, LPNs should ensure that the assisted personnel have the appropriate competency, skills, and knowledge for the delegated functions they accept.
In conclusion, most LPNs do not have clear delegation policies to follow; therefore, it is necessary to develop a new policy. LPNs delegate their duties to the assistive personnel provided they understand the task’s expectations and successfully perform the functions. LPNs should effectively communicate to the assistive personnel to facilitate successful task delegation. LPNs delegate duties such as motion exercises, ambulation, utilizing comfort devices, and data gathering. Delegation is essential because it improves the quality of care. The LPN has to ensure the assistive personnel has the necessary competence to accept various delegated tasks.
References
Toney-Butler, T. J., & Martin, R. L. (2018). Florida nursing laws and rules. StatPearls Publishing.