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Difficulty: HardClient Care Assignments and Collaboration

While coordinating care on a progressive neurological unit, a practical nurse (PN) prepares to assign routine mobility assistance to an assistive personnel (AP). To comply with the National Guidelines for Nursing Delegation, arrange the PN's actions in the required chronological order.

  1. 1Review the clients' current acuity levels and neurological stability to confirm they are appropriate for delegated care.
  2. 2Confirm the AP possesses the required facility-approved training to safely manage mobility equipment.
  3. 3Direct the AP on the exact distance to ambulate each client and specify which physiological changes to report.
  4. 4Observe the AP periodically while they assist the clients to ensure the tasks are executed safely.
  5. 5Obtain a comprehensive report from the AP regarding how well the clients tolerated the activities.

Answer

The correct chronological sequence aligns with the Five Rights of Delegation: 1) Review client acuity and stability, 2) Confirm AP competency, 3) Direct the AP with specific parameters, 4) Observe performance periodically, and 5) Obtain a final report on client tolerance.
The delegation process must follow a strict chronological sequence to ensure safety. The PN must first confirm the client is stable enough for delegation (Right Circumstance). Next, the PN verifies the AP is competent to perform the care (Right Person). Then, the PN gives specific instructions and reporting limits (Right Direction). While the task is occurring, the PN monitors the AP (Right Supervision). Finally, the PN follows up to determine how the client responded (Right Evaluation).

Step-by-Step Solution

1
Determine the right task and right circumstances.
The PN reviews the clients' acuity and neurological stability.
Delegation is only safe when the client's condition is stable and predictable.
2
Ensure the right person is selected.
The PN confirms the AP has the training to manage mobility equipment.
The AP must possess documented competency before a task is assigned.
3
Provide the right direction and communication.
The PN provides exact ambulation distances and parameters for reporting.
Clear, two-way communication ensures the AP understands exactly what to do and what findings require immediate escalation.
4
Implement the right supervision.
The PN observes the AP periodically during the task execution.
The PN retains accountability and must monitor the AP to ensure safe care delivery.
5
Conduct the right evaluation.
The PN obtains a comprehensive report on client tolerance.
The delegation loop is closed by evaluating the outcome of the task and documenting the results.

Key Concept

The National Guidelines for Nursing Delegation require a sequential application of the Five Rights: Right Task, Right Circumstances, Right Person, Right Direction/Communication, and Right Supervision/Evaluation.
Estimated Time:1m 30s
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Topics

Client Care Assignments and Collaboration

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