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Difficulty: MediumClient Care Assignments and Collaboration

A licensed practical nurse (LPN) in a rehabilitation facility is planning to delegate morning ambulation for a medically stable client to an unlicensed assistive personnel (UAP). Place the following steps of the delegation process in the correct chronological order.

  1. 1Assess the client's current clinical stability and baseline mobility status.
  2. 2Determine if the UAP has the documented competency to safely ambulate this specific client.
  3. 3Provide clear instructions regarding the ambulation distance and specific observations to report.
  4. 4Verify that the UAP understands the instructions and accepts the delegated responsibility.
  5. 5Follow up with the UAP to review the client's response to ambulation and evaluate the outcome.

Answer

The correct chronological sequence is: Assess the client, determine UAP competency, provide clear instructions, verify understanding, and finally evaluate the outcome.
According to the NCSBN National Guidelines for Nursing Delegation, the delegation process must follow a logical sequence. The nurse must first assess the client to ensure stability (Right Circumstance). Next, the nurse verifies the competence of the delegatee (Right Person). After matching the person to the task, the nurse must communicate clear expectations and parameters (Right Direction/Communication). The nurse then verifies that the delegatee understands and accepts the task. Finally, the nurse must follow up to evaluate the client's response and the outcome of the task (Right Supervision/Evaluation).

Step-by-Step Solution

1
Prioritize client safety by performing a clinical assessment.
The nurse confirms the client is stable and suitable for delegation.
Delegation must always begin with evaluating the client's current condition.
2
Match the task to the appropriate healthcare team member.
The nurse verifies the UAP is competent to perform the ambulation.
The delegatee must have the demonstrated knowledge and skills to perform the task safely.
3
Communicate the specific requirements of the task.
The nurse provides exact parameters, such as distance to walk and specific signs to report.
Clear communication prevents errors and sets concrete expectations.
4
Confirm two-way communication.
The UAP acknowledges understanding and accepts the task.
This ensures the delegatee is confident and prepared to proceed without confusion.
5
Perform supervision and evaluation.
The nurse follows up on the client's status after the ambulation is completed.
The delegating nurse retains accountability for the outcome and must evaluate the results.

Key Concept

The National Council of State Boards of Nursing (NCSBN) delegation process follows a sequential framework: assessing the client, verifying delegatee competency, providing clear communication, confirming understanding, and evaluating the final outcome.
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Topics

Client Care Assignments and Collaboration

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