A licensed practical/vocational nurse (LPN/VN) is reviewing delegation practices on a subacute unit. Match each inappropriate delegation scenario with the specific NCSBN 'Right of Delegation' that has been violated.
- Delegating an assistive personnel (AP) to evaluate a diabetic client's skin integrity and determine if a dressing is needed.Right Task
- Directing an AP to ambulate a client who developed sudden, severe shortness of breath and diaphoresis five minutes ago.Right Circumstance
- Assigning the administration of a routine tap water enema to an AP who has not been trained or checked off on this specific procedure.Right Person
- Instructing an AP to 'monitor the client with heart failure' without specifying which vital signs to check, the frequency, or when to report abnormalities.Right Direction and Communication
Answer
Evaluating skin integrity matches to Right Task; ambulating an unstable client matches to Right Circumstance; assigning an untrained AP matches to Right Person; and giving vague instructions matches to Right Direction and Communication.
The NCSBN Five Rights of Delegation require the nurse to ensure the task itself is delegable (Right Task), the patient is stable and the setting is appropriate (Right Circumstance), the delegatee is individually competent (Right Person), and the instructions are clear and specific (Right Direction and Communication). Evaluating skin is an assessment, which violates the Right Task. Ambulating an acutely unstable patient violates the Right Circumstance. Using an untrained AP ignores individual competency, violating the Right Person. Vague monitoring instructions lack parameters, violating Right Direction and Communication.
Step-by-Step Solution
Key Concept
NCSBN Five Rights of Delegation