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Difficulty: HardAssignment, Delegation and Supervision

A registered nurse (RN) is planning to delegate the application of bilateral antiembolism stockings for a client with congestive heart failure to an unlicensed assistive personnel (UAP). According to the National Council of State Boards of Nursing (NCSBN) delegation process, arrange the RN's actions in the correct chronological order from first to last.

  1. 1Perform a comprehensive assessment of the client's lower extremity skin integrity and peripheral circulation.
  2. 2Verify the unlicensed assistive personnel's documented competency and previous experience with this specific task.
  3. 3Provide explicit instructions regarding the correct stocking size and specify that any skin discoloration must be reported immediately.
  4. 4Conduct rounds to observe the client and verify that the stockings are applied smoothly without any restrictive bands.
  5. 5Evaluate the client's circulatory outcome, document the intervention, and offer constructive feedback to the unlicensed assistive personnel.

Answer

The correct sequence follows the NCSBN delegation model: assess the client first, verify delegatee competency, provide specific communication, supervise the task, and finally evaluate the outcomes and provide feedback.
The National Council of State Boards of Nursing (NCSBN) delegation model requires a specific sequence to ensure client safety and safe practice. The RN must first assess and plan (evaluating client stability), then assess the delegatee (verifying competency). This is followed by communication (providing clear instructions), surveillance and supervision (observing the task), and finally evaluation and feedback.

Step-by-Step Solution

1
Assess the client's condition and determine if the task is appropriate for delegation.
The RN establishes that the client is clinically stable.
Client assessment is always the fundamental first step to ensure the 'Right Circumstance' for delegation.
2
Verify the UAP's competency and skills.
The RN confirms the UAP is qualified to apply the stockings.
The RN must ensure the 'Right Person' is selected before assigning the task.
3
Communicate directions clearly.
The UAP understands exactly how to perform the task and what clinical findings to report.
The 'Right Direction/Communication' ensures clear parameters are set before the task begins.
4
Supervise the delegated task.
The RN visually confirms the stockings are placed correctly without wrinkles.
The RN retains accountability and must provide the 'Right Supervision' to maintain client safety.
5
Evaluate the outcome and provide feedback.
The intervention is documented, and the UAP receives professional guidance.
Evaluation completes the delegation process, ensuring therapeutic goals are met and supporting staff development.

Key Concept

NCSBN Delegation Process
Estimated Time:1m 30s
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Topics

Assignment, Delegation and Supervision

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