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Difficulty: HardAssignment, Delegation and Supervision

An oncology nursing team consists of a registered nurse (RN) and an unlicensed assistive personnel (UAP). They are providing care for several clients receiving active treatment for various malignancies. Which of the following tasks are appropriate for the RN to delegate to the UAP? Select all that apply.

  1. Emptying a closed-wound drainage device and recording the output volume for a client recovering from a mastectomyAnswer
  2. B
    Assessing the peripheral intravenous insertion site of a client receiving vesicant chemotherapy for early signs of extravasation
  3. Assisting a client with mild chemotherapy-induced stomatitis to perform oral hygiene using a normal saline rinseAnswer
  4. D
    Teaching the visiting family members of a client with severe myelosuppression about the specific requirements for neutropenic precautions
  5. Applying a protective skin barrier paste to the intact skin around a client's established colostomy stomaAnswer
  6. F
    Obtaining a client's vital signs during the first 15 minutes of a packed red blood cell (PRBC) transfusion

Answer

The correct tasks to delegate are emptying the closed-wound drainage device, assisting with oral hygiene, and applying barrier paste to an established colostomy stoma.
The RN can safely delegate routine tasks that have predictable outcomes and do not require nursing assessment, clinical judgment, or teaching. Emptying a closed-wound drainage device, assisting with normal saline oral hygiene, and applying barrier paste to an established colostomy stoma are all standard, unchanging procedures that fall within the scope of practice for a UAP.

Step-by-Step Solution

1
Analyze the scope of practice for an unlicensed assistive personnel (UAP).
UAPs can perform routine, standard, and unchanging tasks that do not require clinical judgment, nursing assessment, or client teaching.
Delegation decisions must adhere to National Council of State Boards of Nursing (NCSBN) guidelines and the five rights of delegation.
2
Evaluate the options for tasks involving assessment and clinical judgment.
Assessing an intravenous site for extravasation and monitoring a client during the first 15 minutes of a blood transfusion require RN-level clinical judgment and cannot be delegated.
These activities involve interpreting clinical data and identifying potential high-risk complications.
3
Evaluate the options for tasks involving client education.
Teaching family members about neutropenic precautions is an RN responsibility.
Providing initial education and evaluating the comprehension of complex safety protocols are strictly outside the UAP's scope of practice.
4
Identify the routine, standard tasks appropriate for the UAP.
Emptying a drainage device, assisting with oral hygiene, and applying skin barrier paste to an established stoma are appropriate.
These are routine activities of daily living (ADLs) or standard procedures with predictable outcomes performed on stable clients.

Key Concept

Delegation of Care to Unlicensed Assistive Personnel (UAP)
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Topics

Assignment, Delegation and Supervision

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