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Difficulty: HardAssignment, Delegation and Supervision

A clinical nurse on an acute vascular surgical unit is coordinating care for four clients with complex needs. The staffing mix includes the registered nurse and one experienced unlicensed assistive personnel (UAP). Which intervention demonstrates a safe and legally sound delegation decision by the nurse?

  1. A
    Observing and documenting a client's swallowing coordination during their initial trial of clear liquids following a carotid endarterectomy
  2. B
    Reviewing the sequence of post-amputation stump care with a client and their family prior to a scheduled physical therapy session
  3. C
    Obtaining the initial set of vital signs for a client admitted from the emergency department with suspected mesenteric ischemia and worsening abdominal pain
  4. Applying anti-embolism stockings to a client with chronic venous insufficiency who is preparing for dischargeAnswer

Answer

Applying anti-embolism stockings to a client with chronic venous insufficiency who is preparing for discharge.
Applying anti-embolism stockings to a stable client preparing for discharge is a standard, routine task with predictable outcomes. It does not require nursing assessment, clinical judgment, or evaluation, making it well within the safe scope of practice for an unlicensed assistive personnel (UAP).

Step-by-Step Solution

1
Analyze the requested task to determine if it involves assessment, teaching, or evaluation (EAT).
Tasks involving EAT must be performed by the registered nurse.
Unlicensed assistive personnel are not licensed or trained to perform tasks requiring clinical judgment.
2
Evaluate the clinical stability of each client described in the options.
Clients who are newly admitted, unstable, or experiencing acute changes require direct RN care.
Delegation to a UAP requires the client to be medically stable with predictable health outcomes.
3
Identify the task that is routine, standard, and assigned to a stable client.
Applying anti-embolism stockings for a discharge-ready client meets all delegation criteria.
This task aligns with the UAP's scope of practice and strictly adheres to the Five Rights of Delegation.

Key Concept

Principles of Safe Delegation to Unlicensed Assistive Personnel
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Topics

Assignment, Delegation and Supervision

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