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Difficulty: MediumAssignment, Delegation and Supervision

The primary nurse on an acute stroke unit is determining appropriate task assignments for an unlicensed assistive personnel (UAP). Which of the following tasks are safe and appropriate to delegate to the UAP? Select all that apply.

  1. Recording the volume of oral fluids consumed by a client on a strict fluid restrictionAnswer
  2. B
    Assessing a client's ability to safely swallow during their first meal following a cerebrovascular accident
  3. C
    Evaluating the skin integrity beneath a client's newly applied bilateral soft wrist restraints
  4. Performing passive range-of-motion (ROM) exercises on the affected extremities of a client with hemiparesisAnswer
  5. E
    Educating a client's family members about environmental safety modifications to prevent falls at home
  6. Applying moisture barrier ointment to intact perineal skin while providing routine incontinence careAnswer

Answer

The appropriate tasks to delegate to the UAP are recording oral fluid intake, performing passive ROM exercises, and applying moisture barrier ointment to intact skin.
The correct options represent tasks that are routine, have predictable outcomes, and do not require clinical judgment. A UAP is trained to document basic intake and output, perform standard physical mobility assistance like ROM, and provide basic skin care to intact skin.

Step-by-Step Solution

1
Analyze the UAP's legal scope of practice.
UAPs can perform routine, standard tasks with predictable outcomes, such as assisting with basic activities of daily living (ADLs), measuring intake and output, and routine hygiene.
To establish a baseline for which interventions do not require independent nursing judgment.
2
Apply the 'EAT' (Evaluate, Assess, Teach) rule to the given options.
Assessing swallowing capability, evaluating skin integrity under restraints, and educating the family clearly violate the EAT rule.
Registered nurses cannot delegate assessment, evaluation, or teaching responsibilities to unlicensed personnel.
3
Select the tasks that fit within standard UAP parameters.
Recording fluid intake, performing passive ROM, and applying barrier cream to intact skin are correctly identified as safe delegations.
These specific tasks involve standard, unchanging procedures for stable clients and carry minimal risk of immediate physiological instability.

Key Concept

Delegation to Unlicensed Assistive Personnel (UAP)
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Topics

Assignment, Delegation and Supervision

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