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Difficulty: MediumAssignment, Delegation and Supervision

During the morning shift on a cardiac step-down unit, a registered nurse (RN) is organizing the daily workload. Which of the following tasks are safe and appropriate for the RN to delegate to an unlicensed assistive personnel (UAP)? Select all that apply.

  1. Emptying and recording the output of an indwelling urinary catheter for a client admitted with heart failureAnswer
  2. B
    Evaluating the redness around a peripheral intravenous (IV) insertion site after the client reports discomfort
  3. C
    Assisting a client to the bedside commode for the first time following a permanent pacemaker insertion
  4. Measuring the routine morning vital signs of a client who is scheduled for discharge later in the dayAnswer
  5. Applying barrier cream to the intact perineal skin of an older adult client who experiences urinary incontinenceAnswer

Answer

The tasks appropriate to delegate to the UAP are emptying and recording the output of an indwelling urinary catheter, measuring the routine morning vital signs of a stable client, and applying barrier cream to intact perineal skin.
The RN can safely delegate tasks that involve standard, unchanging procedures, have predictable outcomes, and do not require nursing assessment, clinical judgment, or teaching. Emptying a urinary catheter, taking routine vital signs on a stable client, and applying barrier cream to intact skin are all routine tasks that fall safely within the scope of practice for unlicensed assistive personnel (UAP).

Step-by-Step Solution

1
Analyze each task to determine if it requires nursing assessment, clinical judgment, or teaching (the 'EAT' rule).
Evaluating the IV site and assisting a client out of bed for the first time post-procedure both require initial nursing assessment and clinical judgment.
The RN is legally accountable for all nursing care and cannot delegate tasks that fall outside the UAP's scope of practice.
2
Identify the tasks that involve routine, standard procedures with predictable outcomes on stable clients.
Emptying a catheter, taking routine vital signs on a stable client ready for discharge, and applying cream to intact skin meet these criteria.
Tasks delegated to a UAP must be routine, non-invasive, and have a minimal risk of unpredictable results.

Key Concept

Delegation and Scope of Practice (The Five Rights of Delegation)
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Topics

Assignment, Delegation and Supervision

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