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Zorluk: ZorClient Care Assignments and Collaboration

The healthcare team on an acute care medical-surgical unit is organizing client care for the shift. Match each specific clinical task to the interprofessional team member most qualified and legally authorized to perform it.

  • Administering a continuous intravenous (IV) heparin infusion for a client with deep vein thrombosisRegistered Nurse (RN)
  • Performing tracheostomy care and suctioning for a client with a stable, well-established airwayLicensed Practical/Vocational Nurse (LPN/VN)
  • Reporting a client's decreased oral fluid intake and dry mucous membranes to the primary nurseUnlicensed Assistive Personnel (UAP)
  • Facilitating home health services and securing durable medical equipment for a client nearing dischargeCase Manager

Cevap

The RN administers the continuous IV heparin; the LPN/VN performs tracheostomy care on the stable airway; the UAP reports the oral intake and dry mucous membranes; and the Case Manager facilitates home health services.
Each task is appropriately delegated according to the principles of safe client care. The RN handles unstable, high-risk interventions requiring advanced assessment (IV heparin). The LPN/VN manages stable clients with predictable outcomes (established tracheostomy). The UAP handles basic care and reporting without making clinical judgments. The Case Manager coordinates resources across the continuum of care.

Adım Adım Çözüm

1
Evaluate the IV heparin task.
Matched with the RN.
Heparin is a high-alert medication requiring independent clinical judgment, continuous lab monitoring, and IV dose titration, which exceeds the scope of the LPN/VN and UAP.
2
Evaluate the tracheostomy care task.
Matched with the LPN/VN.
While it is a sterile procedure, the airway is stable and established. The LPN/VN is legally authorized and educationally prepared to safely perform this predictable task.
3
Evaluate the reporting of fluid intake.
Matched with the UAP.
The UAP can observe and report findings to the nurse. This does not involve independent nursing assessment or clinical decision-making.
4
Evaluate the discharge coordination task.
Matched with the Case Manager.
Securing home services and durable medical equipment is a collaborative administrative and coordination function best suited for the Case Manager.

Anahtar Kavram

Interprofessional collaboration and delegation based on legal scope of practice and the NCSBN National Guidelines for Nursing Delegation.
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