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Zorluk: Çok zorAssignment, Delegation and Supervision

The nursing supervisor on a cardiovascular step-down unit is evaluating the task assignments established by the charge nurse. The current shift's staffing matrix includes an experienced core unit registered nurse (RN), an RN floated from an orthopedic surgical unit, a licensed practical nurse (LPN), and an unlicensed assistive personnel (UAP). Which assignment represents the safest and most legally sound application of delegation principles?

  1. Assigning the orthopedic float RN to care for a client four days post-coronary artery bypass grafting who requires sternal wound dressing changes, scheduled oral analgesics, and progressive ambulation.Cevap
  2. B
    Instructing the UAP to apply bilateral sequential compression devices and assist a client into a high-Fowler's position immediately following a percutaneous coronary intervention via the right femoral artery.
  3. C
    Delegating the UAP to complete the initial respiratory assessment and independently titrate a client's supplemental oxygen flow rate based on continuous pulse oximetry readings.
  4. D
    Assigning the orthopedic float RN to assume primary care for a newly admitted client experiencing unstable angina and frequent premature ventricular contractions who requires continuous cardiac monitoring.

Cevap

The most appropriate assignment is directing the orthopedic float RN to care for the stable client who is four days post-coronary artery bypass grafting and requires wound care, oral analgesics, and ambulation.
The correct assignment safely matches the competency of the float RN with the needs of a stable client. An orthopedic float RN possesses strong core competencies in post-operative care, including incisional wound management, pain control, and progressive mobility. A client who is four days post-coronary artery bypass grafting (CABG) is considered clinically stable with predictable outcomes, making this an ideal and legally sound assignment that frees the specialized core cardiovascular RN to manage higher-acuity admissions.

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1
Analyze the competency and scope of practice for the orthopedic float RN.
The float RN is highly skilled in post-surgical care, wound management, and mobility, but lacks specialized cardiovascular training.
Float nurses should be assigned clinically stable clients with conditions similar to the patient population on their home unit.
2
Evaluate the acuity and stability of the clients described in the distractors.
The client with unstable angina is highly unstable; the post-catheterization client requires strict physiological positioning; the client needing oxygen titration requires complex clinical judgment.
Unstable clients or those requiring specialized assessments must be assigned to the experienced core unit RN.
3
Assess the tasks delegated to the UAP in the scenario.
Titrating oxygen and placing a post-femoral catheterization client in high-Fowler's position are unsafe and outside the UAP scope of practice.
UAPs cannot perform clinical assessments, evaluate patient responses, or manage unstable procedural positioning that could cause hemorrhage.
4
Select the assignment that safely matches staff competency with client stability.
Assigning the stable post-operative CABG client to the orthopedic float RN is the safest and most legally sound choice.
It perfectly aligns the float RN's surgical expertise with a stable client who has predictable, routine post-operative outcomes.

Anahtar Kavram

Assignment, Delegation, and Scope of Practice
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Konular

Assignment, Delegation and Supervision

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