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Zorluk: Çok zorAssignment, Delegation and Supervision

A charge nurse on a medical-surgical unit is coordinating care assignments for the upcoming shift. The staffing mix includes the charge nurse, a registered nurse (RN) floated from the inpatient psychiatric unit, an experienced licensed practical/vocational nurse (LPN/VN), and an unlicensed assistive personnel (UAP). Which of the following task assignments are appropriate? Select all that apply.

  1. Assigning the float psychiatric RN to perform a suicide risk assessment and manage continuous observation for a medically stabilized client following an intentional overdoseCevap
  2. Delegating the UAP to perform routine oropharyngeal suctioning using a Yankauer catheter for a stable client with a history of a cerebrovascular accidentCevap
  3. C
    Directing the LPN/VN to administer a scheduled intravenous (IV) push dose of furosemide to a client with acute decompensated heart failure
  4. Delegating the LPN/VN to reinforce previously taught infection control measures to a client with methicillin-resistant Staphylococcus aureus (MRSA) being discharged homeCevap
  5. E
    Assigning the float psychiatric RN to perform the initial admission assessment on a client transferred from the emergency department with acute diabetic ketoacidosis
  6. F
    Delegating the UAP to assist a client with a new tracheostomy and severe dysphagia with their first oral feeding since surgery

Cevap

The appropriate assignments are assigning the float psychiatric RN to the stabilized overdose client, delegating the UAP to perform Yankauer suctioning, and delegating the LPN/VN to reinforce infection control instructions.
Safe delegation requires matching the complexity of the task and the stability of the client with the competency and legal scope of the staff member. A psychiatric float RN is the clinical expert for a stabilized overdose client requiring suicide risk observation. An LPN/VN is fully qualified to reinforce previously provided RN education. A UAP can safely perform non-sterile, routine oral suctioning with a Yankauer catheter.

Adım Adım Çözüm

1
Analyze the staff mix provided in the scenario.
The team consists of an RN floated from a psychiatric unit, an experienced LPN/VN, and a UAP.
Understanding the unique qualifications and legal scope of practice for each team member is the foundation of safe delegation.
2
Evaluate the appropriate scope for a float RN.
The float RN should be assigned clients who are physiologically stable with predictable outcomes, or clients whose conditions match their specialized expertise (e.g., psychiatric/behavioral needs).
Float nurses should not be assigned complex, physiologically unstable clients outside their typical specialty.
3
Differentiate between RN-only tasks and permissible LPN/VN tasks.
Initial assessments, IV push medications for acute conditions, and initial teaching must remain with the RN. Reinforcing teaching and administering routine care can go to the LPN/VN.
This aligns with national scope of practice guidelines protecting clients from care provided beyond a license's limits.
4
Determine the safety of UAP assignments based on task complexity and client stability.
Oropharyngeal suctioning is a clean, routine procedure suitable for a UAP. First-time feedings for clients with severe dysphagia carry high aspiration risk and require RN assessment.
UAPs cannot perform tasks requiring clinical judgment or nursing assessment.

Anahtar Kavram

Delegation Principles, Scope of Practice, and Float Nurse Assignments
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Konular

Assignment, Delegation and Supervision

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