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Zorluk: OrtaAssignment, Delegation and Supervision

A registered nurse is managing the care of several clients on an orthopedic trauma unit and is working with an unlicensed assistive personnel (UAP). Which task is most appropriate for the nurse to delegate to the UAP?

  1. Emptying a surgical closed-wound drainage device and recording the output volume for a stable client who is two days post-operative from a total knee arthroplastyCevap
  2. B
    Evaluating the bilateral pedal pulses and capillary refill of a client who returned from the post-anesthesia care unit one hour ago following a femur repair
  3. C
    Assisting a client with their initial oral intake following a cervical spinal fusion who is exhibiting signs of mild dysphagia
  4. D
    Instructing a client on the proper technique for performing isometric leg exercises to prevent deep vein thrombosis prior to discharge

Cevap

The most appropriate delegation is having the UAP empty the surgical closed-wound drainage device and record the output volume for the stable, two-day post-operative client.
Emptying a surgical drain and recording the output is a routine, standard procedure that does not require nursing judgment or complex assessment. Because the client is two days post-operative and clinically stable, the outcomes of this intervention are highly predictable. Therefore, this task is safe and appropriate to delegate to the unlicensed assistive personnel.

Adım Adım Çözüm

1
Analyze the scope of practice for an unlicensed assistive personnel (UAP).
UAPs are permitted to perform routine, standardized care tasks that have predictable outcomes and do not require nursing judgment or complex critical thinking.
Establishing the foundational rules for safe delegation is necessary to evaluate the options.
2
Evaluate each task against the National Council of State Boards of Nursing (NCSBN) delegation guidelines.
Tasks involving clinical assessment (evaluating pulses), patient teaching (instructing on exercises), and managing unstable or high-risk patients (feeding a client with dysphagia) violate the principles of delegation.
Identifying which tasks fall strictly under the registered nurse's scope of practice eliminates inappropriate delegations.
3
Select the task that represents a routine activity for a stable client.
Emptying a surgical drain and recording the output for a client who is two days post-operative and clinically stable is the only task that aligns with the UAP's scope of practice.
Confirming the correct choice based on the safety and stability of the client and the routine nature of the task.

Anahtar Kavram

Delegation to unlicensed assistive personnel (UAP) must exclude tasks requiring clinical assessment, nursing judgment, or patient education, and should be limited to routine tasks for stable clients.
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Assignment, Delegation and Supervision

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