National Council of State Boards of Nursing, Inc/1997
The Five Rights of Delegation
All decisions related to delegation of nursing activities must be based upon the fundamental principle of public
protection. Licensed nurses have ultimate accountability for the management and provision of nursing care,
including all delegation decisions. However, seldom is a single nurse accountable for all aspects of the delegation
decision-making process, its implementation, supervision, and evaluation.
The Five Rights of Delegation, identified in Delegation: Concepts and Decision-making Process (National
Council, 1995), can be used as a mental checklist to assist nurses from multiple roles to clarify the critical elements
of the decision-making process. Nursing service administrators (all levels of executive/management nurses) and
staff nurses each have accountability in assuring that the delegation process is implemented safely and effectively
to produce positive health outcomes.
Nursing service administrators (NSA) and staff nurses must work together collaboratively and cooperatively to
protect the public and maintain the integrity of the nursing care delivery system. The following principles delineate
accountability for nurses at all levels from NSA to staff nurses.
Right Task
Nursing Service Administrator (NSA) Staff Nurse
n Appropriate activities for consideration in
delegation decisions are identified in UAP job
descriptions/role delineation.
n Appropriate delegation activities are identified
for specific client(s).
n Organizational policies, procedures and
standards describe expectations of and limits
to activities.
n Appropriate activities are identified for
specific UAP.
Generally, appropriate activities for consideration in delegation decision-making include those:
1. which frequently reoccur in the daily care of a client or group of clients;
2. which do not require the UAP to exercise nursing judgment;
3. which do not require complex and/or multi-dimensional application of the nursing process;
4. for which the results are predictable and the potential risk is minimal; and
5. which utilize a standard and unchanging procedure.
Right Circumstances
Nursing Service Administrator (NSA) Staff Nurse
n Assess the health status of the client
community, analyze the data and identify
collective nursing care needs, priorities, and
necessary resources.
n Assess health status of individual client(s),
analyze the data and identify client specific
goals and nursing care needs.
n Provide appropriate staffing and skill mix,
identify clear lines of authority and reporting,
and provide sufficient equipment and supplies
to meet the collective nursing care needs.
n Match the complexity of the activity with the
UAP competency and with the level of
supervision available.
n Provide appropriate preparation in
management techniques to deliver and
delegate care.
n Provide for appropriate monitoring and
guiding for the combination of client, activity
and personnel.
