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A joint statement from the American Nurses Association (ANA) and the National Council of State Boards of Nursing (NCSBN) on the importance and safe practices of nursing delegation. It outlines the principles, considerations, and resources for effective delegation in nursing. The statement emphasizes the accountability and responsibility of RNs in delegating tasks, the importance of communication, and the role of organizational support.
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ANA • 8515 Georgia Avenue, Suite 400 • Silver Spring Maryland 20910-3492 • 301.628.6500 • Fax 301.628.5001 • www.nursingworld.org
ANA • 8515 Georgia Avenue, Suite 400 • Silver Spring Maryland 20910-3492 • 301.628.6500 • Fax 301.628.5001 • www.nursingworld.org
ANA • 8515 Georgia Avenue, Suite 400 • Silver Spring Maryland 20910-3492 • 301.628.6500 • Fax 301.628.5001 • www.nursingworld.org
ANA • 8515 Georgia Avenue, Suite 400 • Silver Spring Maryland 20910-3492 • 301.628.6500 • Fax 301.628.5001 • www.nursingworld.org
Appendix B National Council of State Boards of Nursing
Decision Tree for Delegation to Nursing Assistive Personnel
Is within the NAP range of functions Frequently recurs in the daily care of a client or group of clients; Is performed according to an established sequence of steps; Involves little or no modification from one client-care situation to another; May be performed with a predictable outcome; Does not inherently involve ongoing assessment, interpretation, or decision-making which cannot be logically separated from the procedure(s) itself; and Does not endanger a client’s life or well-being
ANA • 8515 Georgia Avenue, Suite 400 • Silver Spring Maryland 20910-3492 • 301.628.6500 • Fax 301.628.5001 • www.nursingworld.org
Step Two – Communication
The nurse: Assesses the assistant’s understanding o How the task is to be accomplished o When and what information is to be reported, including 9 Expected observations to report and record 9 Specific client concerns that would require prompt reporting. Individualizes for the nursing assistive personnel and client situation Addresses any unique client requirements and characteristics, and clear expectations of: Assesses the assistant’s understanding of expectations, providing clarification if needed. Communicates his or her willingness and availability to guide and support assistant. Assures appropriate accountability by verifying that the receiving person accepts the delegation and accompanying responsibility
The nursing assistive personne l Ask questions regarding the delegation and seek clarification of expectations if needed Inform the nurse if the assistant has not done a task/function/activity before, or has only done infrequently Ask for additional training or supervision Affirm understanding of expectations Determine the communication method between the nurse and the assistive personnel Determine the communication and plan of action in emergency situations.
Documentation : Timely, complete and accurate documentation of provided care Facilitates communication with other members of the healthcare team Records the nursing care provided.
ANA • 8515 Georgia Avenue, Suite 400 • Silver Spring Maryland 20910-3492 • 301.628.6500 • Fax 301.628.5001 • www.nursingworld.org