Excellence in Nursing Delegation: Mastering the 5 RIGHTS

Excellence in Nursing Delegation: Mastering the 5 RIGHTS

Delegation is an essential component of efficient senior living healthcare delivery. It allows the RN to focus more on complex nursing tasks and patient care while ensuring that routine and less complex tasks are completed. It is important to look at the principles that guide the execution of nurse delegation. These principles not only ensure that the nurse and their license are protected from poor delegation but also ensure that the best care is being carried out by the most qualified people.

  • 1. Right Task: The RN must choose which tasks are best to be delegated. In most states, there are no hard rules that guide this decision. Instead, the complexity of the task and the ability of the caregiver are taken into consideration. However, there are limits to what can be delegated. Typically, any injectable medication cannot be delegated, as these tasks require complex knowledge to perform. Also, any nurse tasks where the nurse must use discretion and cannot be put into a simple, followable workflow cannot be delegated.

  • 2. Right Circumstances: Delegation needs to be appropriate for the condition of the resident as well as the setting they are in. Highly stressful situations and residents may lead delegated caregivers to make mistakes. In these situations, it is best if the resident is served by an RN to provide the best healthcare for the resident and reduce the liability of the community.

  • 3. Right Person: This is the absolute core of delegation. The right person refers not only to the person who is delegated but also the resident themselves. Caregivers who can be delegated will typically have gone through state courses and testing, so they understand what is expected of them and have a rudimentary understanding of anatomy and tasks that could be delegated to them. These certifications alone do not necessarily qualify a caregiver to be delegated, and the RN must use their discretion on whether the caregiver can do the task.The other person to take into consideration is the resident themselves. Residents who are able to guide and direct the correct medication to the correct places may not need delegation at all. This can be complicated by residents in memory care who experience sundowners and may be in excellent cognitive condition in the morning and then experience a dramatic decline throughout the day.

  • 4. Right Supervision: The RN retains all the responsibility for the task and must provide ongoing supervision and feedback to the caregivers. The best way to ensure that this supervision is being done well is if your RN frequently visits your community. At On it RN, we are constantly training caregivers, reviewing procedures, and giving feedback. Our nurses attend staff meetings and huddles and provide up-to-date changes in best practices for the caregivers.

  • 5. Right Direction and Communication: This is the most crucial portion of delegation and often the one that is left on the sidelines. Effective communication will not only ensure the care plan is continually being met but will also ensure the caregiver is confident and able to consistently do the task at a high level. This means regular visits to the community and the resident and the caregiver. Tasks should have clear, easy-to-understand directions that are specific to each resident. Finally, these directions should be kept in a central place that is easy for the caregiver to reference. This is the value of On it RN's "My Digital Binder." This online HIPAA-compliant binder ensures a central place for all tasks and documents to be kept up to date and easily accessible by caregivers.

Delegation is challenging and can have major medical and legal implications if done without great care. Unfortunately, more facilities put themselves in harm's way by offering this service as a stopgap in care instead of going about delegation with forethought. Nurses who understand the FIVE RIGHTS of delegation will offer better care to your residents and better training to your caregivers."