A charge nurse is delegating tasks to nursing personnel on a 10-bed medical-surgical nursing unit. Which of the following assignments is an example of overdelegation?

Assigning the most efficient AP to perform glucometer monitoring for each client

Assigning two assistive personnel (AP) to ambulate all clients

Assigning a new graduate nurse to perform a wet-to-dry dressing change

Assigning the most competent RN to perform a central line dressing change

Answer and Explanation

The Correct Answer is C

A.   This task is generally appropriate for an assistive personnel (AP) if it is within their scope of practice and if proper training has been provided. Glucometer monitoring is a routine task that APs can often perform, assuming they are trained in using the glucometer and understanding the importance of accurate readings.

B.   Assigning two APs to ambulate all clients might be seen as overdelegation if the task requires more clinical judgment or if there are other tasks that need to be managed concurrently. Ambulating clients can sometimes be complex depending on their condition, and it’s essential to ensure that APs are appropriately trained and that the workload is balanced.
C.   Assigning a new graduate nurse to perform a wet-to-dry dressing change could be considered overdelegation if the task requires advanced skills and experience that the new graduate might not yet possess. Wet-to-dry dressing changes can be complex and require a certain level of expertise to ensure proper technique and patient safety.
D.   This task is typically appropriate for an RN with the necessary competencies and experience. A central line dressing change requires specific skills and knowledge, and delegating this task to the most competent RN ensures that it is performed correctly and safely. This is not considered overdelegation because it matches the task to the skill level of the RN.

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Correct Answer is B

Explanation

A. According to the National Council of State Boards of Nursing (NCSBN), there are actually 5 rights of delegation. These are the Right Task, Right Circumstance, Right Person, Right Direction/Communication, and Right Supervision/Evaluation. Each of these rights helps ensure that tasks are delegated appropriately and safely.
B. This statement indicates an understanding of delegation. While the nurse can delegate tasks, they remain accountable for the outcome. This means the delegating nurse must ensure that the task is completed appropriately and the results are satisfactory. The responsibility for the task remains with the nurse, even though the execution is handled by someone else.

C. It is important for the delegate to ask questions if they are unclear about the task or need additional information. Effective communication and clarification are crucial for ensuring that tasks are performed correctly. The delegate has the right and responsibility to seek clarification to ensure safe and effective task performance.
D. While the nurse manager may oversee and support delegation processes, the responsibility for delegating specific tasks generally falls to the registered nurse (RN) who is managing the care for that shift. The RN assesses which tasks can be delegated and to whom, based on the needs of the patients and the skill level of the assistive personnel.

A. The client urine output has been 50 mL since surgery. B. The client's pain level has decreased since the administration of morphine. C. Serosanguineous drainage noted on the abdominal dressing. D. Postoperative laboratory results are Hgb 15% and Hct 40%.

Correct Answer is A

Explanation

A. A urine output of less than 30 mL/hour is considered oliguria and is a critical finding that requires immediate notification to the provider. It could indicate potential complications such as dehydration, hypovolemia, or renal impairment.
B. While pain management is important, a decrease in pain is expected after administering morphine. This is not a critical finding that requires immediate notification to the provider.
C. A small amount of serosanguineous drainage is expected in the early postoperative period. It would only be a concern if the drainage was excessive, bright red, or increasing in amount.
D. Postoperative laboratory results are Hgb 15% and Hct 40% are within normal ranges and do not require immediate notification to the provider.

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A charge nurse is delegating tasks to nursing personnel on a 10-bed medical-surgical nursing unit. Which of the following assignments is an example of overdelegation?

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