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 A

Explanation

A. This is a crucial step in the cascade of care, as it involves connecting individuals with OUD to treatment services. Without engagement, subsequent steps like medication initiation and recovery cannot be achieved.
B. While recovery is the ultimate goal of OUD treatment, it is a later stage in the cascade. It follows successful engagement, medication initiation, and retention in care.
C. This is not a primary focus of the cascade of care framework, although it can be a relevant outcome measure to assess the effectiveness of treatment.
D. While important, medication initiation is a step that occurs after engagement in care. It is not the foundational element of the cascade.

A. A child who has a head injury B. A child who is experiencing sickle cell crisis C. A child who has streptococcal pharyngitis D. A child who has a new diagnosis of type 1 diabetes mellitus

Correct Answer is D

Explanation

A. A child with a head injury may require close monitoring for neurological changes, which could involve frequent assessments and interventions. While not directly related to infection risk, the needs of this child may be different from those of a postoperative child, making this pairing less ideal due to differing care needs and potential disruptions.
B. A child in sickle cell crisis is likely experiencing significant pain and requires specialized care for pain management and hydration. This condition is not contagious but can be complex and may require frequent interventions, making it less ideal to room with a postoperative patient who needs a controlled environment for recovery.
C. Streptococcal pharyngitis is a contagious infection caused by Group A Streptococcus. To minimize the risk of postoperative infection, it is generally advisable to avoid placing a postoperative patient in the same room with someone who has a contagious infection. This would help in preventing the potential spread of infection to the postoperative child, who is already vulnerable.
D. A child with a new diagnosis of type 1 diabetes mellitus requires education and management of blood glucose levels. This condition is not contagious and does not pose a risk of infection to a postoperative patient. Therefore, the needs of this child align well with the postoperative child, as both are managing chronic conditions rather than dealing with infections.

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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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Correct Answer is D

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