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
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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Related Questions
Correct Answer is B
Explanation
A. While timing is important in delegation, it is not one of the five specific rights.
B. This is one of the five rights of delegation. Effective communication ensures that the AP clearly understands the task, expectations, and any necessary information. It also involves providing clear directions and feedback.
C. The room where the task is performed is not a factor in determining the appropriateness of delegation.
D. Documentation is a responsibility of the nurse, but it is not one of the five rights of delegation.
Correct Answer is B
Explanation
A. The hospital supervisor is responsible for overseeing the day-to-day operations of the hospital, including staff management. However, in the immediate chain of command, the supervisor might not be the first point of contact for specific unit issues unless the concern escalates beyond the unit level.
B. The charge nurse is the immediate supervisor on the unit and is usually the first point of contact for issues related to staff behavior or performance. Reporting the concern to the charge nurse is appropriate because they have the responsibility to oversee the staff on the unit, address concerns, and ensure the safety and well-being of both patients and staff. The charge nurse can assess the situation and take appropriate action, such as further investigation or reporting to higher authorities.
C. The unit director is responsible for overall management and administration of the unit, including staff issues. While the unit director is a higher level of authority than the charge nurse, it is often appropriate to first report to the charge nurse, who is closer to the situation and can address it more immediately.
D. The Chief Nursing Officer (CNO) is a top executive responsible for nursing practices across the entire hospital or healthcare system. Reporting directly to the CNO is generally not the first step in the chain of command for concerns about a coworker’s impairment.
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