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 D

Explanation

A. While exercise can be beneficial, a client in a manic phase may find it overstimulating, leading to increased agitation.
B. This option is not ideal as the client may be tempted to overeat or engage in impulsive behaviors related to food.
C. A day room is typically a high-traffic area with potential for noise and stimulation, which can exacerbate manic symptoms.
D. This is the best option for a client in the manic phase. A quiet environment can help reduce overstimulation, allowing for better management of symptoms.

A. "The AP can re-delegate a task to another AP who has similar work experience." B. "The nurse should consider the AP's level of experience when making delegation decisions." C. "The nurse relinquishes accountability for client outcomes when care is delegated to an AP." D. "The AP can provide client education about how to perform basic self-care to the client."

Correct Answer is B

Explanation

A. This statement reflects a misunderstanding of delegation principles. Typically, the original delegating nurse is responsible for ensuring that the task is completed correctly and safely. APs are not authorized to re-delegate tasks to other APs. The nurse must ensure that the task is assigned appropriately and directly to the right individual, considering their qualifications and experience.
B. This statement demonstrates an understanding of proper delegation practices. When delegating tasks, the nurse should indeed consider the AP's level of experience and competence. Delegating tasks based on the AP's skills ensures that the tasks are performed safely and effectively, aligning with the principle that delegation should be based on the qualifications and experience of the person to whom the task is assigned.
C. This statement reflects a misunderstanding of accountability in delegation. When a nurse delegates a task to an AP, the nurse does not relinquish accountability for client outcomes. The nurse remains accountable for ensuring that the task is delegated appropriately and that the care provided meets professional standards.
D. This statement indicates a misunderstanding of the AP’s role. APs typically do not provide client
education, as this requires specialized knowledge and assessment skills that are within the scope of practice of licensed nurses. Client education, especially about self-care, is generally performed by registered nurses who can assess the client’s understanding and provide detailed instructions.

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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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