1. Management of Care: Delegation and Supervision: Tasks to Delegate to Assistive

Personnel

 A licensed nurse is responsible for providing clear directions when delegating

a task initially and for periodic reassessment and evaluation of the outcome of

the task. RN’s can delegate to other RN’s, PNs, or AP

 Nurses may only delegate tasks appropriate for the skill and education level of

the individual who is receving the assignment (the delegate). They may not

delegate the nursing process, client education, or tasks that require nursing

judgment to PN’s or AP

 Prior to delegating client care, nurses should consider the: predictability of the

outcome, potential for harm, complexity of care, need for problem solving and

innovation, and level of interaction with the client.

 Example of tasks RN’s may delegate to PN’s: monitoring findings (as input

to the RN’s ongoing assessment), reinforcing client teaching from a standard

care plan, tracheostomy care, suctioning

 Examples of tasks RN’s may delegate to AP: activities of daily living ad

routine tasks

2. Management of Care: Legal Responsibilities: Application of Restraints

 It is important for nurses to understand the laws governing nursing practice to

help protect themselves and clients rights

 Nurses must ensure that clients understanding their rights and must protect

their clients rights

 Regardless of the clients age, nursing needs, or health care setting, the basic

tenents are the same. The client has the right to: understanding the aspects of

care to be active in the decision making process, accept, refuse, or request

modification of the plan of care, and receive care from competent individuals

who treat the client with respect.

 A provider must have a written prescription of restraints for 24hrs

3. Safety and Infection Control: Client Safety: Fall Risk Precautions

 Complete a fall risk assessment for each client at admission and at regular

intervals. Individualize the plan for each client

 Be sure client knows how to use the call light and within reach

 Use fall risk alerts, color coded wristbands, provide regular toileting and

orientation for clients who have cognitive impairment

 Provide adequate lighting, use of grab bars, hourly rounding, lowest position

and locked the brakes

 For clients who are sedated, unconscious, or otherwise compromised, keep the

side rails up

 Avoid the use of side full side rails for clients who get out of bed or attempt to

get out of bed without assistance

4. Safety and Infection Control: Home Safety: evaluating Client Understanding

 Nurses play an important role in promoting safety in the clients home and

community.