Prioritizing client care:

o Systemic before local

Acute before chronic

• Actual problems before potential ones

Listen carefully to clients and do not assume

o o Recognize and response to trends vs transit findings

o Recognize indications of medical emergencies and complications vs expected

findings • Apply clinical knowledge to procedural standards to determine the priority action

Client care assignments:

• Assigning is performed in a downward or lateral manner with regard to members of the healthcare team.

Client factors are:

Condition of client and level of care needed

Specific care needs such as cardiac monitoring or ventilation mechanical

Special precaution needs such as isolation or fall precautions or seizures, procedures requiring time commitments

Health care team factors:

Knowledge and skill levels of the team members

Supervision that is necessary

Nurse to client ratio

Experience with similar clients

Familiarity of staff member with unit

Additional factors;

If receiving an unsafe assignment, the nurse should bring the unsafe

assignment to the attention of the scheduling charge nurse and negotiate new assignment, if the issue is not resolve, take the concern up the chain of command Nurse should file a written protest to the assignment such as an assignment

despite objection (ADO) or document of practice situation (DOPS) with

the appropriate administrator If not follow proper failure to accept the assignment following proper channels could be considered client abandonment.

Delegations to an assistive personnel:

ADLS

Bathing, dressing, toileting, ambulating, feeding if pt has no problems with swallowing

Positioning

Routine task, bed making