Maryland Delegation Checklist
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FAQ
The licensed nurse cannot delegate any activity that requires clinical reasoning, nursing judgment or critical decision making. The licensed nurse must ultimately make the final decision whether an activity is appropriate to delegate to the delegatee based on the Five Rights of Delegation (NCSBN, 1995, 1996).
Most UAPs, including nursing assistants, are not certified to change sterile dressings, distribute medications, insert or remove any tubing, or conduct tube feedings. Such tasks should be therefore left to the overseeing nurse or clinical licensed professional.
Proceed with delegation. The UAP is responsible for accepting only those delegated acts for which they are competent to perform. Only the implementation of a task/activity may be delegated. Assessment, planning, evaluation, and nursing judgment cannot be delegated.
Delegation generally involves assignment of the performance of activities or tasks related to patient care to unlicensed assistive personnel while retaining accountability for the outcome. The registered nurse cannot delegate responsibilities related to making nursing judgments.
In general, simple, routine tasks such as making unoccupied beds, supervising patient ambulation, assisting with hygiene, and feeding meals can be delegated. But if the patient is morbidly obese, recovering from surgery, or frail, work closely with the UAP or perform the care yourself.
The nurse assigned to the clients is responsible for the delegation process of communication, supervision/monitoring, and evaluation of the performance of the task/activities. the nurse also maintains accountability for the decision to delegate and the provision of safe nursing care.
Among the tasks that CANNOT be legally and appropriately delegated to nonprofessional, unlicensed assistive nursing personnel, such as nursing assistants, patient care technicians, and personal care aides, include assessments, nursing diagnosis, establishing expected outcomes, evaluating care and any and all other
Although there is considerable variation in the language used to talk about delegation, ANA and NCSBN both defined delegation as the process for a nurse to direct another person to perform nursing tasks and activities.
UAP (unlicensed assistive personnel)Under the supervision of the RN.Can't delegate duties.Duties depend on state's protocol. In some states, the CNA can take classes and become certified to check blood glucose/draw blood, EKG etc.
(6) "Delegation" means the act of authorizing an unlicensed individual, a certified nursing assistant, or a medication technician to perform acts of registered nursing or licensed practical nursing.
