Delegation is only to UAPs only not LVN

Facilities can mandate RN delegation by policy and procedure FALSE

Only the RN can decide whether you are going to delegate or not.

With regard to delegation, the term client includes not only the receipt of care TRUE

Rns may delegate medication administration in certain circumstances. TRUE (med aids)

Rns may never delegate injectable medications or inhalation treatments. FALSE

Immunization may be delegated because it is not a medication: no assessment needed

The decision to delegate belongs to the RN. TRUE

ADLs are always considered nursing tasks that must be delegated. FALSE 224 are delegated

RULE 21117 AND 21112 21112 224 (DELEGATION IN AN ACUTE CARE CENTER) AND 225 (ASSISSTED
LIVING ENVIRONMENT)

Know them for the jurisprudence exam (rule 224 and 225)

76th Texas Legislature chapters 301 and 303 (302)

Assessment: essential components: functions of the RN

Can delegate reinforcement of teaching to LVN but not the initial teaching

The rule clearly make the RN responsible for all nursing care delegated

Delegating: an RN delegating in accordance with this rule should not be subject to disciplinary action by
the BNE even if the unlicensed person makes a mistake: If you delegated appropriately.

However the RN may still be liable in a progessional liability suit for any injury to a patient.

Vicarious liability

Student function under the “exception to the rule”

Transfer of task without transferring accountability: DELEGATION

The RN can delegate only those tasks for which you are responsible. If you have no direct responsibility
for the task, then you can’t delegate that task.

Rule 224: a guide to assist with decision making

Job descriptions and agency policies cannot force delegation decisions (checklist)

Before you can delegate, you must ASSESS your client!

Decisions are based on many individual factors

Who can delegate:

Rns from the BNE

Physicians from the BME

LVNs so not have delegatory authority

RNs make assignments to LVNs and delegation to UAPs

Client has to be stable: if Unstable DO NOT DELEGATE

Rule 225 (3-gate-keeping criteria)

Independent living environment

Is client willing and able to participate in decisions about the overall management of the client’s
heath care

The task is for a stable, predictable condition

Have to meet all three, if not, it cannot be delegated

Rule 225 (3 levels of task)

ADLs not delegated

Health maintenance activities not delegated

Delegated nursing tasks

RN accountability

Is responsible for proper performance of the assessment required

Is not accountable for an UAPs actual performance of ADLs

Civil liability

Delegation resource packet: decision tree: www.bon.state.tx.us

Nursing tasks under 224 always must be delegated

First responsibility of the nurse in delegating a task: assess the status of the client

A delegated task becomes the responsibility of : individual who delegates the task

An important step to better delegation is: be specific ehyn you delegate

Full assignment: assign can: bath mr. w, an unconscious client

Which task to delegate with can: feed a stroke client who has minimal dysphagia