Delegation involves assigning the responsibility of performing a task to another person while maintaining accountability for the outcome.
Tasks that can safely be delegated to an unlicensed assistive personnel (UAP), include noninvasive interventions, such as skincare, hygiene, range-of-motion exercises, mobility and grooming. The care given by UAP are routine tasks that do not require an assessment.
It is important to be aware that LPN restrictions vary by state.
Tasks that can be assigned to an LPN include the tasks performed by a UAP, but also include certain invasive tasks, such as changing dressings, inserting a urinary catheterization and medication administration (oral, subcutaneous, and intramuscular). The LPN can also gather patient data, but it is the RNs responsibility to interpret the data. An LPN cares for stable patients with predictable outcomes.
LPNs can perform dressing changes and observe a patient's response to treatments and record data. Any negative changes to a patient's status should be reported to the supervising RN.
It is within the scope of practice for LPNs to insert and remove urinary catheterizations. They can collect urine specimens.
LPNs are licensed to give oral and intravenous medications. They are unable to give IV push medications, IV medications through a central venous access device, a central venous line or a midline catheter.
Registered nurses are responsible for assessments, discharge planning, health education, care planning, evaluating patient data, care of invasive lines, and administering parenteral medications. They must never delegate any element of the nursing process, which includes; Assessment, Diagnosis, Planning, Implementation, Evaluating (ADPIE). An RN often cares for the unstable patients.
There are certain tasks that RNs should not delegate to LPNs, such as the starting transfusions of blood or blood products, starting or monitoring parenteral nutrition and medication, and accessing central venous access devices or central venous lines.
RNs are educated in interpreting data, assessing and incorporating patient education into their care. These tasks are incredibly important to ensure that patients are successful and knowledgeable in managing their health at home. RNs educate the patient on their health condition, what problems to watch for, and how to handle them. They assess the level of patient knowledge about the medications prescribed, and whether any equipment is needed when returning home, etc.
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