Section 9-2 - Principles of Delegation (a) All decisions related to delegation and assignments are based on the fundamental principles of protection of the health, safety and welfare of the public. - (i) The RN takes responsibility and accountability for the provision of nursing practice.
- (ii) The RN directs care and determines the appropriate utilization of any CNA involved in providing direct client care.
- (iii) The RN may delegate components of care but does not delegate the nursing process itself. The functions of assessment, planning, evaluation and nursing judgment are pervasive to nursing practice and cannot be delegated.
- (iv) The decision of whether or not to delegate or assign is based upon the RN's judgment concerning the condition of the patient, the competence of members of the nursing team and the degree of supervision that will be required of the RN if a task is delegated.
- (v) The RN delegates only those tasks for which she or he believes the other health care worker has the knowledge and skill to perform, taking into consideration training, cultural competence, experience and facility/agency policies and procedures.
- (vi) The RN individualizes communication regarding delegation to the CNA and client situation. The communication should be clear, concise, correct and complete. The RN verifies comprehension with the CNA and that the CNA accepts the delegation and the responsibility that accompanies it.
- (vii) Communication must be a two-way process. CNA must have the opportunity to ask questions and/or for clarification of expectations.
- (viii) The RN uses critical thinking and professional judgment when following the Five Rights of Delegation:
- (D) Right directions and communication; and
- (E) Right supervision and evaluation.
(b) Chief nursing officers are accountable for establishing systems to assess, monitor, verify and communicate ongoing competence requirements in areas related to delegation.