prioritization-delegation-and-assignment-practice-exercises-for-the-nclex-examination-4th-edition

2. The second level is immediately subsequent to the first level and includes
concerns such as mental status changes, untreated medical issues, acute
pain, acute elimination problems, and imminent risks.
3. The third level is health problems other than those at the first two levels,
such as more long-term issues in health education, rest, coping, and so on
(p. 171).
Maslow's hierarchy of needs can be used to prioritize from the most crucial
survival needs to needs related to safety and security, affiliation (love,
relationships), self-esteem, and self-actualization (Alfaro-Lefevre, 2017, p. 170).
Delegation and Assignment
The official definitions of assignment have been altered through ongoing
discussion among nursing leaders, and terminology distinctions such as
observation versus assessment, critical thinking versus clinical reasoning, and
delegation versus assignment continue to be contentious as nursing leaders
attempt to describe complex thinking processes that occur in various levels of
nursing practice. Historically, the definition of assignment was “designating
nursing activities to be performed by another nurse or assistive personnel
that are consistent with his/her scope of practice (licensed person) or role
description (unlicensed person)” (National Council of State Boards of Nursing
[NCSBN], 2004). In 2016, the NCSBN published the results of two expert panels
to clarify that assignment includes “the routine care, activities, and procedures
that are within the authorized scope of practice of the RN or LPN/LVN or part
of the routine functions of the UAP (Unlicensed Assistive Personnel) . . . that
are included in the coursework taught in the delegatee's basic educational
program” (NCSBN, 2016b, p. 6-7). Delegation was defined as “transferring to a
competent individual the authority to perform a selected nursing task in a
selected situation” (NCSBN, 1995). This definition of delegation remains the
current definition for purposes of this book. Both the American Nurses
Association (ANA) and the NCSBN describe delegation as “the process for a
nurse to direct another person to perform nursing tasks and activities.” The
ANA specifies that delegation is a transfer of responsibility rather than
authority (ANA and NCSBN, 2006, p. 1).
Some state boards have argued that “assignment” is the process of directing a
nursing assistant to perform a task such as taking blood pressure, a task on
which nursing assistants are tested in the certified nursing assistant
examination and that would commonly appear in a job description. Others
contend that all nursing care is a part of the RN scope of practice and therefore
that such a task would be “delegated” rather than “assigned.” Other nursing
leaders argue that only when a task is clearly within the RN's scope of practice,
and not included in the role of the assistive personnel, is the task delegated. In
2006, the ANA and the NCSBN collaborated in their Joint Statement on
Delegation and altered the definition of assignment to “describes the
distribution of work that each staff member is responsible for during a given
shift or work period” (ANA and NCSBN, 2006, p. 1). This “work plan”
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