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

Supervision
Whenever a nurse delegates, he or she must also supervise. Supervision is
defined by the NCSBN as “the provision of guidance and direction, oversight,
evaluation and follow up by the licensed nurse for accomplishment of a
nursing task delegated to nursing assistive personnel” (NCSBN, 2005, p. 194).
The act of delegating is just the beginning of the RN's responsibility. As for the
accountability of the delegatees (or persons given the task duty), these
individuals are accountable for “[accepting] the delegation and for their own
actions in carrying out the act” (NCSBN, 1995, p. 3). For example, nursing
assistants who are unprepared or untrained to complete a task should say as
much when asked and can then decline to perform that particular duty. In such
a situation, the RN would determine whether to allocate time to train the
assistive personnel and review the skill as it is learned, to delegate the task to
another competent person, to do it herself or himself, or to make arrangements
for later skill training. The ANA defines supervision as “the provision of
guidance or direction, guiding, and influencing the outcome of an individual's
performance of a task” (ANA and NCSBN, 2006, p. 1). In both definitions, it is
clear that the RN's job continues throughout the performance and results of task
completion.
Scope of Practice for RNs, LPNs/LVNs, and UAPs
Heretofore this text has discussed national recommendations for definitions.
National trends suggest that nursing is moving toward standardized licensure
through mutual recognition compacts and multistate licensure, and as of July
2016, 25 states had adopted the nurse license compact allowing a nurse in a
member state to possess one state's license and practice in another member
state, with six states pending (NCSBN, 2016c). Standardized and multistate
licensure supports electronic practice and promotes improved practice
flexibility. However, each RN must know his or her own state's regulations.
Except for the 25 licensure compact participants, definitions still differ from
state to state, as do regulations about the tasks that nursing assistants or other
assistive personnel are allowed to perform in various settings.
For example, UAPs are delegated tasks for which they have been trained and
that they are currently competent to perform for stable patients in
uncomplicated circumstances; these are routine, simple, repetitive, common
activities not requiring nursing judgment, for example, activities of daily living,
hygiene, feeding, and ambulation. Some states have generated statutes and/or
rules that list specific tasks that can or cannot be delegated (NCSBN, 2005, pp.
178–179). However, trends indicate that more tasks will be delegated as
research supports such delegation through evidence of positive outcomes.
Acute care hospitals nursing assistants have not historically been authorized to
administer medications. In some states, specially certified medication assistants
administer oral medications in the community (group homes) and in some
long-term care facilities, although there is substantial variability in state-
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