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

Delegation and assignment: the five rights
As you contemplate the questions in this workbook, you can use mnemonic
devices to order your thinking process, such as the “five rights.” The right task
is assigned to the right person in the right circumstances. The RN then offers
the right direction and communication and the right supervision and evaluation
(Hansten and Jackson, 2009, pp. 205–206; NCSBN, 1995, pp. 2–3, Hansten,
2014a, p. 70; NCSBN, 2016b, p 8).
Right Circumstances
Recall the importance of the context in clinical decision making. Not only do
rules and regulations adjust based on the area of practice (i.e., home health care,
acute care, long-term care), but patient conditions and the preferred patient
results must also be considered. If information is not available, a best judgment
must be made. Often RNs must balance the need to know as much as possible
and the time available to obtain the information. The instability of patients
immediately postoperatively or in the intensive care unit (ICU) means that a
student nurse will have to be closely supervised and partnered with an
experienced RN. The questions in this workbook give direction as to context
and offer hints to the circumstances.
For example, in long-term care skilled nursing facilities, LPNs/LVNs often
function as “team leaders” with ongoing care planning and oversight by a
smaller number of on-site RNs. Some EDs use paramedics, who may be
regulated by the state emergency system statutes, in different roles in hospitals.
Medical clinics often employ “medical assistants” who function under the
direction and supervision of physicians, other providers, and RNs. Community
group homes, assisted living facilities, and other health care providers beyond
acute care hospitals seek to create safe and effective care delivery systems for
the growing number of older adults. Whatever the setting or circumstance, the
nurse is accountable to know the specific laws and regulations that apply.
Right Task
Returning to the guideposts for navigating care, the patient's four Ps (purpose,
picture, plan, and part), the right task is a task that, in the nurse's best
judgment, is one that can be safely delegated for this patient, given the patient's
current condition (picture) and future preferred outcomes (purpose, picture), if
the nurse has a competent individual to perform it. Although the RN may
believe that he or she personally would be the best person to accomplish this
task, the nurse must prioritize the best use of his or her time given a myriad of
factors. “What other tasks and processes must I do because I am the only RN on
this team? Which tasks can be delegated based on state regulations and my
thorough knowledge of job descriptions here in this facility? How skilled are
the personnel working here today? Who else could be available to help if
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