See Figure 3.2 for an illustration of the intersecting responsibilities of the employer/nurse leader, licensed nurse, and delegatee with two-way communication that protects the safety of the public. Instead, the RN should perform this task themselves or delegate it to an AP who has received additional training on feeding assistance. However, if a client has recently experienced a stroke (i.e., cerebrovascular accident) or is otherwise experiencing swallowing difficulties (e.g., dysphagia), this task cannot be assigned to AP because it is not considered routine care. Feeding patients is typically part of the routine role of AP. This task is outside the traditional role of AP, but the delegatee has received additional training for this delegated responsibility and has completed competency validation in completing this task accurately.Īn example illustrating the difference between assignment and delegation is assisting patients with eating.

Nursing responsibilities are delegated by a licensed nurse who has the authority to delegate and the delegated responsibility is within the delegator’s scope of practice.Īn example of delegation is medication administration that is delegated by a licensed nurse to AP with additional training in some agencies, according to agency policy.

The licensed nurse cannot delegate nursing clinical judgment or any activity that will involve nursing clinical judgment or critical decision-making to AP.

The licensed nurse who delegates the “responsibility” maintains overall accountability for the client, but the delegatee bears the responsibility for completing the delegated activity, skill, or procedure. Competency validation should be specific to the knowledge and skill needed to safely perform the delegated responsibility, as well as to the level of the practitioner (e.g., RN, LPN/VN, AP) to whom the activity, skill, or procedure has been delegated.

The context and processes associated with competency validation will be different for each activity, skill, or procedure being delegated.

The delegatee has obtained the additional education and training and validated competence to perform the care/delegated responsibility.A delegatee is allowed to perform a specific nursing activity, skill, or procedure that is outside the traditional role and basic responsibilities of the delegatee’s current job.ĭelegation is summarized in the NGND as the following : Therefore, if a nurse does not feel it is appropriate to delegate a certain responsibility to a delegatee, the delegating nurse should perform the activity themselves.

Accountability is defined as being answerable to oneself and others for one’s own choices, decisions, and actions as measured against a standard. However, the licensed nurse still maintains accountability for overall client care. Delegation is allowing a delegatee to perform a specific nursing activity, skill, or procedure that is beyond the delegatee’s traditional role and not routinely performed, but the individual has obtained additional training and validated their competence to perform the delegated responsibility. The NGND defines a delegatee as an RN, LPN/VN, or AP who is delegated a nursing responsibility by either an APRN, RN, or LPN/VN, is competent to perform the task, and verbally accepts the responsibility. It is important to note that states have different laws and rules/regulations regarding delegation, so it is the responsibility of all licensed nurses to know what is permitted in their jurisdiction. These guidelines apply to all levels of nursing licensure (advanced practice registered nurses, registered nurses, and licensed practical/vocational nurses ) when delegating when there is no specific guidance provided by the state’s Nurse Practice Act (NPA). In 2019 the National Council of State Boards of Nursing (NCSBN) and the American Nurses Association (ANA) published updated joint National Guidelines on Nursing Delegation (NGND). There has been significant national debate over the difference between assignment and delegation over the past few decades.

Delegation process 3 elements