Delegation is defined in statute as “directing a competent person to perform a selected nursing activity or task in a selected situation under the nurse's supervision" KRS 314.011(2). Only a licensed nurse can delegate.
Who is responsible and accountable for the delegation of nursing tasks?
Only a licensed nurse can delegate.
In accordance with KRS 314.021(2), nurses are held responsible and accountable for their decisions regarding the supervision and delegation of nursing acts to unlicensed personnel who provide nursing assistance, based upon the nurse's educational preparation and current clinical competence in nursing.
How do I determine what nursing tasks may be delegated?
When aspects of nursing care need to be delegated beyond the traditional role, nurses may delegate some nursing acts to Unlicensed Assistive Personnel (UAP). UAP who provide assistance to nurses may contribute to the implementation of the plan of nursing care when the delegation of the task does not jeopardize the client welfare. Tasks may be delegated only after a nursing assessment is made and, in the nurse’s judgment, it is decided that delegation of the task is appropriate.
What about Supervision?
Supervision is defined as “the provision of guidance by a qualified nurse for the accomplishment of a nursing task with periodic observation and evaluation of the performance of the task including validation that the nursing task has been performed according to established standards of practice.”
What about the Degree of Supervision?
- Factors to be determined by the delegator include:
- The stability and acuity of the patient;
- The training and competency of the delegate;
- The complexity of the nursing task being delegated; and
- The proximity and availability of the delegating nurse to the delegate when the nursing task is performed.
What about the Degree of Supervision of the LPN?
- Determined by the LPN’s supervisor; and
- Is based on a patient’s condition, as determined by the LPN’s supervisor.
- A supervisor may provide supervision without being physically present in the immediate vicinity of the LPN, when:
- A patient’s condition is stable;
- Predictable, and Rapid change is not anticipated; but
- The supervisor must be readily available.
- A supervisor must be physically present in the immediate vicinity of the LPN and immediately available to intervene in care, when:
- A patient’s condition is or becomes unstable.
- A patient is receiving blood, blood components, or plasma volume expanders.
- A patient is receiving peritoneal dialysis or hemodialysis.
Additional Guidance Related to Delegation