Never delegate assessment, the first dose or any IV/titrated medication, teaching, or care of an unstable client to UAP.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A nurse is delegating tasks but remains accountable for the outcomes. Which statement best reflects the nurse's accountability in delegation?
Answer: A. The nurse who delegates remains accountable for the appropriateness of the delegation, adequate supervision, and the overall client outcome. Delegation does not transfer professional accountability to the UAP or LPN/LVN.
Question 2 of 5
A nurse is delegating to a UAP at the start of the shift. Which instruction reflects appropriate delegation?
Answer: B. Appropriate delegation includes a specific task, the parameters, and what to report. Telling the UAP to report a temperature above 38.5 degrees Celsius gives a clear limit and reporting expectation. Vague directions, delegating assessment-level judgment, or delegating teaching are inappropriate.
Question 3 of 5
The nurse delegates a task to UAP. Which statement reflects an appropriate element of the delegation process?
Answer: A. Effective delegation includes clear, specific directions and the expectation that the UAP reports findings back to the nurse. The nurse remains accountable for the outcome, so simply assuming completion or delegating without instruction is unsafe.
Question 4 of 5
After delegating a task to a UAP, the RN remains responsible for:
Answer: B. The RN retains accountability for the outcome and must supervise, follow up, and verify the task was done correctly. Delegation does not transfer the RN's accountability.
Question 5 of 5
A nurse delegates vital signs to a UAP but the client is unstable. The nurse should:
Answer: B. Unstable clients require RN assessment — the nurse takes/verifies the vitals and assesses the unstable client rather than relying on delegation, because interpretation and judgment are needed.
Keep the streak going with more questions like these, each with a full rationale.
What is delegation to uap?
The RN may delegate only stable, predictable, routine tasks with established outcomes to UAP, but never the nursing process itself (assessment, planning, evaluation, teaching, judgment). Memory aid: UAP get the tasks that are STABLE and ROUTINE.
Key points to remember
- UAP may take vital signs, perform ADLs (bathing, feeding, ambulating), do basic hygiene, measure intake and output, collect routine specimens, and reposition stable clients.
- UAP cannot assess, plan, evaluate, teach, administer most medications, perform sterile procedures, or care for unstable or unpredictable clients.
- The RN retains accountability for delegated tasks even though the UAP performs them.
- Feeding a client at high aspiration risk (dysphagia, post-CVA) should NOT be delegated to UAP.
- UAP may reinforce previously taught information but may never provide new client teaching.
- Delegate care of stable, chronic, predictable clients to UAP; keep unstable and acute clients for licensed staff.
Nursing priorities
- Match the task to the UAP's scope, training, and the client's stability before delegating.
- Give clear, specific directions including what to report and when to report it back.
- Supervise and follow up on delegated tasks; verify completion and outcomes.
- Keep all assessment, evaluation, teaching, and clinical judgment with the licensed nurse.
- Intervene immediately if a UAP is assigned a task outside their scope.
Red flags: report now
- Never delegate assessment, the first dose or any IV/titrated medication, teaching, or care of an unstable client to UAP.
- Report-now: a UAP reports a vital sign or finding outside expected parameters (the RN must assess, not the UAP).
- Never assign a UAP to feed a high-aspiration-risk client or to perform a sterile/invasive procedure.
References
Clinical references for this topic
