Never delegate assessment, teaching, evaluation, or care of an unstable patient to a UAP or LPN.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A nurse is asked to perform a procedure that is outside the nurse's scope of practice and for which the nurse has no training. What is the most appropriate action?
Answer: B. A nurse must practice within the legal scope of the state nurse practice act and within personal competence. Performing a task outside one's scope or training places the client at risk and exposes the nurse to liability. The nurse should decline and notify the supervisor so a qualified person performs the task.
Question 2 of 5
Which is a correct principle of accountability in nursing practice?
Answer: B. Nurses are accountable for their own actions, practicing within their scope, and for delegated tasks they supervise. Blaming others or exceeding one's scope is not accountable practice.
Question 3 of 5
An RN is delegating to an LPN/LVN and a UAP. Which task is best matched to the LPN/LVN's scope rather than the UAP's?
Answer: A. Administering routine scheduled medications by an established route is within LPN/LVN scope and beyond UAP scope. Bathing, transferring, and recording intake and output are appropriate UAP tasks.
Question 4 of 5
A nurse is delegating tasks to unlicensed assistive personnel (UAP) when caring for a client with active tuberculosis on airborne precautions. Which task is appropriate to delegate to the UAP?
Answer: A. Obtaining and recording vital signs is within the UAP scope of practice and can be delegated, provided the UAP uses appropriate PPE. Teaching about medications, interpreting sputum results, and assessing response to therapy require the judgment of a licensed nurse and cannot be delegated to UAP.
Question 5 of 5
A home care nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is appropriate to delegate?
Answer: B. Assisting a stable client with bathing and grooming is within the UAP scope of practice. Teaching, assessing a new wound, and adjusting medication doses require the judgment of a licensed nurse and cannot be delegated to a UAP.
Keep the streak going with more questions like these, each with a full rationale.
What is scope of practice?
The RN is responsible for assessment, planning, evaluation, teaching, and tasks that require nursing judgment. Practicing outside one's scope is a legal and licensure violation.
Key points to remember
- The state Nurse Practice Act and Board of Nursing legally define each nurse's scope of practice.
- The RN retains assessment, initial nursing diagnosis, care planning, evaluation, and patient teaching; these cannot be delegated.
- The RN may delegate stable, predictable, routine tasks to LPNs/LVNs and unlicensed assistive personnel.
- The five rights of delegation are the right task, circumstance, person, direction, and supervision.
- The RN remains accountable for the outcome of any delegated task.
- An unstable patient or one requiring nursing judgment should be cared for by the RN, not delegated.
Nursing priorities
- Delegate only stable, routine tasks that match the team member's role and competence.
- Match assignments to the patient's acuity, assigning unstable patients to the RN.
- Provide clear directions and expected outcomes when delegating, and verify completion.
- Decline tasks outside your legal scope or for which you lack competence, and seek clarification.
- Retain assessment, teaching, evaluation, and judgment-based decisions for the RN.
Red flags: report now
- Never delegate assessment, teaching, evaluation, or care of an unstable patient to a UAP or LPN.
- Never perform a procedure outside your legal scope or competence even if directed to.
- Report immediately if asked to take an assignment you are not qualified or licensed to perform.
References
Clinical references for this topic
