1. Hathaway, Lisa RN, MSN

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One of the RN's increasing roles in the healthcare environment today is delegating to UAP. Why is this becoming so prevalent? One way to address changes in managed care, cost-related issues, and the current shortage of RNs coupled with an increasing number of patients needing care is to employ UAP, who are an important part of the healthcare team.

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The American Nurses Association definition of UAP is unlicensed individuals who are trained to function in an assistive role to the licensed RN in the provision of patient care, with activities being delegated by and under the supervision of the licensed RN in accordance with state nurse practice acts. Delegation can be defined as the process of transferring to a competent individual the authority to perform a selected task in a selected situation. The RN turns over the actual task to be done to UAP, yet retains accountability for the task, ensuring it's carried out correctly and safely. Often, it's up to the RN to decide what can and can't be delegated safely.


Here are some important steps to follow when delegating to UAP:


* Identify if a task is acceptable for delegation. Tasks that are performed routinely, without potential for risk, and don't require the nursing process are often those that can be successfully delegated. Examples include transporting stable patients for testing, delivering specimens to the lab, clerical duties, answering the phone, making beds, delivering equipment, and delivering patient meals. There are also tasks that require some skill, but don't require assessment or evaluation, such as recording the vital signs of a stable patient, assisting the RN with a procedure, cleaning up after a procedure, and assisting with positioning a patient for examination. Any tasks that require a professionally trained person to evaluate or assess the patient's response to treatments or medications or other skills requiring evaluation of patient response are better left to the RN to perform. To be on top of your practice, it's best to find out what the law says regarding delegation to UAP in your state.

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* Know your UAP. What level of training have they had? Have they successfully performed this task before? Are you as the professional comfortable with delegating the task to them, knowing you'll still carry the responsibility for its safe and successful completion?


* Assess your own communication skills. Are you accurately able to delegate to UAP what you need done and when? Be as specific as possible and make sure UAP have a solid understanding of the tasks you're asking them to perform. Are you able to give UAP feedback by evaluating the tasks performed and letting them know whether your objective was met?



In today's fast-paced healthcare arena of too much to do and too little time to do it, working well with UAP and knowing how to best utilize their level of expertise can be a vital component of delivering safe and competent care to your patients.


Lisa Hathaway, RN, MSN

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