Case Studies Nursing Delegation

Case Studies Nursing Delegation-34
It was part of a wider UK research project to explore how newly qualified nurses recontextualise the knowledge they have gained during their pre-registration nurse education programmes for use in clinical practice.Ethnographic case studies were conducted in three hospital sites in England.

It was part of a wider UK research project to explore how newly qualified nurses recontextualise the knowledge they have gained during their pre-registration nurse education programmes for use in clinical practice.

Five styles of how newly qualified nurses delegated care to healthcare assistants were identified: the do-it-all nurse, who completes most of the work themselves; the justifier, who over-explains the reasons for decisions and is sometimes defensive; the buddy, who wants to be everybody’s friend and avoids assuming authority; the role model, who hopes that others will copy their best practice but has no way of ensuring how; and the inspector, who is acutely aware of their accountability and constantly checks the work of others.

Newly qualified nurses require educational and organisational support to develop safe and effective delegation skills, because suboptimal or no delegation can have negative effects on patient safety and care.

In order to determine whether a decision to delegate is appropriate, the nurse must take into account the employer’s policies; patient needs; complexity of health problems; the health care worker’s job description, knowledge base, and demonstrated competency; the knowledge needed to deliver the care required; the predictability of the anticipated outcome and specific risk factors.

Because the nurse is responsible for evaluating nursing care by monitoring patient outcomes, she must supervise workers to whom she has delegated.

The essence of nursing practice is the application of the nursing process,1 which provides the foundation for nursing diagnosis, outcome identification, and care planning. For example, an unlicensed worker may measure vital signs but the nurse analyzes the data for comprehensive assessment, nursing diagnosis, and planning care.

a) The employer is legally responsible for hiring appropriate staff and for establishing written policies and procedures on delegation, including who the delegator is (facility or nurse), workers to whom authority has been or can be delegated, the process for delegation, and guidelines for care.

Data collection methods included participant observations and semi-structured interviews with newly qualified nurses, healthcare assistants and ward managers.

A thematic analysis was used to examine the data collected.

The assignment of care to others, including nursing assistants, licensed practical nurses, and other registered nurses, is perhaps one of the most important daily decisions that nurses make.

Proper and appropriate assignments facilitate quality care.

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