1 Practice Assignments and Delegation
Learn how to assign and delegate care safely by matching the activity to the patient’s needs, the recipient’s authority and competence, and the supervision available.
and
An allocates care or tasks already within the recipient’s authorized role or routine responsibilities. is a nurse’s decision, where law permits, to authorize another qualified person to perform a specific nursing activity.
Legal definitions and permitted tasks vary by state and setting. Nurses must follow the applicable nurse practice act, regulations, and employer policy.
Assess the task and circumstances
Before assigning or delegating, consider whether the activity is allowed by law, the recipient’s role, and organizational policy, and whether the nurse has authority to delegate it. Evaluate the patient’s condition and whether it is sufficiently stable and predictable, as well as the activity’s risks and the suitability of the setting, equipment, and resources.
Confirm that the individual has received relevant training and has current competence for the specific activity. A job title alone does not establish . Also determine whether the nurse can provide the direction, monitoring, follow-up, and timely intervention required.
Keep nursing judgment with the nurse
Activities requiring assessment, clinical reasoning, nursing judgment, care planning, or evaluation should not be delegated to assistive personnel. does not transfer nursing judgment.
For example, a nurse might delegate routine vital-sign collection for a stable patient to a trained worker and instruct the worker to report specified results promptly. The nurse interprets the findings and reassesses the patient. A new or unstable patient, or unexpected findings, may make that inappropriate or require immediate reassessment.
Apply the five rights
Use the as a practical safety check:
Right task: The activity is permitted and appropriate to delegate.
Right circumstance: The patient’s condition and available resources make safe.
Right person: The recipient is authorized and competent to perform the specific activity.
Right direction and communication: Give clear, patient-specific instructions, limits, expected results, and when and how to report concerns. Confirm that the recipient understands and accepts the task.
Right supervision and evaluation: Monitor as needed, remain available to intervene, follow up, and evaluate the patient’s response and the completed activity.
Follow through and remain accountable
remains with both the delegating nurse and the recipient, but their responsibilities differ. The nurse remains accountable for the decision and appropriate oversight and evaluation of the patient’s care. The recipient is responsible for performing an accepted activity correctly, communicating concerns, and documenting as required.
The nurse should reassess if the patient’s condition changes, instructions are misunderstood, or the recipient reports difficulty. The recipient should ask questions, decline a task they are not competent or authorized to perform, and promptly report unexpected findings or an inability to complete the task.
Neither person should pass the task to another person without proper authorization. Document care and communication according to law and policy. Safe means delegating an appropriate activity—not nursing judgment—and ensuring that the right person, circumstances, communication, and supervision are in place.