communication

Elements for Review

Described activity/task:

Task 1 AM Vital signs

Task 2

AM Care

Task 3

OOB to chair

Task 4

FS BS

Level of Client

Stability

Score the client’s level of stability:

0. client condition is chronic/stable/predictable

1. client condition has minimal potential for change

2. client condition has moderate potential for change

3. client condition is unstable/acute/strong potential for change

2

Level of

UAP Competence

Score the UAP competence in completing delegated nursing care activities in the defined client population:

0. UAP - expert in activities to be delegated, in defined population

1. UAP - experienced in activities to be delegated, in defined population

2. UAP - experienced in activities but not in defined population

3. UAP - novice in performing activities and in defined population

0

Level of Licensed

Nurse Competence

Score the licensed nurse’s competence in relation to both knowledge of providing nursing care to a defined population and competence in implementation of the delegation process:

0. Expert in the knowledge of nursing needs/activities of defined client

population and expert in the delegation process

1. Either expert in knowledge of needs/activities of defined client

population and competent in delegation or experienced in the

needs/activities of defined client population and expert in the

delegation process

2. Experienced in the knowledge of needs/activities of defined client population and competent in the delegation process

3. Either experienced in the knowledge of needs/activities of defined client population or competent in the delegation process

4. Experienced in knowledge of defined population but novice in delegation

5. Novice in the knowledge of defined population and novice in delegation

4

Potential

for Harm

Score the potential level of risk the nursing care activity has for the client ( risk is probability of suffering harm):

0. None

1. Low

2. Medium

3. High

1

Frequency

Score based on how often the UAP has performed the specific nursing care activity:

0. Performed at least daily

1. Performed at least weekly

2. Performed at least monthly

3. Performed less then monthly

4. Never performed

0

Level of

Decision-making

Score the decision-making needed, related to the specific nursing care activity, client (both cognitive and physical status) and client situation:

0. Does not require decision making

1. Minimal level of decision making

2. Moderate level of decision making

3. High level of decision making

1

Ability for

Self-Care

Score the client’s level of assistance needed for self-care activities:

0. No assistance

1. Limited assistance

2. Extensive assistance

3. Total care or constant attendance

0

TOTAL

8

Decision to delegate: Yes or No

Yes

Task 1: VS

Total score is 8 (slightly high score is due to nurse being a novice in delegation. Decision: will delegate this task to UAP, but will provide direction that UAP should notify RN immediately if any vital signs are abnormal, specifically BP less than 100 systolic or HR greater than 90

Task 2: AM care

Task 3: OOB to chair

Task 4: FS BS