Understanding the complexities of effective management and delegation in nursing is crucial, a necessity underscored by the comprehensive Hurst Review Services. At the heart of nursing management lies the critical imperative to base decisions on sound knowledge, especially understanding one's nursing content thoroughly before undertaking management and delegation tasks. The Hurst form delineates key concepts such as assignment, which involves distributing tasks among staff according to their responsibilities and accountability. It explores the roles of Nursing Assistive Personnel (NAP) who perform tasks that do not require nursing judgment in settings with structured nursing organizations, focusing on clients in uncomplicated situations. Moreover, the form delves into the delegation process, emphasizing that while tasks can be delegated, accountability always remains with the delegator. Supervision is highlighted as essential, requiring guidance, oversight, and evaluation to ensure tasks are completed correctly. The principles of delegation call for a careful assessment of competence and caution against assuming capability based on job descriptions alone, urging ongoing training and clear, explicit communication of expectations. Significantly, it touches on the legal ramifications of delegation, recommending malpractice insurance, and underscores the importance of a thoughtful delegation to LPNs and NAPs, especially when handling complex care scenarios. Furthermore, it introduces a fresh perspective on delegation for new nurses, encapsulating the '5 rights of delegation' and providing practical questions to reinforce understanding. The Hurst form is an indispensable guide, aiming to refine management and delegation skills, essential for delivering competent and efficient patient care.
| Question | Answer |
|---|---|
| Form Name | Hurst Review R Form |
| Form Length | 5 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min 15 sec |
| Other names | rn nclex review notes pdf, hurst review student manual pdf, hurst nclex review book, hurst nclex review student manual |
XVIII. MANAGEMENT AND DELEGATION
A.General Information:
•The judgments that you make in management and delegation situations have to be based on _________________ knowledge.
•You MUST know your _________ content, and then you can move on to management and delegation, okay?
B.Definition:
1.Assignment: the distribution of _________ that each staff member is responsible for during a given shift or work period.
•The RN assumes along with their assignment all the ______________________
and accountability for the work done.
2.Nursing assistive personnel: any _____________________ personnel to whom nursing tasks are delegated and who work in settings with structured nursing organizations.
a. NAP’s can perform tasks on _____________ clients in uncomplicated situations.
b. Tasks like ___________, simple, repetitive, common activities that do not require nursing judgment such as hygiene, feeding, ambulation. Everyday things!
3.Delegation: is transferring to a competent individual the _______________ to perform a selected nursing task in a selected situation.
a. Even though the authority to perform the task is delegated; the ______ always retains the accountability for the delegation.
b. RN to RN assignments transfer ________ responsibility and accountability.
c. With delegation, you can _______________ the responsibility but ______ the accountability.
4.Supervision: guidance and __________________, oversight and evaluation by the RN to see that the delegated task is accomplished.
a. You must _________________ to see that the nursing tasks that you delegated are done properly.
b. You must communicate a _________ frame and the _______________ of the task.
•You’ve got to tell people what you want done ___________, and what you want done by a particular time.
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c.Provide ___________ directions and expectations of how you want the task to be performed and define the findings you wish ________________.
d.We need to ask these three questions after delegated task is completed:
•Was the task done _________________?
•Was the task done in the proper __________ frame?
•Were the client’s ___________ met?
C. Delegation Principles:
1.Don’t assume someone is competent to do something just because of their ______
description.
a.It is the RN’s responsibility to figure out the staff’s strength and
_________________.
b.This will help you delegate to the ___________ personnel and improve client care.
c.When you identify a weakness you are supposed to ___________, teach, teach.
2.When staff members are pulled to a new floor, you should pretend they are a brand
_______ nurse all over again.
• Do not give this nurse any clients requiring any ______________________ care.
NCLEX® Critical Thinking Exercise:
I’m an ER nurse with 15 years of experience and I get pulled to the Labor and Delivery Unit. Which client are you going to give me?
1.The client with a severe DVT
2.The client in active labor
3.The client who is 8 hours
4.The client requiring fetal monitoring
3.Purchase your ________ malpractice insurance.
a.When staff members performs tasks that have not been delegated and a problem occurs the RN’s primary responsibility is to __________, __________,
__________.
b.You better teach, and you had better ___________________ what you taught.
c.Always fill out an _______________ report, and go home and
__________________ the incident, it’s very important that you protect yourself.
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D.Delegation to the LPN and NAP:
1.First, what is the LPN’s role in the nursing process?
a.The RN never delegates ___________________.
b.The LPN can assist the RN in __________ collection but that is not assessment in the NCLEX world.
c.The LPN cannot do any form of __________________, because evaluation involves assessment, and we never delegate assessment.
2.The ______ must do the admission history.
• If someone else, such as an LPN collects the admission data for you, never sign off on the form until you have _________________ the data.
3.Can the LPN implement tasks on the plan of care? _________
4.Can a LPN devise a teaching plan for a newly diagnosed diabetic? ___________
5.What type of clients can the RN delegate to the LPN? ______________
a.An unstable client is medically fragile and requires a _________________ level of care.
b.A client can be ______________ and stable at the same time.
•Don’t let a complex chronic diagnosis make you think the client is unstable and has to be seen only by the RN.
c.Always consider a new admit ________________.
•The RN should go assess the newly admitted client first; the new admission is your ______________.
NCLEX® Critical Thinking Exercise:
Which of the two clients would the RN delegate to the LPN?
1.A newly diagnosed diabetic who has a
2.A
d. Can the LPN perform any tasks in an unstable situation? __________
6.What type of clients can the RN delegate to the Nursing Assistive Personnel?
_________________________________________
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7.Delegating routine tasks to LPNs and NAPs.
•The same activity may ___________ in each situation. We know that feeding a healthy client who has two broken arms is different than feeding a client who has dysphagia; bathing a weak client is not the same as bathing a client who is severely burned.
•So, if there is ever a degree of potential ___________, the RN must retain the task, no matter how routine it is.
E.Delegation and the Brand New Nurse:
1.The head nurse is not only the manager on the floor, you as an RN are a manager of client care.
2.The 5 rights of delegation
•The right ________
•The right circumstances
•The right _________
•The right ______________
•The right supervision and evaluation
F.Practice Questions:
1.You have a client with pneumonia requiring the following interventions. Which action could be delegated to the NAP?
O1. Monitor the sputum for changes
O2. Offer fluids between meals
O3. Teach family to record intake and output
O4. Assess respiratory rate with ambulation
2.An
1.Take vital signs every two hours
2.Report temperature greater than 100.4ºF
3.Monitor white blood cell count
4.Teach good hand washing technique
5.Display Protective Isolation on client’s door
6.Plan daily care to minimize client exposure
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3.Which client could be assigned to an LPN working under the supervision of an RN?
O1. Client with abdominal pain schedule for a CT scan
O2. Client being discharged with home oxygen.
O3. Client with post op wound infection taking oral antibiotics.
O4. Client with vomiting that is receiving intravenous electrolytes solutions.
4.Which intervention could the RN delegate to an LPN?
O1. Evaluating a client’s blood pressure for orthostatic hypotension.
O2. Assisting the physician in the insertion of a nasogastric tube.
O3. Providing explanation of glucose utilization to a new diabetic.
O4. Planning the tasks of turning, bathing and ambulating an immediate post op client.
*TESTING STRATEGY*
You may delegate a task, but the responsibility and accountability remains with you, the RN!!! Licensure conveys privilege, but with privilege comes accountability.
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