What is delegation in nursing?

Delegation is the transfer of responsibility for performance of a task to another healthcare professional while retaining accountability for the outcome. In other words, a nurse asks another person to perform a task that would otherwise be theirs to perform, but is still responsible for the outcome. 

Why is delegation important in nursing? 

Delegating tasks to other team members has many advantages for nurses. Next to reducing burnout, helping with time management, and improving collaboration and skill development in the healthcare team, delegation can improve patient care when nurses can focus on more complex patient needs while delegating less complex tasks. 

Delegation can carry risks when tasks are carried out by less qualified team members, requiring nurses to diligently gauge who they delegate tasks to by following the 5 rights of delegation in nursing. 

What are the 5 rights of delegation in nursing?

The 5 rights of delegation in nursing are:

1. Right task: task must be appropriate for delegation
2. Right circumstance: conditions must be suitable for delegation of the task, e.g. considering client’s health status
3. Right person: team member taking over the task must have necessary skills and licensure
4. Right direction: specific instructions needed
5. Right supervision: ensure task was carried out appropriately, help develop skills

What is overdelegation in nursing? 

Overdelegation refers to a situation in which a nurse has delegated a task to a team member that is beyond that team member’s scope of practice, skill level, or training. It can also mean delegating too many tasks to a team member, overwhelming them. This can lead to patient safety risks due to inadequate quality of care, burnout of team members, and even legal issues. 

Nurses should always make sure delegation is permissible according to the state scopes of practice, the team member’s position or job description, and facility procedures and policies. 

Before delegating a task, always consider: 

• Potential for harm
• Complexity of task
• Amount of problem-solving and innovation required 
• Unpredictability of outcome
• Level of client interaction 

Nursing delegation examples

Tasks RNs can delegate to LPNs or LVNs

• Assisting RN in data collection and client monitoring
• Reinforcing RN’s teaching
• Administering medications
• Inserting a urinary catheter
• Administering enteral tube feedings
• Dressing changes, tracheostomy care, suctioning

Tasks that CANNOT be delegated to LPNs/LVNs

• Independent assessment or client education, establishing outcomes, evaluating care
• Administering high-risk medications
• Administering IV push medications, titrating medications
• Client admission or discharge

Tasks RNs can delegate to unlicensed assistive personnel (UAP)

• Assisting clients with ADLs (eating, bathing, toileting, ambulating)
• Obtaining routine vital signs
• Monitoring and recording intake/output (food, drink, urine)

Tasks that CANNOT be delegated to assistive personnel 

• Any task requiring critical thinking, professional judgment, professional knowledge (medication administration, tube feeding, wound care, dressing changes, sterile technique)
• Assessments or client education
• Establishing outcomes, evaluating care