...Continuing Education Effective Delegation: Understanding Responsibility, Authority, and Accountability Christine Mueller, PhD, RN, FAAN, and Amy Vogelsmeier, PhD, RN The obligation to provide safe, quality care creates challenges and concerns when registered nurses (RNs) delegate duties to unlicensed assistive personnel. These challenges and concerns are magnified in today’s health care environment of shrinking resources; patients with complex, chronic conditions; health care settings with high patient acuity rates; and the use of sophisticated technology. To make safe, effective delegation decisions, RNs must understand the responsibility, authority, and accountability related to delegation. Delegation decisions must be based on the fundamental principle of public protection. This article describes effective delegation by presenting the factors affecting delegation, explaining when and what an RN can delegate, and describing the delegation process. Learning Objectives ⦁ ⦁ ⦁ Identify three factors that affect delegation. Discuss what registered nurses can and cannot delegate. Explain the steps of the delegation process. N ursing’s Social Policy Statement (American Nurses Association [ANA], 2010), the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001), and individual state nurse practice acts (NPAs) underscore the responsibility, authority, and accountability of registered nurses (RNs) for their nursing practice. The RN’s obligation...
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...improve success greatly. Taking personal responsibility, a student can lead a healthy lifestyle and considerably improve college grades. Personal responsibility is taking accountability for actions, accepting the consequences that come from those actions, and realizing how to improve. Many times there are outside forces that try to inhibit success while in college. The duties and responsibilities required from work, family, social responsibility, and health can all interfere with choices for success. The hours at work, whether full-time or part-time do not always stop when leaving work. Sometimes work is brought home, putting in extra hours to complete the project instead of using good time management skills and delegation to get it done. Families are a full-time job and contain extraordinary obligations. Family responsibility does not stop when leaving for work, running errands, or have a night out with friends. When one’s child or spouse gets sick or an emergency happens, everything generally stops to take care of them. Class work time is lost when fulfilling obligations to organizations and other personal commitments. “For non-traditional students, task oriented coping is related to learning goals and to higher GPAs” (Morris, Brooks, & May, 2003, p. 6). Accepting the grades received while in college is a part of the personal responsibility for college success. Making a personal...
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...Nightingale Executive Summary Western Governor’s University Nightingale Executive Summary Nightingale Community Hospital is a 180 bed hospital that provides acute care and a range of services to their community. Nightingale has four core values that consist of safety, community, teamwork, and accountability. Communication is a key concept in achieving and defining those values. According to the National Patient Safety Goal Data in regards to communication for Nightingale Community Hospital there is not consistency and goals are not being met for the following: reporting critical results within 60 minutes as evidenced by documentation, verbal orders/read-backs, unacceptable abbreviations, and time out hospital wide. Critical Results Within 60 Minutes Nightingale Hospital has showed variations in compliance with reporting critical results within 60 minutes for the months of January through December. Compliance went from 63% in January to 80% in December. In between this time there have been significant variances. As noted there from the data there was only 56% and 57% compliance for the months of June and July. Reporting of Critical Results with 60 minutes should be at 100% compliance. Verbal Orders/Read-Backs The ED met 100% compliance with verbal order/read-back audits for the fiscal year to date. Ortho is at 62% compliance. The other departments at Nightingale Hospital are ranging from 91% to 99%. For JCAHO standards the departments should be at 100%. ...
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...alleviate stress in the health care system (Wright, 2014). Nursing managers and organizations have the responsibility for reviewing the high requirements for nurses and providing resources...
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...were in existence, in the United States” (Creasia & Friberg, 2011). The third and final pathway, a traditional college or university based program, requires four years to complete. Graduates receive a bachelor of science in nursing degree (BSN). “In 2008, 748 BSN programs were in existence, in the United States” (Creasia & Friberg, 2011). ADN/AAN and diploma level education is comparable. The number of diploma programs is small compared to the number of associate and baccalaureate programs; therefore, I will limit this analysis to exploring the difference in the level of competency between BSN and AND/AAN. Associate level education focuses on the technical aspects of nursing care. ADN/AAN educated nurses demonstrate critical thinking skills, clinical competence and nursing knowledge needed to care for patients at the bedside. “The associate level nursing degree did not exist prior to 1952;...
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...different situations and with different types of people, to fulfil the leadership role. Having reflected on my own leadership style, I have thought about the way in which as a leader, I have historically led a team. Over the years working within a nursing background I found it difficult to be a specific type of leader due to the thinking that as a nurse you never led, you were a manager that was led. I was far from the truth… I have worked with very different people from all levels of abilities from cleaners through to consultant doctors and have led differently depending on the person I am leading. A scenario I can recall was a time when I instructed a cleaner to decontaminate a side room ready for another patient to occupy. I used a Delegation style approach to the task and 4 hours later, I found the task was not completed due to poor time management by the cleaner. This had a negative consequence of delaying another patient’s admission to the unit until the task was completed and caused conflict between myself and the cleaner as she had not undertaken the task I had set. The positives of this leadership style so I thought, were not to dictate to her what she has to do, but to allow her to lead herself and prioritise her workload knowing that an empty bed will soon need to be filled. Upon reflection, I would have benefited using a Participative approach in order to agree a deadline with the cleaner, to help prioritise her workload and better manage her time. The benefits of...
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...Sellman & Thomas, 2005, p18). How individuals collaborate and work towards a common goal for the benefit of the patient is essential for a swift recovery. This essay will discuss the roles and responsibilities of three health care professionals in the rehabilitation process of Mr Robinson and how their collaboration will ensure his timely recovery. One of the selected professionals will be explored in significant detail, discussing legal and moral issues and statutory regulations of their practice, using both examples and reflection from clinical placement and the group presentation. Evaluating Mr Robinson’s medical history the three professionals that I have chosen to discuss are; speech and language therapist, physiotherapist and social worker. Since the passing of his wife he has reported a loss of appetite, reduced mobility, and difficulties in maintaining his daily routine/regime. By helping him with these issues he would be able to regain a good quality of living. Speech and language therapists (SALT) assess and treat speech, language and communication problems in people of all ages enabling them to communicate to the best of their ability. They also work with people who have eating and swallowing problems (The NHS, 2006). The nurses and doctors who care for Mr Robinson may have concerns regarding his weight loss and initially refer him to the SALT team. The...
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...Professional Roles & Values Project Tammy Padgett Western Governors University Functional Differences The main focus of the Board of Nursing in every state is ensure the safety of the public's health. They do this by making sure that all individuals in the nursing profession practice safe nursing. I reside in the state of Florida and the Florida Board of nursing is the regulatory government agency that is responsible for the issuance of all licenses to competent nurses. The Florida Board of Nursing has many other responsibilities as well. They approve and accredit nursing schools and education programs for training new nurses. They develop rules and regulations and policies to ensure the minimal standards are being met. They investigate all complaints and enforce disciplinary action if needed. The Nurse Practice Act is also enforced by the Board of Nursing in order to ensure that all nurses meet the requirements in order to provide safe practice. There are many Professional Nursing Organization (PNO) that are offered for nurses to join. They can be located in the state the nurse resides in or they can be national or international based. They assist the nurse in staying current in his or her field of practice or specialty ensuring that they are up to date on all technology and educational matters in their specialty. They also act as a voice, an advocate for nurse. The American Nurses Association (ANA) "is the only full-service professional...
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...Nurses today face many ethical dilemmas in the delivery of patient care. What can or should be done for the patient versus the wishes of the patient’s physician conflicting with the personal beliefs the nurse holds to be true. The client’s wishes may conflict with the institutional policies, physician professional opinion, the client’s family desires, or even the laws of the state. According to the nursing code of ethics, the nurse’s first allegiance is to the client (Blais & Hayes, 2011, pg. 60). The ethical ideals of each nurse must be weighed with the laws of the state along with providing the most ethical care for the patient. The advancements in medical technology make it possible to sustain a patient life where previously there was no hope of recovery. These advancements have put nurses in the forefront of decision making begging the question “just because we can, should we” to be answered. Nurses need to understand the legalities involved with these new technologies to practice safely and effectively. Scientific achievements have opened new ground for nursing exploration. In response to the need for nursing input into social and legal issues, nurses now find career opportunities as forensic nurses, legal nurse consultants, and nurse-attorneys (Blais & Hayes, 2011, pg. 75). This paper will explore the ethical and legal issues encountered by nurses in two case studies. The American Nurses Association Code of Nursing Ethics could influence a final decision in each case study...
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...for England, Wales, Scotland, Northern Ireland and the Islands. • We exist to safeguard the health and wellbeing of the public. • We set the standards of education, training and conduct that nurses and midwives need to deliver high quality healthcare consistently throughout their careers. • We ensure that nurses and midwives keep their skills and knowledge up to date and uphold the standards of their professional code. • We ensure that midwives are safe to practise by setting rules for their practice and supervision. • We have fair processes to investigate allegations made against nurses and midwives who may not have followed the code. b Standards for medicines management Introduction The Nursing and Midwifery Council (NMC) is the UK regulator for two professions: nursing and midwifery. The primary purpose of the NMC is protection of the public. It does this through maintaining a register of all nurses, midwives and specialist community public health nurses eligible to practise within the UK and by setting standards for their education, training and conduct. One of the most important ways of serving the public interest is through providing advice and guidance to registrants on professional issues. The purpose of this booklet is to set standards for safe practice in the management and administration of medicines by registered nurses, midwives and specialist community public health nurses. Standards for medicine management replace the Guidelines for the administration of...
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...I will strive to provide the best, safest, most ethical and compassionate nursing care that I can for all patients and family members with whom I come in contact. I began my post-high school academic career as an accounting major. I enjoyed the challenge of manipulating a report until I had balanced. I thought I had found my calling. As my first semester was nearing an end, I found myself contemplating the thought of sitting behind a desk all day. I wondered if I would find fulfillment in this work as a career? The more I pondered this thought, the more I realized that this was not the right career path for me. I saw images of the medical assistant program in the catalog at the school where I was attending. I could not shake the thought of the medical field for a profession. I attained my medical assistant degree and worked in the field for 10 years. The longer I worked, the more I realized that there was more that I wanted to do, but my current degree restricted me from going further. I researched nursing school programs and selected one with a night/weekend program that would allow me to continue working full-time during my studies. I have a family that I needed to continue to provide for and this seemed to be the best fit. My nursing school decision was fortified when I was selected for an award by the nursing faculty from all four semesters for excellence in the clinical setting. After graduation, I began my nursing career working as a case manager for orthopedic...
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...Chapter 3: Health History and Physical Examination MULTIPLE CHOICE 1. A patient who is actively bleeding is admitted to the emergency department. Which approach is best for the nurse to use to obtain a health history? a.|Briefly interview the patient while obtaining vital signs.| b.|Obtain subjective data about the patient from family members.| c.|Omit subjective data collection and obtain the physical examination.| d.|Use the health care provider’s medical history to obtain subjective data.| ANS: A In an emergency situation the nurse may need to ask only the most pertinent questions for a specific problem and obtain more information later. A complete health history will include subjective information that is not available in the health care provider’s medical history. Family members may be able to provide some subjective data, but only the patient will be able to give subjective information about the bleeding. Because the subjective data about the cause of the patient’s bleeding will be essential, obtaining the physical examination alone will not provide sufficient information. DIF: Cognitive Level: Apply (application) REF: 45 TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance 2. Immediate surgery is planned for a patient with acute abdominal pain. Which question by the nurse will elicit the most complete information about the patient’s coping-stress tolerance pattern? a.|“Can you rate your pain on a 0 to 10 scale?”| b.|“What...
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...nursing leadership and or management (any of the topics reviewed in the course can be used). Critically evaluate the current impact of the topic upon nursing practice and the evolving health care system. Include recommendations for the future of nursing and nursing leaders. The paper is to be eight to ten (8-10) typed pages excluding the reference page and the title page. Use APA format including title page, introduction, conclusion, etc. The paper must be well-written using correct spelling, grammar, and sentence structure. Grading Criteria | Points | Current literature/research on the topic (minimum of five; at least 2 outside nursing, one of which must be from business) | 5 points | Evaluation of the impact of this issue on nursing leadership practice and health care system | 20 points | Recommendation for the future of the nursing profession | 30 points | Provide an exemplar of a nursing leader implementing the recommendations discussed in criterion c above. | 30 points | Scholarly writing | 15 points | TOTAL | 100 points | Stress and Time Management By: Annette Hall St. Joseph’s College of Maine NU506: Nursing Leadership Instructor: Jayne Rogers July 9, 2012 Abstract Managing stress and time in our lives and careers is important to our health and well- being. Nurses in particular have an unusually high stress level. Nurses and nurse managers alike must use stress and time management strategies to decrease burnout and fatigue...
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...NCLEX-RN® DETAILED TEST PLAN 2010 NCLEX-RN Detailed Test Plan ® Effective | April 2010 Item Writer/Item Reviewer/Nurse Educator Version Mission Statement The National Council of State Boards of Nursing, composed of member boards, provides leadership to advance regulatory excellence for public protection. Purpose and Functions The purpose of the National Council of State Boards of Nursing (NCSBN ) is to provide an organization through which boards of nursing act and counsel together on matters of common interest and concern affecting the public health, safety and welfare, including the development of licensing examinations in nursing. ® The major functions of NCSBN include developing the NCLEX-RN and NCLEX-PN examinations, performing policy analysis and promoting uniformity in relationship to the regulation of nursing practice, disseminating data related to NCSBN’s purpose and serving as a forum for information exchange for NCSBN members. ® ® Copyright© 2010 National Council of State Boards of Nursing, Inc. (NCSBN) All rights reserved. NCSBN , NCLEX , NCLEX-RN and NCLEX-PN are registered trademarks of NCSBN and this document may not be used, reproduced or disseminated to any third party without written permission from NCSBN. ® ® ® ® Permission is granted to boards of nursing to use or reproduce all or parts of this document for licensure related purposes only. Nonprofit education programs have permission to use or reproduce all or parts of this document...
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...discussing separation of powers. This note criticizes the Court’s approach in Clinton v. City of New York and argues that the Court should have addressed the more important issue of separation of powers. In doing so, however, this note will argue that there was not even violation of the Presentment Clause like the Majority had decided. In analyzing the Line Item Veto Act under separation of powers, this note argues for a functionalist approach, recognizing the need for a workable government, as opposed to the more textual, narrow formalist approach. Because the Line Item Veto Act did not violate separation of powers or threaten our tri-partite system of government, the Court should not have struck down the Act as an unconstitutional delegation but should have instead upheld the Act as a sound policy decision of both Congress and the President. II. The Line Item Veto Act In 1996, the Line Item Veto Act was signed into law. With the purpose of promoting savings, ensuring fiscal accountability, eliminating wasteful federal spending, and eliminating certain special tax breaks, the Act gave the President the authority to cancel three types of provisions that had been signed into law: “(1) any dollar amount of discretionary...
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