From the desk of Adrianne E. Avillion, DEd, RN

Staff Development Weekly: Insight on Evidence-Based Practice in Education, September 4, 2012

Editor’s note: This feature is written by nursing professional development expert Adrianne E. Avillion, DEd, RN. Each week, Adrianne writes about an important issue in the area of professional development or answers reader questions. If you have a question for Adrianne, e-mail her at

Tips for teaching appropriate delegation

All of us have faced questions about what is, and what is not, appropriate for delegation. Historically, the issue of delegating occurs more than is legally appropriate in times of short-staffing or nursing shortages. Nursing professional development (NPD) specialists are often consulted about delegation issues. Here are some tips when dealing with the complexities of delegation:

  • Remember, and teach others to remember, that registered nurses are ultimately responsible for the care delivered to their patients. They may have licensed practical nurses (LPN) and nursing assistants providing much of the patient care to specific patients, but these members of the healthcare team are functioning under the direction of RNs. If an LPN or nursing assistant performs procedures or other aspects of care for which they are trained and allowed to do by licensure, certification, and hospital policy/procedure, but perform them incorrectly, they are responsible for their errors. But if the RN fails to properly supervise, or delegates a task that the LPN or nursing assistant is not trained to perform or cannot legally perform according to licensure, certification, or hospital policy/procedure, then that RN is as liable as the LPN or nursing assistant who performs the task.
  • Keep the phone number and web site address of nurse licensing boards readily available on all nursing units. Nurses should be empowered to contact these boards to inquire about the appropriateness of delegation of specific tasks. They should not be told to bombard the NPR department with questions that require a simple inquiry.
  • Obtain copies of the nurse practice acts for RNs and LPNs in your states and have them readily available on all units. Many nurses are unfamiliar with the nurse practice acts in their respective states. The acts point out why certain tasks cannot be delegated. For example, nursing assistants cannot regulate oxygen flow because oxygen is considered a medication as outlined in most state nurse practice acts.
  • Incorporate delegation into your education programs whether they be distance education, simulation, or classroom. It’s not hard to insert a bit of information about delegation regardless of the “primary” topic of the education program.
  • Never be afraid to consult with your state board of nursing about delegation. Remember, helping licensed nurses to adhere to their nurse practice acts is one of the purposes of the state boards.

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