• Delegation involves delegators (RNs) and Delegatees
(HCAs).
• RNs assign responsibilities and authority
accountability to HCAs.
• Effective delegation demands competence, skills,
and knowledge.
• Improve patient care and coordination among carestakeholders
• Delegation needs action plan and appropriate
procedure
• Plan entails communication, resolution, feedback,
and evaluation.
• Delegation is collaborative and requires various
stakeholders.
• RN –Examines/assesses
the patient’s needs
• Decides on the what to
delegate (scope)
• Look onto HCA’s skills,
knowledge, and
competence
• Communicate clear and
concise guidelines and
expectations.
• Does supervision and
expect feedback
• Evaluates the feedback
• Makes resolution and
report to patients/families
Source: (Hansten, & Jackson, 2009)
• Robert (RN) assesses a TB patient
• He examine Effie’s credentials and patient’s
needs
• Communicates the guidelines, direction and
expectations to Effie
• Delegates the patient care to Miss Effie
• Effie takes to execute her delegation work
• Robert continues to supervise and direct
Effie
• Effie reports back to Robert for evaluation
• Delegation follows some principles and rules
• Task must be assigned according to
competence
• It gears towards best quality patient care
• RN must define the delegation
scope/boundary
• RN has delegation liability; HCA for care
• HCAs must report cases outside their
competence
• RN should coordinate all operations and
stakeholders
• Effie cares for the patient as delegated
• Notes the patients situation, but find
complications
• She is aware of the complication's risks
• Effie reports to Robert to take over
• Cardiac issue is not within her competency
• Robert assesses the case and recommends
transfer
• He involves various health care
stakeholders/practitioners.
• Robert, CCU RN
• CCU Nurses
 Coordinates transfer and
treatment
 Receive the Patient at CCU
• Medical Surgery Nurses
 Prepare patient for Surgery
• Medical Laboratory
technician
• Respiratory therapist
• Hospital ICU
coordinator/Supervisor
• Physician/Doctors
 Test patient’s body samples
 Chest TB/Cardiac therapy
 Coordinates housekeeping
 Work with nurses to treat
• Each stakeholder’s must contribute to patient
care
• Their presence must increase patient
recovery
probability
• Their number and skills must be manageable
• All stakeholders should be competent and
skilled
• Each should show work commitment and
dedication
• There should be balance of
interest/capabilities
• All should abide by the care guidelines
• Communication-RN to notify all the stakeholders
• RN direction-RN provides guidelines and
responsibilities
• Delegation- Every practitioner works on tasks
assigned
• Supervision – Managing RN continues to monitor
operations
• Conflict-resolution – stakeholders constitute
measure to avert disputes
• Feedback – RN expects and receive feedbacks
• Evaluation – RN evaluates the feedbacks about
patients
• All recommendations should uphold quality
patient care.
• Thus the measures must follow legitimate
principles
• It‘s proper to consider context and resources
• Consider direction, activity, circumstances, and
person rights
• Ensure the delegation rights support patients
care
• Certify competent entities at minimal resource
use
• Involve all stakeholders in decision-making and
care
• Right Task- Delegate appropriate task or
scope
• Right Circumstances – Delegation context to
match resources
• Right communication – use clear and concise
directives
• Right supervision- Monitor, intervene, and
evaluate need
• Right person – delegate responsibilities to
competent persons
 Note: If all is right, Patients benefit more
 Always prioritize on caring for the patients
• Delegation is imperative and powerful in healthcare
• It involve two main partners; delegator and delegatee
• Depends on workers’ competence, skill and
knowledge
• Health care stakeholders produce synergistic patient
care
• Delegation and choosing stakeholder require critical
factors
• Effective delegation improve efficiency and quality
care
• Delegation is complex, but necessary in healthcare
Hansten, R. I., & Jackson, M. (2009). Clinical Delegation
skills: A handbook for Professional Practice.
Sudbury, MA: Jones and Bartlett.
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Persily, C. A. (2013). Team Leadership and Partnering in
Nursing and Health Care. New York, NY: Springer
Pub.Co.
Weiss, S., & Tappen, R. (2014). Essentials of Nursing
Leadership & Management: Concepts, Connections
& Skills. Philadelphia: F. A. Davis Company.