Delegation and assignment are two key concepts in nursing that are essential for effective patient care and efficient workflow within healthcare settings. Delegation refers to the process of a registered nurse (RN) directing another person, such as a licensed practical nurse (LPN) or an unlicensed assistive personnel (UAP), to perform certain tasks while maintaining accountability for the patient. On the other hand, assignment involves a nurse directing a person to perform tasks that are already within their scope of practice.
In the state of Oklahoma, APRNs, RNs, and LPNs are responsible for the care of patients under their supervision, within their respective scopes of practice. Delegation is most appropriate for tasks that do not require nursing assessment, judgment, or teaching during implementation. However, before delegating a task, the nurse must assess each patient to ensure that the UAP or LPN is competent and capable of performing the task safely and effectively.
Proper delegation is crucial for improving patient care and enhancing the efficiency of the healthcare team. Nurse managers can employ three strategies to reduce risks and strengthen the efficiency of unit workflow. First, they should communicate goals clearly to everyone involved in patient care. This includes discussing the purpose and goals of the assigned tasks, as well as establishing a timeline and expectations for reporting. Clear communication ensures that all team members are on the same page and working towards the same objectives.
Second, it is important to identify the necessary skills and education levels required for each task. This can be achieved by providing a readily accessible reference, such as a display of the RN, LPN, and UAP scopes of practice in a common area. Scope of practice may vary between states and facilities, so having this information readily available helps to avoid confusion and ensures that tasks are appropriately assigned to individuals with the required qualifications.
For instance, in a previous facility where I worked, LPNs were able to administer IV medications with a certification offered through the hospital. The majority of LPNs obtained this certification, which greatly contributed to patient care and assignment distribution. However, in my current facility, LPNs are not permitted to administer IV medications, which places more responsibility on the nurse and can lead to a greater burden in medication administration. Understanding the scope of practice among team members is crucial in assigning tasks effectively and utilizing the skills and capabilities of each individual.
Lastly, rewarding accomplishments can be a significant motivating factor for the healthcare team. People work more efficiently and are happier in their work when they feel appreciated and recognized for their hard work. As Marquis and Huston (2021) suggest, “No one likes to be assigned more work only to be ignored for his or her labor.” Simple gestures, such as thanking and recognizing employees for their contributions, can have a profound impact on morale and foster a sense of appreciation among team members.
In conclusion, delegation and assignment are important concepts in nursing practice that can greatly impact patient care and unit workflow. Nurse managers can adopt strategies such as clear communication of goals, identification of necessary skills and education levels, and rewarding accomplishments to reduce risks, strengthen efficiency, and promote a positive work environment. By effectively delegating tasks and assigning responsibilities, nurses can optimize the use of resources and enhance overall patient outcomes.