- State of New Jersey’s Nursing Board Standards for Delegation
The State of New Jersey has a board of nursing that is charge of foreseeing the nursing rules and statutes. Pursuant to this, the board has a standard decision making tool that is used to approve delegation practices among nurses in the state. This decision making tool is clearly stipulated under the laws governed by the division of consumer affairs. The steps can be found in the New Jersey’s website URL:........... In essence, the delegation process is as follows:
Step 1: Determination of whether the RN has conducted and completed an assessment of the nursing care needs (The State of New Jersey, 2011). In the event this has been done we proceed to step 2, if not the assessment must be completed before the delegation progresses.
Step 2: Determination of whether the designated practice is licensed based on the scope of practice for nurses (The State of New Jersey, 2011). Here if the response is a ‘yes’ delegation proceeds to the next step, and in the event it is a ‘no’ no delegation is done.
Step 3: Determination of whether the person to be delegated the duty has undergone proper training (The State of New Jersey, 2011). If the response is ‘yes’ the delegation proceeds to the next step, while in the event it is a ‘no’ proper training should be provided.
Step 4: Determination of whether the task can be conducted without prior knowledge of nursing (The State of New Jersey, 2011). In this case, if it a ‘yes’ then we can delegate even to an untrained individual while in the case this is not the case the RN must complete the task.
Step 5: Determination if the tasks can be predicted in a reasonable pattern (The State of New Jersey, 2011). If the response is a ‘yes’ then delegation proceeds, while in the event it is a ‘no’ then delegation stops.
Step 6: Determination of whether the task can be performed following the precise directions that cannot be changed (The State of New Jersey, 2011). If it is a ‘yes’ then delegation proceeds, while if it is a ‘no’ delegation stops.
Step 7: Determination of whether the task can be completed without the need of complex and critical decisions (The State of New Jersey, 2011). If the response is ‘yes’ delegation continues, if ‘no’ delegation stops.
Step 8: Determination of whether the task can be performed without the requirement of conducting repeated nursing assessments (The State of New Jersey, 2011). If the response is ‘yes’ delegation continues, if ‘no’ the process of delegation stops.
Step 9: Determination of whether the process can be completed without the danger of life threatening impacts (The State of New Jersey, 2011). If the response is ‘yes’ delegation will continue, if the response is ‘no’ delegation will stop.
Step 10: Determination if there is sufficient supervision available to oversee the delegation process (The State of New Jersey, 2011). If ‘yes’ then delegation proceeds and if ‘no’ then delegation does not proceed.
Step 11: Determination of whether there are specific legislations, rules, and laws limiting or prohibiting delegation (The State of New Jersey, 2011). Finally, at this stage if the response is ‘yes’ it implies the RN can delegate the task, while if ‘no’ implies that the RN may not delegate.
2. Delegation Policy at Organizational/Practice Setting
At the organizational level where I work, the administration of the health institution has also laid out standard rules that govern the manner in which delegation should be carried out. In ad much as rules are operational, there are certain elements that are missing in reference to the State of New Jersey’s Nursing Board standards. The elements missing from the health institution’s delegation procedures are as follows:
- Step 3 requiring the determination of whether the assigned person for the task to be delegated has undergone required training. This implies that there is a high probability of unregistered nurse being delegated a task. According to Kleinman and Saccomano (2006) there is need to establish the UAP’s level of knowledge and skill capacity (p.167).
- Step 10 requiring the availability of sufficient supervision to foresee the delegation process. This could be resulting from the shortage of RNs in the institution; hence, in the event a task is delegated to a UAP then supervision may not be available. This contravenes one of the five rights of delegation, which stipulates the right to supervision, evaluation, monitoring, and adequate intervention (Kleinman & Saccomano, 2006).
3. Implementation of the Delegation policy in Practice setting
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The delegation policy is specifically used for the completion of patient care assessments. Since the institution has a number of UAPs hired to assist RNs in achieving their tasks, the delegation policy is necessary to ensure that nothing goes wrong. In as much as the delegation policy does not take into account the State of New Jersey’s Nursing Board requirement of step 3, the tradition of UAPs to work hand in hand with RNs ensures that they acquire necessary skills to assist in normal tasks. In this regard, in situations when the UAP is delegated a task, then the RN will have to determine whether the task can be delegated or not. Consequently, this avoids the potential of life threatening dangers from occurring.
4. Awareness Among RN colleagues and Recommendations for Professional Development .
After conducting a short assessment on my colleagues I discovered a number of issues regarding delegation. First, a third of the RNs were unaware that there was a standard algorithm provided by the state of New Jersey to implement delegation. Secondly, despite the administration’s efforts to provide standard guidelines for delegation there are times when some RNs delegate tasks that are beyond the scope of UAPs. Thirdly, there is need for the entire team of RNs to be educated on New Jersey’s delegation requirements. To achieve this, the administration of the health institution will first be informed of the missing elements in its delegation algorithm. Once corrections have been made, the next step will entail arranging a special training session in which all RNs and UAPs will be required to attend. Finally, once the training is conducted, an assessment will be performed, and follow up teams formulated to evaluate the adoption of the new recommendations.
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