Delegation

Board Rule 224 - Overview of Delegation
https://www.bon.texas.gov/faq_delegation.asp

Delegation is an essential nursing skill that RNs use to maximize the nursing care provided to clients. The decision to delegate requires a thorough working knowledge of BON Rules (§224, §225, and §217 .11) and other relevant regulations. When an RN or APRN delegates a task to unlicensed staff or assistive personnel the RN is accountable and retains the duty to maintain patient safety [Rule 217.11(1)(B)] . Patient safety supersedes other mandates such as facility policy or physician order.

The decision to delegate must incorporate:

1. The needs of the patient and the stability of the patient’s condition;
   
2. The RN assessment of the potential for patient harm;
   
3. The complexity of the task;
   
4. The predictability of the outcomes;
   
5. The abilities of the unlicensed assistive personnel (UAP) staff to whom the task is delegated;
   
6. The context of other patient needs to achieve the most benefit from nursing care since the RN is responsible and accountable for safe and appropriate delegation (§224.5, RN Accountability for Delegated Tasks), delegation is utilized at the RN’s discretion.

Delegation defined

The terms delegate and assign can be confusing and lead to questions regarding the licensure responsibilities associated with the terms. Delegation is defined as “authorizing an unlicensed person to provide nursing services while retaining accountability for how the unlicensed person performs the task. It does not include situations in which an unlicensed person is directly assisting a RN by carrying out nursing tasks in the presence of a RN.”

The five "rights" of delegation

• "Right" Task
  
• "Right" Circumstances
  
• "Right" Person
  
• "Right" Direction/Communication
  
• "Right" Supervision/Evaluation
  

Resources

Texas Board of Nursing Rules and Regulations relating to Nurse Education, Licensure and Practice