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Nurse Delegation Forms Inquiry Instruction

this is the earth register nurse re and.calm and in this video I'm going to be.going over delegation so what what are.we doing is I'm going to be covering.those main topics that you need to know.about delegation for your nursing.lecture exams and for the in CLECs exam.then after I go over those topics we're.going to practice some in click style.questions over delegation and I'm going.to walk you through how to break down.those questions and how to answer them.correctly and then of course after you.watch this video you can access the free.quiz that will give you more practice.questions on delegation so let's get.started first let's start out talking.about what is delegation in nursing it.is where a licensed nurse and we're.talking about a registered nurse.transfers responsibility to a person who.is competent to complete a task.so in nursing we have registered nurses.and registered nurses can delegate to a.licensed practical nurse an LPN or.unlicensed assistive personnel which is.like the CNA the nursing assistant now.why would a nurse and Arion want to.delegate other tasks to these people.well it helps free up the registered.nurse to care for those more critical.patients that like the LPN the CNA can't.really care for and to complete other.tasks that the other people on the.nursing team it's not within their scope.of practice to complete like teaching.educating assessing planning patient.care and evaluating that patient care.that all falls to the registered nurse.however not all tasks can be delegated.by the registered nurse many times those.tasks the nurse the registered nurse has.to do it themselves so delegation is.really a skill if you're not working as.a nurse yet you're a new grad it's.something that you develop over time and.in order to be successful in nursing you.have to get delegation down to help.provide good patient care now there are.several factors that determine whether a.task can be delegated to these other.people on the nursing team so let's look.at those factors okay first you.want to ask yourself this is how I.remember it does this house that I'm.delegating to this person require tape.okay tape we're talking about tea.teaching is this a task that's going to.we're gonna have to teach this patient.educate them there goes to only the.registered nurse a is it an assessment.like one of those comprehensive.assessments or a mission assessment that.goes to the RN is it P planning are you.planning the patient's care the nursing.diagnosis those nursing interventions.having to draw that up that falls to the.REM or is it e evaluating that patient.care evaluating the plan of care how.they're responding to these nursing.interventions do we need to make another.nursing diagnosis for this patient so.all that will fall to the RN that the.Orion really cannot delegate to the LPN.and especially the nursing assistant.other factors include this state and.facilities protocol every state in the.United States is really different on.what they allow the LPN and the nursing.assistant to do so whenever you do get.your job as a registered nurse you've.got to review and look at that ask your.shifts leader your nurse manager if.you're never sure about if you're gonna.delegate a task what a person can do.because for instance let me just give.you some examples um in some states LPNs.can take a certification course and.start IVs and give IV medications so in.other states they can't do that another.thing is that nursing assistants in some.states can become certified to draw.blood obtain EKGs or check blood glucose.levels however in some they cannot so.you always want to look at that whenever.you do practice but for in CLECs they're.really going to ask you those.generalized type of tasks that they can.do they don't really get into the.nitty-gritty like how each state is.different because I think NCLEX knows.that every state is different on what.they allow each profession of Nursing to.do another thing that you want to look.at whenever you're delegating to help.protect you to make sure that you're.doing it right which throws in the other.factors is the five rights of nursing.delegation and I would remember these.five rights the first right is right.task.so as the register nurse can you.actually delegate this task so in other.words is this task within your scope of.practice to delegate to an LPN or a.nursing assistant if not is it only a.task that you can do as an RN so.whenever you're looking at that task or.trying to figure it out you need to ask.yourself is this a low-risk task that's.going to have low probability of.problems that exists for instance.there's not going to be any of this.outside the box thinking that this.person has to know in order to complete.it it's very straightforward and of.course does this task require tape and.if it does only the Orion can do and.remember tape again with teaching.assessment planning or evaluating the.second DRI is right circumstance and.this depends on what is going on.specifically with that patient and what.is going on with that person that you.are delegating the task to so let's talk.about the patient so whenever you're.looking at those tests options on your.exam you want to ask yourself is this.patient stable or are they unstable and.if the patient's unstable you want to.take care of those tasks you don't want.to be delegating those out to the LPN or.to the nursing assistant for instance.let's say that you have a patient who.has has an active GI bleed they are.literally just throwing up blood.everywhere they're very hypotensive.their heart rates tachycardic you want.to be the one to get those bottle signs.as a registered nurse you don't want to.delegate that out because your patient's.unstable and you need to be there.getting those vital signs in addition.you want to look at that workload of the.person that you are delegating that.tasks to are they stretch thin for.instance let's say you had a nursing.assistant you're you normally have two.on your unit but one called in well you.don't want to be delegating all these.tasks about nursing assistant because.they have so much on their plate right.now.so you're gonna have to take over those.tasks if normally that they would do the.third RIE is right person and.as a registered nurse you want to make.sure that you're asking a person who has.demonstrated competency in doing the.specific task you're asking them so do.they have experience doing it and you.know a lot of times you have to ask.yourself you know they're an LPN but.have they had enough experience to do.this task I'm asking them because just.because it's within their scope of.practice does it necessarily give you.the ability to delegate that to them you.have to make sure that they have.competency in doing it and then of.course you want to make sure it's.actually within their scope of practice.which is deemed by your state and.facilities protocol for them to actually.be able to do that tasks and the fourth.right is right direction / communication.and as a registered nurse you want to.make sure that you were explaining in a.very clear straightforward way how to.perform this specific task that you are.delegating and what this person should.expect and report to you and lastly the.last right is right supervision and as.the Orion you always want to follow up.with evaluating and supervising how the.tasks was completed and ensure it was.completed properly don't forget about it.because as the Orion you are still.accountable for that task that you.delegated which leads me to my next.point that I want you to remember so as.the Orion when you delegate a task to an.Opie in a CNA the count ability is not.transfer to the person who is doing the.tasks for you.so as the registered nurse you were.still accountable and responsible for.that task getting done and getting done.correctly so you want to make sure you.always go back behind them and make sure.that it was done because you're still.accountable for it another thing I want.to talk about is delegation among the.other with nursing assistants and LPNs.now whenever you delegate something to a.nursing assistant the unlicensed.assistive personnel they cannot go and.read Ella gate that task to another.person they I'm a licensed assistive.personnel do not have that ability to.delegate now for L Pan's it's a little.bit different and.States in some states LPNs can delegate.in some states they can't so again.always just look at your state and.facility protocols now let's quickly.look at the role of each of these.disciplines and what they would do in.most cases okay first we're going to.talk about the unlicensed assistive.personnel and that's like your CNA s.okay they are supervised by the.registered nurse but they can't delegate.tasks now what do these people do they.do just the basic care even though it's.basic care it really helps us out as the.registered nurse so what do they do they.help the patient ambulate turn baby they.calculate eyes and OSA intake and output.except for the IV that falls to the.registered nurse they perform mouth care.help the patient to the bathroom linen.changes feeding but if you have a.patient who's aspirating or major risk.of that as the nurse registered nurse.you want to be the one assisting with.that so you can watch for those signs.and symptoms and look at what's.happening and make critical judgments.say hey this patient is definitely.aspirating we probably want to do a.swallow study and get something else for.this patient so they're not aspirating.they also collect vital signs on a.stable patient weights they do not give.any kind of medications this includes.creams or anything that's either the LPN.or the registered nurse now whenever.you're looking at test options you don't.want to delegate tasks to the nursing.assistant when the patient is unstable.you need to do that yourself so what.some examples well say we have a.scenario the patient just had heart.surgery and when they have heart surgery.like open-heart we like to get them up.and ambulate them get them out of bed.well if the patient is literally just.post off day one from surgery they need.to get up and emulate we would don't.want to delegate that to the nursing.assistant we want to be the one who does.that because that patients at risk for.having issues they just had heart.surgery so that wouldn't be something we.want to delegate specifically to them.in addition let's say.that the patient just had a new awesome.e an ileostomy.we don't want to delegate that task to.the nursing assistant to be the one to.change the bag to look and calculate the.output we the register nurse wants to be.there looking at that stoma looking at.the skin around it how much is that.stoma putting out we want to be there to.look at those results because the.patient is post-op and they're at risk.for having some potential outcomes that.aren't predictable now let's look at the.duties of the LPN okay they are.supervised by the Orion and their duties.depend on the state in the facilities.protocols along with that LPNs training.and then some safe they can delegate to.the unlicensed assistive personnel now.let's look at the duties that they can.do in most cases well of course they can.perform all these duties over here that.your nursing assistant can do and.whenever you're assigning patient.assignments out because a lot of.questions like to ask you that you want.to pick the patient that is the most.stable so it's predictable what's gonna.happen with them and they have like a.chronic case it's not something acute.that can rapidly change like for.instance let's say ye on bray syndrome.that syndrome can change rapidly patient.can have paralysis where they can't.breathe so we wouldn't want to assign.and LPN to a patient who has that and.you don't want to assign them new.admissions because the Orient needs to.do that comprehensive admission.assessment gathering all that important.information for their health history.also you wouldn't want to assign them a.patient who is going to be discharged.they need a lot of discharge education.because that's the role of the.registered nurse and they're unstable.you don't want to assign a patient that.of course or if they're like fresh.post-op now if they're like days five.six seven patient we're getting a feel.for them they're predictable they're out.of that dangerous period of being.post-op so the LPN what they do is they.help us gather data to contribute to our.assessment so they can listen to heart.sounds lung sounds and bowel sounds and.report that to the registered nurse who.can interpret those findings.listen to those findings if the LPN has.found anything abnormal but the RN is.the one who completes that comprehensive.assessment so if you see an assessment.option that is for the RN not the LPN.also the LPN does not interpret data.they only collect it and they report it.to the Orion so the RN if the LPN tells.the RN heard crackles the Orion will.interpret that listen possibly thinking.we've got fluid overload they can look.at those lab results and interpret that.report that to the physician the LPN.does routine procedures that again have.that predictable outcome doesn't require.that critical thinking or dealing with.something unexpected they can do things.like obtaining an EKG doing glucose.checks inserting Foley Foley catheters.wound care ostomy care they can assist.with implementing the nursing.interventions on the care plan but they.don't develop the care plan or those.nursing interventions the registered.nurse does they can give medications.except for those IV medications and they.don't give blood products like a blood.transfusion platelets TPN or other.things like that so just to recap you.wouldn't want to delegate anything to.the Orion that requires educating the.patient planning out patient care like.doing the care plan developing that.nursing diagnosis the interventions or.evaluating the care plan seeing if the.patient is meeting that or anything that.deals with assessment now let's talk.about the REM okay the RN delegates to.the LPN and the unlicensed assistive.personnel which we just seen now when.they delegate do they transfer their.accountability to that person for that.task no they maintain that so they are.accountable for that delegated task.getting done and been done correctly.they can do all the duties of the LPN in.the nursing assistant some of their.duties include whenever you are.assigning assignments to an RN you would.want to give them the most critical.complex patient that is on the unit the.new admissions the fresh post-op and.a lot of discharge teaching so it's like.the flip what you wouldn't want to.assign to the LPN is what you'd want to.assign to the Orient so be thinking.about that when you're looking at those.test options they complete the.comprehensive assessment on admission.assessment they can give all medications.IV chemo blood transfusion all of it.they do the invasive procedures like.they mess with the central lines they.can remove those they access sub-q ports.and they assist the md at bedside with.those invasive procedures they develop.that nursing care plan the nursing.diagnosis the interventions they.evaluate that update the care plan.because this requires critical thinking.to interpret those patient findings they.found during the assessment the labs.going on the RN is going to look at all.that data interpret that and formulate.what that patient needs nursing wise.based on those findings that's the role.of the RM they're gonna collaborate with.other members of the healthcare team to.help that patient get better continue.with care and again as the RN what do.you never want to delegate to the LPN or.unlicensed assistive personnel for.testing purposes and in the real world.never delegate unstable complex patients.and don't delegate a task that requires.tape teaching assessment planning and.evaluation now let's look at some.incorrect style questions okay our first.question says as the Orion you are.making the patient assignments for the.next shift which patient would you.assign to the LPN a a 68 year old male.patient experiencing atrial fibrillation.and is receiving a diltiazem trip B a 25.year old female patient newly admitted.with diabetic ketoacidosis C an 85 year.old female patient with Alzheimer's.disease who has a colostomy and.scheduled two feedings or D a 45 year.old male patient who is ordered to.receive two units of packed red blood.cells.okay so let's leave our options okay.the question wants to know which tasks.are we going to delegate to the LPN for.these patient assignments so we want to.number one pick a patient who's stable.we don't want to pick someone who's.unstable we want to look at what's going.on with that patient are they gonna be.receiving certain medication certain.treatments because remember the LPN does.those standard procedures not those.invasive procedures so let's look at our.options okay a patient's 68 years old.they're an afib and they're on a Delta.ISM drip patient doesn't sound stable do.they they're an atrial fibrillation.which is a dysrhythmia cardiac.dysrhythmia and they're on a drip which.means they're getting IV cardizem delt.high exam and that drip if you've ever.worked with it you have to titrate the.drip based on the doctors parameters to.keep that heart rate within a certain.parameter so we wouldn't want to.delegate that or give that patient to.the LPN that would we want to give up to.an Orion okay be 25 year old patient.newly-minted with DKA diabetic.ketoacidosis okay there are some things.that really make some flags go off in.this statement number one they're newly.admitted we know that the Orion really.needs to take those new admission cases.because they're just newly admitted we.really don't know what's going on with.them they can be unpredictable we want.to give the LPN someone who's been there.for a while their chronic and their.predictable and we can make sure we know.what's going on so that's one big key.but what they're admitted with is.another one diabetic ketoacidosis so.that requires you to pull back from your.memory banks of that condition that's.where they can have really high blood.Sugar's and think to the treatment of.that they're going to be usually a lot.of times on an IV insulin drip and you.have to titrate that drip that's complex.critical care so you would want to.assign that to an LPN I mean to an Orion.not an LPN so mark that out okay option.C 85 year-old patient with Alzheimer's.disease.they have a colostomy and two feedings.okay what's going on with this patient.are they stable unstable they're stable.they have Alzheimer's disease which is a.chronic case now one thing that may.throw someone off is the cloths me are.the two feedings that is within the.scope of practice of an LP M they can.provide ostomy care and they can.administer two feedings those are.standard routine procedures that an LPN.can do so that is our answer but let's.see why D isn't our answer which most.you probably know and.forty-five-year-old who needs two units.of packed red blood cells patient needs.blood.so that is best assigned to the RN.because LPS do not administer blood or.blood products so that would be Excel in.her answer SC Mike's question says as a.registered nurse which tasks below can.you delegate to the experience.LPN a performing an assessment on a new.admission be collecting a urine sample.from an indwelling Foley catheter C.developing a plan of care for a patient.who is admitted with guillain-barre.syndrome d educating a patient about how.to monitor for side effects associated.with warfarin which is also coumadin e.auscultate e lung and bowel sounds F.evaluating a patient's understanding on.how to administer subcutaneous.injections of an ox appearance sodium.which is lovenox or G administering an.influenza vaccine now this question.wants to know out of all these tasks.which tasks can the Orion delegate to.the LPN so it's one of those lovely.select all that apply and remember what.I said at the beginning of the lecture.as the Orion don't delegate a task that.requires tape so what was tape again.tape was teaching a assessing p planning.and then e for evaluating so don't want.to do that so we look for options like.that and we eliminate it makes our life.a lot easier and then of.something that a invasive procedure we.wouldn't want to delegate that or.something like that so looks like at our.options okay.a admission assessment nope not going to.delegate that number one it's an.admission assessment so they need that.comprehensive assessment that's what the.RN is going to do now the LPN can listen.to like Heart Lung bowel sounds report.that to the RN what they heard and help.gather data but the RN is responsible.for the admission assessment so know.okay be collecting a urine sample from a.Foley catheter absolutely they can do.this they can collect samples so that.would be that because that's one of.those straightforward routine procedures.we do okay see developing a plan of care.for a patient with Gyan bere syndrome.know that again pulls back to our little.mnemonic developing planning they don't.the nurse the registered nurse develops.the plan of care for patients those.nursing diagnosis interventions that the.LPN can help with implementing those so.from our style.efore educating rd sorry.educating about side effects of warfarin.the coumadin no that's educating falls.back to our T for teaching so the nurse.would the REM would be responsible for.that not the LP m e for auscultate een.the lung and bowel sounds yes the LPN.can do that and report to the Orion what.they found so you can delegate that F.for evaluating patient ministry sub-q.injections of lovenox.that is again another teaching aspect of.patient care the registered nurse is.responsible to that for that so that.would be no and then G administering a.flu vaccine yes an LPN can be delegated.to administer a vaccine so they could.definitely do that just really IV.medications blood products things like.that that they cannot do so our answers.are B.and G next question says on your unit.there are two ourian's one is a new RN.and the other is an experienced Orion in.addition there are 3 LP ins and 2.nursing assistants which task delegated.to one of the nursing assistants by the.new RN needs to be reevaluated a apply.hydrocortisone cream to eczema on skin.after giving the patient a bath be.assist the patient with administering a.fleet enema see empting an ostomy bag or.d collecting and recording a patient's.blood pressure heart rate temperature.oxygen saturation respirations and pain.ratings so this question wants to know.which tasks delegated by that new orient.who that nursing assistant needs to be.reevaluated they shouldn't have.delegated those tasks to the nursing.assistant because the nursing assistant.isn't allowed to do it so let's look at.our options ok 8 apply hydrocortisone.cream to eczema on skin after bath well.we know nursing assistants can give.baths but what they want the nursing.assistant to do after the bath is.questionable hydrocortisone cream that.is a medication so you just can't hand.the nursing assistant the cream and say.you know after you give about just put.that cream on those red scaly areas that.would require that the nursing assistant.administers that medication which they.are not allowed to administer.medications that would be something LPN.or the Orion would do so this is.something that definitely needs to be.re-evaluated so that's one of our.answers B assists the patient with.administering a fleet enema this is.something that a nursing assistant does.not do this is where you would instill.some fluids into the rectum to help.alleviation whatever is going on with.the patient that would be something that.you would want to delegate to an LPN or.do yourself that's not something you can.delegate to the nursing assistant.remember they do basic care basic tasks.so that would definitely be something.things to be reevaluated see emptying an.ostomy bag yes they can do this this is.just basic helping with elimination to.lateen a draining that bag with the.stool or whatever type of.awesome me they have it could be Yuri.ostomy witch's house urine they just.empty that same concept of the patients.and diapers or has a pad on them helping.them change that so yes they could do.that so that's not one of our answers.and then D collecting and recording.patients blood pressure heart rate.respirations oxygen saturation.temperature and pain rating always just.make sure you look at everything that.you're asking them to collect and record.and that all falls into what a nursing.assistant can do so that is not an.answer so what needs to be re-evaluated.is options a and B okay so that wraps up.this review over delegation thank you so.much for watching don't forget to take.the free quiz and to subscribe to our.channel for more videos.

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Make it fast. Ask them as few questions as possible (don't collect unnecessary information) and pre-populate as many fields as possible. Don't ask offputting questions where the respondent might have to enter sensitive personal information. If some users see you collecting sensitive information, they might not be ready to share that with you yet based on what you are offering, and they will think twice about completing the form.

What does it take to become an entrepreneur?

“The more you know, the more you realise you don’t know. The less you know, the more you think you know.” To realise your dream of becoming an entrepreneur and serve the human(ity), one should be highly ambitious to improve the odds against megasuccess. To inscribe your name in the history books, the following rules apply to any career and ambitions: 1. Specialize in a very small niche, develop a core skill: Specialization is one of the great, universal laws of life. Ths is how the life itself evolved. A small business that does not specialize, whether in services or product domains, will soon d Continue Reading

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