ATI RN Comprehensive Practice A Remediation
Assignment, Delegation and Supervision
o Managing Client Care: Appropriate Assignment for Assistive Personnel
The AP can obtain vital signs on patients who are not in critical
conditions, but if a critical finding or value is to be found, the nurse should
be notified.
The AP can obtain intake and output of the patient. The AP should
notified the nurse if the output is less than 30 mL/hr unless there is a
exception to the client such as the patient is on dialysis where some of
them do not produce any more urine.
The AP can reposition the client every two hours to prevent bed sores.
o Managing Client Care: Delegating Tasks to an Assistive Personnel
The RN can delegate to the AP to obtain vital signs on patients that are
stable. However, not on patients who need close monitoring such as tele or
ICU.
The RN can delegate to the AP to feed patients who do not have a swallow
precaution.
The RN can delegate to the AP to assist with patients who need help with
their ADLs.
o Managing Client Care: Delegating to a Licensed Practical Nurse
The RN can delegate to the LPN administration on medications with
exceptions to IV medications.
The RN can delegate the task of reinforcing client teaching from a
standard care plan but not discharge teaching.
The RN can delegate the task of monitoring findings however the LPN
cannot do the initial assessment of the client.
o Managing Client Care: Evaluating Time Management Skills
Data should be collected over time and not just isolated incidents.
Peer review can be a source of valuable data. It is usually shared with the
peer and unit manager.
Evaluation is discussed with the employee and the employee can provide
comments or feedback on the evaluation.
Client Rights
o Professional Responsibilities: Responding to Client Request for Information
The client has full rights to their medical records and the nurse should
follow the agency’s policy when the client requests to read or obtain a
copy of the record.
The client’s record cannot be copied unless it is for an authorized
exchange of documents between health care institutions.
Client’s information cannot be disclosed to unauthorized individuals.
, Collaboration with Interdisciplinary Team
o Cystic Fibrosis: Priority Finding to Report to the Provider
The nurse should report to the provider if the client is experiencing
hemoptysis or pneumothorax.
If the client is having airway issues, report the findings to the provider.
Report any findings of respiratory signs and symptoms to the provider.
o Grief, Loss, and Palliative Care: Educating Staff Nurses About Organ Donation
Requests for tissue or organ donations must be made specifically by
trained personnel.
The nurse needs to be sensitive to cultural and religious influences.
Maintain ventilatory and cardiovascular support for vital organ retrieval.
Concepts of Management
o Community Assessment, Education, and Program Planning: First Action When
Preparing an Educational Program for a Local Rural Community
The nurse should first assess the community to see what deficits they are
facing before preparing an education program.
The nurse should gather all data that is needed before she can start putting
her program into action.
The nurse should expand the assessment from the individual to the
community or aggregate level.
Performance Improvement (Quality Improvement)
o Managing Client Care: Conducting a Root Cause Analysis
A root cause analysis analyzes the possible causes and relationships that
can exist.
It investigates the consequences and possible causes.
A root cause analysis is commonly done for sentinel events such as
client’s death, client care resulting in serious physical injury, but it can
also be done as part pf the quality improvement process.
o Managing Client Care: Priority Action to Take if Medications Are Unavailable
If a staff member witnesses an inappropriate action by a coworker, it must
be reported by using the chain of command.
Nurses have a responsibility to be advocates and identify and report any
ethical situations.
Some state nurse associations offer protection for nurses who report
substandard or unethical practice.
o Managing Client Care: Priority Action When Implementing Change
Use current data to make informed clinical decisions to provide the best
practice.
Change traditional nursing practice with new research-based practices.
Lewin’s change theory is a common model for promoting planned change,
which as three stages: unfreezing, change/movement, and refreezing.
Assignment, Delegation and Supervision
o Managing Client Care: Appropriate Assignment for Assistive Personnel
The AP can obtain vital signs on patients who are not in critical
conditions, but if a critical finding or value is to be found, the nurse should
be notified.
The AP can obtain intake and output of the patient. The AP should
notified the nurse if the output is less than 30 mL/hr unless there is a
exception to the client such as the patient is on dialysis where some of
them do not produce any more urine.
The AP can reposition the client every two hours to prevent bed sores.
o Managing Client Care: Delegating Tasks to an Assistive Personnel
The RN can delegate to the AP to obtain vital signs on patients that are
stable. However, not on patients who need close monitoring such as tele or
ICU.
The RN can delegate to the AP to feed patients who do not have a swallow
precaution.
The RN can delegate to the AP to assist with patients who need help with
their ADLs.
o Managing Client Care: Delegating to a Licensed Practical Nurse
The RN can delegate to the LPN administration on medications with
exceptions to IV medications.
The RN can delegate the task of reinforcing client teaching from a
standard care plan but not discharge teaching.
The RN can delegate the task of monitoring findings however the LPN
cannot do the initial assessment of the client.
o Managing Client Care: Evaluating Time Management Skills
Data should be collected over time and not just isolated incidents.
Peer review can be a source of valuable data. It is usually shared with the
peer and unit manager.
Evaluation is discussed with the employee and the employee can provide
comments or feedback on the evaluation.
Client Rights
o Professional Responsibilities: Responding to Client Request for Information
The client has full rights to their medical records and the nurse should
follow the agency’s policy when the client requests to read or obtain a
copy of the record.
The client’s record cannot be copied unless it is for an authorized
exchange of documents between health care institutions.
Client’s information cannot be disclosed to unauthorized individuals.
, Collaboration with Interdisciplinary Team
o Cystic Fibrosis: Priority Finding to Report to the Provider
The nurse should report to the provider if the client is experiencing
hemoptysis or pneumothorax.
If the client is having airway issues, report the findings to the provider.
Report any findings of respiratory signs and symptoms to the provider.
o Grief, Loss, and Palliative Care: Educating Staff Nurses About Organ Donation
Requests for tissue or organ donations must be made specifically by
trained personnel.
The nurse needs to be sensitive to cultural and religious influences.
Maintain ventilatory and cardiovascular support for vital organ retrieval.
Concepts of Management
o Community Assessment, Education, and Program Planning: First Action When
Preparing an Educational Program for a Local Rural Community
The nurse should first assess the community to see what deficits they are
facing before preparing an education program.
The nurse should gather all data that is needed before she can start putting
her program into action.
The nurse should expand the assessment from the individual to the
community or aggregate level.
Performance Improvement (Quality Improvement)
o Managing Client Care: Conducting a Root Cause Analysis
A root cause analysis analyzes the possible causes and relationships that
can exist.
It investigates the consequences and possible causes.
A root cause analysis is commonly done for sentinel events such as
client’s death, client care resulting in serious physical injury, but it can
also be done as part pf the quality improvement process.
o Managing Client Care: Priority Action to Take if Medications Are Unavailable
If a staff member witnesses an inappropriate action by a coworker, it must
be reported by using the chain of command.
Nurses have a responsibility to be advocates and identify and report any
ethical situations.
Some state nurse associations offer protection for nurses who report
substandard or unethical practice.
o Managing Client Care: Priority Action When Implementing Change
Use current data to make informed clinical decisions to provide the best
practice.
Change traditional nursing practice with new research-based practices.
Lewin’s change theory is a common model for promoting planned change,
which as three stages: unfreezing, change/movement, and refreezing.
