Solution guide (updated spring 2022)
Delegation for effective task management. - A nurse is responsible for providing
clear directions when a task is initially delegated and for periodic reassessment and
evaluation of the outcome of the task.
RNs must delegate tasks so that they can complete higher level tasks.
RNs may delegate to other RNs, PNs or APs.
PNs may delegate to other PNs or APs.
Predictability of outcome: Is this routine, or is this new, is there potential for
complications
Potential for harm: Is the client stable? Risks? Aspiration, Bleeding
Complexity of Care: Does the delegatee have the license to perform the task, and
the training?
Need for problem solving: Does this require the nursing process? Assessment skills
or judgment
Level of client interaction: Is there psychosocial support needed?
TO PN - Monitoring findings
Reinforcing client teaching
Tracheostomy Care
Suctioning
NG tube patency
Enteral Feedings
Insert Catheter
Administering Meds
TO AP - ADLs Bathing, Grooming, Dressing, Toliet
Ambulating
Feeding
Positioning
Routine tasks
Bed making
,Specimen Collection, I and Os
Vitals For stable clients
Concepts of management—Strategies to identify solutions to community health
problems - Planning
Organizing:
Controlling:
Directing:
Staffing:
Planning: - What needs to be done, and who is going to do it
Organizing: - Lines of authority, communications, and where decisions are made
Directing: - Influences and motivates people to perform
Controlling: - The evaluation of performance and unit goals to ensure outcomes are
met
Staffing: - Adequate staffing, and staffing mix
Characteristics of managers: - Hold formal positions of authority and power,
Possess clinical expertise, Network with members of the team, Coach subordinates,
Make decisions for the organization: Resources, Budget, Hiring, and Firing
Conflict Management between health care workers -
Autonomy: - The ability of the client to make personal decisions, even when those
decisions might not be in the client's own best interest
Beneficence: - Care that is in the best interest of the client
Fidelity: - Keeping one's promise to the client about care that was offered
Justice: - Fair treatment in matters related to physical and psychosocial care and
use of resources
Nonmaleficence: - The nurse's obligation to avoid causing harm to the client
Veracity: - The nurse's duty to tell the truth
, Examples when an incident report should be filed: - Medication errors,
Procedure/treatment errors, Equipment related injuries/errors, Needlestick injuries,
Client falls, Visitor/Volunteer injuries, Threat made to client or staff, Loss of
property.
Establishing Priorities---Facility Protocols: Triage evaluation of peds - Emergent:
Urgent
Nonurgent:
Expectant:
Emergent: - Highest priority, life threatening injuries but also have high survival
rate once stable
Urgent: - Second highest priority can wait 40-60 mins for treatment
Nonurgent: - Minor injuries that are not life threatening and do not need immediate
attention
Expectant: - Lowest priority, expected to die, Comfort care, but not restorative care
Determining Priority Care for a group of clients -
Prioritizing Care for multiple home care clients - Life before limb
Acute before Chronic
Actual problems before potential problems
Listen carefully to clients and don't assume
Trends vs Transient findings Complications vs expected findings
Prioritizing Care for post op clients - Airway, Breathing, Circulation, Disability,
Examination/Exposure
Maslow's Hierarchy - Physiological, Safety and Security, Love and Belonging,
Self-esteem, Self-Actualization
Speaking to a client who has a hearing Impairment - Learn the clients' preferred
method of communications and make accommodations.
Avoid covering your mouth