NGN ATI LEADERSHIP PROCTORED EXAM
delegation/supervision - answer--*5 rights*
1. task
2. circumstance
3. person
4. direction and communication
5. supervision and evaluation
-based on individual client needs, facility policies and job descriptions, state NPA, professional standards
-consider the individual's education, training, and experience
-RNs can delegate to:
>>other RNs
>>LPNs
>>APs
delegating to AP - answer---ADLs
-bathing
-grooming
-dressing
-toileting
-ambulating
-feeding without swallowing precautions
-positioning
-bed making
-VS for stable clients
,NGN ATI LEADERSHIP PROCTORED EXAM
-specimen collection
-I&O
>>follow facility policies and stage practice guidelines
right task - answer--repetitive, requires little supervision, and relatively noninvasive
right task: AP to assist pt with bedpan and pneumonia
wrong task: delegate AP to administer a nebilizer to a pt with pneumonia
right circumstance - answer---assess health status and complexity of care required by the client
-match the complexity of care demands to the skill level of the health care team
-consider workload
right circustance: delegate to AP to measure VS on stable pt
wrong: delegate AP to measure VS on pt who is post-op and received naloxone to reverse respiratory
depression
right person - answer---assess and verify competency of the health care team member
>>within scope of practice and necessary competence and training
-continual performance reviews
right: delegate a LPN to adminster enteral to a client who has a head injury
,NGN ATI LEADERSHIP PROCTORED EXAM
wrong: delegate an AP to adminster enteral feedings to a client who has a head injury
right direction/communication - answer---data that needs to be collected
-method and time line for reporting (when to report concerns/findings
right: delegate an AP to assist in room X with (something very specific) before X amount of time
wrong: delegate an AP to assist with (something nonspecific) in room x
right supervision/evaluation - answer---directly or indirectly
-clear directions and expectations
-monitor performance
-provide feedback
-intervene if necessary
-evaluate and identify needs for quality improvement activities
right: delegate the ambulation of the client and provide positive feedback to the AP after completion of
task
wrong: delegate the ambulation of a client to an AP without supervision to determine the need for
intervntion and failing to provide feedback to the AP
delegating to LPN - answer---monitoring client findings as input for the RNs ongoing assessment of the
client
-reinforcing client teaching from a standardized care plan
-performing tracheostomy care and suction
-perform uncomplicated wound care
, NGN ATI LEADERSHIP PROCTORED EXAM
-checking NG tube patency
-administering enteral feedings
-inserting urinary catheter
-administering medications
>>not IV meds
responding to inappropriate delegation - answer--*DO NOT DELEGATE*:
-nursing process
-client education
-tasks that require clinical judgement to LPNs or APs
*CONSIDER*:
-predictability of outcome
-potential for harm
-complexity of care
-need for problem solving and innovation
-level of interaction with the client
when a nurse receives an unsafe assignment - answer---bring the assignment to the attention of the
scheduling/charge nurse and negotiate a new assignment
-if unresolved take it up chain of command
-file a written protest to the assignment
>>assignment despite objection
>>document of practice situations
-failure to accept the assignment without following the proper channels can be considered client
abandonment
delegation/supervision - answer--*5 rights*
1. task
2. circumstance
3. person
4. direction and communication
5. supervision and evaluation
-based on individual client needs, facility policies and job descriptions, state NPA, professional standards
-consider the individual's education, training, and experience
-RNs can delegate to:
>>other RNs
>>LPNs
>>APs
delegating to AP - answer---ADLs
-bathing
-grooming
-dressing
-toileting
-ambulating
-feeding without swallowing precautions
-positioning
-bed making
-VS for stable clients
,NGN ATI LEADERSHIP PROCTORED EXAM
-specimen collection
-I&O
>>follow facility policies and stage practice guidelines
right task - answer--repetitive, requires little supervision, and relatively noninvasive
right task: AP to assist pt with bedpan and pneumonia
wrong task: delegate AP to administer a nebilizer to a pt with pneumonia
right circumstance - answer---assess health status and complexity of care required by the client
-match the complexity of care demands to the skill level of the health care team
-consider workload
right circustance: delegate to AP to measure VS on stable pt
wrong: delegate AP to measure VS on pt who is post-op and received naloxone to reverse respiratory
depression
right person - answer---assess and verify competency of the health care team member
>>within scope of practice and necessary competence and training
-continual performance reviews
right: delegate a LPN to adminster enteral to a client who has a head injury
,NGN ATI LEADERSHIP PROCTORED EXAM
wrong: delegate an AP to adminster enteral feedings to a client who has a head injury
right direction/communication - answer---data that needs to be collected
-method and time line for reporting (when to report concerns/findings
right: delegate an AP to assist in room X with (something very specific) before X amount of time
wrong: delegate an AP to assist with (something nonspecific) in room x
right supervision/evaluation - answer---directly or indirectly
-clear directions and expectations
-monitor performance
-provide feedback
-intervene if necessary
-evaluate and identify needs for quality improvement activities
right: delegate the ambulation of the client and provide positive feedback to the AP after completion of
task
wrong: delegate the ambulation of a client to an AP without supervision to determine the need for
intervntion and failing to provide feedback to the AP
delegating to LPN - answer---monitoring client findings as input for the RNs ongoing assessment of the
client
-reinforcing client teaching from a standardized care plan
-performing tracheostomy care and suction
-perform uncomplicated wound care
, NGN ATI LEADERSHIP PROCTORED EXAM
-checking NG tube patency
-administering enteral feedings
-inserting urinary catheter
-administering medications
>>not IV meds
responding to inappropriate delegation - answer--*DO NOT DELEGATE*:
-nursing process
-client education
-tasks that require clinical judgement to LPNs or APs
*CONSIDER*:
-predictability of outcome
-potential for harm
-complexity of care
-need for problem solving and innovation
-level of interaction with the client
when a nurse receives an unsafe assignment - answer---bring the assignment to the attention of the
scheduling/charge nurse and negotiate a new assignment
-if unresolved take it up chain of command
-file a written protest to the assignment
>>assignment despite objection
>>document of practice situations
-failure to accept the assignment without following the proper channels can be considered client
abandonment
