Nursing Delegation to Nursing Assistive Personnel
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Are there laws and rules in place that support the delegation?
Standards of Registered Professional Nursing Practice. Amended. 410-11-.01 (c)
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NO
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If not in the licensed nurse's scope of practice, then cannot delegate to the nursing assistive personnel (NAP). Authority to delegate varies; so licensed nurses must check the jurisdiction's statuses and regulations.
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YES
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Is the task within the scope of the delegating nurse?
Taking vital signs is within the scope of practice of licensed nurses as it is a part of gathering data so that an assessment can be formed.
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NO
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Do not delegate.
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YES
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Has there been assessment of the client needs?
There should always be an assessment of the client before delegating any task to unlicensed personnel. The client must be in a stable condition. The unlicensed assistive personnel may then take vital signs to report to the nurse, who will then assess the vital signs.
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NO
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Assess client needs and then proceed to a consideration of delegation.
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YES
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Is the delegating nurse competent to make delegation decisions?
The licensed nurse must be knowledgeable and educated in what is appropriate to delegate to unlicensed assistive personnel. This is key to patient safety.
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NO
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Do not delegate until evidence of appropriate education available, then reconsider delegation; otherwise do not delegate.
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YES
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Is the task consistent with the recommended criteria for delegation to nursing assistive personnel (NAP)?
Taking vital signs is an activity that is within the NAP range of functions, is a common task that occurs multiple times a day, is performed in a standard manner, involves little or no modification from client to client, has a predictable outcome, does not involve the nursing process, and does not endanger the client.
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NO
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Do not delegate.
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YES
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Does the nursing assistive personnel have the appropriate knowledge, skills, and abilities (KSA) to accept the delegation?
Does the ability of the NAP match the care needs of the client?
All NAPs should be competent and well versed in taking vital signs.
All clients need vital signs taken regularly, therefore the ability of the NAP matches client needs.
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NO
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Do not delegate until evidence of education and validation of competency available, then reconsider delegation; otherwise do not delegate.
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YES
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Are there agency policies, procedures, and/or protocols in place for this task/activity?
Vital signs must be taken every 4 hours unless otherwise specified. There are other protocols, such as to sanitize the equipment between clients.
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NO
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Do not proceed without evaluation of need for policy, procedures, and/or protocol or determination that it is in the best interest of the client to proceed with delegation.
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Decision Tree
