Finkelman, Leadership and Management for Nurses: Core Competencies for Quality
Care, 3rd edition.
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Chapter 15: Delegation for Effective Outcomes
LEARNING OUTCOMES AND SUGGESTED CLASSROOM AND CLINICAL
ACTIVITIES
LEARNING OUTCOME 1
Examine the definition of “delegation” and related delegation roles.
Suggestions and Strategies for Classroom Experience
• Review the definition of “delegation” and discuss all terminology found in the
definition. Ask students to review delegation roles as noted in Figure 15-1.
Suggestions and Strategies for Clinical Experience
LEARNING OUTCOME 2
Critique the benefits of using delegation.
Suggestions and Strategies for Classroom Experience
• Ask student to identify the benefits of using delegation—for the RN, other staff,
patient, and impact on patient care.
Suggestions and Strategies for Clinical Experience
• In clinical conference ask students to identify one example of when delegation
was used and determine if it was a benefit. Students should provide rationales for
their choices.
LEARNING OUTCOME 3
Examine key legal issues related to delegation.
Suggestions and Strategies for Classroom Experience
• Ask students how they would respond as RNs if they were asked to delegate a
nursing intervention (change dressing, remove IV, etc.) to a UAP. They should
Suggestions and Strategies for Clinical Experience
• In clinical conference the clinical group should discuss potential legal issues
related to delegation that students have questions about their clinical experiences.
LEARNING OUTCOME 4
Compare and contrast responsibility, authority, and accountability as they apply to
delegation.
Suggestions and Strategies for Classroom Experience
• Students should review content in text on responsibility, authority, and
Suggestions and Strategies for Clinical Experience
• In clinical conference ask students to identify examples they have observed or
participated in related to responsibility, authority, and accountability, and how
this related to delegation.
LEARNING OUTCOME 5
Apply the delegation process in clinical situations when unlicensed assistive personnel
are used.
Suggestions and Strategies for Classroom Experience
• Ask students to apply the delegation process (Figure 15-1:Delegation Tree) to the
example the students provided for assignment related to Learning Outcome 3.
Apply information found in Boxes 15-1 and 15-2.
Suggestions and Strategies for Clinical Experience
LEARNING OUTCOME 6
Assess methods to monitor and improve delegation to reach effective patient outcomes.
Suggestions and Strategies for Classroom Experience
• Students should identify the parts of the Delegation Tree (Figure 15-1) that relate
Suggestions and Strategies for Clinical Experience
KEY CHAPTER CONCEPTS
1. Delegation is the transfer of responsibility for the performance of a task from one
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2. There are many benefits to using delegation. Some of these are cost-effectiveness in
4. State boards of nursing, scope of practice and nurse practice acts, labor unions, and
5. The state practice act is the legal guide for delegation in the nursing practice, providing
the legal framework for practice.
6. In order to properly and lawfully delegate tasks, nurses must know what certified and
8. Using professional judgment through the application of the nursing process and the
Box 15-1 and Box 15-2).
9. The healthcare organization is responsible for the acts of its employees when they are
11. Accountability identifies who is answerable for what has been done. The delegator
12. A staff member who performs a task or job is responsible for his own performance;
however, the delegator still is accountable through the decision to delegate.
14. Authority is the right to act or command the action of others and is determined by job
position and the state nurse practice act.
15. The increased use of unlicensed assistive personnel (UAP) with a variety of titles,
16. The National Council of State Boards of Nursing (NCSBN) guidelines on delegation
17. When staff delegate to UAP, the staff nurse as well as nurse manager need to
18. There are specific types of activities that cannot be delegated to UAP. These include
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20. There are eight essential elements for effective delegation. They are emphasizing the
professional nursing practice, defining delegation, reviewing specific laws and
21. There are barriers to effective delegation. Examples are; “I would rather do it
22. To remove delegation barriers, RNs must fully understand why delegation would be
23. There are key guidelines that should be followed to ensure consistency in effective
delegation. RNs must start with a positive attitude, clarify availability, carefully consider
how directions are given during delegation, provide clear directions, be fair about
undesirable activities, indicate priorities, and give and receive feedback.
APPLYING LEADERSHIP AND MANAGEMENT
BSN and Master’s Essentials: Application to Content
Chapter identifies which Essentials apply to the chapter content. This information is
education standards apply to the chapter content and the nursing profession.
My Hospital Unit: An Evolving Case Experience
See the overview of the My Hospital Unit feature found in the front of the textbook.
Refer students to the specific My Hospital Unit scenario found in the chapter.
This chapter feature can be used in a variety of ways within a course. Students can be
Applying AONE Competencies
The AONE competencies for nurse leaders are found in Appendix A. Ask students to
identify which of the AONE competencies apply to the content in the chapter.
Engaging in the Content: Critical Thinking and Clinical Reasoning and Judgment
See Discussion Questions and Application Exercises at the end of the chapter. Online
options are noted.
Chapter Features: Case Study and Applying Evidence-Based Practice
The Chapter Features: Case Study and Applying Evidence-Based Practice features may
ADDITIONAL CASE
This case is not found in the textbook. It may be used for individual or team assignments:
written assignment and classroom or online team discussions. It may also be used as an
essay question for exams.
Case:
You are the mentor for a new graduate. She is very engaged in orientation and has many
questions. Over a lunch break the new nurse tells you that the area of nursing practice
that she is most worried about is delegation. She does not feel prepared and is fearful of
delegation and the responsibility.
Questions:
1. What would you say to try to decrease her fears?
2. How might you help her better understand delegation?
3. What might you do to help her implement effective delegation?