Delegation in Practice What does the New York State Board of Nursing say about Unlicensed Assistive Personnel and their role, and the role of the Registered Nurse? Describe the responsibilities of the Registered Nurse when delegating patient care tasks. How does the ICU environment differ from a general medical-surgical unit as far as assigned responsibilities for Unlicensed Assistive Personnel?
Title: Delegation of Patient Care Tasks: A Comparison between the ICU and General Medical-Surgical Units
Introduction
Delegation is a crucial aspect of nursing practice, allowing nurses to allocate tasks and share responsibilities with unlicensed assistive personnel (UAP) to provide safe and effective patient care. This paper will explore the role of UAP as defined by the New York State Board of Nursing, the responsibilities of registered nurses (RNs) when delegating patient care tasks, and the differences in assigned responsibilities for UAP between the intensive care unit (ICU) and general medical-surgical units.
The Role of Unlicensed Assistive Personnel (UAP)
The New York State Board of Nursing outlines the role of UAP in their regulations. UAP are individuals who are not licensed but have received training to perform specific patient care tasks under the supervision of a licensed healthcare professional, such as an RN (New York State Education Department, 2021). The board specifies that UAP’s role is to provide assistance with activities of daily living, basic nursing care, and other tasks to support patient comfort and well-being. These tasks may include activities such as bathing, feeding, ambulation assistance, vital signs measurement, and specimen collection (New York State Education Department, 2021).
Responsibilities of Registered Nurses (RNs) in Delegation
RNs play a critical role in delegation, ensuring safe and appropriate care delivery. When delegating patient care tasks to UAP, the RN must consider several factors. First, the RN must assess the patient’s condition, stability, and complexity of care needs. Based on this assessment, the RN determines which tasks can be safely delegated to UAP while taking into account individual UAP competencies and scope of practice (Specht et al., 2018).
During the delegation process, the RN is responsible for providing clear instructions to UAP, including the purpose and expected outcomes of the delegated tasks, specific steps to perform them, potential risks, and necessary precautions. The RN also ensures that the UAP understands these instructions and has the necessary resources to carry out the delegated tasks safely (American Nurses Association, 2017).
RN delegation also requires ongoing supervision and evaluation. The RN remains accountable for monitoring the UAP’s performance, providing feedback, and intervening if necessary to ensure patient safety and quality care. Regular communication and collaboration with the UAP and other healthcare team members are essential aspects of effective delegation (American Nurses Association, 2017).
Differences in Assigned Responsibilities for UAP: ICU vs. General Medical-Surgical Units
The ICU environment differs significantly from a general medical-surgical unit in terms of patient acuity and complexity of care needs. Consequently, the responsibilities assigned to UAP may vary accordingly.
In the ICU, patients often require intensive monitoring, complex interventions, and frequent assessments. Consequently, UAP in the ICU may have limited responsibilities compared to those in general medical-surgical units. These responsibilities may primarily focus on basic patient care tasks, such as assistance with hygiene, mobility, and feeding, as well as specific duties like obtaining and recording vital signs (Fancscio-Wills et al., 2020).
UAP in the ICU may also receive specialized training to support critical care nurses in specific tasks related to the management of high-acuity patients, such as turning and repositioning ventilated patients, performing EKGs, or assisting with suctioning (Joint Commission, 2021). The UAP’s role in the ICU environment may further be contingent on individual facility policies, the UAP’s experience and qualifications, and the nurse’s ongoing assessment of patient needs and acuity.
In contrast, UAP in general medical-surgical units may assume broader responsibilities due to the lower acuity of patients. Alongside basic nursing care, UAP in these units may assist with medication administration, perform simple wound care, and coordinate patient activities. However, it is important to note that the specific responsibilities of UAP in both ICU and general medical-surgical units should align with state regulations, facility policies, and educational requirements (Joint Commission, 2021).
Conclusion
Delegation is a vital component of nursing practice, enabling RNs to allocate tasks to UAP to optimize patient care delivery. The New York State Board of Nursing defines the role of UAP and outlines their responsibilities in supporting patient comfort and well-being. RNs, when delegating patient care tasks, have the responsibilities of assessing patient needs, providing clear instructions and ongoing supervision and evaluation. The assigned responsibilities for UAP may differ between the ICU and general medical-surgical units, reflecting variations in patient acuity and complexity of care needs.