Thoughtful Nursing Practice: Reflections on Nurse Delegation Decision-Making

Delegation Knowledge and Practice Among Rehabilitation Nurses

“…The literature shows that nurses lack knowledge about tasks that can be delegated according to their individual board of nurse examiners (Bittner & Gravlin, 2009; Brooks, 2009; Kleinman & Saccomano, 2006; McInnis & Parsons, 2009; Williams & Cooksey, 2004). Approved in 1997 by the Delegate Assembly, the NCSBN identified The Five Rights of Delegation, which delineate accountability at all levels of nursing.…”

“…Each state regulates delegation for professional nursing in its Nurse Practice Act (NPA; Habgood, 2000; McInnis & Parsons, 2009; Reising & Allen, 2007). For example, in 2001 the 77th Texas Legislative Session passed House Bill 456 to review and make recommendations regarding delegation for nursing care to people with functional disabilities in independent living environments and acute care settings.…”

AORN Position Statement on Orientation of the Registered Nurse and Surgical Technologist to the Perioperative Setting*

“… that in collaboration with the perioperative registered nurse (RN) in the circulating role, all perioperative team members promote a culture of safety and effective communication that facilitates and supports a safe patient outcome; teamwork is an essential element in a successful orientation program; facilities should consider forming an advisory committee that incorporates both experienced perioperative RNs and surgical technologists (STs) to work with the orientation coordinator to design and implement both an orientation program and a preceptor development program; certain, basic responsibilities should be incorporated into the orientation of perioperative RNs and STs, and these should be met consistently to ensure optimal patient outcomes; the orientation of perioperative RNs and STs should be measurable (eg, competency assessments that are both role and scope specific); implementation and evaluation of the orientation program should be outcomes focused, be centered on the nursing process, and incorporate the Perioperative Patient Focused Model and the Perioperative Nursing Data Set; new graduate RNs should participate in formal, transition‐to‐practice programs; and novice STs should participate in structured, orientation programs. …”

“… the perioperative RN should be oriented to both the scrub and circulating roles during the orientation period, the scope of responsibility of the perioperative RN includes the scrub role as it relates to patient outcomes, the perioperative RN performing in the role of the scrub person is practicing nursing, and the perioperative RN should be oriented to his or her responsibilities in the coordination of care and delegation of specific duties of the scrub role …”

“…• the perioperative RN performing in the role of the scrub person is practicing nursing, 7,8,11,12,14,[20][21][22] and…”