Lead: Nursing Delegation and Interprofessional Care

John is part of an interdisciplinary care team on a surgical unit. Interdisciplinary care teams:

• Increase fragmentation of care.

• Improve quality of patient care.

• Increase duplication of services.

• Need to include licenced and unregulated care providers.

The nurse manager is setting up the room assignments for the unit. One patient on the unit is in critical condition and is going to require more care than the others. Before delegating a task, a nurse manager should:

• Delegate the admission assessment to the licenced practical nurse.

• Review the employee’s performance assessment for the most recent period.

• Assess the amount of guidance and support needed in a particular situation.

• Create a task analysis of critical behaviours for the patient.

A key advantage that a nurse manager has in terms of delegating is that:

• Patients receive less attention because too many staff members make it difficult to coordinate care.

• Nurses report less pressure to perform necessary tasks themselves.

• Administration can predict overtime more accurately.

• Team skills can be used more effectively.

The nurse on the shift from 2300 to 700 hours is assigning a component of care to an unregulated care provider. The night nurse should remain:

• Accountable and responsible.

• Accountable and liable.

• Authoritative and liable.

• Responsible and task oriented.

The night nurse understands that certain factors need to be considered before tasks are delegated to others. These factors include which of the following?

• Complexity of the task and the age of the delegate.

• Potential for benefit and the complexity of the task.

• Potential for benefit and the number of staff.

• Complexity of the task and the potential for harm.

During a fire drill, the nurse manager becomes very assertive and directive in her communications with staff. This type of situational leadership depends on:

• Supportive behaviour by the leader and immature followers.

• The relationship with the followers and the type of behaviour of the leader.

• Well-trained followers, combined with a strong leader who acts quickly.

• The leader’s ability to evaluate personnel and communicate that evaluation.

The unit manager is working in a large metropolitan facility and is told that two unregulated care providers are to be assigned to work with her. Delegation begins with:

• Acknowledging the arrival of the second unregulated care provider on the unit.

• Providing clear directions to both unregulated care providers.

• Matching tasks with qualified persons.

• Receiving reports from the prior shift.

Although interdisciplinary health care teams are the ideal in Canada, which of the following is an identified barrier to interdisciplinary collaboration?

• Power equalities.

• Overlapping scopes of practice.

• Lack of legislative authority.

• Lack of professional association support.

Who is accountable when a registered nurse performs a “transfer of function” from a physician activity?

• The physician.

• The director of nursing.

• The nurse.

• The institution.

In some provinces, a restricted activities or controlled acts model is currently in place. A main distinction between this model and the model of licensure that is still used in most other provinces is that:

• Each health care provider is registered to conduct specific tasks.

• Specific acts are licenced.

• Acts cannot be shared among health care providers unless they are registered.

• Nurses are bound by exclusive scopes of practice.