A home hospice RN is leading care for a 72-year-old patient with end-stage heart failure. The team includes one LPN and a hospice aide. Which tasks may the RN appropriately delegate to the LPN or hospice aide? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Correct options: 1, 3, 5. Option 1 is correct because the LPN may reinforce teaching that was previously provided by the RN. Option 3 is correct because the LPN may administer scheduled oral and subcutaneous opioids and antiemetics that have been ordered and reviewed. Option 5 is correct because the hospice aide’s scope includes personal care such as bathing, oral hygiene, and gentle range-of-motion exercises. Option 2 is incorrect because titrating an opioid PCA basal rate requires nursing judgment and is outside the hospice aide’s scope. Option 4 is incorrect because the initial admission assessment and development of the plan of care are non-delegable RN responsibilities.
The five rights of delegation guide every handoff to LPN or UAP/aide: right task, right circumstance, right person, right direction or communication, and right supervision or evaluation. Initial assessment, planning, evaluation, and teaching are RN-only functions. The LPN scope generally includes administering scheduled medications (oral, SC, IM, sometimes IV per state), reinforcing teaching, performing focused assessments, and monitoring stable patients; LPNs cannot perform the initial holistic assessment, IV push of high-risk drugs (state-dependent), or titration of vasoactive or analgesic infusions. The hospice or CNA aide scope is limited to personal care: bathing, oral hygiene, dressing, basic comfort measures, ambulation assistance, and basic vital signs. Aides cannot administer medications, perform sterile procedures, conduct assessments, or modify a care plan.
A home hospice RN is leading care for a 72-year-old patient with end-stage heart failure. The team includes one LPN and a hospice aide.
Five Rights of Delegation — Right task, right circumstance, right person, right direction/communication, right supervision/evaluation. Apply each before any handoff to LPN or UAP/aide. Initial assessment, planning, evaluation, and teaching are RN-only functions.
LPN Scope of Practice — Generally includes administering scheduled medications (oral, SC, IM, sometimes IV per state), reinforcing teaching, performing focused assessments, monitoring stable patients. Cannot do initial holistic assessment, IV push of high-risk drugs (state-dependent), titration of vasoactive or analgesic infusions.
Hospice/CNA Aide Scope — Personal care: bathing, oral hygiene, dressing, basic comfort, ambulation assistance, basic vital signs. Cannot administer medications, perform sterile procedures, conduct assessments, or modify a care plan.