A charge nurse is reviewing delegation assignments made by a new graduate nurse. Which delegation assignment requires immediate intervention by the charge nurse?

The Five Rights of Delegation

Before delegating any task, the nurse must verify the Right Task, Right Circumstance, Right Person, Right Direction/Communication, and Right Supervision/Evaluation. The task must be within the delegatee's legal scope and the patient's condition must be stable and predictable.

Critical Distinction: Tasks That CANNOT Be Delegated to a UAP

The core principle is that any component of the nursing process requiring clinical judgment, assessment, or evaluation must be performed by a licensed nurse (RN or LPN). Do not delegate the following to a UAP:

• Initial or ongoing assessments: This includes assessing a patient's response to treatment, such as pain medication effectiveness, as it requires clinical judgment to interpret findings and modify the plan of care.
• Evaluation of patient outcomes: Determining if a patient is progressing toward goals is a nursing evaluation function.
• Patient education and teaching: Formal health teaching requires a comprehensive assessment and knowledge base held by licensed personnel.
• Formulation of the nursing care plan: Care planning is a complex, analytical process exclusive to the RN.

Safe Delegation to an LPN

An LPN can perform tasks requiring focused assessment and technical skills for patients with predictable outcomes. Appropriate tasks include:

• Administering oral, subcutaneous, and intramuscular medications (excluding IV push in most jurisdictions).
• Performing sterile and non-sterile wound dressing changes for chronic, stable wounds.
• Monitoring patient status and reporting changes to the RN.
• Reinforcing previously taught patient education.

Safe Delegation to a UAP

UAPs are essential for providing direct, hands-on care for stable patients. Tasks appropriate for delegation include:

• Measuring and recording vital signs (temperature, pulse, respiration, blood pressure).
• Measuring intake and output.
• Assisting with activities of daily living (bathing, ambulation, toileting, feeding).
• Performing basic hygiene and comfort measures.
• Reporting subjective complaints or objective changes to the nurse.

Immediate Intervention Trigger

The charge nurse must intervene immediately when a delegation assignment violates legal scope of practice or places a patient at risk. Asking a UAP to "assess" a patient's response is a direct violation because it demands the clinical judgment to evaluate the effectiveness of a pharmacological intervention, a function strictly reserved for the licensed nurse.