A registered nurse is working with a licensed practical nurse (LPN) and unlicensed assistive personnel (UAP) on a medical-surgical unit. The nurse has four patients with varying acuity levels. Which task delegation demonstrates the most appropriate use of the nursing team's scope of practice?
1Delegate medication administration for a stable diabetic patient to the LPN, while assigning the UAP
2Assign the UAP to provide wound care for a patient with a complex surgical incision, while the LPN performs medication administration.
3Have the LPN conduct patient education about insulin administration techniques, while the UAP monitors vital signs.
4Delegate routine vital signs and basic hygiene care to the UAP, while assigning the LPN to administer medications under RN supervision.✓ 정답
해설
Proper delegation matches tasks to each team member's scope of practice. Option 4 appropriately delegates routine care to UAP and oral medication administration to LPN under RN supervision, ensuring patient safety and legal compliance. Other options involve tasks beyond UAP or LPN scope, such as complex wound care or patient education.
Clinical Judgment
This question assesses the core principles of delegation. The RN must assign tasks considering each team member's legal scope of practice and the patient's condition. Appropriate delegation is the foundation of patient safety and team efficiency. The key is to clearly distinguish "tasks only an RN can do," "tasks an LPN can do," and "tasks a UAP can do." The RN's unique duties (initial assessment, care plan development, complex patient education, unstable patient management) cannot be delegated.
Memory Tip:
RN is Responsible for Non-delegable tasks (initial assessment, planning, complex education). LPN performs Limited tasks under supervision (medications for stable patients, basic wound care). UAP provides Underlying basic care only (vital signs, hygiene, mobility).
KR vs US:
The role distinction between nursing assistants and nurses in Korea does not perfectly align with the UAP/LPN/RN system in the US. On the US NCLEX, this legal role differentiation and delegation principle is a very important topic. Korean nurses must familiarize themselves with the clear legal standards in the US regarding 'who can do what.'
Clinical Practice Guide
Considerations for RN delegation decisions: 1) Is the task within the team member's legal scope? 2) Is the team member proficient in the skill? 3) Is the patient's condition stable? (If unstable, the RN should manage directly) 4) Can clear instructions and appropriate supervision be provided?
Caution:
In SATA (Select All That Apply) questions, tasks that "can" and "cannot" be delegated to an LPN are often mixed. Patient education requires special attention. An LPN can reinforce education already provided by the RN, but providing new or complex education (e.g., teaching insulin injection technique for the first time) is the RN's responsibility.
Delegation — Delegation. The RN assigns specific tasks to other team members (LPN, UAP) while retaining responsibility and supervisory authority.
Scope of Practice — Scope of practice. Defines the legal limits of tasks that a healthcare professional with each license/qualification can perform.
Licensed Practical Nurse — Licensed Practical Nurse. Provides basic nursing care under the supervision of an RN, and performs limited tasks such as administering oral, subcutaneous, and intramuscular medications to stable patients.
Unlicensed Assistive Personnel — Unlicensed assistive personnel. These are unlicensed support staff such as nursing assistants who perform only non-judgmental, routine tasks like measuring vital signs and basic hygiene care.
Patient Education — Patient education. The initial education to teach new information or skills is the responsibility of the RN, and the LPN can only reinforce existing education.