Delegation and Nursing Judgment
The ANA Code of Ethics (2001) notes that delegation is based on the RN's judgment concerning a patient's condition, the competence of all members of the nursing team, and the degree of supervision required. This statement coincides with the Five Rights of Delegation developed by the NCSBN (1995). These Rights of Delegation include: (a) the right task, (b) the right circumstance, (c) the right person, (d) the right direction/communication, and (e) the right supervision.
Additionally, four guidelines for effective delegation have been identified by Koloroutis (2004, p. 136). They include the following:
1. Delegation requires RNs to make decisions based on patient needs, complexity of the work, competency of the individual accepting the delegation, and the time that the work is done.
2. Delegation requires that timely information regarding the individual patient be shared, defines specific expectations, clarifies any adaptation of the work in the context of the individual patient situation, and provides needed guidance and support by the RN.
3. Ultimate accountability for process and outcomes of care – even those he or she has delegated - is retained by the RN.
4. RNs make assignments and the care provider accepts responsibility, authority, and accountability for the work assigned.