Author Question: The licensed practical/vocational nurse (LP/VN) delegates the insertion of urinary straight ... (Read 62 times)

FButt · **on:** Jul 17, 2018

The licensed practical/vocational nurse (LP/VN) delegates the insertion of urinary straight catheterization to a nursing assistant (NA) without first assessing the client's situation and failed

to read the client's history of previous urinary strictures (a narrowing of the urethra). The NA had never performed the task before on a client, but had practiced on a lab mannequin. The LP/VN did not provide any directions or when to ask the nurse for help. The NA performed the task forcing the urinary catheter and traumatized the client's urethra, resulting in bleeding. The LP/VN promptly cared for the client after the complication occurred. Which of the five delegation rights did the LP/VN fail to consider resulting in an improper assignment? Select all that apply.
A) Right task
B) Right circumstances
C) Right person
D) Right direction/communication
E) Right supervision/evaluation

Question 2

The main task of the nurse manager is to make client assignments. Which information about each staff member must the nurse manager prioritize in order to make appropriate assignments?

A) Continuing education record
B) Year of graduation from nursing school
C) Job description
D) Absenteeism and tardiness record

pallen55 · **Reply #1 on:** Jul 17, 2018

Answer to Question 1

Ans: A, B, C, D
Feedback:
The National Council State boards of Nursing/American Nurses Association (NCSBN/ANA) document https://www.ncsbn.org/Delegation_joint_statement_NCSBN-ANA.pdf lists the right task, circumstances, person, direction/communication, and supervision/evaluation as the five rights of delegation. The LP/VN did not delegate the right task and should have caught this by reading the client's history and performing an assessment of the client. The LP/VN should have stopped the delegation at the first step of the process. The right circumstances did not exist because the client has a history of urinary strictures, and may need a special catheter or if any resistance is noted while attempting the catheterization, the procedure should be stopped and the ordering physician notified. The right person was not considered properly because the client needed someone with experience and the LP/VN delegated the task to an NA who had not performed the procedure on a client and only had practiced it in the lab on a mannequin. The nurse should always provide directions for a delegation and at what point the NA should ask for help. The LP/VN did supervise and evaluate the situation, but by missing the other stopping points, the consequences of the delegation were unfavorable for the client.

Answer to Question 2

Ans: C
Feedback:
Individuals' job descriptions form the basis of a safe and efficient client assignment. These are more important than continuing education. Attendance records and high school education are not relevant.