Clinical Delegation Skills: A Handbook for Professional Practice Book

Ch. 1 The Overall Process of Delegation 1

The Definition 2

The Model: The Key to Delegation 3

The Skill 8

Delegation as Integral to Professional Practice 9

References 12

Ch. 2 Know Your World 15

Influence of Nurse Shortages 17

Evolution of Healthcare Payment Systems 20

Demographic Trends 23

Healthcare Delivery Trends 26

Changing Nature of Work 27

Safety and Balanced Assessments 28

Evolution of the Art and Science of Nursing Practice 29

Continual Planning for Transfer and Discharge 33

Implementation of Clinical Pathways 33

Technology Evaluation 38

Client Accountability for Care: Health Education 39

Growth of Home Care 42

Redesign of Care Delivery Systems 42

Where Do We Go from Here? 54

An Invitation 55

References 58

Ch. 3 Know Your Practice: Is My license on the line? 63

The State Board of Nursing 65

The National Council of State Boards of Nursing 72

The Nurse Practice Act 74

Rules and Regulations 76

The Test 77

The LPN Role 89

Delegation and the Nursing Process 91

Conclusion 97

References 99

Ch. 4 Know Your Organization: What About Where I Work? 101

In the Beginning 103

The Nonunion Environment 111

The Mission Statement 111

The Organizational Structure 116

The Impact of Redesign 116

The Quality Program 122

Safety in Practice Models 124

Educational Resources 127

Your Role in Organizational Success 129

References 131

Ch. 5 Know Yourself 135

Level of Clinical Experience: From Novice to Expert 138

Exploring Barriers 142

Other Barriers 156

Determining the Potential Benefits 166

Conclusion 171

Appendix 5-A Nursing Expertise Self-Report Scale 175

Instructions for Completingthe Nursing Self-Report Scale 177

References 178

Ch. 6 Know What Needs to Be Done 181

Defining the Role 183

The PTA Model 185

Getting the Job Done 192

Additional Samples for Planning Care 216

Conclusion 221

References 224

Ch. 7 Know Your Delegate 227

Who Are the Delegates? 228

Assessing the Role Played by Each Delegate 230

Official Expectations of Each Role 231

Practice Acts and Regulations 231

The Question of Competency: Evaluating and Maintaining from a Regulatory Perspective 232

Accountability for Competence 240

Job Descriptions 240

Validated Competencies: The Organizational Perspective 242

The Impact of the Mission on Job Roles 245

Unofficial Expectations of Each Role 246

Assessing the Delegate's Strengths 250

Assessing the Delegate's Weaknesses 253

Assessing the Delegate's Motivation 259

Your Responsibility for the "General Climate" of Motivation 263

Assessing the Delegate's Preferences 264

Assessing Cultural Differences 266

Conclusion 268

References 270

Ch. 8 Know How to Communicate 273

Communication as a Part of the Plan for the Day, Shift, or Case 274

Delegate Responses 275

Communication Styles: Passive, Aggressive, Assertive 278

Effective Assigning 283

Assertive Follow-Up 289

Nonverbal Behaviors 292

Conclusion 293

References 297

Ch. 9 Know How to Resolve Conflict: Getting Coworkers to Work Together as a Team 299

Conflict as a Concept 299

Sources of Conflict 300

Cost of Conflict 304

Strategies for Conflict Resolution 306

Innovative Issue Resolution Process: A Collaborative Method 317

Case Study Analysis of Collaborative Resolution 322

Conclusion 326

References 329

Ch. 10 Know How to Give Feedback 331

Benefits of Giving and Receiving Feedback 334

The Power of Feedback 335

The Process 337

Giving Feedback to the Delegate 339

Application to the Delegation Process 341

Requesting and Receiving Feedback 348

Upward Feedback 349

Conclusion 352

References 353

Ch. 11 Know How to Evaluate: How Well Has the Delegation Process Produced the Outcomes I Want to Achieve? 355

Evaluation: Continuous, Problem-Related, and Periodic 357

Continuous Evaluation 359

Specific Incident or Problem-Related Evaluation: Critical Thinking 368

Periodic Evaluation 384

Case Study Analysis of Evaluation 386

Documentation and the Delegation Process 389

Conclusion 395

Celebrate me Success of the Team! 396

References 399

Appendix 11-A Nurse Delegation Forms 402

Index 419