Nursing Delegation Principles

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Questions and Answers

What is the main purpose of performance appraisals?

To increase employee workload without feedback

To establish social connections among staff

To evaluate job performance against set goals (correct)

To create more job openings in the organization

Which step is involved in supporting an employee during coaching?

Allow the employee unlimited time to complete tasks

Avoid setting any measurable goals

Check progress and discuss obstacles (correct)

Critique their mistakes harshly

How should compliments be given during the appraisal process?

Only during formal meetings

Only when the work is perfect

Regularly to encourage good performance (correct)

To manipulate the staff's emotions

What should be evaluated when assessing performance appraisals?

Strengths, weaknesses, and development needs Signup and view all the answers

What should performance appraisals contribute to within an organization?

Organizational training needs planning Signup and view all the answers

When should milestone meetings be established during coaching?

At the start of the coaching process Signup and view all the answers

What is a key characteristic of effective supervision?

Keeping supervision at an appropriate distance Signup and view all the answers

What should be a focus during the collaboration step in coaching?

Discussing potential obstacles and solutions Signup and view all the answers

What is one of the primary objectives of performance appraisal?

Improving work performance Signup and view all the answers

Which of the following is essential for making appraisal schemes work effectively?

Engaging managers, employees, and union representatives Signup and view all the answers

During an appraisal interview, what should be encouraged?

Employee self-assessment Signup and view all the answers

What is an important aspect of the structure of the appraisal interview?

Summarize agreed plans Signup and view all the answers

Which is NOT a typical objective of performance appraisal?

Managing company budgets Signup and view all the answers

What is advised for the seating arrangement during an appraisal interview?

To be comfortable and free from interruptions Signup and view all the answers

What should appraisers focus on while assessing an employee's performance?

Job description and performance Signup and view all the answers

What is one of the key roles of a performance appraisal according to its objectives?

Administering merit pay Signup and view all the answers

What is the primary goal during the changing stage of the transformation process?

To help individuals learn new concepts Signup and view all the answers

Which of the following is NOT a mechanism mentioned for facilitating change?

Ignoring new information Signup and view all the answers

In Kotter's model, what does the first step, 'Establish a sense of urgency', involve?

Communicating why change is needed Signup and view all the answers

What is the purpose of the refreezing stage in the change process?

To stabilize new behaviors or attitudes Signup and view all the answers

Which step in Kotter's model corresponds to the CHANGING phase?

Empower broad-based action Signup and view all the answers

What does the term 'Guiding Coalition' refer to in Kotter's model?

A cross-functional group with power to lead change Signup and view all the answers

Which of the following actions is encouraged during the CHANGING phase?

Encouraging risk-taking and problem-solving Signup and view all the answers

How is positive reinforcement used during the refreezing stage?

To reinforce desired changes Signup and view all the answers

What is the primary distinction between reactive and proactive change?

Reactive change occurs in response to perceived issues, while proactive change is based on planning. Signup and view all the answers

Which of the following is NOT considered an internal factor causing organizational change?

Economic forces Signup and view all the answers

What is the first stage of Lewin's 3-Phase Change Model?

Unfreezing Signup and view all the answers

What role do individuals play in the process of organizational change?

They are central to the change process. Signup and view all the answers

Why is motivation important in the change process?

It is necessary for initiating the change process. Signup and view all the answers

What does proactive change aim to address?

Potential future difficulties and discrepancies. Signup and view all the answers

According to the assumptions of change models, what is a characteristic of resistance to change?

It exists even when the goals of change are highly desirable. Signup and view all the answers

Which action is part of the unfreezing stage in Lewin's change model?

Creating awareness for a need for change. Signup and view all the answers

What is the primary responsibility of the delegator when involving a student or junior nurse?

To ensure the student has the necessary training. Signup and view all the answers

Which of the following is NOT one of the Five Rights of Delegation?

Right communication Signup and view all the answers

What should the delegator consider when deciding whether to delegate a task?

Knowledge, skill, and ability of the student Signup and view all the answers

Which step of successful delegation involves analyzing tasks and identifying those that would benefit others?

Planning Signup and view all the answers

What is essential for ensuring effective communication during delegation?

Providing the necessary information and guidelines Signup and view all the answers

What does the 'Right supervision and evaluation' in the Five Rights of Delegation entail?

Providing the appropriate monitoring, evaluation, and feedback Signup and view all the answers

Which principle emphasizes the importance of confirming understanding and acceptance of delegation?

Communicating and verifying comprehension Signup and view all the answers

Why is it important to provide opportunities for questions when delegating tasks?

To clarify expectations and reduce misunderstandings Signup and view all the answers

What is the primary focus of delegation in a nursing context?

Entrusting others to act and assume responsibility for certain tasks Signup and view all the answers

Which factor is NOT typically considered when determining if a nursing task is delegatable?

The nurse's personal workload Signup and view all the answers

Which of the following is an example of a non-delegatable nursing task?

Performing complex tracheotomy suctioning Signup and view all the answers

What must be true about a specific delegated nursing task?

It is only delegatable for a specific individual in a specific situation Signup and view all the answers

Which of the following principles does NOT apply to delegation in nursing?

Transferring authority without considering competence Signup and view all the answers

When might a registered nurse be required to perform nursing tasks instead of delegating them?

If the task does not meet delegation criteria Signup and view all the answers

Which task is likely to require prior assessment before administration?

Injecting certain medications Signup and view all the answers

What is a key characteristic of competent assistive personnel in delegation?

They possess the skills necessary to perform selected tasks safely Signup and view all the answers

Study Notes

Delegation

Delegation is primarily about entrusting others with responsibility for tasks. Delegates act and initiate independently, assuming responsibility alongside the manager.
Effective managers understand the strengths and weaknesses of their colleagues.
Employees are viewed as team members, crucial for achieving goals.
Authorization granted by a licensed professional to another (licensed or unlicensed) person to perform tasks within the delegator's scope of practice, but not the delegatee's scope, constitutes legal practice.
Not every nursing task is delegable.
Nurses must consider legal criteria, professional standards, and individual student needs before delegating tasks.
A task may be delegable to a student/junior nurse under the supervision of a registered nurse (RN), if the situation permits and it is safe.
Tasks are specific to the student; a task delegable to one student might not be suitable for another.
Certain nursing procedures, such as complex tracheotomy suctioning or medication administration requiring dose calculation, are non-delegable and require a registered nurse's direct performance.
Certain medications (administered by injection) and services requiring nursing assessments are non-delegable.
Delegation is a complex process where authority is transferred. This is often to assistive personnel within the specific situation.

Principles of Delegation

The delegator takes responsibility for the care.
The delegator directs care and determines the suitability of delegation.
The delegator delegates tasks and clarifies expectations.
The delegator uses their nursing judgment based on the student/junior nurse's condition, competence, and determined supervision.
The delegator communicates and validates the comprehension and acceptance of responsibilities.
The delegator provides opportunities for the student/junior nurse to ask questions.
The delegator participates in setting up systems to evaluate ongoing competency in delegation.
The delegator uses critical thinking and professional judgment (five rights of delegation). This ensures the task, circumstances and the delegated individual are all appropriate. The delegator must ensure direction and communication are clear, appropriate and concise.
The delegator ensures appropriate monitoring, evaluation, intervention, feedback, and documentation.
The delegator only delegates tasks that the student/junior nurse possesses the knowledge, skills, ability to perform safely, cultural competence, experience, meets institutional policies and procedures.

Five Steps to Successful Delegation

Step One: Planning involves analyzing tasks, identifying suitable tasks, determining goals, visualizing results, considering resources and timeframes, and choosing the right person.
Step Two: Engaging involves presenting a clear picture, gaining commitment, communicating goals and expected results. This includes deadlines and relevant pertinent information.
The speaker provides specific training as needed, which includes demonstrations, explanations and "teach backs". This is completed to ensure the task is well understood.
Step Three: Collaborating involves reviewing the goal; discussing possible obstacles and solutions. The steps to overcome these include establishing communication barriers and/or scheduling coaching sessions (if needed).
Milestone meetings are scheduled.
Step Four: Supporting allows the employee to practice and get up to speed. Progress is monitored, support is given positively, and the need for coaching or further support is evaluated.
Obstacles and solutions must be discussed, encouragement and support are offered, and a relaxed and efficient work environment is created.
Realistic time constraints must be considered.

Step Five: Appreciating

Showing interest in the results, and providing compliments for good work.
Recognizing and providing credit when deserved.
Unacceptable work, including unfinished, inaccurate or substandard work must be addressed directly.
Accountability for unsatisfactory results.
The delegation process must be revisited and improvements implemented.
Suggestions and complaints are welcomed.

Performance Appraisal

Performance appraisals are periodic evaluations of job performance against responsibilities, goals, and assigned tasks.
It identifies employee strengths and weaknesses, identifies areas that might need potential training or development.
Performance appraisals are essential for effective staff management, employee development and organizational improvement.
Annual performance appraisals are important for monitoring standards, agreeing on expectations and objectives, and determining the necessary delegation of responsibilities.
Staff Performance appraisals are essential for career and succession planning. It also helps with staff motivation, attitude and behavior development.
Performance appraisals are a regular recorded review of how the individual has performed and a plan for future development.

Objectives of Performance Appraisal

Improving work performance
Administering merit pay
Advising employees of work expectations
Counseling employees
Making promotion decisions
Motivating employees
Assessing employee potential
Identifying training needs

Making a Success of Appraisal

Gaining senior manager commitment
Consulting relevant stakeholders (managers, employees, trade union representatives)
Training appraisers to ensure fairness and objectivity.
Keeping the appraisal scheme simple.
Maintaining written records to provide feedback and monitor appraisals.
Focusing on work description for performance and avoiding character assessments.

Appraisal Interview

Providing adequate notice to employees.
Using self-assessment forms to help employees prepare.
Allowing adequate time (at least one hour) for the interview.
Providing a comfortable and quiet interview setting to avoid interruptions during the appraisal.
The appraiser should highlight employee strengths, provide methods to improve and discuss future performance goals.
Both parties review success to date, agree on objectives and discuss development needs.

The Structure of The Interview

Explaining the purpose and scope of the appraisal and the job responsibilities involved.
Discussing job requirements, objectives and demands.
Encouraging the employee to discuss strengths, weaknesses and areas where improvements are needed.
Discussing how far agreed objectives were met.
Agreeing on future objectives.
Discussing development needs (education, training, skills, experience).
Summarizing agreed upon feedback.
Establishing an appeal process in case of any disagreement on the appraisal.

Change Management

Change Management is an alteration in how tasks are completed. It affects organizational purposes, like objectives, strategy, culture, tasks, and activities.
Change management includes structure, technology, leadership styles, personality, social systems, compensation methods, interpersonal functioning.

Sources of Change

Internal factors include personnel problems and managerial decisions that cause change.
External factors include political change, social factors, economic forces and technological change that drive change.

Types of Change

Reactive (Unplanned) Change: Change occurs in response to threats, problems or opportunities. This change occurs spontaneously or randomly.
Proactive (Planned) Change: This change results from a process that anticipates future issues, threats, and opportunities. It's driven by a perception of a gap between the desired and actual state of affairs.

Models and Dynamics of Planned Change

Change impacts key organizational components.
Change often alters the pattern of interactions/coordination within the organization.
Leaders need appropriate models/strategies to manage the change.
Models like Lewin's 3-phase process and Kotter’s 8-steps are helpful.

Assumptions of Change Models

The change process involves learning something new and altering existing attitudes, behaviors and organizational practices.
Motivation is essential for change to occur.
Individuals are central to organizational change.
Resistance to change may occur despite change aims being desirable.
Change requires reinforcement of the new attitudes, behaviors, and organizational practices.

Lewin's 3-Phase Change Model

Unfreezing: The stage where a situation is prepared for change. Existing attitudes/behaviors are challenged to create a need for something new, this is often driven by the recognition of a problem.
Changing: The modification of existing systems and the introduction of new ones. This stage involves providing new information, developing new behaviors and new perspectives.
Refreezing: The stage where the change is stabilized and integrated into the norm. The change is solidified by providing opportunities to practice the new behavior and methods and through positive reinforcement.

Kotter's Model

Kotter's model outlines 8 steps.
These steps support Lewin's model by first unfreezing behaviors, changing processes and strengthening new processes.
Step 1 - Establish a sense of urgency
Step 2 - Create a guiding coalition
Step 3 - Develop a vision and strategy
Step 4 - Communicate the change vision
Step 5 - Empower broad-based action.
Step 6 - Create short-term wins.
Step 7 - Consolidate gains and produce more change.
Step 8 - Anchor new approaches in the culture.

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Description

This quiz focuses on the essential principles of delegation in nursing. It covers how to effectively delegate tasks considering legal guidelines and individual competencies. Understand the importance of recognizing team members' strengths and weaknesses in achieving healthcare goals.