Editing RN Delegation and Supervision (section)

== Accountability, liability, and refusal ==

Because accountability is retained, the RN can be held responsible for an adverse outcome that follows an inappropriate delegation, inadequate direction, or absent supervision, even though another person physically performed the act. The RN may also be accountable for failing to delegate appropriately when doing so was necessary for safe, timely care.

A delegatee has the right and the obligation to refuse a delegated task when the task is outside the delegatee's scope or competence, when the direction is unclear, or when the delegatee believes the task is unsafe for that client. The RN then either performs the task, delegates to a different qualified person, or provides training and direct supervision as policy allows.

Employers share responsibility. Organizations are expected to have written delegation policies, defined job descriptions, competency validation processes, and adequate staffing so that safe delegation is possible (NCSBN and ANA, 2019).