Editing Fundamentals of Nursing (section)

== Delegation and scope of practice ==

The five rights of delegation are the right task, the right circumstance, the right person, the right direction and communication, and the right supervision and evaluation.

The registered nurse may not delegate assessment, nursing diagnosis, care plan development, evaluation of outcomes, initial patient teaching, or the care of an unstable patient. The registered nurse retains accountability for the outcome of any delegated task.

Licensed practical or vocational nurses generally may perform focused data collection, administer most medications within state scope, perform sterile dressing changes, insert catheters, provide tracheostomy and ostomy care, reinforce teaching already initiated by the registered nurse, and monitor stable patients with predictable outcomes. They report findings and any change in condition to the registered nurse. Specific scope varies by state and by facility policy, and the nurse is responsible for knowing the applicable nurse practice act.

Assistive personnel may perform standard, unchanging tasks with predictable outcomes: bathing, feeding a patient without swallowing difficulty, oral care, ambulating a stable patient, transferring, positioning, toileting, making beds, measuring and recording vital signs and intake and output on stable patients, and applying compression devices. They may not assess, teach, evaluate, or perform any task requiring nursing judgment, and any abnormal value they report must be verified by the nurse.