Wednesday, May 2, 2012

Delegation mnemonics

RN 
- Invasive procedure = I AM RN EDUCATED
Initial/Comprehensive/Baseline (assessments)


Assess (FREQUENT/ONGOING =UNSTABLE Patients)
MANAGING and LEADING client care environment
Ex. Clients who are in severe and Refusing Meds (needs more assessment)


Review
NSG Process/ NSG Judgement Use (APIE= Assessment,Planning, Implementation,Evaluation)


Encourage
Develop
Use Of IV meds (ex. plasma, blood products-- these and IV are done by RN only)
Consult/Counsel/Suggest & Update
- ADMISSION .. NEW & POST OP
Teach 
Educate 
DISCHARGE & ADMISSION Preparation


LPN/LVN- 
-Certain Invasive Task =I-SOUND STAR CROSS ++
IM adm


SQ adm.
ORAL meds adm 
URINARY CATHETERIZATION
Nitroglycerin
- DREASSING of WOUND (CHANGING & IRRIGATING) very commonly seen Q.
SUCTIONING
TUBE FEEDING
- Auscultate/Listen
Routine/Standard


Check(s) 
Reinforce/remind
Observe 
Set up (basic equipment)
Specimen Collection & Data Colletion 
+
-Blood glucose readings
-Monitor
-Review/Teach-- Usually standard practices (hand washing/hygiene) or med administration (ie. eye drops) -- RN mostly teaches/educated and LPNs Reinforce
+
CAST & TOE Amputation are stable clients and need on going assessment and pain mgt./La Charity Book(Don’t know too..just dont deprive with it.. just follow the book
Data Collection such as LISTENING to LUNG SOUNDS & CHECKING for PERIPHERAL EDEMA_Part of LPN scope of practice: /LaCharity Book
** Don't assign LVN/LPN to do a task an nurse assistant can complete**


NURSING ASSISTANT/UAP- Unlicense assistive personnel
- Non Invasive procedure/Basic Care =SPARRTACUS GROAM +++
-SKIN CARE (ex. bed rest with a skin tear and hematoma from a fall 2 days ago, Apply and care for a client’s rectal pouch )
-POSITIONING-- Special positioning-- requires initial education by RN -- assistant will assist not teach
-AMBULATION/ Assisting with ADL (AMBULATION of FRACTURED HIP only RN& PT) ( Patienst with CHESTUBE ambulating the hall-LPN/LVN)
-RECORDING & MONITORING of V/S (BP,Pulse, Oxygen sat,)
-RANGE OF MOTION &EXERCISE
-TRANSPORT OF CLIENT
-ASSIST (Assisting for Prep for SITZ Bath)
-COLLECTION OF 
-URINE &
-STOOL
-GROAM (Groaming & Hygiene Measure, Bathing & checking water temp)
+
WEIGHTING
INTAKE & OUTPUT
FEEDING 
+ 
- Remind/Reinforce: usually reminds pt. TO do something rather than HOW to do it (skills previously taught by other health care professional or precaution measures)***
- They can detach suction and remove a foley but not connect or insert
- Gather (equipment)
+
- Measurement of ankle and bracial blood pressure for ankle brachial index calculation.(Calculated already)
( Calculation on the ankle-brachian index is responsibility of RN)
-Experienced Nsg Assistant should have been taught how to..
Monitor Apical Pulse, However, the RN should observe to be sure that s/he mastered this skills.
---La Charity Book---


NEW RN
-Education and hospital orientation includes.. SAFE administration of IV meds.
-STABLE PATIENTS


SOME KEY POINTS:
Patients that require teaching about drugs or need procedures done are NOT RN priority. 


PHYSICIAN
-Informed Consent
-Medical diagnosis
-Prescriptions
-Order procedures


Avoid These Assignments for New/Float/LVN/LPN/Traveling
-New onset/sudden/acute
-New admission
-Transfer
-Newly diagnosed
-Discharge
-Require education/teaching (beyond basic skills -- tend to be complex and specific to patients on that particular unit)
- Unstable (ie. High risk of sudden respiratory failure, or requires frequent assessments and changes in therapy(like electrolyte imbalances)
Give:
- Chronic
- Routine meds/procedures
- Stable


ALL HEALTHCARE WORKERS
- Responsible for knowing about and implementing standard precautions + airborne/droplet/contact --> therefore all can teach about it or prepare a room for it

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