Delegate specific tasks to specific people using appropriate supervision.
So this can't be simply, "keep an eye on Mr. Smith in Room 12." Delegation has to be specific. So we have to define parameters that we're assessing for. We have to define accountability and measurement of those parameters to a specific person who is able to manage that task. In other words, if you have an aide that is going to be taking vital signs you don't want to tell them, "can you please take vital signs on Mr. Smith every 15 minutes because I need to know if she has a transfusion reaction?" Instead you need to say to her, "please take vital signs on Mr. Smith every 15 minutes, I'm looking for a transfusion reaction and I will check the vital signs that you get every 15 minutes to make sure that they remain in the normal range".
You don't want to give a specific parameter to somebody who doesn't know how to interpret that information. So for example, you couldn't tell the aide, "come back and tell me if her temperature goes up." Okay, well her temperature didn't go up but she's hypotensive and tachycardic; you see, that wasn't a good delegation. We need to define specific accountability and specific parameters. By doing so you will decrease your chance of liability, you'll increase accountability for the things that happen with your patients, and you will improve outcomes.
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.