Transcript Delegation
Janie Lee Hall, School Health Advocate, NW Region
Office of School & Adolescent Health
Public Health Division, NMDOH
Delegation is “the transferring
to a competent individual the
authority to perform a selected
nursing task in a selected situation”
◦ UAP: Unlicensed Assistive Personnel
◦ NAP: Nursing Assistive Personnel
◦ Individuals who are trained to function in an assistive
role to the registered nurse in the provision of student
care activities as delegated by and under the supervision
of the registered professional nurse (NASNC, 200)
In schools, this may be the health assistant, educational
assistant, teacher, secretary, or anyone who accepts
delegation from the school nurse and is not licensed by
the State Board of Nursing (NASN, 2004)
New Mexico Nurse Practice Act
Local, State and National Standards of Practice
District Policy and Procedures
The Delegating Nurse:
Shall assign/delegate to unlicensed persons only
those nursing actions which that person is prepared,
qualified, or licensed, or certified to perform
Is accountable for assessing the situation and
responsible for the decision to delegate or make the
assignment
The Delegating Nurse:
Is accountable for each activity delegated, for
supervising the delegated activity, and for
assessing the outcome of the delegated activity
May not delegate the specific functions of
nursing assessment, evaluation and nursing
judgment to non-licensed persons
The New Mexico Nurse Practice Act governs the
practice of all nursing, including delegation
Delegation is the process of assigning a nursing
task to a competent person who is not a nurse
Only a registered nurse can legally delegate
Only a registered nurse can decide when, what and
to whom to delegate
Delegation is a process that requires ongoing training,
supervision, and documentation
A delegated task may not be further delegated to
another person except by a the nurse
The nurse must supervise the health outcome of the
student
The parent notifies the school nurse of a specialized
nursing procedure that needs to be performed at school
Written orders from the student’s primary care provider
must verify the need for specialized health services, and
indicate time, frequency, condition(s), and management
of side effects
The School Nurse transcribes the orders, and
determines if elements of care can be delegated
The School Nurse writes the Individualized Healthcare
Plan (IHP) and is responsible for all changes and
revisions
The School Nurse provides training and supervision of
delegated tasks/care activities
The task is within the UAP range of functions
Frequently recurs in the daily care of client(s)
Performed according to an established sequence
of steps
Involves little or no modification from one
situation to another
Criteria for Delegation to UAP (continued)
May be performed with a predictable outcome
Does not inherently involve ongoing assessment,
interpretation, or decision-making, which cannot
be logically separated from the procedure itself
Does not endanger the client’s life or well-being
Accept the responsibility for delegated tasks
Affirm understanding of expectations
Ask questions regarding delegation and seek
clarification of expectations as needed
Inform nurse if you have not or infrequently
performed a delegated task/function/activity
Demonstrate competence to perform specific task
Ask for additional training/supervision as needed
Safely perform tasks as trained
Follow protocols and guidelines
Determine communication & documentation
methods with the nurse
Understand plan of action in emergency situations
Acknowledge liability for actions outside scope (eg:
practicing nursing without a license)
Provide adequate staffing
Follow-up on every report of concern
Provide education and orientation to all employees,
including training on delegation
Remember: The RN may not delegate the specific
functions of nursing assessment, evaluation and
nursingjudgment to non-licensed persons
However, under the direction & supervision of the
School Nurse, the Health Assistant may:
Collect, report and record basic objective &
subjective data
Observe and report signs & symptoms or
deviations from normal health status
Your nurse is at her other school today.
She calls you 15 minutes before a tube
feeding is scheduled. She says she won’t
be able to get back in time and for you
to perform the tube feeding. You have
seen it performed once, 2 months ago.
You just finished assisting a student with his
medication. Another student runs in vomiting
and you are helping that student. The nurse
(who happens to be in the office that day) tells
you that she will document the medication
for you, since you are busy.