Understanding direction and delegation

Delegation is the transfer of responsibility for the performance of an activity from one person to another with the former retaining accountability for the outcome.

Direction is the active process of guiding, monitoring and evaluating the nursing activities performed by another. Direction is provided directly when the registered nurse is actually present and observes, works with and directs the person; direction is provided indirectly when the registered nurse works in the same facility or organisation as the supervised person but does not constantly observe his/her activities. The registered nurse must be available for reasonable access, i.e. must be available at all times on the premises or contactable by telephone (in community settings).

The principles of delegation

1 The decision to delegate is a professional judgment made by a registered nurse and should take into account:

• the health status of the health consumer

• the complexity of the nursing intervention required

• the context of care,

• and the level of knowledge, skill and experience of the persone.

2 The decision to delegate must be consistent with the service provider’s policies.

3 The registered nurse must ensure the enrolled nurse understands the nursing interventions required, and knows when to ask for assistance and when to report back to the registered nurse.

4 The registered nurse is responsible for monitoring and evaluating the outcomes of delegated nursing care.

To simplify , when you ask an HCA or EN to do anything you should be aware of these factors