Delegation (Nursing)
Delegation in nursing authorizes another qualified person to perform a specific activity. The delegating nurse remains accountable for the decision and oversight. The person accepting the activity is accountable for their own performance.
Exam Tip
Use the five rights of task, circumstance, person, direction and communication, and supervision and evaluation. Assignment distributes routine authorized work. Delegation requires legal authority, and nursing judgment stays with the nurse.
What Is Delegation in Nursing?
When the jurisdiction permits it, an authorized licensed nurse may delegate a specific activity to a qualified team member. The nurse remains accountable for the delegation decision and appropriate supervision. The delegatee is responsible and accountable for carrying out an accepted task correctly.
The Five Rights of Delegation
| Right | Question to Ask |
|---|---|
| Right Task | Is this task appropriate to delegate? (Within legal scope and suitable for the patient, without transferring nursing judgment) |
| Right Circumstance | Is the patient stable? Are there factors that make delegation unsafe? |
| Right Person | Is the delegatee competent and legally allowed to perform this task? |
| Right Direction/Communication | Have I given clear, specific instructions including what to report? |
| Right Supervision/Evaluation | Am I available to supervise and evaluate the outcome? |
Examples of Routine CNA Assignments
| Common assignments within CNA/UAP scope | Examples requiring a licensed nurse or separate legal authority |
|---|---|
| Vital signs on stable patients | Nursing assessment or evaluation |
| ADL assistance (bathing, feeding, grooming) | Medication administration without separately authorized training/delegation |
| Ambulation as directed in the care plan | Procedures outside the aide's authorized role |
| Intake and output measurement | Independent clinical teaching |
| Specimen collection (routine) | Care plan development |
| Bed making and room preparation | Independent assessment of an unstable patient |
Delegation vs. Assignment
| Delegation | Assignment |
|---|---|
| Authorizing a specific activity beyond the person's usual role where law permits | Allocating work already within a licensed nurse's scope or a UAP's routine duties |
| Nurse is accountable for the decision, supervision and follow-up | Each team member is accountable for their own work |
Key Delegation Principles
- Accountability is shared by role: the nurse for delegation and supervision, the delegatee for their performance
- Never delegate assessment, planning, evaluation, or tasks requiring nursing judgment
- Consider the patient's condition: stable patients = safer to delegate
- Verify the delegatee's competency before delegating
- Provide clear instructions including when to report back
- Follow up and evaluate the outcome
Exam Alert
Delegation is heavily tested in the Coordinated Care category (18-24% of NCLEX-PN). Use the Five Rights of Delegation for every delegation question. State law controls which nurses may delegate; nursing judgment itself is not delegated to a CNA. The nurse remains accountable for the delegation decision and follow-up.
Use the current care plan and the applicable state rules. Official guidance.
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Scope of Practice (Nursing)
Scope of practice defines what a healthcare professional is legally authorized to do. LPN/LVN practice depends on the jurisdiction's nursing laws, the setting, required supervision and the nurse's competence.
Care Plan (Nursing)
A nursing care plan records a patient's identified needs, measurable goals and nursing interventions. The RN leads nursing care planning, and the LPN/LVN contributes findings and helps develop, implement and update the plan within the applicable scope of practice.
Nursing Process
The nursing process is a cyclical framework for planning, delivering and evaluating patient-centered care. ADPIE is a common way to remember assessment, diagnosis, planning, implementation and evaluation.
Licensed Practical Nurse (LPN)
An LPN is a licensed practical nurse. California and Texas use the title licensed vocational nurse (LVN). LPNs/LVNs provide nursing care under the direction and supervision required by their jurisdiction.
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