Accountability and Responsibility underpin the decision making process to delegate.
The process has five elements to consider to assist decision making, particularly where decisions may be more complex. For the purposes of this framework the five process elements have been called the 5 R’s- reminding nurses and midwives whether or not conditions for each element are ‘right’ to enable delegation to occur safely, efficiently and in a person- centred manner.
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The decision making process for delegation of nursing and midwifery tasks or duties comprises the right:
Confirming the right task requires consideration whether or not the activity:
- is within the authority of the delegator to delegate
- is performed in systematic steps that require little or no modification
- can be performed to give a predictable outcome within agreed parameters
- does not involve assessment/decision making beyond the scope of the task.
Confirming the right circumstance requires consideration of:
- the condition of the person receiving care
- the person being involved in the development of, and is in agreement with, his/her person-centred plan of care.
Confirming the right person to delegate requires consideration of whether or not the delegatee:
- has the required knowledge and skills to carry out the task competently
- has the necessary time to undertake the task
- is confident to carry out the task.
Providing and confirming the right direction requires:
a person-centred plan of nursing or midwifery care, based on an assessment of nursing/midwifery needs guided by appropriate risk assessments, which has been developed and agreed with the person receiving care
clear person-centred communication about the:
- delegated task
- standard of outcome based on professional and organisational standards, policies and procedures
- time requirement for review
Providing and confirming the right support and evaluation required that the delegator puts in place a system or process to:
- enable advice in line with the person-centred plan of nursing and midwifery care
- enable the raising and escalating concerns appropriately
- determine the outcome of the delegated task.