1.1 RN vs LPN vs UAP Delegation & Assignment Principles
Analyze legal scopes of practice under national delegation guidelines, distinguishing non-delegable professional assessments from routine stable tasks.
Key NCLEX-RN Clinical Takeaways
- Remember the acronym EAT: The RN CANNOT delegate Evaluation, Assessment, or initial Teaching.
- UAPs are assigned routine, non-invasive ADLs (bathing, feeding non-dysphagic, routine vitals) on stable clients.
- LPNs care for stable clients with predictable outcomes, sterile wound dressings, and routine medication administration.
- The 'first' of any clinical intervention (first post-op ambulation, initial assessment, first dose of IV med) belongs to the RN.
Delegation is a core competency tested on the NCLEX-RN. The registered nurse transfers the responsibility of performing a specific nursing activity to a qualified individual while retaining ultimate accountability for the outcome.
Delegation decisions hinge on client stability, complexity of activity, and predictability of clinical response. The 5 Rights of Delegation: Right Task, Right Circumstance, Right Person, Right Direction/Communication, and Right Supervision/Evaluation.
Unlicensed Assistive Personnel (UAP) perform non-invasive, routine tasks on stable clients. LPNs perform skilled routine interventions for stable clients under RN supervision. Any task requiring nursing judgment, clinical evaluation, or assessment is non-delegable.
A registered nurse (RN) is planning shift assignments for four clients on a post-surgical medical-surgical unit. The unit is staffed with one RN, one licensed practical nurse (LPN/VN), and one unlicensed assistive personnel (UAP). Which clinical task is most appropriate for the RN to delegate to the UAP?