mod 1-EBP&elimination-delegation scenarios

PN1-Module 1-elimination and EBP Clinical Judgment is the process of integrating evidence-based practice, critical-thought, the Nursing Process, knowledge, skills, and attitudes, as well as application of theory to practice in order to promote safe, quality care to clients in all settings. Keeping that in mind, answer the following scenario: You are the Charge Nurse in a large Urban Emergency Department (ED). You nursing staff include: 1. RN with 12 years of Trauma ED experience 2. New RN with 6 months ED experience 3. RN from the Medical Surgical floor with 8 years of experience The following patients are in the ED, which patient will you give to each of the nurses and why? 1. A 76-year-old client who was involved in a motor vehicle accident and has hematuria. 2. A 38-year-old client with kidney stones complaining of severe pain. 3. A 24-year-old diabetic client with an acute urinary tract infection who will require discharge teaching. 4. An 80-year-old client that has not had a bowel movement for 4 days. When it comes to delegation, a nurse, specifically a charge nurse, must know the 5 rights to properly delegate and assign tasks to the right personnel to best perform that specific function. Before assigning any tasks, the charge nurse should know or get familiar with the people who will be working the floor, their capabilities, and their scope of practice. The 5 rights to delegation includes: the right task, right circumstance, right person, right communication, and right supervision (Treas & Wilkinson, 2014). The RN is not only responsible for the delegation, but also seeing the big picture, the team the RN is working with, and be able to take responsibility if anything goes wrong, the fault comes back to the RN assigning the task. 1) The 76-year-old client who was involved in a motor vehicle accident and has hematuria should be assigned to the RN with 12 years of trauma ED experience because the patient was recently in a MVA and bleeding which requires further assessment, such as ABC and disorientation, from an experienced nurse for prompt intervention and treatment. 2) The 38-year-old client with kidney stones complaining of severe pain can be delegated to the RN with 6 months of ED experience. This patient is unstable with severe pain and need careful vital sign assessment, along with onset of symptoms, and thorough medical history. The med-surg RN should be taken care of patients who are the most stable and least acute needs (Marquis, & Huston, 2015). 3) The 24-year-old diabetic client with an acute urinary tract infection who will require discharge teaching can be delegated to the med-surg RN with 8 years of experience. because she is a RN which can provide patient discharge teaching. This RN is consider a float nurse and not specific to the ED, but is capable of providing discharge teachings.