NU371 Week 2 HESI Case Study Delegation of Nursing Management Already Graded A+

NU371 Week 2 HESI Case Study Delegation of Nursing Management Already Graded A+ A registered nurse (RN) who passed their NCLEX-RN exam 5 months ago and is working in a rural Emergency Department (ED). Their unit is short staffed, and their manager has determined that they are ready to progress to the charge nurse role, although they are relatively new to the nursing profession. Today is the first time they have been in the charge nurse role.The nurse arrives on the unit at 6:30 am and places their belongings in their locker. They walk around the unit to see how things are going. Soon, the night charge nurse signals to begin shift report. They go to the charge nurse office to receive report. After receiving report from the night shift charge nurse, which activities should the nurse anticipate completing during the first hour? Select all that apply. o Delegate tasks to unlicensed assistive personnel (UAP). o Identify tasks needed for assignment and delegation. o Reconcile a client’s medication prescriptions. o Assign clients to staff nurses according to acuity. o Inspect the code cart equipment and supplies. o Distribute breakfast trays as they arrive on the unit. o Delegate tasks to unlicensed assistive personnel (UAP). · Delegating tasks to UAPs for the day is a charge nurse action that should be performed during the first hour of the shift to make good use of unit personnel resources. o Identify tasks needed for assignment and delegation. · The charge nurse should first identify the tasks needed for assignment and delegation during the first hours of the shift. o Assign clients to staff nurses according to acuity. · Making client assignments is a charge nurse action that must be performed before or during the first hour of the shift to make the best use of unit personnel resources. o Inspect the code cart equipment and supplies. · Inspecting the code cart is a charge nurse action that must be performed during the first hour of the shift to ensure that emergency equipment is available and functional on the unit. As the charge nurse considers the unit assignments and tasks for the day, they think about the evidence based guidelines for delegation. Which elements are part of the Five Rights of Delegation? Select all that apply. o Right supervision. o Right documentation. o Right circumstances. o Right task. o Right instructions. o Right purpose. o Right supervision. · Supervision is directing, guiding, and evaluating the task performance quality of assistive personnel. o Right circumstances. · Circumstances are a very important element of clinical decision making. The contextual elements of circumstances include policies and procedures, area of nursing, client condition, and preferred client results. o Right task. · The right task is one that can be safely delegated for a specific client, given that client’s current condition, preferred outcomes, and availability of a competent individual to perform it. o Right instructions. · The right directions or instructions is an important part of the five rights of delegation. The person receiving delegation needs to know specifically what the delegator expects. The charge nurse checks the code cart and equipment for safety and function. Which inspections are necessary to ensure that the defibrillator is serviceable and ready for use during an emergency? Select all that apply. o Code cart seals are not broken. o Electrical cords are in good repair. o Defibrillator passes a system check. o A bag valve mask resuscitator is present. o Defibrillator pads/paddles are available. o Suction equipment is present. o Electrical cords are in good repair. · Electrical cords must be in good repair to avoid a safety hazard and for the defibrillator unit to be serviceable and ready for use during an emergency. o Defibrillator passes a system check. · The defibrillator should pass a system check at the beginning of every shift to ensure that the defibrillator unit is serviceable and ready for use during an emergency. o Defibrillator pads/paddles are available. · Defibrillator paddles or pads are required to deliver the electrical impulse to the client during an emergency. The charge nurse sees a staff member arriving late and walking off balance. Which action is the most important intervention for the charge nurse to take? o Ask the staff member to join them in the nurse manager’s office. o Provide the staff member with a clinical assignment for the day. o Have the staff member perform a Romberg test in the nurses’ station. o Tell the staff member to clock out and send them home for the day. o Ask the staff member to join them in the nurse manager’s office. · The charge nurse should get the manager involved with evaluating the staff member’s condition. The charge nurse should also assist the manager with documenting evidence and confronting the staff member about the problem. The nurse manager meets the charge nurse and the staff nurse on the unit as they are headed to the nurse manager’s office. The charge nurse and the nurse manager both observe the staff nurse's behavior and the nurse manager asks the staff nurse how things are going. The staff nurse apologizes for being late and makes jokes about how bad the traffic is out there. The staff nurse is asked to go to the nurse manager’s office where the manager asks them to submit to a drug test. Three police officers arrive at the Emergency Department (ED). One of the officers casually asks an experienced nurse, who the police officer knows, to collect a blood sample from a comatose client who arrived by ambulance from a major accident during the previous shift. The experienced ED staff nurse begins to gather the equipment necessary for the requested blood sample and prepares to draw the blood. Which action is most important for the charge nurse to take? o Stop the staff nurse from collecting blood for the police because it is against hospital policy. o Do nothing. The staff nurse is capable of collecting this sample. o Stop the staff nurse and ask the hospital supervisor about the blood sampling policy. o Assist the staff nurse with collecting an adequate blood sample. o Stop the staff nurse and ask the hospital supervisor about the blood sampling policy. · The police officer has not presented any legal grounds for collecting this client’s blood, which should be found in the hospital policy. Many hospital policies include requiring consent by the client, requiring a legal warrant from a judge, or establishing that the client is under arrest. The charge nurse is a new to the position and should check with their resources before allowing collection of this blood sample by an outside agency without a healthcare provider prescription. The hospital operations supervisor tells the charge nurse that blood cannot be drawn for a law enforcement agency unless the client gives consent, the client is under arrest, or the police officer can provide a warrant from a judge that specifically states that the blood sample collection be drawn. The charge nurse thanks the supervisor and goes to the treatment room where the staff nurse and police officers are awaiting his response. The client remains comatose. The charge nurse tells the staff nurse and the police officers the conditions for blood sample collection and shows them a printed copy of the hospital policy. The staff nurse tells the charge nurse, that they do this all the time and it is no problem. The staff nurse then prepares to collect the blood sample as the police observe. Which is the best action for the charge nurse to take in this situation? o Tell the nurse that this action is unethical, that it violates hospital policy, and that this procedure should stop. o Check on the other unit staff and ensure that they have had their breaks. o Call the hospital supervisor back and confirm the institutional policy. o Defer to the staff nurse who has many more years of experience. o Tell the nurse that this action is unethical, that it violates hospital policy, and that this procedure should stop. · The police officer has still not presented any legal basis for obtaining this blood sample and the experienced staff nurse is about to violate this comatose client’s right to refuse this blood sampling as well as violate hospital policy. With this response, the charge nurse is using the evidence-based team STEPPS® approach to address unsafe or unethical actions by applying the acronym CUSS (Concerned, Uncomfortable, Safety/Ethical issue, Stop). The experienced staff nurse stops immediately and a police officer calls a police supervisor. A judge provides a warrant and then the nurse collects the blood sample. Soon, an agitated older client with acute altered mental status arrives by ambulance. The emergency medical service (EMS) personnel have the client strapped to a gurney and are standing in the hall way waiting for instructions. The triage nurse asks the charge nurse which treatment room is available for an agitated older client with acute altered mental status. Which treatment room would be the most ideal place for this client? o Clean gurney in the hall way. o First available treatment room. o Room nearest the nurses’ station. o Trauma treatment room. o Room nearest the nurses’ station.