Improving patient care through effective nurse delegation to assistive personnel
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Toni Hamilton, DNP, RN, Toni.hamilton@icloud.com
- Sigma Affiliation
- Lambda Rho at-Large
Introduction: The well-recognized shortage of registered nurses has amplified the need for additional assistance to deliver essential nursing care in many health care settings. The increasing complexity of health care needs combined with patients’ expectations of receiving immediate care further amplifies this need, especially in acute care. To compensate for this shortage, models of care have been modified to increase the number of assistive personnel (AP). Nursing oversight for patient care is complicated by a continuously changing health care environment and requires licensed nurses to delegate aspects of nursing care to AP while maintaining accountability for patient outcomes. This quality improvement project evaluated the knowledge and willingness of medical-surgical-telemetry nurses to delegate tasks to AP and its impact on patient falls and hospital-acquired pressure injuries (HAPI) for a two-month period after an educational intervention.
Methods: A pre/post survey design was employed to assess the knowledge and willingness of medical surgical-telemetry nurses to delegate tasks to AP working within a new caregiver model after receiving an educational intervention. Patient falls and HAPI rates were collected pre/post intervention and compared for statistical differences.
Results: Key findings associated with the aims of this project which were to decrease unit falls and HAPI rates during the project period by 5% and increase nursing knowledge related to delegation by 25% were not achieved. The results lacked statistical significance for improving the outcomes measured.
Conclusions: The findings of this quality improvement project provided marginal support for the existing evidence that education on delegation has the potential to increase RN knowledge, but this element alone may not be enough to ultimately impact patient outcomes related to patient falls and HAPI. Further studies are needed to explore the barriers associated with a lack of or poor delegation practices amongst nurses to AP in acute care and other health care settings.
| Type | DNP Capstone Project |
| Acquisition | Self-submission |
| Review Type | None: Degree-based Submission |
| Format | Text-based Document |
| Evidence Level | Quality Improvement |
| Research Approach | N/A |
| Keywords | Nurse Delegation; Nursing Supervision; Assistive Personnel; Communication |
| Grantor | Jacksonville University |
| Advisor | de Tantillo, Lila |
| Level | DNP |
| Year | 2022 |
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