Prescribed: hydromorphone continuous infusion at 1 mg/hr

Available: hydromorphone 20 mg/100 mL DSW

How many mL/hr will the nurse program the IV pump? Record your answer in whole number.

Effective nursing delegation is governed by the Five Rights of delegation, which ensure clinical safety when transferring tasks to unlicensed assistive personnel (UAP). The nurse maintains ultimate accountability for patient outcomes, necessitating continuous oversight and evaluation of the delegated task to prevent clinical negligence.

Rationale:

A. Informed consent is a legal requirement for procedures or research participation where risks and benefits are disclosed to the patient. It does not apply to the interprofessional delegation of routine physiological measurements like blood pressure. This concept involves patient autonomy rather than nursing supervision.

B. The nurse failed to provide adequate supervision and evaluation, which includes monitoring performance and ensuring clear communication of reporting parameters. The RN must verify that the UAP knows to report hemodynamic instability immediately. This oversight is a breach of professional delegatory responsibility.

C. Checking vital signs is the right task to delegate to a UAP as it is a routine, non-invasive procedure. The error did not occur because the task was inappropriate, but rather because the follow-up was insufficient. The task itself falls within the standard UAP scope of practice.

D. A UAP is generally the right person to measure blood pressure in a stable environment. There is no evidence in the prompt that the individual lacked the technical competency to use the sphygmomanometer. The failure was in the management of the personnel rather than their selection.

SBAR communication ensures structured, concise, systematic, clinical-communication during patient care transitions. It standardizes information exchange by organizing situation, background, assessment, and recommendation, reducing miscommunication, improving provider response time, and enhancing patient safety outcomes.

Rationale:

A. Incorporating personal feelings about the patient introduces subjective bias into clinical communication. SBAR requires objective, factual data only. This subjectivity compromises clarity and professionalism. It detracts from clinical accuracy and may lead to misinterpretation of patient status.

B. Introducing self to the provider establishes professional identification before communication begins. It ensures clarity of the caller’s role and accountability. This introduction facilitates effective interaction. It supports communication by ensuring the provider recognizes the nurse and clinical context.

C. Including the names of family members at bedside is not essential unless directly relevant to care decisions. SBAR prioritizes critical clinical data. This information is extraneous in most cases. It does not enhance clinical-communication or immediate decision-making processes.

D. Implicating others in the patient's care introduces blame and is unprofessional. SBAR focuses on patient status and recommendations. This behavior disrupts collaboration. It undermines teamwork and does not contribute to effective clinical communication.