NURSING AND HEALTH

American Nephrology Nurses' Association: Position Statement

American Nephrology Nurses' Association: Position Statement

The American Nephrology Nurses' Association (ANNA) believes every patient has the right to professional nursing care that encompasses all aspects of the nursing process and meets or exceeds the ANNA Standards and Guidelines of Clinical Practice for Nephrology Nursing. This is to include, but is not limited to, assessment of patient needs, the development of a plan of nursing care, implementation of nursing interventions, and the monitoring and evaluation of these nursing actions. The ultimate goal of the nursing process is to effect positive patient outcomes. ANNA recognizes that achievement of favorable patient outcomes is a collaborative effort between nurses, physicians and other personnel. The American Nurses Association has developed position statements that are helpful in answering questions about assistive personnel and delegation of tasks. The American Nurses Association has recognized that the fundamental principles for appropriate use of assistive personnel in nursing include the following concepts:

The nursing profession determines the scope of nursing practice

The nursing profession defines the roles of assistive personnel involved in providing direct patient care

The nursing profession defines the education, training and utilization for any unlicensed assistive roles;

The RN is responsible and accountable for the provision of nursing practice

The RN supervises and determines the appropriate utilization of any unlicensed assistant

The purpose of unlicensed assistive personnel is to enable the professional nurse to provide nursing care for the patient

Delegation has been defined as “the transfer of responsibility for the performance of an activity from one person to another while retaining accountability for the outcome” (ANA, 2005). The American Nurses Association's legal definition for delegation is “transfer of responsibility for the performance of a selected nursing task from a licensed nurse authorized to perform the task to someone who does not otherwise have the authority to perform the task” (Rule 4723-13-01(C) OAC).The National Council of State Boards of Nursing (NCSBN) (1995) has summarized the five rights of delegation which are found in the accompanying box.

Regulatory Guidelines for Delegation

The American Nurses Association developed regulatory guidelines for the delegation of tasks to assistive personnel that have been in effect since 1995.These rules were developed from professional standards and literature and are consistent with the Nurse Practice Act. The American Nurses Association regulations governing delegation are legally binding on nurses licensed in United States. A thorough understanding of these rules is essential. Not only must nurses protect their own licenses by knowing what is expected of them, but by knowing the law, they can also protect their patients from unsafe practice. The three guiding concepts set forth in the American Nurses Association rules on delegation (Chapter 4723-13 OAC) include:

A registered nurse must assess the situation or circumstances involved when delegation is being considered.

The unlicensed person must have the current ability to perform the task safely.

The delegating nurse or other licensed nurse must supervise the performance of the task.

Delegation Principles

The American Nurses Association's rules on the standards for delegation include the following principles (OBN, 1996):

Delegation is unnecessary if the particular activity or ...