Principals used by the delegating RN when working with UAP in an acute care setting are based on the needs and condition of the healthcare consumer. The patient is evaluated for stability of condition, potential for harm, complexity of tasks needed, and qualifications and abilities of the UAP delegated to complete these tasks. The decisions regarding delegation of assignments are based on the fundamentals of the safety and welfare of the patient. “RN must carefully assess what skills and knowledge each UAP has or risk increased personal liability for the failure to do so” (Houston, 2017). Protection of both the licensed RN and the patient remains the responsibility of the supervising RN; both RN and UAP must be forthcoming when asked to complete a task they are not familiar with or out of their scope of practice. “RN must make no assumptions about the educational preparation or training of a UAP” (Houston, 2017). The RN must never lose sight that the responsibility is to provide appropriate high-quality care and that the UAP may take the place of a licensed professional, but their scope of practice varies with the institution and training is generally facility based. UAP must be delegated tasks within the scope of practice within the institution, medication administration is not permitted unless the state has granted UAP the right to pass medications within certain settings such as schools and long-term care facilities. “Only RN’s have the formal authority to practice nursing and activities that rely on the nursing process or require specialized skill, expert knowledge or professional judgement should never be delegated” (Houston, 2017). New York state reports that the RN works independently under their license and is held to a standard of excellence; the RN may also be held responsible for the UAP and the care the provide when working under the RN’s license. “The dynamic of a continuously changing healthcare climate and the expectations of the nursing profession compel RN’s, as members of the interprofessional healthcare team, to be vigilant and action oriented regarding nursing practice and RN delegation” (ANA, 2012).

American Nurses Association. (2012). ANA’s Principal for Delegation by Registered Nurses to Unlicensed Assistive Personnel (UAP). Retrieved from http://www.nursingworld.org (Links to an external site.)

Huston, C. Professional Issues in Nursing. [Bookshelf Ambassadored]. Retrieved from https://ambassadored.vitalsource.com/#/books/9781975140366/ (Links to an external site.)

Office Of The Professional- New York State Education Department. (2016). Nursing Guide to Practice.Retrieved from hhtps://www.op.nysed.gov