Accountability cannot be transferred, in contrast to authority and duty. Instead, it comes with the territory when authority is granted. Everyone who embarks on a project and accepts a position in an organization has responsibility for the results of their work.

1. Chapter 17
Delegating: Authority,
Accountability, Responsibility
in Delegation Decisions

2. Learning Outcomes
 Examine the role of the employer or nurse leader,
nurse delegator and delegatee in the delegation
process.
 Distinguish between authority, accountability and
responsibility in the delegation process.
 Evaluate how tasks and relationships influence the
process of delegation.
 Describe the challenges of delegating to unlicensed
nursing personnel (UNP).
 Identify strategies to overcome underdelegation,
overdelegation, and improper delegation.
 Comprehend the legal authority of the registered
nurse in delegation.

3. Delegation: An Art and Skill of
Professional Nursing Practice
 A multifaceted decision-making strategy
 Implemented to improve the work
performance of staff in the healthcare
organization
 Implemented to achieve nursing goals and
improve patient care outcomes

4. Nurse Practice Act (NPA)
 Rules and regulations and policies for state
 Set up by each state
 NPA has jurisdiction of delegation

5. Delegation Terms (1 of 2)
 Responsibility
 Reliability, dependability, and obligation to
accomplish work.
 Authority
 Ability to perform duties in a specific role
 Accountability
 If actions were appropriate, includes a detailed
explanation

6. Delegation Terms (2 of 2)
 Delegator
 Licensed nurse who delegates nursing
responsibilities or allocates a portion of work
related to patient care
 Delegatee
 Individual who is delegated a nursing
responsibility by a licensed nurse, competent to
perform task or activity and must verbally accept
responsibility

7. Assignment vs Delegation
 Assignment is accepting the care within the
scope of practice of the nurse
 Delegation is when specific task are
requested and be completed and overseen
by the licensed person

8. Organizational and Individual
Accountability
 Organizational Accountability
 Crucial to delegation
 Relationship based
 Shared governance fosters
 Individual Accountability
 Individuals’ ability to explain actions
 Requires one to be answerable for actions

9. Legal Authority to Delegate
 Nurse retains accountability
 Legally responsible
 Must ensure task is completed by right
person
 Person must be supervised

10. The Five Rights of Delegation
 Task
 Appropriate and legal
 Circumstance
 Appropriate environment/resources/ equipment
 Person
 Willing and able with expertise
 Direction/Communication
 Clear/concise instructions
 Supervision
 Monitor and evaluate patient

11. Situational Leadership Model®
 Follower’s Readiness: Ability and
willingness
 Ability: job readiness
 Willingness: psychological readiness
 Leaders/managers need to behave
differently in specific situations

12. Challenges of Delegating
 Often unlicensed nursing personnel are the
delegatee
 Job descriptions vary
 Multiple designations and levels
 Requires awareness of individual ability

13. Delegating in Diverse Teams
 Complicated by multiple factors
 Age
 Gender
 Ethnicity
 Culture

14. Barriers to Effective Delegation
 Underdelegation
 Overdelegation
 Improper Delegation

15. Conclusion
 Multifaceted Process
 Learned skill
 Requires critical thinking and clinical
judgements
 Understand delegation skills