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ANA’s Principles for Delegation | Definitions • 6
assessment and evaluation of the impact of interventions on care provided to
the patient (adapted from Fowler, 2008, p. 49).
Delegation involves “the transfer of responsibility for the performance of a task
from one individual to another while retaining accountability for the outcome.
Example: the RN, in delegating a task to an assistive individual, transfers
the responsibility for the performance of the task but retains professional
accountability for the overall care” (ANA, 2010a, p. 64).
Healthcare consumer. “The person, client, family, group, community, or population
who is the focus of attention and to whom the registered nurse is providing services as
sanctioned by the state regulatory bodies” (ANA, 2010a, p. 65).
Nursing process. “A critical thinking model comprising the integration of
singular, concurrent actions of these six components: assessment, diagnosis,
identification of outcomes, planning, implementation, and evaluation” (ANA,
2010b, p. 41).
Responsibility. The ANA has stated that responsibility involves liability with
the performance of duties in a specific role (ANA, 2001). Responsibility is a
two-way process that is both allocated and accepted (adapted from CHCM,
2007, p. 34; Weydt, 2010). Assistive personnel accept responsibility when they
agree to perform an activity delegated to them (Weydt, 2010).
Supervision. ANA defines supervision to be the active process of directing,
guiding, and influencing the outcome of an individual’s performance of a task.
Similarly, the National Council of State Boards of Nursing (NCSBN) defines
supervision as the provision of guidance or direction, oversight, evaluation, and
follow-up by the licensed nurse for the accomplishment of a delegated nursing
task by assistive personnel. Individuals engaging in supervision of patient
care should not be construed to be managerial supervisors on behalf of the
employer under federal labor law (ANA & NCSBN, 2006).
Unlicensed assistive personnel (UAP). An umbrella term to describe a job
class of paraprofessionals who assist individuals with physical disabilities, mental
impairments, and other healthcare needs with their activities of daily living and
provide care—including basic nursing procedures—all under the supervision
of a registered nurse, licensed practical nurse, or other healthcare professionals.
They provide care for healthcare consumers in need of their services in
hospitals, long-term care facilities, outpatient clinics, schools, private homes,
and other settings. UAP by definition do not hold a license or other mandatory
professional requirements for practice, though many hold various certifications.