title: Delegation in Long-term Care: Scope of practice or job description?
abstract: This study is a qualitative, descriptive study of how registered nurses (RNs) (N=33) in leadership roles in institutionalized long-term care settings delegate care, including their strategies and processes for delegating care, and their perceptions of barriers to effective delegation and potential benefits of delegation. Findings indicate two key approaches to delegation, including the "follow the job description" approach, emphasizing adherence to facility-level roles and job descriptions, and the "consider the scope of practice" approach, emphasizing consideration of multiple aspects of scope of practice and licensure, and the context of care. While the former resulted in more clarity and certainty for the RN, the latter facilitated a focus on quality of resident care outcomes as linked to the delegation process. Barriers to effective delegation were comparable among RNs using either approach to delegation, and almost all RNs could describe benefits of delegation for long-term care.
authors.affiliation: School of Nursing, Duke University Medical Center ; Center for the Study of Aging and Human Development, Duke University Medical Center.
authors.forename: Kirsten N
authors.initials: KN
authors.lastname: Corazzini
authors.affiliation: School of Nursing, Duke University Medical Center ; Center for the Study of Aging and Human Development, Duke University Medical Center.
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Anderson
authors.affiliation: School of Nursing, Queens University.
authors.forename: Carla Gene
authors.initials: CG
authors.lastname: Rapp
authors.affiliation: School of Nursing, University of Minnesota.
authors.forename: Christine
authors.initials: C
authors.lastname: Mueller
authors.affiliation: School of Nursing, Duke University Medical Center ; Center for the Study of Aging and Human Development, Duke University Medical Center.
authors.forename: Eleanor S
authors.initials: ES
authors.lastname: McConnell
authors.affiliation: School of Nursing, Duke University Medical Center.
authors.forename: Deborah
authors.initials: D
authors.lastname: Lekan
keywords: delegation; licensed practical nurses; long-term care; nurse practice acts; nursing assistants; nursing homes; professional nursing practice; qualitative research; quality of care; registered nurses; scope of practice