Nurses' Perceptions of Effective Delegation in the Acute Care Setting

Nurses in the inpatient setting often have to address multiple patient care concerns and demands, and therefore must delegate tasks to the assigned nursing assistant (Johnson et al., 2015; Magnusson et al., 2017). If the nurse fails to delegate appropriately, tasks may be missed which can result in suboptimal outcomes for patients (Wagner, 2017). Ineffective delegation also creates barriers to communication and teamwork between the nurse and nursing assistant (Bellury, Hodges, Camp, & Aduddell, 2016; Kaernested & Bragadottir, 2012; Wagner, 2017). Delegation to the nursing assistant allows appropriate tasks to be completed under the supervision of the nurse. This qualitative study guided by grounded theory applied a semi-structured interview format through the use of face-to-face audio recorded interviews to collect data from study participants. The semi-structured interview format included a specific set of topics related to delegation and teamwork among nurses and nursing assistants in the hospital setting to ensure topics related to the study were covered (Polit & Beck, 2017). Purposive sampling was used to select participants that work on the general surgery or inpatient rehabilitation unit at a Magnet-recognized facility in the southeastern United States. The sample size of 10 registered nurses provided the researcher with meaningful data that assisted in the emergence of themes and categories. Data analysis was completed using the analytic method of Glaser and Strauss to assist in the emergence of themes or categories related to the nurse’s perception of their ability to effectively delegate (Polit & Beck, 2017). Findings of this study identified the nurse’s role as a delegator as reactive instead of proactive in meeting the patient’s care needs. Participants in this study expressed the need to delegate only if they were unable to complete the task themselves. A reactive approach to delegation does not support teamwork between the nurse and nursing assistant as individuals are working parallel to each other to complete the task at hand. Additionally, perceptions of the nurse’s ability to delegate and their perception of confidence in delegation did not correlate, confirming the need for further research, as well as training and education.