Delegation in long-term care: Scope of practice or job description?

This article presents a qualitative, descriptive study of how registered nurses (RNs) (N=33) in leadership roles in institutional, long-term care settings delegate care. Findings from this study include both the strategies and processes these nurses used for delegating care and also their perceptions of barriers to effective delegation and potential benefits of delegation. Nurses reported two key approaches to delegation, including the “follow the job description†approach, which emphasized adherence to facility-level roles and job descriptions, and the “consider the scope of practice†approach, which emphasized consideration of multiple aspects of scope of practice and licensure along with the context of care. While the former approach 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. Perceived 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. Future directions regarding delegation in long-term care settings are disclosed.