Nursing Delegation Made Simple: The Five Rights Framework for NCLEX Questions
Master nursing delegation for the NCLEX using the Five Rights framework. Learn what RNs can delegate to LPNs and UAPs with clinical examples.
Nursing Delegation: The Five Rights Framework
Delegation questions appear frequently on the NCLEX and often cause confusion. Using the Five Rights of Delegation framework provides a systematic approach to answering these questions correctly every time.
Right Task
The task must be within the delegate scope of practice and competency. RNs cannot delegate assessment, planning, evaluation, or tasks requiring nursing judgment. Tasks that can be delegated to UAPs include vital signs on stable patients, bathing and hygiene, ambulation of stable patients, intake and output measurement, and feeding (without swallowing precautions). LPNs can perform medication administration (in most states), wound care, tracheostomy suctioning, and data collection (not assessment).
Right Circumstance
Consider the patient condition and complexity. Stable patients with predictable outcomes are appropriate for delegation. Do not delegate care of unstable patients, newly admitted patients, or patients with changing conditions. A patient one day after surgery who is ambulating well can have vital signs delegated to a UAP. A patient who just returned from cardiac catheterization should not have vital sign monitoring delegated.
Right Person
The right person is qualified, competent, and has demonstrated the necessary skills. Consider the delegate education, training, and experience. A new UAP may need more supervision than an experienced one for the same task. The RN is responsible for knowing the capabilities and limitations of each team member.
Right Direction and Communication
Provide clear, specific instructions including what to do, when to do it, what to report, and when to report. Instead of saying take vital signs, say take vital signs every 4 hours and report immediately if blood pressure is above 160/90 or below 90/60 or if heart rate is above 100 or below 60. Clear communication prevents errors and ensures appropriate follow-up.
Right Supervision and Evaluation
The RN retains accountability for the delegated task. Follow up on delegated tasks, evaluate outcomes, and provide feedback. Intervene if the delegate reports abnormal findings or if the patient condition changes. The RN cannot delegate the responsibility to supervise. Practice with our category guide mini-exams and review delegation cheat sheets.