Five Rights of Nursing Delegation

Key Points

• Delegation occurs when an RN asks LPN/LVN or assistive personnel to perform a task on the RN’s behalf.
• The RN remains accountable for the delegation decision and outcome.
• Safe delegation requires five rights: task, circumstance, person, communication, and supervision.
• Unstable patients or unclear competencies require immediate RN reassessment.

Pathophysiology

Delegation is a safety-critical workflow decision in dynamic care environments. Errors in delegation can create delayed treatment, omitted reassessment, or inappropriate task execution, increasing preventable adverse-event risk.

Classification

• Right task: Delegated activity is permitted by policy and delegatee role scope.
• Right circumstance: Patient is stable with predictable outcomes for delegated activity.
• Right person: Delegatee has verified competency and required training.
• Right communication: Instructions are clear, specific, and include opportunity for questions.
• Right supervision: RN monitors execution, verifies outcomes, and intervenes when needed.

Nursing Assessment

NCLEX Focus

Before delegating, assess patient stability, delegatee competence, and your ability to supervise in real time.

• Confirm the task is policy-approved for the intended delegatee role.
• Reassess current patient condition for stability and expected trajectory.
• Verify delegatee education/check-offs for specialized skills.
• Determine whether communication pathway supports timely clarifications.
• Ensure RN capacity for follow-up supervision and outcome validation.

Nursing Interventions

• Delegate only tasks that meet all five rights simultaneously.
• Provide concise, explicit directions and expected reporting thresholds.
• Require immediate communication of unexpected findings.
• Perform RN verification for abnormal or high-risk results.
• Document delegation rationale, instructions, and supervision actions.

Accountability Reminder

Delegation transfers a task, not RN accountability for patient safety and care quality.

Pharmacology

Medication-related delegation must follow role limits, policy scope, and RN supervision requirements; when uncertain, the RN should perform the task directly.

Clinical Judgment Application

Clinical Scenario

An RN delegates a patient transfer to assistive personnel and later receives report of near-fall instability.

Recognize Cues: Delegated mobility task now has altered safety context. Analyze Cues: Right circumstance may no longer be met. Prioritize Hypotheses: Patient instability requires RN reassessment before further delegation. Generate Solutions: Reclassify assistance level and adjust delegation plan. Take Action: Intervene directly and update team instructions. Evaluate Outcomes: Transfer proceeds safely with revised support.

Related Concepts

• nursing-diagnosis-and-collaborative-problems - Helps determine when RN-led versus delegated action is appropriate.
• medication-order-types-and-required-components - Supports safe role-based execution after order verification.
• isbar-clinical-handoff-communication - Structured communication framework that improves delegation clarity.

Self-Check

1. Which patient factors can invalidate the right circumstance after delegation begins?
2. Why does right person require competency verification, not assumption?
3. What supervision actions are mandatory when delegated findings are abnormal?