Medication Delegation and Supervision Workflow
Key Points
- Delegation of medication tasks is jurisdiction- and policy-dependent and may include UAP in some states.
- The nurse remains legally accountable for delegated medication tasks.
- Assessment, planning, teaching, evaluation, and nursing judgment cannot be delegated.
Equipment
- Current state regulations and facility delegation policy
- Patient-specific medication plan and MAR
- Delegation communication and supervision checklist
- Documentation pathway for delegated-task oversight
Procedure Steps
- Verify whether medication delegation is permitted in current jurisdiction and facility policy.
- Confirm delegated personnel competency and scope alignment for assigned task.
- Perform required nursing assessment before delegation decision.
- Provide clear task instructions, timing, and expected observation/reporting criteria.
- Supervise delegated medication activity throughout the administration process.
- Remain available for clinical judgment decisions and unexpected patient changes.
- Complete nursing teaching responsibilities that cannot be delegated.
- Reassess patient response and evaluate medication effectiveness after administration.
- Document delegation, supervision actions, and patient outcomes.
- Escalate immediately if delegated task safety concerns arise.
Common Errors
- Delegating tasks outside policy/scope → legal and patient-safety risk.
- Assuming delegated task transfers accountability → RN remains responsible.
- Inadequate supervision during administration → delayed recognition of adverse response.
- Failing to document oversight actions → continuity and legal vulnerability.
Related
- medication-error-reporting-and-escalation - Supervision gaps or delegated-task failures require prompt reporting workflow.
- medication-administration-documentation-and-reassessment - Post-administration reassessment remains an RN responsibility.