Professional Practice, Safety, and Quality
Delegation, Scope, and Quality Improvement
Professional practice questions test prioritization, delegation, and legal-ethical judgment. Know what can be delegated to assistive personnel (vital signs on stable patients, hygiene, ambulation) versus what requires a nurse (assessment, teaching, medication administration, evaluating outcomes). Use the nursing process to prioritize: ABCs, then safety, then psychosocial needs. Understand informed consent - the provider explains, the nurse witnesses and verifies understanding. Know the chain of command for unsafe situations and the nurse's duty to report errors and suspected abuse. Quality improvement uses data to change practice; root cause analysis examines systems rather than blaming individuals.
Traps to Watch
Questions often place a stable task and an unstable patient in the same scenario - always assess the unstable patient first. Do not delegate teaching or evaluation. Do not accept a verbal order without read-back verification. Also, the nurse's first action in an unsafe staffing situation is to follow the chain of command, not to abandon the assignment.
Rule of Thumb
Delegate the task, not the nursing process. If the answer requires judgment, assessment, or teaching, it stays with the nurse.
Worked Example
A nurse has four patients. The most appropriate action is to assess the patient with new shortness of breath first, while delegating stable vital signs and hygiene to assistive personnel.