Delegation and supervision of nursing and midwifery tasks and activities is a fundamental component of a professional registered nurse and registered midwife’s role and responsibilities. These guidelines have been prepared to assist Victorian nurses and midwives to make decisions relating to delegation and supervision in a safe, effective and efficient manner. The guide seeks to reinforce the obligations outlined in existing Nursing and Midwifery Board of Australia (NMBA) publications relating to decision making, and to provide practical recommendations and a framework that will help implement the NMBA’s requirements.
While delegation and supervision has always been a core component of a nurse and midwife’s role, the prevailing healthcare climate encourages team-based models of care where registered nurses and midwives work increasingly with enrolled nurses and care assistants. These changes largely arise from the challenges facing Australia’s healthcare system including: an ageing population; increased chronicity and acuity of disease; technological and practice advances; an ageing workforce; and a constricting labour market.
As the largest component of Australia’s health workforce, nurses and midwives will increasingly be impacted upon by these challenges and must continually look for ways to enhance the delivery of safe, effective and efficient nursing and midwifery care. Delegation and supervision of nursing and midwifery tasks and activities that is based on the needs of the person receiving care allows nurses and midwives an enhanced opportunity to deliver high-quality, person-centred care. In order to be effective, however, nurses and midwives need to have a clear understanding of the requirements of delegation and supervision. These requirements are outlined within documents from the NMBA including its publication A national framework for the development of decision-making tools for nursing and midwifery practice.
While the NMBA’s requirements appear to be reasonably straightforward, an international review of the literature relating to delegation and supervision, as well as discussions with Victorian nurses and midwives, has identified that delegation and supervision is in fact a complex, multifactorial component of a registered nurse and midwife’s role. This process has led to identifying key factors influencing good delegation and supervision practices, which are outlined below and noted in the body of the national framework as key findings.
Registered nurses and registered midwives require access to education specifically designed to develop knowledge and skills in the practice of delegation and supervision of nursing and midwifery tasks and activities.
- Clear organisational policies and procedures will assist delegators/supervisors and delegatees/supervisees to understand the requirements and responsibilities associated with delegation and supervision.
- Development of leadership skills encompassing communication and team engagement is important for safe and effective delegation and supervision.
- Role clarity tools and activities are required. These should include:
- clear, informative position descriptions for all members of the nursing/midwifery care teams
- development and implementation of a capability framework to assist registered nurses and registered midwives to identify skills and competency
- development of documentation that explicitly addresses the key role differentiation between registered nurses, enrolled nurses and care assistants.
- Tools and activities that assist nurses and midwives to fully comprehend and embrace professional accountability and responsibility will enhance delegation and supervision outcomes.
- Point-of-care tools to support delegation and supervision activities will assist nurses and midwives with their practice.
These key findings have formed the basis of the recommendations and a framework to assist Victorian nurses and midwives to safely and effectively undertake the professional requirement of delegation and supervision. The program of work necessary to adopt these recommendations and the associated framework assumes a shared responsibility where individuals, education providers, employers, the Department of Health & Human Services and professional bodies all contribute to the development and implementation of the associated tasks and activities.
The complete Delegation and supervision guidelines for Victorian nurses and midwives is available at the bottom of the page.