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Delegation or directive?
In my practice setting, there is a directive that authorizes nurses to perform defibrillation in specific circumstances. Does this directive serve as the delegation of the controlled act?
No. A directive is an order for more than one client when certain conditions are met. The wording in a directive may refer to a delegation but the directive, in itself, is not delegation.
Delegation and orders (e.g., direct orders and directives) are two distinct authorizing mechanisms. If a nurse is going to perform a procedure that involves a controlled act that is not authorized to them via the Nursing Act, 1991 (e.g., applying a form of energy), that nurse would need delegation as well as an order to perform the procedure. Having an appropriate directive in place satisfies the requirement for an order, but not the requirement for delegation.
Delegation is a process whereby a health professional transfers the authority to perform a controlled act procedure to another individual who would not otherwise have the authority. When nurses accept delegation, they must ensure that they meet the requirements for accepting delegation which are listed in the Authorizing Mechanisms practice guideline. Delegation occurs appropriately when a nurse has met all of the requirements for accepting delegation.