COMMITTEE CHAIR: Dr. Vivian Dawkins

TITLE: ASSESSMENT OF ADVANCED PRACTICE REGISTERED NURSES (APRNS) DELEGATION PRACTICES IN
PRIMARY CARE CLINICS IN TEXAS: AN EVIDENCE BASE PROJECT STUDY

ABSTRACT: Primary care delivery increases capacity and utilizes Advanced Practice Nurses to deliver high-quality, cost-effective care. Unlicensed assistive personnel (UAP) are low- cost and employable resources to add to the primary care team. The APRNs are leaders, and many tasks are delegated to the UAP in busy primary care clinic. Delegation is an essential, complex nursing skill that Advanced Practice Nurses (APRNs) utilize to function more effectively and efficiently. The Texas Board of Nursing (BON) governs the practice of all nurses and the established rules and standards must be known and understood so that APRNs can delegate efficiently and effectively.

This DNP project aimed to identify knowledge and practice of the APRN’s regarding delegation of medication administration to UAPs according to a rule stipulated by the Texas BON. A survey was developed and placed in Qualtrics that included three components: an assessment of practices, knowledge of the delegation rule, and demographic information for the APRNs. Permission to place the invitation on their Facebook page was obtained from the North Harris County Nurse Society and APRNs who were members of the society were invited to participate. The collected data was downloaded in an Excel file from Qualtrics and analyzed using the Intellectus program. The data analysis was placed in frequency and percentage tables.

A physician is present in 44% of the clinics, and 33% of the APRNs delegate medication to the UAPs consistently. 44% of the APRNs incorrectly answered that APRNs can delegate medications to the MAs and 66% of the APRNs incorrectly answered that the physician does not have to be present in the clinic when delegation is given to the MAs regarding medication administration. The study’s outcome, even though limited in terms of the sample size, indicates a need to increase and improve the APRNs practice with knowledge of the delegation rule established by Texas Board of Nursing. Further study with a larger sample size will be essential to firmly establish a need for change in initial APRN education and develop a framework for staff development for APRNs that will include knowledge of the delegation rule and will support a change in practice.

Zoom Meeting:

https://pvpanther.zoom.us/j/91371466107?pwd=QTY2Q3RIemNiRXpjd2RUREJSWlQ1Zz09