An RN has delegated measurement and documentation of hourly intake and outputs (I&Os) on the cardiac care unit to a certified nurse assistant (CNA). Which principle of delegation applies in this situation?

Choice A reason: The nurse remains accountable for delegated tasks, ensuring they are performed correctly. In delegating I&O measurement to a CNA, the RN retains responsibility for patient outcomes, verifying accuracy and appropriateness of the task, as unlicensed personnel operate under the nurse’s license and oversight. Choice B reason: The nurse is not required to perform delegated tasks alongside the CNA. Delegation involves assigning tasks within the CNA’s scope, such as I&O measurement, while the nurse oversees and verifies outcomes. Performing the task together negates the purpose of delegation, which is to distribute workload efficiently. Choice C reason: The nurse must follow up on delegated tasks to ensure accuracy and patient safety. Assuming the CNA’s competence without verification risks errors in I&O documentation, which can affect fluid balance management in cardiac patients, potentially leading to complications like heart failure exacerbation. Choice D reason: While ensuring CNA competence is important, the primary principle is accountability. The nurse must confirm the CNA’s ability before delegation but remains responsible for the task’s outcome. Competence assessment is a prerequisite, but accountability encompasses ongoing oversight and responsibility for the delegated task’s execution.