The five rights of delegation: the right task, the right circumstance, the right person, the right direction and communication, and the right supervision and evaluation.
The boundary that never moves: the RN cannot delegate the nursing process. Assessment, nursing diagnosis, evaluation of care, initial teaching, care planning, and any unstable or unpredictable patient stay with the registered nurse — no matter how routine the task looks or how busy the unit is.
The rights of medication administration: right patient (two identifiers — never the room number), right drug, right dose, right route, right time, right documentation, right reason and right response. The last two are the ones students skip and the examination loves.
High-alert medications (ISMP): insulins, opioids, anticoagulants including heparin and warfarin, concentrated electrolytes such as potassium chloride and hypertonic saline, neuromuscular blockers, chemotherapy and sedatives. All require an independent double check.