Q: We recently hired an assistant director of nursing. As the director of nursing services, what are some tasks I could delegate? 

A: The DNS is accountable for monitoring nursing activities and supervising nursing staff — a complex role for one person to perform alone. Working with an ADON, however, you can more readily improve quality and outcomes for residents and the work environment for staff. 

Consider how the two roles could complement one another. Develop a master list of DNS tasks and determine which you can delegate. Evaluate the ADON’s strengths. If the person is well-organized, assign tasks requiring these skills. If analytical, consider assigning investigations. Here are other tasks to consider: 

Daily tasks: reviewing new admissions to ensure all assessments are completed timely, reviewing incident reports, reviewing new orders to ensure they are care-planned appropriately, reviewing discharge paperwork. 

Weekly tasks: leading resident-at-risk meetings, reviewing wound documentation, reviewing SBARs, reviewing infections and antibiotic prescribing, logging employee infections, reviewing weight logs, tracking and following up on lab data, reconciling narcotic count sheets.

Monthly tasks: monthly order reviews,  systems auditing, reviewing restorative programs and monthly restorative notes, gradual dose-reduction monitoring. 

Quarterly tasks: data tracking for QAPI, staff in-services; medication auditing, survey prep audits and education. 

Make sure the delegations are equitable and fair, with clear expectations. For both delegated and retained tasks, list requirements and frequency. Then, if one of you is unavailable, the other can fill in or delegate to another person..