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Table 3 Task delegation and shifting in practice based on our ward observations

From: Exploring the space for task shifting to support nursing on neonatal wards in Kenyan public hospitals

Category of delegation

Task areas

Tasks that can never be delegated to someone other than a qualified professional

Ordering supplies and equipment from the stores and pharmacy

Resuscitation of babies

Final assessment of nursing students to qualify as nurses

Referral of babies from one hospital to an often-higher care hospital

Delegated to student nurses undertaking clinical training attachments

Weighing babies

Taking vital signs observations

Giving intravenous fluids

Filling the nursing Kardex (a summary of individual patient needs used by nurses to communicate important information on their patient and often updated at every shift change).

Giving treatments—either oral, intra-muscular or intravenous

Delegated to mothers

Cup and NGT (naso-gastric tube) feeding of babies

Filling amounts of milk fed to babies on feeding chart

Top tailing (cleaning baby from head to toe)

Delegated to support staffa

Dusting and cleaning incubators

Cup and NGT (naso-gastric tube) feeding of babies

Top tailing (cleaning baby from head to toe)

Tasks sometimes done/left undone


Emotional support

  1. aLong-term casual employees often sub-contracted by the hospital to primarily provide cleaning services within the hospital although they are also often used to run errands within the different departments in the hospital