You are the charge nurse in a long-term care (LTC) facility that employs RNs, LPNs/LVNs, and UAPs. When you are planning care for a resident with a stage III sacral pressure ulcer, which nursing intervention is best to delegate to an LPN/ LVN?

• A. Choosing the type of dressing to be used on the ulcer
• B. Using the Norton scale to assess for pressure ulcer risk factors
• C. Assisting the client in changing position at frequent intervals
• D. Cleaning and changing the dressing on the ulcer every morning

Answer: (D)

Delegation in nursing rests on matching the task to the team member’s scope and the task’s predictability. For a resident with a stage III sacral pressure ulcer, routine wound care is a stable, repetitive task that the LPN/LVN can perform with an order and facility protocol. Cleaning and changing the dressing each morning fits this role because it involves established steps to maintain wound cleanliness, protect the site, and monitor for changes, while the RN oversees overall assessment and plan adjustment. The LPN/LVN can document wound status and report any concerning findings to the RN, who retains responsibility for evaluating healing and altering the treatment plan.

Choosing the dressing type requires current wound assessment and clinical judgment, which is higher-level nursing decision-making. Using a risk-assessment scale is an RN-level assessment task. Assisting a patient with repositioning is typically a task for UAPs, though the LPN/LVN can support or supervise that care as appropriate.