Chapter 7: Prioritizing Client Care: Leadership, Delegation, and Emergency Response Planning

Different nursing delivery models—functional, team-based, primary, and client-focused approaches—are presented as organizational structures that vary in care continuity and staff coordination. Leadership and management competencies form a central focus, with examination of accountability principles, distinct leadership styles ranging from authoritarian to transformational approaches, and the concept of empowerment as a mechanism for enabling team autonomy through collaborative decision-making. The integration of evidence-based practice into nursing care is emphasized, requiring nurses to synthesize current research findings with clinical judgment and patient values, supported by systematic quality improvement methodologies such as concurrent and retrospective audits. The chapter addresses organizational change using Lewin's three-phase model and provides practical frameworks for resolving interpersonal and workplace conflicts through multiple resolution strategies. Delegation emerges as a critical skill, with detailed guidelines establishing which nursing tasks are appropriate for registered nurses, licensed practical nurses, and assistive personnel, underpinned by the five rights framework ensuring safe task assignment. Prioritization methodologies, including the ABC framework and Maslow's hierarchy, enable nurses to sequence interventions based on physiological urgency and patient stability. The final section covers disaster management and mass casualty response, introducing the START triage system that categorizes injured individuals into emergent, urgent, nonurgent, and expectant categories to maximize survival outcomes during resource-constrained emergency situations. Throughout, the chapter integrates clinical judgment models and practical decision-making tools essential for professional nursing practice.