In acute care settings, registered nurses need to delegate effectively to unlicensed assistive personnel to provide safe care. This project explored the impact of improved delegation-communication between nurses and unlicensed assistive personnel on pressure injury rates, falls, patient satisfaction, and delegation practices. Findings revealed a tendency for nurses to delay the decision to delegate. However, nurses' ability to explain performance appraisals, facilitate clearer communication, and seek feedback improved. Patient outcomes revealed decreased falls and improved patient satisfaction.