Case Study, Chapter 8, Unlicensed Assistive Personnel and the Registered Nurse
The increased use of unlicensed assistive personnel presents both opportunities and challenges for the American health care system. The nurse manager has to deal with the challenge that unlicensed assistive personnel only be used to provide personal care needs or nursing tasks that do not require the skill and judgment of the RN.
1. The nurse manager reviews the national effort to define the scope of practice for unlicensed assistive personnel. In 2007, the American Nurses Association made recommendations for a national and/or state policy for nursing assistive personnel. What are the six actions that should be taken to create a national and/or state policy agenda about the educational preparation of unlicensed assistive personnel and the competencies they should have for safe practice?
2. The need in health care today is for today’s nurses to have highly developed delegation skills in working effectively and efficiently with unlicensed assistive personnel. This is critical to ensure the clients’ needs are met and their safety is not jeopardized. What are the key general principles that the nurse manager needs to review with professional registered nurses in delegating to unlicensed assistive personnel?
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As a medical professor in charge of creating college assignments and answers for medical college students, I believe it is essential for student nurses to understand the role of unlicensed assistive personnel (UAP) in the health care system. The increased use of UAP presents both opportunities and challenges that must be addressed by nurse managers to ensure the delivery of safe and quality care.
1. The American Nurses Association (ANA) made recommendations for a national and/or state policy for nursing assistive personnel in 2007. The following six actions should be taken to create a national and/or state policy agenda about the educational preparation of unlicensed assistive personnel and the competencies they should have for safe practice:
a) Define the scope of practice for UAP in various healthcare settings
b) Develop standardized competencies for UAP education and training
c) Establish a formalized education and credentialing system for UAP
d) Create a process for determining UAP competency and ongoing evaluation
e) Establish a mechanism for continuous quality improvement and oversight of UAP practice
f) Collaborate with stakeholders to promote the safe and effective use of UAP in the healthcare system
2. Delegating tasks to UAP requires highly developed skills from professional registered nurses to ensure safe and quality care for clients. The following key general principles must be reviewed with professional registered nurses when delegating tasks to UAP:
a) Clearly define the task to be delegated and ensure its appropriateness for delegation to UAP
b) Verify the competency of the UAP to perform the task and provide education and training as necessary
c) Monitor the UAP’s performance and provide feedback and supervision as needed
d) Communicate effectively with the UAP and other healthcare team members regarding the delegated task
e) Ensure that UAP are aware of client preferences and limitations
f) Verify that the delegated task has been completed to the appropriate standard of care and document appropriately in client records.
In conclusion, understanding the role and scope of practice of UAP is essential for student nurses. Nurse managers must ensure the effective and safe delegation of tasks to UAP while also promoting continuous quality improvement and oversight of UAP practice.
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