Chapter 8
Unlicensed Assistive Personnel
and the Registered Nurse
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Terminology
Unlicensed assistive personnel (UAP) includes
Nurse aides, nurse extenders
Health care aides
Technicians
Patient care technicians
Orderlies
Assistants or attendants
Nursing assistive personnel (NAP): replacement term by ANA in 2007
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Motivation to Use UAP
Arguments
Maximize human resources: free professional nurses from tasks and assignments not requiring independent thinking and professional judgment (nonnursing tasks and functions)
Cost savings: conflicting findings in research
Controversy
UAP are not supplements but replacements of professional RN staff
Variation in scope of practice and lack of minimum educational and training requirements
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Top Reasons for Being Pulled Away from Patient Care
Documenting information in multiple locations
Completing logs, checklists, and other unnecessary paperwork/data collection
Filling out regulatory documentation
Entering/reviewing orders
Walking to equipment/supply areas, utility rooms, etc.
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Educational Requirements
OBRA regulations for certified nurse’s aides
Minimum of 75 hours of state-approved theory and practice
Successful completion of competency exam in both areas
Most UAP training in employing facility with no formal certification
Formal training at vocational schools and community colleges; focus on long-term care; certification only to meet state requirements
Education for acute care settings facility-based; no required educational standards or guidelines
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Question #1
Is the following statement true or false?
Currently, strict standards related to the educational requirements are in place for UAP.
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Answer to Question #1
False
Wide variations exist in the educational requirements for UAP. For example, OBRA regulations require a minimum of 75 hours of theory and practice, and successful completion of an exam in both areas, while in other cases, training occurs in a facility with no formal certification.
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Certified Medicine Aides
Have worked in licensed nursing home settings, residential care settings, and adult day services in this country for almost four decades
RNs reported feeling pressured to delegate medication administration to UAPs because of inadequate organizational personnel and finances
“Handing over a crucial nursing responsibility under jeopardizing circumstances” (see Research Fuels the Controversy 8.1)
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UAP Scope of Practice #1
ANA: 6 actions necessary to create a national and/or.