Which role would the unlicensed assistive personnel UAP?
Leadership | Legal / Ethical | Uncategorized Show
RN, MSN, Chief Nursing Officer Unlicensed personnel are employed in diverse settings and are required to follow the federal/state requirements and accreditation standards set forth by an organization when delegation of tasks and medication administration have been delegated by a Registered Nurse (RN) or Licensed Practical Nurse (LPN). In these various settings, the question has been asked many times if unlicensed assistive personnel (UAP) should be allowed to administer medications that are delegated to them by licensed nurses and if so, what are the proper ways to do so? The North Carolina Board of Nursing (NCBON) and other boards of nursing in various states allow unlicensed assistive personnel to administer medications under the delegation of a Registered Nurse (RN) and/or licensed practical nurse (LPN). The main questions to be considered when dealing with medication administration among unlicensed assistive personnel involving RN/LPN delegation and medication administration. A series of studies conducted suggest that unlicensed assistive personnel can safely administer medications as long as strict compliance is followed with state regulations, adequate training is received and adhered to, and adequate supervision is provided by the registered nurse (Budden, 2012). However, it is important to note that tasks should not be delegated to UAP’s if the patient is “medically fragile”. Tasks should only be assigned if the task needed is low risk, has a predictable outcome, and does not require assessment according to Joyce Fitzpatrick in Encyclopedia of Nursing Research (2017). Even though each organization is required to have policies and job descriptions pertaining to specific UAPs’ responsibilities, the ultimate accountability bears on the RN and/or LPN. It is imperative that the RN/LPN be cognizant of the education, training, and experience of the UAP, and assess competency in the specific tasks. Delegation of UAPs by RNs/LPNsResponsibilites of RN DelegationIn any type of delegation between a RN and UAPs, it is imperative that the RN maintains overall responsibility and accountability in relation to the capabilities of UAP. These include the following:
All of these must be in place and confirmed BEFORE delegation begins in order to ensure that proper delegation is being delivered by the RN with appropriate ongoing supervision, teaching, and evaluation. Responsibilities of LPN DelegationThe LPN must also be accountable for his/her decisions to delegate technical tasks of medication adminisration to UAP and must do the following:
The LPN must ensure that all laws, standards, policies, procedures, and rules are being applied to each specific practice setting. Keys to Successful Medication Administration by UAPsThe key to having successful UAPs administer medications without an increased number of medication errors seems to correlate with how well the staff members have been trained. Each individual facility can choose how to train their staff regarding medication administration practices, and this is the number one way to ward off an alarming high number of medication errors. In a single-state survey conducted of UAPs employed in 45 different facilities, 52% of these facilities were found to have inadequate medication administration training (Carder & O’Keeffe, 2016). It is important to note the relevance of this statistic and allows one to realize how the fundamental source to decrease medication errors among the unlicensed personnel is to ascertain that a strong and qualified medication training program is in place. Likewise, it is imperative that involvement from the RN/LPN is in place and that the training provided is at the appropriate level of a UAP’s understanding. Even though each organization can formulate their own training requirements and the program used among its staff, training and oversight are two of the most successful strategies in meeting this important goal among unlicensed assistive personnel. Criteria needs to be in place to ascertain that medication safety is understood fully and is being utilized in the proper way by unlicensed staff in an effort to make sure that correct procedures are being followed. Strict compliance with state regulations, adequate education, supervision, and proper duties need to be in place for the UAP’s role to function safely. Medication Error PreventionThe following strategies have also been effective in preventing medication errors among various settings and should be implemented:
The Bottom LineThe utilization of medication management among UAPs allows for nurses to directly influence the quality of care through supervision and training of UAPs. The oversight by the RN/LPN is essential in ensuring safety in the medication administration process. While it is fundamental to ensure that UAPs are properly administering medications, it is also important for unlicensed personnel to fully understand the consequences and accountability issues for any medication errors. The importance of extreme and detailed care in medication administration is always encouraged as individual lives are being impacted each time a medication is given. Love what you
read? What is the role of the UAP?According to the American Nurses Association (ANA), the term “unlicensed assistive personnel” (UAP) applies to an unlicensed individual who is trained to function in an assistive role to the licensed nurse in providing patient/client activities as delegated by the nurse.
What are the roles and responsibilities of the unlicensed assistive personnel?UAP provide direct care to patients related to personal hygiene, vital signs, feeding, ambulation, and toileting, and monitor patients' blood glucose and cognition. UAP reorient and redirect patients with cognitive impairment.
Which roles would the nurse assign to unlicensed assistive personnel?Routine tasks, such as taking vital signs, supervising ambulation, bed making, assisting with hygiene, and activities of daily living, can be delegated to an experienced UAP.
What tasks can be delegated to a UAP?In general, simple, routine tasks such as making unoccupied beds, supervising patient ambulation, assisting with hygiene, and feeding meals can be delegated. But if the patient is morbidly obese, recovering from surgery, or frail, work closely with the UAP or perform the care yourself.
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