Unlicensed Assistive Personnel (UAP)

This position statement was archived on 11/7/2012. AMSN prefers to endorse the position statement of the American Nurses Association (ANA) on Delegation.

IT IS THE POSITION OF AMSN THAT:

  • The provision of safe, accessible, affordable nursing care may include the appropriate utilization of unlicensed assistive personnel (UAP), and changes in the health care environment may alter the activities delegated to UAP.
  • The nursing profession defines and supervises the training and utilization of any UAP. UAP must receive appropriate training and demonstrate competence before assuming new or expanded responsibilities within the clinical setting.
  • Monitoring of the UAP in the clinical setting should be accomplished through existing mechanisms that regulate nursing practice (e.g., state boards of nursing), including clarification of the delegation process and/or restriction of the range of delegable tasks.
  • Any nursing intervention that requires independent, specialized nursing knowledge, skill or judgment cannot be delegated.  While traditional nursing roles may have been redesigned as a result of the nursing shortage, the medical-surgical nurse cannot be replaced by the UAP in the patient care setting.
  • The medical-surgical nurse is responsible and accountable for the decision to delegate patient care activities to UAP, and must provide appropriate supervision during the performance of a delegated task.
  • UAP are accountable to and work under the supervision of the registered nurse when performing a delegated patient care activity.

OVERVIEW:

The ability of the medical-surgical nurse to supervise and delegate to the UAP remains vitally important to the provision of safe and effective patient care.  The registered nurse remains a leader in coordinating patient care and directing the activities of a multi-skilled nursing team.

RATIONALE:

AMSN is committed to the provision of safe, quality patient care through appropriate utilization of a multi-skilled nursing team.

DEFINITIONS:

Unlicensed assistive personnel (UAP) are unlicensed health care providers trained to function in a supportive role by providing patient/client care activities as delegated by the RN.  The term includes, but is not limited to nurse aides, orderlies, assistants, attendants, or technicians. UAP function under the nurse practice act of each state.

Delegation is transferring to a competent individual the authority to perform a selected nursing task in a selected situation (National Council of State Boards of Nursing [NCSBN], 2004). Responsibility for the performance of an activity is transferred to the delegatee, while the delegator retains accountability for the outcome.  The RN uses professional judgment to determine appropriate activities to delegate. The term assignment is used in place of delegation in some states (see state nurse practice acts for individual application of terms).

Supervision is the provision of guidance, direction, oversight, and follow up by the RN for accomplishment of a delegated task by UAP (NCSBN, 2005).

Competence is the ability to integrate knowledge, skills, attitudes, and abilities in order to practice safely and ethically in a designated role and setting (NCSBN, 2005).

Accountability is being responsible and answerable for actions or inactions of self and others in the context of delegation (NCSBN, 2005).

REFERENCES:

National Council of State Boards of Nursing (NCSBN). (2005). Working with others: A position paper. Retrieved October 12, 2009, from https://www.ncsbn.org/Working_with_Others(1).pdf