| "Unlicensed Assistive
Personnel (UAP) is a term describing individuals who
have no licensure to practice nursing at any level, regardless
of his or her experience.
If you are a person seeking information on whether
you can perform certain procedures or ADLs, or whether
you as a client are receiving appropriate services,
please consult the Georgia Secretary of State Web page
and navigate their site for the rules that govern Private
Home Care Providers.
For a State-published Decision Tree, see
below or go to http://www.sos.state.ga.us/plb/rn/decision_tree.htm.
Rule Change 410-11-.01 (2)(a)(b)(c)
| - Adopted: July 20-21, 2000 Board
Meeting -
- Effective 8/31/2000 -
GEORGIA BOARD OF NURSING: STANDARDS OF REGISTERED
PROFESSIONAL NURSING PRACTICE.
AMENDED, CHAPTER 410-11, 410-11-.01 (2)(c)
|
Chapter 410-11
Rule 410-11-.01 (2) (a)(b)(c)
(2) The Georgia Board of Nursing recognizes
that assessment, nursing diagnosis, planning, intervention,
evaluation, teaching, and supervision are the major
responsibilities of the registered nurse in the practice
of nursing. The Standards of Registered Professional
Nursing Practice delineate the quality of nursing care
which a patient/client should receive regardless of
whether it is provided solely by a registered nurse
or a registered nurse in collaboration with other licensed
or unlicensed personnel. The Standards are based on
the premise that the registered nurse is responsible
for an accountable to the patient/client for the quality
of nursing care rendered. The Standards of Registered
Professional Nursing Practice shall establish a baseline
for quality nursing care; be derived from the law governing
nursing; apply to the registered nurse practicing in
any setting; govern the practice of the licensee at
all levels of competency.
a. Standards related
to the registered nurses responsibility to apply the
nursing process (adapted from American Nurses' Association
Code for Nurses and Standards of Practice).
The registered nurse shall:
- assess the patient/client in a systematic, organized
manner;
- formulate a nursing diagnosis based on accessible,
communicable and recorded data
(which is collected in a systematic and continuous
manner);
- plan care which includes goals and prioritized nursing
approaches or measures
derived from the nursing
diagnoses;
- implement strategies to provide for patient/client
participation in health promotion,
maintenance and restoration;
- initiate nursing actions to assist the patient/client
to maximize her/his health
capabilities;
- evaluate with the patient/client the status of
goal achievement as a basis for
reassessment, reordering of priorities, new goal-setting
and revision of the plan of
nursing care;
- seek educational resources and create learning experiences
to enhance and
maintain current knowledge and skills appropriate
to her/his area of practice.
b. Standard related to
the registered nurses responsibilities as a member of
the nursing profession.
The registered nurse shall:
- function within the legal boundaries of nursing
practice based upon knowledge of statues and
regulations governing nursing;
- accept responsibility for individual nursing
actions and continued competence;
- communicate, collaborate and function with
other member of the health team to provide optimum
care;
- seek education and supervision as necessary
when implementing nursing practice techniques;
- respect the dignity and rights of the patient/client
regardless of socioeconomic status, personal
attributes or nature of health problems;
- maintain each patient/clients right to privacy
by protecting confidential information unless
obligated, by law, to disclose the information;
- provide nursing care without discrimination
on the basis of diagnosis, age, sex, race, creed
or color;
- delegate and supervise only those nursing
measures which the nurse knows, or should know,
that another person is prepared, qualified,
or licensed to perform;
- retain professional accountability for nursing
care when delegating nursing intervention;
- respect and safeguard the property of clients,
family, significant others and the employer;
- notify the appropriate party of any unprofessional
conduct which may jeopardize patient/client
safety;
- participate in the periodic review and evaluation
of the quality and appropriateness of nursing
care.
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c. Standards related
to the registered nurses responsibilities in assignment
of patient activities to unlicensed assistive personnel
(UAP).
The registered nurse shall: |
- Determine that the care and/or activity to
be performed would be based upon orders or directions
of a licensed physician, licensed dentist, licensed
podiatrist or person licensed to practice nursing
as a registered professional nurse.
- Assign only the care and activities that do
not require the skills and knowledge of a person
practicing nursing as a registered professional
nurse or licensure of another health care professional.
The care and activities to be assigned must
meet all of the following criteria:
a) The care and/or activities do not require
complex observations or critical decisions.
b) The care and/or activities can be safely
performed according to exact, unchanging directions.
c) The outcome and/or results of the activities
are reasonably predictable.
- Verify that the UAP has the necessary knowledge
and skills to accept the assignment.
- Periodically evaluate and review the quality
and appropriateness of the care provided by
the UAP.
- Not assign activities which require licensure
to an unlicensed assistive personnel.
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Authority O.C.G.A. 43-26-5(a) and O.C.G.A. 43-26-12(a)(5).
Note: The change in the rule was the addition of part
(c) which is highlighted in yellow.
Board Policy
Georgia Board of Nursing
Assignment to Unlicensed Assistive Personnel
Policy Statement |
There has been a substantial increase in the use of unlicensed
assistive personnel UAP) to provide direct patient care
services in the changing health care industry. UAPs are
found performing nursing activities in almost all health
care settings. Because there is a potential that the improper
utilization of unlicensed individuals may result in a
risk to public safety, the Georgia Board of Nursing has
promulgated rules regarding the criteria under which a
registered nurse may assign certain tasks to unlicensed
assistive personnel.
Other states have promulgated rules to define the parameters
within which a licensed nurse may allow an unlicensed
individual to provide direct care to patients. Some
states chose to define task lists for UAPs, often because
the state directly regulates these care providers. However,
by creating task lists for UAPs, an unofficial scope
of practice is created. Also, there is no guarantee
that a licensed health care professional is involved
in the assessment of the patient to determine if the
task can be safely provided by a UAP. Therefore, the
Georgia Board of Nursing has determined that development
of lists of activities that may unequivocally be performed
by unlicensed individuals does not result in the best
protection for the public.
Many states have language in their Nurse Practice Act
that specifically provides for delegation to unlicensed
individuals. OCGA 43-26-1 Georgia Nurse Practice Act
does not provide for delegation of licensed activities
to unlicensed individuals. Based upon well-established
administrative case law, RNs may not delegate activities
which require professional nursing licensure to unlicensed
individuals unless they have specific statutory authority
to do so. If the care and activities under the specific
circumstances do require the knowledge and skills of
a registered nurse, and if a registered nurse permits
an unlicensed individual to engage in these activities,
it is inappropriate delegation of licensed activities.
This inappropriate delegation has regulatory consequences.
However, Registered professional nurses may delegate
professional nursing activities to other licensed individuals
where there is statutory authority within their practice
act to perform such acts. (i.e. Licensed Practical Nurses
who are under the direction and supervision of a Registered
Professional Nurse).
The Georgia Board of Nursing has determined that certain
tasks can be individually assigned to unlicensed individuals
and has generated rules to this end. The Rules have
their statutory basis in O.C.G.A. 43-26-12(a)(3) and
O.C.A. 43-26-12(a)(5). The exemptions for the requirement
of licensure as a registered nurse are that:
- (a) No provision in this article shall be
construed to require licensure in Georgia as
a registered professional nurse in:
- (5) The performance of auxiliary services
in the care of patients when such care and activities
do not require the knowledge and skill required
of a person practicing nursing as a registered
professional nurse and when such care and activities
are performed under orders or direction of a
licensed physician, licensed dentist, licensed
podiatrist, or person licensed to practice nursing
as a registered professional nurse;
|
Registered nurses have always utilized unlicensed individuals
to assist in the provision of nursing care. OCGA 43-26-1
et seq. acknowledged that practice by incorporating
certain exemptions from the requirement of professional
nursing licensure within the Nurse Practice Act. OCGA43-26-12
(5) provides an exemption to licensure for the performance
of auxiliary services in the care of patients when such
care and activities do not require the knowledge and
skills required of a person practicing nursing as a
registered professional nurse and when such care and
activities are performed under orders or direction of
a licensed physician, licensed dentist, licensed podiatrist,
or person licensed to practice nursing as a registered
professional nurse. Therefore if the care and activities
meet all the above criteria for the exemption, it is
an unlicensed activity and can be assigned.
The Georgia Board of Nursing has generated rules and
a decision making tool to assist registered nurses and
nurse employers to make appropriate decisions regarding
whether to assign a task to an unlicensed person. The
tool, RN Assignment Decision Tree will assist the registered
nurse to evaluate patient care tasks on an individual
patient basis. It guides the nurse to assign only those
tasks that can be safely performed by trained unlicensed
assistive personnel.
RN Assignment Decision Tree
Assignment to Unlicensed Assistive Personnel (UAP)
If not removed or updated by the State's webmaster,
the following decision tree may be found at http://www.sos.state.ga.us/plb/rn/decision_tree.htm.
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NO
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Do
NOT assign
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Is the care and activity to be performed based
upon orders or directions
of a licensed physician, licensed dentist, licensed
podiatrist, or person licensed to practice nursing
as a registered professional nurse?
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Yes
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YES
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Do
NOT assign
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Does performance of the task require licensure
in another health care
profession?
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No
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YES
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Do
NOT assign
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Does
the task require the knowledge and skills of a
person practicing nursing as a registered professional
nurse?
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®
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No
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May
Assign
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Unsure
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YES
¯
Do
NOT assign
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Does the client’s health status and situation
involve complex observations or critical decisions
that require the knowledge and skills of a professional
nurse?
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No
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NO
¯
Do
NOT assign
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Can the
task be safely performed according to exact, unchanging
directions?
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Yes
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NO
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Do
NOT assign
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Are
the results of the task reasonably predictable?
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Yes
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NO
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Do
NOT assign
to
that
UAP
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Has
the RN verified that the UAP has the knowledge
and skills necessary to accept assignment?
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Yes
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May
assign
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