The Role of Nursing Assistive Personnel in the Rehabilitation Setting
Nursing Assistive Personnel
It is recognized that nursing assistive personnel (NAP) make a significant contribution to the care and welfare of patients in a variety of clinical settings, including rehabilitation. It is the American Nurses Association's (ANA) belief that "the utilization of NAPs in the provision of specific aspects of direct and indirect patient care, as the result of delegation and direction by a registered nurse (RN) in accordance with state nurse practice acts, is an appropriate, safe, and resource-efficient method of providing nursing care." (ANA, 2007, Position Statement). The Center for American Nurses (2006) position statement, Registered Nurse Utilization of Nursing Assistive Personnel, recognizes that NAPs provide "support services which are required for the provision of quality patient care, as heath care changes and the registered nurse shortages demand adaptations in the manner care is provided...".
The Association of Rehabilitation Nurses (ARN) further supports the ANA position, finding that utilization of NAPs (formerly known as unlicensed assistive personnel) is necessary for the registered rehabilitation nurse "to achieve the goal of assisting individuals in the restoration and maintenance of maximal physical, psychosocial, and spiritual health" (ARN, 1994, p.1).
• High school diploma or equivalent
Scope of Care
According to the International Council of Nurses' (ICN) position statement, Assistive or Support Nursing Personnel, "the delegation of nursing care and the supervision of assistive nursing personnel is the responsibility of nurses" and "the role, preparation, standards, and practice of assistive nursing personnel must be defined, monitored, and directed by registered nurses" (ICN, 2000, p. 1). This responsibility is based on the nursing scope and standard of practice prescribed by the individual state nurse practice acts and regulations.
In settings or states where the job responsibilities for NAPs is subject to state regulation, the tasks delegated by the RN shall not exceed any restrictions set forth by the state. The delegation of tasks should be assigned based on The Five Rights of Delegation - right task, right circumstances, right person, right directions and communication, and the right supervision and evaluation (National Council of State Boards of Nursing, 1997).
Basic Skill Set
• Obtaining and documenting vital signs, including temperature, pulse, respirations, and blood pressure and pain level (and notifying the professional nurse when these values are outside of established parameters)
Secondary Skill Set
• Inserting and removing indwelling and intermittent catheters
Care can be provided by NAPs under the supervision of an RN in institutional, residential, outpatient, and community settings. These settings include, but are not limited to, acute care facilities, rehabilitation facilities, skilled nursing facilities, or nursing homes, residential facilities, day care agencies, or private residences.
American Nurses Association. (1992, November). Position statement on registed registered nurse utilization of unlicensed assistive personnel. Washington, DC: Author.
American Nurses Association. (2007). Position statement on utilization of nursing assistive personnel in all settings. Washington, DC: Author
Association of Rehabilitation Nurses. (1994, May). Registered nurse utilization of unlicensed assistive personnel. Skokie, IL: Author
Center for American Nurses. (2006). Registered nurse utilization of nursing assistive personnel: Statement for adoption. Retrieved May 31, 2007 from http://www.centerforamericannurses.org/positions/.
International Council of Nurses. (2000). Assistive or support nursing personnel. Retrieved October 25, 2005 from http://www.icn.ch/psassistive.htm
National Council of State Boards of Nursing, Inc. (1997). The Five rights of delegation. Retrieved August 15, 2007 from http://ncsbn.org/fiverights.pdf
Approved July 1995; Revised October 2003; Revised October 2007
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