CNO Summary - Working With Unregulated Care Providers PDF

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Working With Unregulated Care Providers CNO summary...

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CNO Practice Standards Working With Unregulated Care Providers Sarah Peebles and Helen Nguyen

Unregulated care providers (UCPs) are healthcare workers that have the ability to complete certain aspects of care that are within the scope of practice of a regulated healthcare professional such as RPNs or RNs. Nurses must ensure that the UPC is competent and is able to safely perform the delegated task. The nurse can determine competency by assessing the knowledge and ability of the UCP and ensuring that the UPC can safely perform the care. Before deciding to utilize a UCP in a certain situation, the nurse must ensure that she/he first has the ability to perform the skill competently, that the skill is within her/his scope of practice, and she/he can teach this procedure adequately. She/he must also accept full responsibility or accountability for the results. This is especially important considering that the UPC is practicing under the regulated nurse’s license. The nurse must also evaluate the specific client case and the client’s care plan to ensure that utilizing the UCP is an appropriate action. Nurses can ensure safe performance of the delegated tasks by properly teaching, effectively assigning responsibilities, carefully supervising, and mindfully delegating controlled act to the UCP. Delegation is a transfer of authority from a regulated professional to an unregulated professional to perform an act that they otherwise were not authorized to perform due to its potential risk for harm. Through delegation, UCPs may perform controlled acts such as administering injections, providing procedures involving the dermis and mucous membranes and administering inhalants. If the task is not categorized as a controlled act, delegation is not required for the UCP to perform it. Regulated care providers (nurses), UCPs and residents/patients are affected by the CNO’s practice guidelines. If CNO rules and regulations are not followed, many negative consequences can occur. Possibilities include a registration suspension, an appearance before the College, written performance appraisals from a supervisor submitted to CNO, or a completion of a remedial nursing course. Nurses must use critical thinking to determine whether the utilization of a UCP in a certain situation is appropriate for both of the worker’s competencies, is in accordance with the agency’s guidelines and policies, and is in promotion of the client’s wellbeing.

Questions & Answers

Definitions $200:  True or False? Delegation is the transfer of authority to perform a controlled act procedure from a person who is authorized to perform the procedure to a person who is not otherwise authorized to perform the procedure.  True. $600:  True or False? The only form of supervision is direct supervision.  False. Supervision can be direct or indirect, depending on the circumstances. For direct supervision, the supervisor is physically present during the provision of care. For indirect supervision, the supervisor is not physically present but monitors activities by having the UCP report regularly to the supervisor, or by periodically observing the UCP’s activities. $1000:  Assigning is the act of determining or allocating responsibility for particular aspects of care to another individual. Does assigning include the assigning of procedures under the controlled act?  Yes.

Delegation $200:  True or False? Only RNs and doctors can delegate UCPs.  False. RPNs may also delegate UCPs.

$600:  True or False? Once delegated, UCPs are accountable to the CNA.  False. UCPs are accountable to their employers. They are not accountable to an external body, and there is no regulatory mechanism to set standards or monitor quality of service. $1000:  True or False? Name one of the three controlled act procedures that can, by exception, be delegated to a UCP.  Options include performing procedure below the dermis or mucous membrane, administering a substance by injection or inhalation or putting an instrument, hand or finger into a body orifice or artificial opening into the body.

Regulations $200:  True or False? A nurse can delegate any UCP to perform a procedure, regardless of whether or not the nurse has first-hand knowledge of that UCP’s competence.  False. $600:  True or False? Putting an instrument, hand or finger into a body orifice or artificial opening into the body always requires delegation.  False. It only requires delegation if it is not a routine activity of living. $1000:  True or False? If a nurse does not follow the CNO policies on “Working with Unregulated Care Providers” they will lose their job.  Although in some circumstances this may happen, often it does not. Some possibilities

of consequences include a registration suspension, an appearance before the College, written performance appraisals from a supervisor submitted to CNO, or a completion of a remedial nursing course....