Unlicensed assistive personnel

Unlicensed assistive personnel (UAP) are paraprofessionals who assist individuals with physical disabilities, mental impairments, and other health care needs with their activities of daily living (ADLs). UAPs also provide bedside care—including basic nursing procedures—all under the supervision of a registered nurse, licensed practical nurse or other health care professional. UAPs must demonstrate their ability and competence before gaining any expanded responsibilities in a clinical setting. While providing this care, UAPs offer compassion and patience and are part of the patient's healthcare support system. Communication between UAPs and registered nurses (RNs) is key as they are working together in their patients' best interests. The scope of care UAPs are responsible for is delegated by RNs or other clinical licensed professionals.

UAPs care for patients in hospitals, residents of nursing facilities, clients in private homes, and others in need of their services due to old age or disability. By definition, UAPs do not hold a license or other mandatory professional requirements for practice, though many hold various certifications. They are collectively categorized under the group "personal care workers in health services" in the International Standard Classification of Occupations, 2008 revision.

In the United States, the responsibilities and duties of a UAP include:

Most UAPs, including nursing assistants, are not certified to change sterile dressings, distribute medications, insert or remove any tubing (such as nasogastric tubes), or conduct tube feedings. Such tasks should be therefore left to the overseeing nurse or clinical licensed professional. UAPs must be delegated responsibilities. The nurses are ultimately accountable for all the care patients receive as a result of their delegating. Due to the nursing shortage and to reduce the heavy workload placed on nurses, delegating tasks to UAPs and other nursing staff such as licensed practical nurses (LPNs) is crucial.

Nursing assistant, nursing auxiliary, auxiliary nurse, patient care technician, home health aide/assistant, geriatric aide/assistant, psychiatric aide, nurse aide, and nurse tech are all common titles for UAPs. There are some differences in scope of care across UAPs based on title and description.

Unlicensed assistive personnel are important members of the health care team who often hold a high level of experience and ability. While they do not require extensive health care training to practice their profession, manual dexterity and good interpersonal communication skills are usually necessary. They often undergo some formal education, apprenticeship or on-the-job training in areas such as body mechanics, nutrition, anatomy and physiology, cognitive impairments and mental health issues, infection control, personal care skills, and record-keeping.

Training for UAPs is available from various outlets such as home health care agencies, community colleges, vocational schools, eldercare programs, and on-the-job training.

The National Association of Health Care Assistants defines the role of CNAs as: