Baseline review: The role of HCAs in general practice

Abstract

Health care assistants play a major role in general practice. This review gives insights into learning and development opportunities that will help to deliver high quality patient care

Unlicensed assistive personnel in ambulatory care

“…In some cases, delegation of inappropriate skills was inadvertently attempted by clinic managers or other staff. 13,15,21 In other cases, there was a need for training and clarification of the UAP scope, competency, and role before nurses and other team members felt comfortable delegating tasks to UAP. 3,12,24 Training nurses on delegation, and establishing a shared understanding of what should be delegated, was found to help in implementing UAP roles within the clinic team.…”

“…Delegation was often listed as a source of confusion or concern. In some cases, delegation of inappropriate skills was inadvertently attempted by clinic managers or other staff 13,15,21. In other cases, there was a need for training and clarification of the UAP scope, competency, and role before nurses and other team members felt comfortable delegating tasks to UAP 3,12,24.…”

“…3,[12][13][14] Common clerical tasks performed by UAP included chart preparation, restocking, and referrals. 3,[15][16][17][18] Clinical tasks assigned to UAP varied widely, including height and weight measurement, 17 vital sign measurement, [14][15] ECG recording, 18 venipuncture/ phlebotomy, [13][14][17][18][19][20] urinalysis, 12 vaccination/injections, 10,13,18 ear irrigation, 21 wound care/ dressing changes, [13][14][15] instrument reprocessing, 10 and diagnostic testing. 11,14 In specialty settings, a wide variety of specialty-specific skills were noted, including foot care, 10 removal of peripheral IV catheters, 20 administering screening questionnaires, 19 various therapy services procedures, 22 and assisting with biopsies.…”

“…10 Without regulation, it was easy for UAP roles to evolve differently in different organizations or even in different parts of a single organization. 4,21 For example, staff in an organization with unclear expectations found that some nurses delegated to UAP effectively, but others hesitated to delegate anything to them. 21 Such inconsistency led to ineffective use of UAP, diminishing their value to the organization.…”

“…When UAP roles were unregulated, clear organizational policy was found to be especially necessary to ensure effective delegation 10. Without regulation, it was easy for UAP roles to evolve differently in different organizations or even in different parts of a single organization 4,21. For example, staff in an organization with unclear expectations found that some nurses delegated to UAP effectively, but others hesitated to delegate anything to them 21.…”