using Unregulated Health Care Providers: Framework for their use

Definition and Delegation Issues

Unregulated health care workers (UHWs) are constituents of many healthcare provision teams. Though traditionally registered nurses and licensed practical nurses have been the principal patient care providers; such a situation is changing in countries such as Canada where the role of unregulated workers has increased as a method of controlling healthcare costs (ARNNL & CLPNNL, 2009; Statistics Canada, 2008; ICN, 2006). Such increases in utilization of unregulated workforce in the healthcare industry has also been brought about by the increase in the number of individuals in old age (>65 years) who need care and conditions that necessitate such care that outstripping the available nurse professionals capacity (Janes, et al., 2008; ICN 2006; CPNA, 1999). It is however the increasing intricacy of care that is being placed under the responsibility of UCPs without any formal regulative mechanisms that has raised concerns among professional   patient care practitioners (ARNNL & CLPNNL, 2009; Janz, 2004).

The unregulated care providers have range of names by which they are referred and work in diverse settings (CNA, 2008). CRNM (2002) for instance defines UHWs as “caregivers who provide personal care or support for activities of daily living to individuals” (p. 3). However; at times assistants providing such clinical skills as medication administration, changing dressings or any delegated duty by licensed health professionals fall under UHW designation (CNA, 2008). While in hospitals UHWs could perform duties in acute care, complex continuing care, pharmacy and rehabilitation under the supervision of health professionals; in home or community care settings such are employees of agencies and thus could serve as the principal care giver in these settings following the prescribed care plan by the centre (CNA, 2008). When UHWs are employed in communities they could play specific roles such as being the community’s health representatives e.g. in locations where they are more suited to relate with the population culturally (CNA, 2008). It is also notable that UHWs could comprise individuals trained professionally in other countries but have not yet acquired relevant certification to practise in the host country (CNA, 2008). The College of Nurses of Ontario – CNO (2009) states that UCPs comprise “personal support, workers, health care aides, homemakers, family visitors, personal attendants, psychiatric assistants and lay visitors” (p. 4).

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