Unlicensed assistive personnel (UAP) is an umbrella term to describe a job class of paraprofessionals who assist individuals with physical disabilities, mental impairments, and other health care needs with their activities of daily living (ADLs) and provide bedside care — including basic nursing procedures — all under the supervision of a Registered Nurse, Licensed Practical Nurse or other health care professional. They provide care for patients in hospitals, residents of nursing facilities, clients in private homes, and others in need of their services such as due to effects of old age. UAPs, by definition, 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.[1]
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The Nursing Assistant, Nursing Auxiliary, Auxiliary Nurse, Patient Care Assistant, Patient Care Technician, Home Health Aide/Assistant, Geriatric Aide/Assistant, Psychiatric Aide, Nurse Aide, or Nurse Tech are all common titles that are considered to be UAPs in many countries.
In the United States, the Certified Nursing Assistant typically works in a nursing home or hospital, and performs everyday living tasks for the elderly, chronically sick, or rehabilitation patients who cannot care for themselves. There are some differences in scope of care across UAPs based on title and description. Typically, government certification indicates a more in-depth training and qualification that covers a wider scope of responsibility.[2][3] These certification exams are distributed by the state. Classes to study for these exams are provided by the American Red Cross as well as other providers. The courses offered by the American Red Cross encompass all facets that are addressed in the state exams from communication to health terms to sensitivity.
Similar titles in the United Kingdom and elsewhere include Healthcare Assistant, Healthcare Support Worker, or Clinical Support Worker, who usually work in hospitals or community settings under the guidance of a qualified healthcare professional.[4]
Personal Support Worker is the title for a similar type of health worker in Canada. Some of the responsibilities and duties of a Personal Support Worker include, but are not limited to:[5]
Surgical technologists are considered UAPs in the US, where they are also sometimes called "Scrub tech". However the title can mean different things in different countries. For example in Mozambique, surgical technologists are medical professionals trained and registered to perform advanced clinical procedures including emergency surgery.[6]
Birth assistants, such as doulas, childbirth educators and other persons providing emotional support and general care and advice to women and families during pregnancy and childbirth, are also typically considered UAPs. They are distinguished from midwives, physicians, nurses, and other professionals who are trained and licensed to provide basic and emergency pregnancy and childbirth-related health care services and manage complications.
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, a high level of 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 records-keeping.[1][2][4][7] Most community colleges offer CNA training in one semester. However, there are other sources that offer accelerated programs.
In the context of ageing populations and health care reform, UAPs are in growing demand in many countries.
However, without formal health professional qualifications, UAPs are unable to often perform some tasks due to issues of liability and legality. Attempts to regulate, control, and verify education have been made in some places. This allows an employer to verify experience and knowledge as well as to assist in preventing individuals who have been "struck off" (had registration/certification invalidated) from continuing to work in healthcare roles. For example in the UK, the credibility of the Healthcare Assistant and other social care workers is intended to be strengthened by their compulsory registration from 2009 with the General Social Care Council in England or its Scottish or Welsh equivalents.
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