Unregulated Care Providers In Community Settings

This document outlines the responsibilities and accountabilities of the nurse¹ when collaborating with the client, family, health care professionals and employers to meet the needs of a client in the community setting through authorizing unregulated care providers to perform a nursing tasks associated with a client’s routine activities of daily living.

Background

Unregulated care providers include, but are not limited to, health care aides, support workers, personal care attendants, and student support workers whom are not regulated by legislation and have a variance in educational preparation; from on the job training to formal educational courses. Unregulated care providers have a scope of employment usually specified in a job description and are accountable for their individual actions and decisions, within this scope of employment, and to their employers.

Unregulated care providers have a valuable role in supporting the independence of individuals with health care needs in the community (e.g. home support agencies, and personal care homes). One important role is performing nursing tasks associated with the client’s routine activities of daily living, that is not automatically within their scope of employment.

Authorization

The nurse, in collaboration with the client, family, health professionals, and an employer can authorize an unregulated care provider to perform a select nursing task. As a result, the responsibility for authorizing and preparing unregulated care providers can be shared among health professionals/stakeholders. For example, a community health nurse provides education to the unregulated care provider and the ongoing monitoring of the unregulated care provider’s performance and the client’s health status is assessed by an nurse employed by an agency. Therefore, communication of responsibilities between team members is crucial.

The nurse establishes authorization through selecting one of the following methods (Appendix A):

1. Assistance
   A client, or client’s family, who is directing their own care or that of a family member; may request assistance of an to provide education (theory and practical) to an unregulated care provider to perform a nursing task.
   
   The nurse delivers the education and confirms with the client /family that monitoring of the unregulated care provider’s performance remains the responsibility of the client /family. The unregulated care provider is accountable to the client/family for the nursing task provided.
   
   The nurse instructs the unregulated care provider, client and/or family to seek health care services if there is a change in the client’s status in response to the care.
   
   Example
   Due to his arthritis, Mr. Smith can no longer draw up and administer his own insulin. Mr. Smith requests a nurse to provide education to an unregulated care provider to assist him in safely preparing and administering his insulin.

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