Debate rages over increased use of aides

Questions raised on quality and cost benefit

Facilities and home health agencies are using an increased number of unlicensed assistive personnel (UAP) to perform patient care tasks once reserved for nurses. There is little debate that UAPs are a vital part of the health care delivery system in United States. Yet, the increased use of UAPs across the continuum of care over the past five years has both nursing professionals and consumers worried about quality of care.

Case managers also are struggling with questions of cost/benefit and clinical outcomes raised when UAPs replace RNs in delivering hands on nursing care. In this issue of Case Management Advisor, we will outline the main questions being hotly debated by nursing associations, state legislatures, and disabled advocacy groups. The effects of the UAP debate are so far reaching that we have addressed it from both a disability management and long-term care perspective.