Registered Nursing Associates Working in Primary Care GUIDANCE
Registered Nursing Associate (RNA) A member of the nursing team who will provide care and support for patients and service users. This role is intended to address a skills gap between Health Care Support Workers and Registered Nurses. ‘Nursing Associate’ is a protected title in law NMC Nursing and Midwifery Council Scope of Practice Defined as the range of roles, functions, responsibilities and activities which the individual is educated, competent and authorised to perform Registered Nursing Associate 6 platforms Registered Nurse 7 platforms Be an accountable professional Be an accountable professional Promoting health and preventing ill health Promoting health and preventing ill health Improving safety Improving safety Provide and monitor care Assessing needs and planning care Provide and evaluate care Working in teams Leading and managing nursing care and working teams Contributing to integrated care Co-ordinating care RNAs will contribute to most aspects of care as part of the integrated nursing team, including delivery and monitoring of planned care. The standards and the differences between the registered nursing associate and the registered nurse role have been summarised as below by the NMC:
As registered professionals Nursing Associates (NAs) are accountable to the NMC for their own professional conduct and practice. NAs will typically work under the direction of a Registered Nurse or another registered professional. In Primary Care (PC) NAs will have the skills to care for people safely with integrity, expertise, respect and compassion. The intention of the NMC is for NAs to be an important part of the nursing team working alongside Registered Nurses and Health Care Support Workers (HCSWs). The work NAs undertake should be guided by standard operating procedures, local and national polices or systems of work guided by their Clinical Lead in the practice. They will also be able to support, supervise and act as a role model to trainee nursing associates, healthcare support workers and those new to care roles. The role of trainee/ apprentice Nursing Associates or those awaiting NMC registration is covered by the Scope of Practice for Nurses, Midwives and Nursing Associates in training. This guidance relating to the scope of practice is intended as an aide for those working in primary care. ‘Scope of practice’ is defined as the range of roles, functions, responsibilities, and activities which the individual is educated, competent and authorised to perform. It is important to recognise the role of the Nursing Associate (NA) is relatively new and still evolving. Green related tasks – core proficiency Registered NAs working under (non-direct) supervision of a Registered Nurse can undertake: The NA is accountable for accepting tasks delegated, ensuring they are using their skills and knowledge to work within their scope of practice. They will be required to contribute to service development and demonstrate and contribute to their own, and others, professional development. Key: Green Included in core proficiency Amber Requires additional training and competency assessment before being undertaken Red Currently outside the scope of practice • Venepuncture • Height, weight and BMI checks • Lifestyle advice • Blood Pressure • ECGs • Wound care (non-complex) • Measure and interpretation of blood glucose levels • Diabetic Foot Checks • Intramuscular (IM) and Subcutaneous (SC) Injections • Vaccinations (Flu, Pneumonia, Coronavirus) • Measurement and recording of peak flows • Health Checks • Delegation to HCAs
Red related tasks – Registered Nurse Associates cannot Registered NAs working under (non-direct) supervision of a Registered Nurse cannot: Amber related tasks – additional training required The following skills and extended roles require additional training and assessment of competence before undertaking them. The NA should be working to national, local and practice polices, as appropriate, under supervision of a Registered Nurse to deliver the following: Please note Annual reviews for asthma should not be carried out by NAs as these require a management plan, and as this constitutes planning of care, this is the responsibility of a registered nurse. NAs can undertake the 4–8-week follow-up review of patients with asthma who have had changes to their management plan following their annual review. Please refer to local and national guidelines for minimum training requirements and competencies expected before undertaking an extended role. All medications should be delivered only under Patient Specific Directions (PSDs). • Assess, plan and co-ordinate care independently • Ear irrigation • Travel consultations and vaccinations • Baby, childhood and adult vaccinations • Cervical screening • Supporting Learning Disability reviews • Sexual health screening and history taking • Annual contraceptive checks • Complex wound care, including compression bandaging • Goserelin ‘Zoladex’ implants • Doppler Ultrasound test • Annual reviews for long term conditions (e.g. diabetes, asthma) • Lung function tests (Spirometry) • Fractional Exhaled Nitric Oxide (FeNO) testing • Supervision and support of students in practice • Long term conditions, annual reviews for patients with diabetes, hypertension and COPD Many thanks to colleagues who have contributed to this guidance. Authors: Nicola Lakic, Lead Nurse for Nursing Associates, Croydon Wendy Majewska, TNA Lead SWL ICS Resources: https://www.rcn.org.uk/Professional-Development/Accountability-and-delegation https://www.nmc.org.uk/standards/standards-for-nursing-associates/standards-of-proficiency-fornursing-associates/ https://www.rcn.org.uk/Professional-Development/Accountability-and-delegation https://www.nmc.org.uk/standards/standards-for-nursing-associates/standards-of-proficiency-fornursing-associates/ Preceptorship for Nursing Associates - Leaflet.pdf (hee.nhs.uk) June 2023
RkJQdWJsaXNoZXIy MTA4ODM=