USE OF UNLICENSED ASSISTIVE PERSONNEL IN TELEPHONE TRIAGE?

By October 25, 2017faqs

QUESTION:

I would like information on the role of unlicensed assistive personnel in telephone screening and transmission of information to a provider so the provider can make a decision regarding care of the patient vs. telephone triage. Any standards, protocols, decision trees, etc.

ANSWER:

You’ve asked a popular question! Unfortunately there are no standards that I’m aware of that speak directly to the use of unlicensed assistive personnel (UAP) in telephone triage. I noticed that you were very careful with your wording… “telephone screening and transmission of information to a provider so the provider can make a decision”. If it were only that clear-cut! Unfortunately, as you probably realize, when we “take messages” from patients, we are doing some level of assessment just by determining which questions to ask, which information to record (and which to disregard as irrelevant), and how quickly to bring it to the attention of the provider. The bottom line is that we’re performing assessment-related activities, even if we don’t directly recognize them as formal assessment (which I believe they are).

My advice is to have RNs manage these calls because patients often fail to clearly articulate their concerns, and someone who isn’t trained to recognize the significance of subtle problems or who doesn’t recognize important implicit information, might miss the boat entirely. While it’s tempting to use UAP in this manner, it’s helpful to realize that telephone triage might be the most sophisticated form of professional nursing practice that’s taking place in your setting. That realization makes it more obvious that telephone triage (or “screening patients”) is not a task that should be taken lightly and delegated to personnel who don’t have adequate training and aren’t licensed to practice nursing.

It would be great if you would consider joining AAACN. We do have a Telehealth Nursing Practice Special Interest Group that includes a listserve on which members can post questions just such as yours. And I’d imagine if you posted this question there, you might get a variety of responses to your excellent question.

Please let me know if I can be of further assistance. This is a question that unfortunately doesn’t have the black-and-white responses we’d love to see.

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