delegation UAP (suction)

[Ackeem, BSN, MSN, RN, APRN]

Hello everyone :)

I completed UWORLD a couple of weeks ago and now doing the NCLEX mastery app. While doing UWORLD i learnt that a UAP can perform non sterile oral suctioning. However NCLEX mastery is indicating that a UAP isn't suppose to suction period. I understand that they can't do sterile suctioning of an unconscious or conscious patient, however seems oral suctioning is in the grey area.

Can someone clarify this for me please?

Thank you

Ackeem

[Jareen]

No because suctioning comes with assessment

[NurseGirl525, ASN, RN]

With oral care a UAP can suction. How else would you perform oral care on say somebody who is intubated and needs it every two hours? I'm not sure what you mean it requires assessment? Oral care does not require an assessment.

[NurseGirl525, ASN, RN]

I think I would need to know in what context NCLEX mastery was using suction. On a Trach no, because there could be oxygenation issues and the nurse may need to hyper oxygenate and oxygen is considered a med and can't be administered by a UAP. Oral care does fall under the role of a UAP, therefore that little bit of suction that gets done is fine. Its not really an invasive procedure.

[Ackeem, BSN, MSN, RN, APRN]

I didnt see this question on the NCLEX in fact i only got 1 delegation question from the 265 qs which is weird.

@nursegirl525 i went back and found the questions on nclex mastery. One question specifically ask what care can a UAP perform, suctioning was one of the options, they literally just had suctioning on a whole. In the rationale it said UAP aren't suppose to suction period. It did also state that in some states they do, but in reality they arent suppose to.

Its hard to say, because it is such a grey area.

[Jareen]

I never said oral care requires assessment , I said suctioning requires assessment, after suctioning the nurse assess the effect of the suctioning and since uap cannot assess, this task cannot be delegated ...do not delegate what you can eat: e:evaluate a:assess t:teach

[Ackeem, BSN, MSN, RN, APRN]

I never said oral care requires assessment , I said suctioning requires assessment, after suctioning the nurse assess the effect of the suctioning and since uap cannot assess, this task cannot be delegated ...do not delegate what you can eat: e:evaluate a:assess t:teach

Thats the reasoning i used also Jareen.

[JustBeachyNurse, LPN]

Suctioning to clear or maintain an airway or prevent aspiration is out of the scope of a CNA as ongoing assessment is needed.

Incidental suctioning during oral care is within the scope of a CNA as long as competency has been documented.

In nclex world suctioning refers not to do oral care but to clear or maintain a patent airway regardless if it's oral, nasal or tracheal (think oral suctioning blood or secretions in a patient in respiratory distress. Nursing assessment is needed and as such can't be delegated)

[Tamarabeth]

The question on uworld that had me ? Was as follows:

The nurse is caring for a mechanically ventilated client with a tracheostomy tube in the ICU. What client tasks can be safely delegated to the UAP. SATA

And they stated 4. Perform oral care, using a tonsil tip suction device to suction the oopharnyx is a correct answer.