Working with HCAs

Take this quiz and test your knowledge!

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You are an LPN supervisor working for a home care agency. You work with health care assistants (HCAs). Which answer best describes your responsibility when assigning client care to an HCA?

 

A: After determining the assigned activity is within the HCA’s job description, document the care the HCA provides.

That’s not correct. While LPNs are responsible for determining the activity is within the HCAs job description, LPNs are not responsible for documenting care given by other health care providers. LPNs are responsible for assessing clients, planning care and assigning care appropriately to HCAs. See Principle 1 in the Working with Health Care Assistants and the Documentation Practice Standards.

B: After reviewing the client’s plan of care, identify activities that could be assigned to the HCA and provide ongoing support.

That’s correct! Before assigning care to an HCA, the LPN assesses the client’s needs, determines the activity is within the HCA’s job description, and identifies any potential risks. See Principle 4 in the Working with Health Care Assistants Practice Standard.

C: It is not within LPN Scope of Practice to assign care to HCAs, therefore the responsibility lies with the employer.

That’s not correct. LPNs may provide training and ongoing support and guidance to HCAs if it is an employer expectation set out in the LPN’s job description.

LPNs only assign care to HCAs when it is:

  • within the LPN scope of practice
  • within the LPN’s individual competence
  • permitted within limits sets by the employer
  • within the HCA core competency profile
  • within the HCA's role description and training,and
  • set out in a client's care plan

See Principles 3 and 5 in the Working with Health Care Assistants Practice Standard.

D: Assign all responsibility for client care to the HCA and teach the client how to instruct and supervise the HCA.

That’s not correct. After an LPN assigns care to an HCA, the LPN continues to be responsible for assessing the outcomes of the care and for updating the overall plan of care. See Principle 6 in the Working with Health Care Assistants Practice Standard

Assignment to HCAs occurs when the required task falls within the HCAs role description and training, as defined by the employer or supervisor. The employer is responsible and accountable for developing role descriptions that clearly outline the tasks that can be assigned to an HCA in that agency/health authority. In British Columbia (BC), HCAs have no legally defined scope of practice and are not members of a regulated health profession. While some HCAs are registered with the BC Care Aide and Community Health Worker Registry and have a core competency profile, all HCAs have a job description and are accountable to their employers for the satisfactory performance of assigned care.

photo courtesy of Christiana Care