Supervision of unlicensed assistive workers in ambulatory settings.

It is important to examine the role of supervision in facilitating change and promoting the success of care delivery models using UAP in ambulatory care. Good supervision is a role expectation of all professional nurses, and is especially important in ambulatory settings where patient care objectives and patient diversity and complexity may not be well understood by UAP. The ramifications for nurse executives and managers include ensuring that organized opportunities to learn and be supported in supervision are part of the development of every staff nurse in the ambulatory setting. Sufficient time must be allocated in staffing models so that staff nurses can supervise appropriately. Nurse executives and managers must also assist staff nurses in finding rewards and satisfaction in supervision. Research must be designed to provide a database to assist in decisions about the optimal numbers of UAP that can be effectively used in ambulatory models without compromising patient outcomes. Research is also needed regarding the optimal number of UAP that can be effectively supervised by one staff nurse.