背景:全球仍经历着1500万卫生劳动力短缺,导致大多数国家的医疗工作者与人口的比例处于次优状态。有人建议使用低技能的护理助理作为一种节省成本的人力资源,用于卫生战略,可以显着降低配给的风险,延迟,或错过护理。然而,表征,角色分配,regulation,无证辅助劳动力的临床治理机制仍不清楚或不一致。这项研究的目的是绘制和整理护理助理如何标记的证据,利用,受管制,并在正规医院环境中管理,以及它们对患者护理的影响。
方法:我们对PUBMED的文献进行了范围审查,CINAHL,心理信息,EMBASE,WebofScience,Scopus,谷歌学者。使用参与者-上下文-概念框架进行搜索和资格筛选。专题内容分析指导了调查结果的综合。
结果:共有15个国家的73条记录被纳入最终的全文审查和综合。其中大部分(78%)来自高收入国家。许多标题用来描述护理助理,这些在国家内部和国家之间有所不同。在赋予的角色上,护理助理执行直接患者护理,家政服务,文书和文件,搬运,患者流量管理,订购实验室测试,应急响应和急救职责。在美国存在需要更高能力水平的额外扩展角色,澳大利亚,和加拿大。对患者护理或护士的感知和经验的影响既有积极的情绪,也有消极的情绪。15个国家的临床和组织治理机制差异很大。Licensure,监管机制,这些国家基本上没有或没有报告任务转移政策。
结论:用于描述护理助理和他们执行的任务的术语在不同国家和医疗保健系统中差异很大。有,因此,需要审查和更新国际和国家职业分类,以明确和更有意义的护理助理命名法。此外,护理助理与护理结果或护士经验之间的关联尚不清楚.此外,低收入和中等收入国家缺乏这方面的经验证据。
BACKGROUND: A 15 million health workforce shortage is still experienced globally leading to a sub-optimal healthcare worker-to-population ratio in most countries. The use of low-skilled care assistants has been suggested as a cost-saving human resource for health strategy that can significantly reduce the risks of rationed, delayed, or missed care. However, the characterisation, role assignment, regulation, and clinical governance mechanisms for unlicensed assistive workforce remain unclear or inconsistent. The purpose of this study was to map and collate evidence of how care assistants are labelled, utilised, regulated, and managed in formal hospital settings as well as their impact on patient care.
METHODS: We conducted a scoping
review of literature from PUBMED, CINAHL, PsychINFO, EMBASE, Web of Science, Scopus, and Google Scholar. Searches and eligibility screening were conducted using the Participants-Context-Concepts framework. Thematic content analysis guided the synthesis of the findings.
RESULTS: 73 records from a total of 15 countries were included in the final full-text
review and synthesis. A majority (78%) of these sources were from high-income countries. Many titles are used to describe care assistants, and these vary within and across countries. On ascribed roles, care assistants perform direct patient care, housekeeping, clerical and documentation, portering, patient flow management, ordering of laboratory tests, emergency response and first aid duties. Additional extended roles that require higher competency levels exist in the United States, Australia, and Canada. There is a mixture of both positive and negative sentiments on their impact on patient care or nurses\' perception and experiences. Clinical and organisational governance mechanisms vary substantially across the 15 countries. Licensure, regulatory mechanisms, and task-shifting policies are largely absent or not reported in these countries.
CONCLUSIONS: The nomenclature used to describe care assistants and the tasks they perform vary substantially within countries and across healthcare systems. There is, therefore, a need to
review and update the international and national classification of occupations for clarity and more meaningful nomenclature for care assistants. In addition, the association between care assistants and care outcomes or nurses\' experience remains unclear. Furthermore, there is a dearth of empirical evidence on this topic from low- and middle-income countries.