BACKGROUND: Allied health assistants (AHAs) support allied health professionals (AHPs) to meet workforce demands in modern healthcare systems. In an Australian context historically, AHAs have been sub-optimally utilised. Prior research has identified that AHAs and AHPs working in health, disability and aged care sectors, and the Vocational Education and Training (VET) industry, may benefit from access to resources to support the optimisation of the AHA workforce. As a part of a Victorian department of health funded project, several resources were developed in line with workforce recommendations for use in each of the above sectors. Recommendations and resources covered the broad areas of pre-employment training, workforce planning and governance, consumer-centred therapy and supports, recruitment and induction and workplace training and development. This study aimed to evaluate the engagement with these newly designed resources to support optimisation of AHAs in the Victorian context.
METHODS: Semi-structured interviews were conducted to evaluate engagement with resources, from the perspective of AHAs, AHPs and allied health leaders (AHLs) in the health, aged care or disability sectors, and educators and managers of allied health assistance training. Thematic analysis was conducted using team-based framework analysis.
RESULTS: Thematic framework analysis of the interview data identified four themes; Why participants accessed the resources; How participants engaged with the resources; What (if any) changes in practice occurred as a result of engaging with the resources in a participant\'s local context, How did participants envision the resources being utilised for AHA workforce optimisation in the future. Responses were mapped to the AHA workforce career pathway at the career preparation, career development and career trajectory tiers.
CONCLUSIONS: Appetite for AHA workforce development and optimal utilisation is evident across Victoria, Australia. Readily accessible resources that inform AHA role and scope of practice, delegation practice, or improve the ability for an AHA to state their own development needs, were identified as useful by participants. The potential for these resources to assist in the optimal utilisation and development of AHA workforces across the career continuum differs according to the role, sector and geographical location of the resource user. Further study is needed to investigate the transferability of these resources to national and global contexts.

BACKGROUND: Nurses\' satisfaction has an impact on organizational and patient outcomes. Integrated care system in South Korea was established in 2015 to improve care quality and decrease caregiving burden. Since then, nurses\' satisfaction has increased due to an increase in nursing staffing. However, besides nurse staffing, various work environments still affect nurse satisfaction.
METHODS: Individual online surveys were conducted with participants to determine their personal characteristics, work environments, and hospital characteristics. We used mixed-effects linear regression equation contained both fixed and random effects.
RESULTS: This study included 2,913 nurses from 119 hospitals. Their average job satisfaction was less than 6 points out of 10 points. Age, shift type, perceived workload, and delegation criteria were significant factors influencing nurses\' satisfaction. There was no significant factor among hospital characteristics. The satisfaction level of nurses was high for no-night rotating shift, low perceived workload, and clear delegation criteria.
CONCLUSIONS: Nurses\' satisfaction is affected by several work environmental factors. Low nurse satisfaction has a substantial impact on both patients and nurses. Therefore, nurse managers and hospitals should determine factors influencing their satisfaction and develop strategies to improve their satisfaction.

OBJECTIVE: To describe the activities nurses perceived to be delegable to other staff (delegable activities) in order to estimate the time nurses spend on delegable activities and explore nurses\' reasons for not delegating these activities.
METHODS: Mixed-methods explanatory sequential.
METHODS: In total, 236 nurses from 27 medical and surgical wards of five hospitals in northern Italy completed a web-based survey during a single shift between June and July 2022. Minutes spent on delegable activities, staff member to whom participants could have delegated and reason(s) for not delegating were reported. Chief nurses provided specific wards\' characteristics using a paper-and-pencil questionnaire. Twenty semi-structured interviews were conducted to explore delegable activities and reasons for not delegating. Quantitative and qualitative results were merged using joint displays.
RESULTS: Participants spent approximately one-quarter of their time performing delegable activities, mainly delegable to nurse aides or nurse clerks, and performed due to a lack/shortage of staff or their concurrent participation in other activities. Participants recognized that activities requiring clinical assessment and decision-making skills cannot be delegated, whereas technical activities and indirect care should be delegated. Organizational, structural and cultural factors, as well as patient characteristics, available staff and experience affected delegation, leading nurses to perform delegable activities to ensure patient care.
CONCLUSIONS: Nurses spend a considerable part of their time on delegable activities due to a lack of staff or support services and suboptimal organization, which could be addressed by optimal staff management, but also to the complexity of the contexts, including individual and cultural factors that should be addressed through policy interventions.
CONCLUSIONS: This study estimates the time nurses spend on delegable activities in acute care settings. Our findings highlighted the reasons that sustain the decision not to delegate that policymakers, healthcare managers, and nurse educators should consider to promote nurses\' delegation skills.
UNASSIGNED: MMR checklist.
UNASSIGNED: None.

The nurse staffing crisis requires nurses and administrators to think differently about how to get things done. Delegation is key to doing more work with fewer registered nurses (RNs) and retaining current RN staff. Responsibility for effective delegation does not rest solely with the RN but begins with the institution, and includes both the delegator and delegatee. While effective delegation has often been referred to as an art, knowing the science behind delegation can aid in honing a skill necessary for top of license practice.

Delegation of clinical tasks from physiotherapists to physiotherapy support workers varies considerably in musculoskeletal outpatient physiotherapy services leading to variation in patient care. This study aimed to develop consensus amongst physiotherapists, support workers and managers about what components should be included in a future framework to guide effective and safe delegation of clinical tasks to physiotherapy support workers in United Kingdom\'s National Health Service musculoskeletal outpatient physiotherapy services.
A consensus study was carried out, using Nominal Group Technique. Seven physiotherapists, ten physiotherapy support workers and ten physiotherapy operational/clinical leads from 13 musculoskeletal physiotherapy services within United Kingdom\'s National Health Service were recruited through the Chartered Society of Physiotherapy\'s professional networks and social media. Three separate, role-specific consensus groups were convened, involving participants generating, discussing and rating on a Likert scale, components for inclusion in a future delegation framework.
32 out of 38 generated items reached consensus of ≥70%, i.e. a mean of ≥4.9 on a 7-point Likert scale, across the three groups. Items were grouped under five main categories: 1) training/Continuous Professional Development for physiotherapists and support workers; 2) need for a clear delegation process; 3) competencies 4) defining the role of support workers and 5) safety net.
Key stakeholder groups were able to reach consensus on five priority areas which will be developed into a best practice framework to standardise delegation and guide physiotherapists when delegating clinical tasks to support workers.

In community nursing, the administration of insulin for people with type 2 diabetes can be delegated by registered nurses to healthcare support workers. Although a voluntary framework in England provides national guidance, little is known about its uptake. The project aim was to determine the roll-out, characteristics and support needs in relation to the delegation of insulin administration in community settings. An online survey was disseminated to community nursing services in England via social media and nursing networks. Of the 115 responding organisations, 81% (n=93) had an insulin delegation programme, with most initiated since 2018. From these services, 41% (n=3704) of insulin injections were delegated daily, with benefits for patients, staff and services reported, along with some challenges. Delegation of insulin administration is an established and valued initiative. Awareness of the national voluntary framework is increasing. National guidance is considered important to support governance arrangements and safety.

This paper explores the implications of Indonesia\'s agreement to delegate the Flight Information Region (FIR) of air navigation services to Singapore, specifically in the airspace of the Riau and Natuna islands, as stated in Presidential Regulation Number 109 of 2022. Using the normative juridical method, this study examines the intricate details of the agreement, with a focus on its potential legal consequences for Indonesia\'s national and international obligations. Although Indonesia retains sovereignty over its territory, this analysis scrutinizes the nuanced provisions of the agreement and their implications, particularly in terms of the technical aspects of air traffic services provided by the Singapore Air Traffic Services Provider above Indonesia\'s territories, which the agreement does not explicitly delineate the responsibilities or shared consequences in law. The purpose of this paper is to elucidate Indonesia\'s increased responsibility under the new agreement and emphasize the importance of a careful approach to its implementation. By exploring the multifaceted dimensions of national and international interests, this study seeks to highlight the imperative for Indonesia to navigate the agreement prudently. Ultimately, this analysis aims to provide a comprehensive understanding of Indonesia\'s obligations, potential challenges, and essential considerations under the renewed agreement of 2022, underscoring the significance of a balanced approach in safeguarding Indonesia\'s interests on both national and international fronts.

In this paper we explore the factors that determine delegation of implementation in project aid. In particular, focusing on the importance of informational asymmetry between levels of government, we empirically assess whether this choice is influenced by the relative importance of the local information at the recipient country level. Moreover, we test whether this choice can in turn influence project performance. Using information on more than 5800 World Bank projects for the period 1995-2014, and controlling for characteristics at both country and project level, we find that transparency does influence the probability that a project is implemented locally rather than nationally. More specifically, a one standard deviation decline in transparency increases the probability of a locally implemented project by three percentage points. We also find that a local implementing agency may increase the probability of a successful project only up to a certain level of a country\'s transparency.

Decentralized Identifiers have recently expanded into Internet of Things devices and are crucial in securing users\' digital identities and data. However, Decentralized Identifiers face challenges in scenarios necessitating authority delegation and anonymity, such as when dealing with legal guardianship for minors, device loss or damage, and specific medical contexts involving patient information. This paper aims to strengthen data sovereignty within the Decentralized Identifier system by implementing a secure authority delegation and anonymity scheme. It suggests optimizing verifiable presentations by utilizing a sequential aggregate signature, a Non-Interactive Zero-Knowledge Proof, and a Merkle tree to prevent against linkage and Sybil attacks while facilitating delegation. This strategy mitigates security risks related to delegation and anonymity, efficiently reduces the computational and verification efforts for signatures, and reduces the size of verifiable presentations by about 1.2 to 2 times.

OBJECTIVE: To investigate the experience of nursing assistants being delegated nursing tasks by registered nurses.
METHODS: Mixed method explanatory sequential design.
METHODS: A total of 79 nursing assistants working in an acute hospital in Australia completed surveys that aimed to identify their experience of working with nurses and the activities they were delegated. The survey data were analysed using descriptive statistics. Interviews with 11 nursing assistants were conducted and analysed using Braun and Clarke\'s thematic analysis. Results were triangulated to provide a richer understanding of the phenomena.
RESULTS: Most nursing assistants felt supported completing delegated care activities. However, there was confusion around their scope of practice, some felt overworked and believed that they did not have the right to refuse a delegation. Factors impacting the nursing assistant\'s decision to accept a delegation included the attitude of the nurses, wanting to be part of the team and the culture of the ward. Nursing assistants who were studying to be nurses felt more supported than those who were not.
CONCLUSIONS: Delegation is a two-way relationship and both parties need to be cognisant of their roles and responsibilities to ensure safe and effective nursing care is provided. Incorrectly accepting or refusing delegated activities may impact patient safety.
UNASSIGNED: Highlights the need for implementing strategies to support safe delegation practices between the registered and unregulated workforce to promote patient safety.
CONCLUSIONS: Describes the experiences of nursing assistants working in the acute care environment when accepting delegated care from nurses. Reports a range of factors that inhibit or facilitate effective delegation practices between nurses and nursing assistants. Provides evidence to support the need for stronger education and policy development regarding delegation practices between nurses and unregulated staff.
UNASSIGNED: Complied with the APA Style JARS-MIXED reporting criteria for mixed method research.
UNASSIGNED: No patient or public contribution.