Factors impacting nursing assistants to accept a delegation in the acute care settings : A mixed method study

Aims: To investigate the experience of nursing assistants being delegated nursing tasks by registered nurses.

Design: 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.

Implications for the profession and/or patient care: Highlights the need for implementing strategies to support safe delegation practices between the registered and unregulated workforce to promote patient safety.

Impact: 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.

Reporting method: Complied with the APA Style JARS-MIXED reporting criteria for mixed method research.

© 2024 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.

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Research Funding: Western Australian Nurses Memorial Trust
Article Funding: Open access publishing facilitated by Edith Cowan University, as part of the Wiley - Edith Cowan University agreement via the Council of Australian University Librarians.