Subject(s)
Dementia , Home Care Services , Aged , Caregivers , Dementia/therapy , Family , Grounded Theory , Humans , Nursing HomesABSTRACT
AIM: The purpose of this study was to determine changes in the work nature of nurses after the introduction of Health Care Assistants (HCAs). BACKGROUND: HCAs with a role similar to those adopted in the UK of assisting the nurse were piloted in a teaching hospital in Hong Kong. METHOD: A quasi-experimental design was used to compare the observed activities of HCAs and nurses in four wards of a teaching hospital, before and after the introduction of HCAs. As the amount of staff activity is influenced by the amount of work, patient dependency data were gained from record reviews and nurse interviews. FINDINGS: HCAs in orthopaedic and medical wards provided more basic care than those in surgical and gynaecological wards. Nurses in wards with HCAs performed significantly fewer activities than nurses in control wards. CONCLUSIONS: HCAs presence accounted for a reduction in both direct and indirect care provided by nurses. Overall, HCAs provided more basic than technical and indirect care.
Subject(s)
Job Description , Nursing Assistants/organization & administration , Nursing Staff, Hospital/organization & administration , Nursing, Team/organization & administration , Workload , Activities of Daily Living , Adult , Humans , Nursing Administration Research , Nursing Evaluation Research , Pilot Projects , Time and Motion StudiesABSTRACT
Health Care Assistants (HCAs) were piloted in four wards of a large teaching hospital in Hong Kong. Evaluation of this pilot programme was based on patients' and nurses' satisfaction with HCAs, the HCAs' job satisfaction, and the retention rate of HCAs. Data were collected at 3 and 6-months following the introduction of HCAs to ascertain the level of satisfaction and the rate of HCA retention. Overall, the HCAs' work was seen as satisfactory and contributing to the work being carried out on each ward. Both nurses and patients were highly satisfied with HCA's, the mean total levels of satisfaction by nurses being 97 out of a possible range of 26-104 and for patients 53 out of a possible range of 14-56. While there was a high level of nurses' approval of introducing HCAs into the health care team there were significant differences (P < 0.05) with Nursing Officer, followed by Ward Managers being more in agreement than Registered Nurses. There were eight HCA activities seen by more than 70% of nurses to have been carried out frequently. The mean total job satisfaction of HCAs was 67 out of a possible 17-95. Although the 50% retention rate of HCAs was poor, there was overall satisfaction with the work of the HCAs.
