Search

BACKGROUND: Healthcare is labour intensive, and the importance of a cost-effective and safe health workforce is a critical consideration in the planning of human resources for health. Efforts to constrain costs and manage nurse workloads and staffing norms have seen an increased use of task-shifting or task-sharing as innovations to address strained healthcare staff shortages. The use of hospital-based ward assistants like orderlies has been suggested as a task-shifting initiative that can help nurses and other healthcare professionals to optimise their shift time by spending it on the core clinical care duties that require more technical skills; and also, significantly reduce risks for rationed, delayed or missed care. Characterization, use or non-use, management, and supervision of ward assistants tend to vary globally. This scoping review will map out and document roles and duties, training, regulatory, and clinical governance mechanisms for hospital ward assistants as well as their impact on patients’ care and staffing norms. METHODS: We will conduct a scoping review following the Joanna Briggs Institute (JBI) evidence synthesis guideline. We will conduct searches for relevant literature from PUBMED, CINAHL, PsychINFO, EMBASE, Web of Science, Scopus, and Google Scholar using keywords and synonyms for ward assistants, supportive care assistants, and orderlies. Two reviewers shall independently conduct searches and screen results on relevance, initially by title and abstract, followed by full-text screening based on a pre-defined search strategy and against the inclusion and exclusion criteria following the Participants, Context, and Concepts (PCC) framework. End Note software and a pre-developed form on MS Excel shall be used to aid in screening and data charting. Data charting shall be used to extract relevant information from the eligible full texts namely, bibliographic details, study context, and characteristics, concepts, roles and duties, training content, patient care outcomes, nurses’ experiences, budget implications, and staffing norms related to the utilisation of ward assistants. ANALYSIS: The PRISMA-ScR guidelines shall be used to synthesise, chart, and report evidence on the concepts and roles that characterize ward assistants, their training and management, as well as their impact on patient care in hospital settings across the globe. The findings shall be used to identify research, education, and practice gaps, and implications for human resource management, as well as provide recommendations for future work on task-shifting and task-sharing in healthcare.

Search Strategy for the Scoping review on the role and impact of ward assistants on patient care

The subject of British military medicine during the First World War has long been a fruitful one for historians of gender. From the bodily inspection of recruits and conscripts through the expanding roles of women as medical care providers to the physical and emotional aftermath of conflict experienced by men suffering from war-related wounds and illness, the medical history of the war has shed important light on how the war shaped British masculinities and femininities as cultural, subjective and embodied identities. Much of this literature has, however, focused on the gendered identities of female nurses and sick and wounded servicemen. Increasingly, however, more complex understandings of the ways in which medical caregiving in wartime shaped the gender identities of male caregivers are starting to emerge. This article explores some of these emerging understandings of the masculinity of male medical caregivers, and their relationship to the wider literature around the complex and sometimes contradictory relationship between warfare and medicine. It examines the ways in which the masculine identity of male medical caregivers from the ranks of the Royal Army Medical Corps, namely stretcher bearers and medical orderlies, was perceived and represented both by the men themselves and those they cared for. In doing so it argues that total war played a crucial role in shaping social and cultural perceptions of caregiving as a gendered practice. It also identifies particular tensions between continuity and change in social understandings of medical care as a gendered practice which would continue to shape twentieth-century British society in the war’s aftermath.

Occupational risk of blood-borne infections is investigated mostly among nurses and doctors, studies concerning non-clinical health personnel (nCHP) being rare. The analysis of the occupational exposure to the hepatitis B virus (HBV) infection and the history of vaccination against the HBV in the nCHP group has been the aim of the study.A retrospective analysis of 458 cases of the occupational exposure to biological agents was conducted: group I - doctors (N = 121, 28%), group II - nursing staff (N = 251, 55%), group III - nCHP (N = 86, 19%).In the group III the source was usually unknown (group: I - 0.83%, II - 11.16%, III - 86.05%, p0.001), and the proportion of individuals vaccinated against hepatitis B before the exposure was the lowest (group: I - 98.35%, II - 97.19%, III - 77.91%, p0.001). In this group most exposures resulted from injuries caused by needles/sharps deposited in waste sacks (60%) or anywhere outside of the medical waste container (5%). The possibility of the HBV infection risk during the exposure was found in 25 cases and was significantly more frequent in the group III. The qualification for the HBV post-exposure prophylaxis was also significantly more frequent in the group III.The exposure to the occupational risk of the HBV infection also concerns the non-clinical healthcare personnel. The non-clinical healthcare personnel comprises one of the main groups of the HBV post-exposure recipients. It is essential to determine the causes of the low hepatitis B vaccination coverage in the nCHP and consider introduction of mandatory vaccination in this group in Poland. Med Pr 2016;67(3):301-310.Narażenie zawodowe na zakażenia krwiopochodne bada się przede wszystkim u pielęgniarek i lekarzy, rzadko u innych grup zawodowych pracujących w placówkach opieki zdrowotnej. Celem badania była ocena ryzyka zawodowego narażenia na zakażenie wirusem zapalenia wątroby typu B (WZW B) i realizacji szczepień przeciw WZW B u pracowników pomocniczych zatrudnionych w Zespołach Opieki Zdrowotnej (ZOZ).Retrospektywną analizą objęto 458 osób eksponowanych zawodowo na materiał biologiczny: lekarzy – grupa I (N = 121, 28%), personel pielęgniarski – grupa II (N = 251, 55%) i personel pomocniczy – grupa III (N = 86, 19%).W grupie III pacjent będący źródłem zakażenia personelu (pacjent źródłowy) był najczęściej nieznany (grupa: I – 0,83%, II – 11,16%, III – 86,05%, p0,001), a odsetek wykonanych szczepień przedekspozycyjnych najniższy (grupa: I – 98,35%, II – 97,19%, III – 77,91%, p0,001). Badani z grupy III byli narażeni na zakażenie WZW B najczęściej poprzez skaleczenie/zakłucie ostrym narzędziem znajdującym się w worku ze śmieciami (60%) lub innych miejscach poza pojemnikiem na odpady medyczne (5%). Ryzyko zakażenia WZW B stwierdzono łącznie u 25 osób, jednak istotnie częściej występowało ono w grupie III. Także osoby z tej grupy badanej najczęściej kwalifikowano do profilaktyki poekspozycyjnej zakażenia WZW B.Pracownicy pomocniczy zatrudnieni w służbie zdrowia również są zawodowo narażeni na zakażenie WZW B. Stanowią oni jedną z głównych grup pacjentów, u których stosuje się profilaktykę poekspozycyjną zakażenia WZW B. Konieczna jest ocena przyczyn niższego odsetka szczepień przeciw WZW B u pracowników pomocniczych niż u lekarzy i personelu pielęgniarskiego i wprowadzenie obowiązku szczepień w tej grupie w Polsce. Med. Pr. 2016;67(3):301–310.