[The activities/tasks performed by health care aids in hospital settings: a mixed-methods study].

. The nurses' tasks performed by aids in hospital settings: a mixed-methods study.
Introduction: The role of Nurses' aides (NAs) in the clinical practice has been widely debated to date.
Aims: To describe the activities/tasks performed by NAs and the dedicated time; to identify the activities/tasks shifted from nurses to NAs and to investigate the motivations.
Methods: A multi-center mixed-methods study was conducted. Fifty-six NAs working in 17 hospitals in the North-Italy were observed during daily practice and then interviewed about the motivations associated with task shifting.
Results: NAs mainly performed direct care tasks (67.7% of the observed time), such as helping with personal hygiene, feeding and mobilization. Larger hospitals (p = 0.034), surgical units (p = 0.001), a skill mix> 40% (p = 0.044) and a reduced nurse to patient ratio (p = 0.041), were significantly associated with a higher amount of indirect care activities/tasks performed by NAs. The tasks shifted most frequently from nurses to NAs were: mobilization (22; 39.3%) and personal hygiene (21; 37.5%) of unstable patients, feeding patients with dysphagia (19; 34%), intra-venous set replacement (16; 28.6%) and pressure ulcers' dressing (11; 19.6%). NAs reported that they chose to act autonomously because of their experience and the trust-based relationship with nurses, in order to promptly respond to patients needs and to reduce nurse workload.
Conclusions: It is necessary to further assess the development of the NAs role in the hospital setting to understand their inclusion in the nursing care.