The roles and impact of ward assistants on patient care in hospital settings: a scoping review protocol

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.