Saari Margaret, Xiao Sarah, Rowe Alissa, Patterson Erin, Killackey Tieghan, Raffaghello Julia, Tourangeau Ann E
University of Waterloo, Waterloo, ON, Canada.
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
J Nurs Manag. 2018 Oct;26(7):782-794. doi: 10.1111/jonm.12613. Epub 2018 Apr 30.
Health care needs of individuals living in the community are increasing. To meet the rising need, unregulated care providers are providing more complex patient care. The aim of this review is to articulate the unregulated care provider role by identifying patient care activities offered by unregulated care providers in home care.
A scoping review was conducted. One thousand and eleven published manuscripts were identified in CINAHL, Ageline and MEDLINE. Eleven additional manuscripts were identified through hand searching. Manuscripts were screened for relevancy and data were abstracted to address the research question.
Twenty-eight studies originating from Canada, Sweden, Belgium, UK, USA and New Zealand were included. Three categories of patient care activities provided by unregulated care providers were found: (1) personal care and core skills; (2) delegated tasks and added skills; and (3) specialty roles.
Unregulated care providers predominantly provide assistance with personal care and activities of daily living. However, unregulated care providers also provide care outside their training, including care once provided by nurses.
Guidelines clearly articulating responsibilities of nurses transferring care activities to unregulated care providers should be developed. Processes and policies regarding evaluation and supervision of unregulated care providers providing added skills should be developed to ensure appropriate monitoring and support.
社区居民的医疗保健需求日益增加。为满足不断增长的需求，未经监管的护理提供者正在提供更为复杂的患者护理。本综述的目的是通过确定家庭护理中未经监管的护理提供者所提供的患者护理活动，来阐明其角色。
进行了一项范围综述。在护理学与健康领域数据库（CINAHL）、老年学数据库（Ageline）和医学文献数据库（MEDLINE）中识别出1111篇已发表的手稿。通过手工检索又识别出11篇手稿。对手稿进行相关性筛选，并提取数据以回答研究问题。
纳入了来自加拿大、瑞典、比利时、英国、美国和新西兰的28项研究。发现未经监管的护理提供者提供的三类患者护理活动：（1）个人护理和核心技能；（2）委托任务和附加技能；（3）专业角色。
未经监管的护理提供者主要提供个人护理和日常生活活动方面的协助。然而，未经监管的护理提供者也提供超出其培训范围的护理，包括曾经由护士提供的护理。
应制定明确阐述将护理活动转移给未经监管的护理提供者的护士职责的指南。应制定有关评估和监督提供附加技能的未经监管的护理提供者的流程和政策，以确保进行适当的监测和支持。
