Wong Kang Lynn, Chua Wei Ling, Griffiths Peter, Goh Qin Ling Pearlyn, Low Kye Wern Chelsea, Tan Jia Qi Apphia, Liaw Sok Ying
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
School of Health Sciences, University of Southampton, Southampton, United Kingdom.
Int J Nurs Stud Adv. 2025 Jan 13;8:100293. doi: 10.1016/j.ijnsa.2025.100293. eCollection 2025 Jun.
Unlicensed assistive personnel are increasingly employed to support the nursing workforce in providing bedside care.
To scope the literature on the factors influencing teamwork between registered nurses and unlicensed assistive personnel in acute care settings.
A scoping review was conducted using the Arksey and O'Malley (2005) framework. Eight electronic databases were searched from inception of each database to August 2024 to locate studies that reported issues relating to teamwork between registered nurses and unlicensed assistive personnel on patient care in general wards of acute care settings. Two reviewers independently screened titles, abstracts, and full text for eligibility. The data were extracted, analysed, and synthesised using the data-based convergent qualitative synthesis.
Thirty-eight studies were included. Five themes were generated: (1) role clarity, (2) delegation, (3) communication, (4) ward culture and practice, and (5) interpersonal relationships. Challenges in registered nurses-unlicensed assistive teamwork include unclear roles and responsibilities, ineffective delegation, and communication barriers. Work culture that excludes unlicensed assistive personnel from shift handovers were found to hinder shared goals for patient care. The importance of interpersonal relationships between registered nurses and unlicensed assistive personnel was highlighted to aid in the power disparity between them.
This review found suboptimal teamwork between registered nurses and unlicensed assistive personnel. Teamwork between registered nurses and unlicensed assistive personnel can be improved through clearly defined roles and responsibilities, better delegation practices, effective communication, and improved interpersonal relationships. Future research should focus on optimising communication processes and enhancing registered nurses' delegation skills through education.
在提供床边护理方面，越来越多地雇佣无执照辅助人员来支持护理工作队伍。
梳理关于影响急症护理环境中注册护士与无执照辅助人员团队合作的因素的文献。
采用阿克西和奥马利（2005年）的框架进行范围综述。检索了八个电子数据库，从每个数据库创建之初到2024年8月，以查找报告了急症护理环境普通病房中注册护士与无执照辅助人员在患者护理方面团队合作相关问题的研究。两名评审员独立筛选标题、摘要和全文以确定是否符合要求。使用基于数据的收敛性定性综合法提取、分析和综合数据。
纳入了38项研究。生成了五个主题：（1）角色明确，（2）任务分配，（3）沟通，（4）病房文化与实践，（5）人际关系。注册护士与无执照辅助人员团队合作中的挑战包括角色和职责不明确、任务分配无效以及沟通障碍。发现将无执照辅助人员排除在交接班之外的工作文化会阻碍患者护理的共同目标。强调了注册护士与无执照辅助人员之间人际关系的重要性，以帮助消除他们之间的权力差距。
本综述发现注册护士与无执照辅助人员之间的团队合作存在不足。通过明确界定角色和职责、改进任务分配实践、有效沟通以及改善人际关系，可以提高注册护士与无执照辅助人员之间的团队合作。未来的研究应侧重于优化沟通流程，并通过教育提高注册护士的任务分配技能。
