Models of care using unlicensed assistive personnel. Part II: Perceived effectiveness.

This article describes the results of a NAON-funded descriptive design research project developed to gather data on how clinical nursing assistants are being used in the practice setting by examining the role responsibilities, extent of delegation, training effectiveness, and evaluation measures designed by agencies to evaluate the effectiveness of this model of care. Fifty-three hospitals from 31 states participated in the investigation, with 53 nurses managers, 620 staff nurses, and 305 nursing assistants responding to questionnaires. Overall results indicated that models of care using unlicensed assistive personnel are not working. Primary impediments were identified as lack of role clarity, ineffective educational preparation of nursing assistants, ineffective educational preparation of staff nurses, lack of an adequate infrastructure to support the model, and lack of evaluation systems.