Can health care assistants replace student nurses?

Area of Science:

• Nursing Education
• Healthcare Workforce Studies
• Health Services Research

Background:

• Project 2000 in the UK led to the replacement of traditional student nurses with health care assistants (HCAs).
• Hong Kong is gradually introducing university-based nurse education.
• This study evaluates a health care assistant pilot program in an acute care hospital.

Purpose of the Study:

• To examine the work of HCAs and hospital-based student nurses during the introduction of university-based nurse education.
• To analyze the differences in activities performed by HCAs and student nurses.
• To understand the implications of HCA integration on the roles of qualified nursing staff.

Main Methods:

• Observational data collected in two phases after HCA introduction.
• Analysis using Kruskal-Wallis one-way analysis of variance.
• Comparison of activities performed by student nurses (SNs) and HCAs.

Main Results:

• No significant difference in the total amount of all activities between SNs and HCAs.
• HCAs performed significantly more basic direct care and less technical activity than SNs at both phases (P < 0.001).
• Differences suggest qualified staff do not perceive SNs and HCAs as equally unqualified.

Conclusions:

• The replacement of SNs with HCAs significantly alters the roles of qualified nursing staff.
• Qualified staff will likely spend more time on delegation and supervision of HCAs.
• Changes in direct and indirect care activities are anticipated with HCA integration.