Table 3 Impact of CAs on patient care

1

Timeliness and Efficiency of Care

-Tasks undertaken and completed on time [46]

Positive

-Reduced waiting times [52, 58]

-Shorter period of hospitalization [58]

-Longer length of hospital stay [54, 59]

Negative

2

Quality and Effectiveness of Care

-Nurses get more contact time with patients [52, 60, 61]

Positive

-High number of services provided [58]

-Enhanced psychosocial and emotional care [51, 62,63,64]

-Reduced need for catheter use [65]

-Enhanced knowledge on care [62]

-Reduced in-hospital mortality [66]

-Reduced need for pain management [63, 65]

-Increased patient assessment and monitoring [55, 66]

-No beneficial effect [61]

Negative

-Reduced direct nurse–patient interaction [61, 67, 68]

3

Patient safety

-Reduced risk for complications [65, 69, 70]

Positive

-Reduced medication errors [69]

-Reduced patient injury [48, 54]

-Risk to patient safety [42, 50, 68]

Negative

-Medical complications (Deep venous thrombosis, Unplanned endotracheal extubation, Falls with injuries, Increase in pressure ulcers, High rate of failure to rescue, Increase in hospital acquired infections, Increased in-hospital mortality) [14, 51, 54, 59, 70,71,72]

4

Patient Satisfaction

-Reduced anxiety [42, 50, 68]

Positive

-Enhanced communication of health messages to patients and relatives [62, 64, 73]

-Increased trust and confidence [50, 52]

-Increased patient satisfaction [51, 55, 61]

-Improvement in quality of care [55, 58, 62, 63, 65, 66, 69, 74]

-Experience of respect and dignity [63]

-Misunderstandings and conflicts among patients, relatives, and staff [75]

Negative

-Patients doubt on the competencies of ward assistant [42, 48]

5

Cost of Care

-High hospitalization costs [59]

Negative

6

Professional identity

-Confusion of roles with nurses [48, 52]