Table 2.

Administration approaches, training and education programmes, appraisal tools and main focuses (n=36)

Theme 1: Administration approaches (n=14)
Study	Main focus	Programme/model	Contents
Campbell et al40*	Teamwork Communication	Crew resource management; TeamSTEPPS75; SBART for shift; ANA principles	Not applicable. (This integrated review reported five programmes and virtual simulation scenarios from the previous studies.)
Dutton et al41	Stress	BREATHE stress management programme	Six modules including introduction of stress, assessing stress, identifying stressors, managing stress, avoiding negative coping and mental health
Feng et al43	Vocational identity Work satisfaction	Hospital-only employment model	NAWs were only employed by hospitals and were managed by the nursing department
Gao and Zhao45	Competency Patient satisfaction	Dual employment mode by hospital and company	A tertiary management from hospital: the hospital president, the nursing department and wards head nurse; NAW group leader and head nurse management in wards; and the company management
Liu et al51	Patient satisfaction Nurse satisfaction	Three-level comprehensive management model	A three-level nursing department—head nurse—bed nurse management modal, including regulation and responsibilities, NAW prework training, performance incentive mechanism and care quality control standards
Ma et al52	Job responsibility Care quality control	FMEA model	An FMEA group including head nurses and hospital managers scored the severity, detection and occurrence, and then found approaches to solve the problem
Pfeifer et al57	Relationships of CNAs and patients Patient satisfaction	Care partner programme	A shared mental model education was conducted, including seven aspects on expectations, discussion of current care, teaching of relationships building, discussion on patient experiences, education on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and caring skill stations
Qiu et al59	Patient satisfaction NA satisfaction Turnover/retention	Activities of Daily Living (ADL) Scale stratified and management model	ADL was used to stratify patients and NAW care contents into four levels so as to make care and charge standards
Swann62	Turnover/retention	CNA orientation coaches	A 2-hour programme on clinical and emergency skills
Twigg et al64	Adverse patient outcome	Adding AINs to acute wards	Not applicable
Wu et al68	Competency Patient satisfaction Clinical professional satisfaction	A holistic NAW-centred management model	NAWs received unified management from NAW centre. Regulations, working formulations, continuing education, care quality control by 360° evaluation, application of information system and humanised management were used
Yu69	Hand hygiene	Quality Control Circle (QCC)	A QCC group for observing and analysing NAW’s hand hygiene. Fish bone diagram for analysing factors of low compliance, and brainstorm for intervention methods. Education, facilities adding and everyday detection were used for improving
Zhi et al71	Patient satisfaction	Direct hospital management model	NAWs were only employed by hospitals and were managed by the nursing department or NAW centre.
Zhu et al73	Awareness of work contents Patient satisfaction	Informed sheet	The inform sheet contained care requirements and personalised requirements, signed by both NAWs and patients and leaving to patients

Theme 2: Education and training (n=15)
Study	Main focus	Educational strategy
Friesen and Andersen44*	Palliative care	Collaborative or intradisciplinary palliative education strategies from 16 studies, methods including lectures, case studies, practical training, learning groups, role play, discussions, slide presentations, web-based learning, workshops and feedback discussions
Geoffrion et al46*	Workplace aggression	Education interventions from nine studies, methods including online learning, group discussions, lectures, videos, simulation and role play
Lee et al50	Patient handling and mobility	A 4–8-hour online and face-to-face education programme for nursing staff taught by trained coaches
McKenzie et al53	Patient safety	The Crisis Avoidance and Resource Management using scenarios, taught by senior nurses
Nie et al55	Knowledge and skills patient, clinical professionals and NA satisfaction	A group collaborative training, including lectures, practical training, simulation and group role play
Nørgaard et al56	Communication	A 3-day training programme using role play, lectures, discussions and communication practice, with a 6-month interval between the first 2 days and the last day
Pfeifer et al.57 (2018)	Dementia	A 1-hour dementia education programme using lectures, videos and scenarios
Ritchie et al60	Restorative care	A didactic day and a 3–4-hour practice session, using lectures and practical training, taught by a physical therapist
Small et al61	Continuing education	A continuing and normalised education programme based on teaching plans from RNs at shifts, using lectures, demonstration and return demonstration
Tom63	Patient safety	A 2-day patient safety aide training programme by the Veteran Affair Department, with lectures and a competency test
Wagner65	Delegation and communication	A half-hour learning programme with lectures and video, taught by the practitioner investigator
Ward et al66	Continuing education	The educational offering on the run programme, with flyers, simulation and mini-in-service study
Wilson et al67	Patient handling and mobility	An 8 hour education programme (two 4 hour parts) with lectures, demonstration, discussion and simulations
Zhao et al70	Knowledge and skills Patient and nursing staff’s satisfaction	An ADL-stratified, patient-oriented training model, with a 40-hour training for all levels of NAWs and a 32–48-hour stratified training for different levels, using lectures and practical training
Zhu et al72	Self-protection	A tertiary training model by companies, nursing department and wards using lectures, practical training, competency test and continuing improving

Theme 3: Appraisal tools (n=7)
Study	Main focus	Tools	Contents	Reliability and validity
Appleby38	Intention to following a checklist	A 66-item intention questionnaire	5 demographic items, 7 on clinical context, 7 on habit, 17 on attitude, 15 on subjective norm and 15 on perceived behaviour control	Overall Cronbach’s α 0.83 for HCAs; 24.2% of HCA’s intentions were explained
Campbell et al39	Relational quality between RN and NA and patient safety	A seven-item leader–member exchange questionnaire by Graen and Uhl-Bien76	Seven items on leader satisfaction, understanding, recognition, problem-solving, ‘bail you out’ for employees and confidence and relationships of leader	Overall Cronbach’s α 0.89 for NAs
Dykes et al42	Preventing falls	An eight-item Self-Efficacy for Preventing Falls—Assistant scales	Eight items on confidence, communication, understanding of the environment and team working for preventing falls	Overall Cronbach’s α 0.69–0.74; item total correlation 0.3–0.7
Haigh and Garside47	Feedback of the care certificate	An 18-item questionnaire	Eighteen items on confidence, knowledge and skills and attitudes	Not specified
Haraldsson et al48	Workload	The Structured Multidisciplinary Evaluation Tool (SMET)	22 items on movement, position, pace, eyesight, sitting, noise, space, lighting of workplace and working condition, attitude and satisfaction	Validity test: p values of correlation between SMET subgroup scores and surface electromyography measure outcome were ranged from 0.001 to 0.05, indicating the effectiveness
Kennerly et al49	Nursing culture	The Nursing Culture Assessment Tool	19 items and 6 subscales on expectations, behaviours, teamwork, communication, satisfaction and commitment	Overall Cronbach’s α 0.92, and subscales ranged from 0.60 to 0.93 Validity test: subscale correlations 0.27–0.74, comparative fit index 0.94
Monteiro et al54	Working capacity	The Work Ability Index	Seven items on current work ability, diseases and work impairment	Not specified

*This article is an evidence synthesis.

AIN, assistant in nursing; CNAs, certified nursing assistants; HCAs, healthcare assistants; NA, nursing assistant; NAWs, nursing attending workers; RNs, registered nurses.