Nursing Assistant in Italy: The Principle of Delegation of Health Activities and Liability Profiles.

Background/Objectives: The institution of the nursing assistant (NA) profile in Italy, established by the Decree 28 February 2025 responds to the chronic shortage of healthcare personnel, especially in nursing. This figure, non-healthcare but trained to perform basic healthcare tasks, aims to suppor...

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Publicado en:Nursing Reports Vol. 15; no. 12; pp. 443 - 452
Autores principales: TRonconi, Livio Pietro, Bolcato, Vittorio, Bianco Prevot, Luca, Basile, Giuseppe
Formato: Journal Article
Publicado: MDPI Dec2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2025
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      pub: MDPI
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        atl: Nursing Assistant in Italy: The Principle of Delegation of Health Activities and Liability Profiles.
      aug:
        au:
          TRonconi, Livio Pietro
          Bolcato, Vittorio
          Bianco Prevot, Luca
          Basile, Giuseppe
        affil: Department of Health and Life Science, European University of Rome, 00163 Rome, Italy
      sug:
        subj:
          Certified Nursing Assistants Italy
          Delegation of Authority
          Health Personnel, Unlicensed
          Professional Role
          Health Care Delivery
          Italy
          Continuity of Patient Care
          Support, Psychosocial
          Multidisciplinary Care Team
          Scope of Practice
          Teamwork
          Diet
          Hydration Status
          Drug Administration
          Simulations
          Prehospital Care
          Emergency Care
          Accountability
          Supervisors and Supervision
          Long Term Care
          Pain Management
          Vital Signs
          Electrocardiography
      ab: Background/Objectives: The institution of the nursing assistant (NA) profile in Italy, established by the Decree 28 February 2025 responds to the chronic shortage of healthcare personnel, especially in nursing. This figure, non-healthcare but trained to perform basic healthcare tasks, aims to support nurses and ensure continuity of care, especially in community and long-term care settings, through further nursing activities delegation. The model aligns with international practices, emphasizing delegation within multiprofessional teams, based on formalized protocols and continuous on-site training, within standardized, low-discretion contexts. The delegation of health activities, however, presents legal and medico-legal challenges regarding scope of practice and supervision. Methods: The aim of this paper is critically discussing delegation of health activities to non-healthcare providers and the related issues of liability in team-based delivery of care, considering the specific regulatory setting of health providers in Italy. Results: Critical activities such as nutrition and hydration, in particular artificially, and drug administration highlight the limits of delegation and the ongoing need for professional nurse oversight. In pre-hospital emergency care, standardized, protocol-based systems and simulation-based training successfully integrate non-healthcare personnel within the health team. Conversely, chronic and long-term care remain fragmented, lacking organizational maturity, regular supervision, and uniform regulation. Conclusions: The decree represents a step toward structured team-based care, but its success depends on robust governance, protocol clarity, organizational guidelines, and sustained practice-based education to prevent unsafe delegation and unauthorized practice.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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