Comparison of basic and specialized care between nursing assistants and professional nurses.

INTRODUCTION: Professional nurses are trained to provide direct care; however, in hospital settings, they delegate tasks to nursing assistants, which can lead to adverse events and patient dissatisfaction. OBJECTIVE: To analyze basic and specialized nursing care activities, classifying them according to the scope of competence and level of criticality. MATERIALS AND METHODS: This cross-sectional observational study was conducted between June 2021 and January 2022 and included 141 professional nurses and 259 nursing assistants from a university hospital in Bogotá. A structured questionnaire was used to record the activities performed by both roles, along with their frequency and execution time. Expert consensus was established regarding the set of nursing care activities, their alignment with each role's scope of practice, and the classification of critical activities representing a risk when delegated. Descriptive analysis identified who performed each activity, along with its frequency and execution time. Bivariate analysis assessed differences between the activities performed. RESULTS: A total of 40 basic nursing activities and 17 specialized nursing activities were identified, of which 18 were classified as critical. Significant differences were observed between nursing assistants and professional nurses in the performance and frequency of activities, including neurological assessment, pain management, and medication monitoring. DISCUSSION: The delegation of critical activities to nursing assistants, driven by the multiplicity of administrative and care-related tasks and by inadequate staffing of professional nurses, highlights the need to examine the negative consequences for patients. CONCLUSION: At the hospital evaluated, nursing assistants perform activities that, given the required level of competence and the risks involved, should be carried out by professional nurses.