Observing nursing assistant companions supporting older adults in hospital: A cross-sectional study

Background: Hospital environments may cause or exacerbate behavioural and psychological symptoms of older adults with cognitive impairment. Many hospitals in Australia employ staff as companions to provide constant observation and additional support for those with cognitive impairment and/or at risk of falls; however, little is known about the activities of this role. Aim: To examine the activities of assistant in nursing companions allocated to older patients in hospital. Methods: A cross-sectional study design using an observation tool was conducted at an acute metropolitan hospital in Western Australia. A nonparticipant nurse conducted the observations. Descriptive statistical analysis explored the data and frequencies reported. Findings: Ninety-three observations were completed over a one-month period. Assistants in nursing companions were observed providing direct support to patients in less than half of the observations (49%), while 27% of observations recorded assistants in nursing in other activities, and 24% of observations recorded no active support. During direct support, 40% were undertaking diversionary activities. Environmental safety measures were met for most observations. Most patient surveillance forms were completed (95%); cognitive support plans were not completed for 68% of patients. Discussion: Assistant in nursing companions under the direction of registered nurses can increase patient safety and provide therapeutic engagement; however, they may not be utilised to their full potential. Conclusion: This role is part of contemporary patient care. It is essential that training is provided to both assistants in nursing and nurses who prepare and supervise them to ensure an effective contribution to patient safety and care quality. (c) 2025 The Author(s). Published by Elsevier Ltd on behalf of Australian College of Nursing Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).