Task-shifting among nurses and therapists in an acute hospital setting

Background Amidst demographic development and nursing shortage, task-shifting has emerged as a viable solution. While well-documented among doctors and nurses, less is known about task-shifting between nurses and physio- and occupational therapists. Aim(s) This study aims to explore facilitators, barriers and experiences regarding task-shifting among nurses and physio- and occupational therapists, addressing the increasing fluidity of roles and responsibilities in healthcare systems. Design Exploratory sequential mixed-methods design Methods Data were collected through focus groups, individual interviews, and surveys conducted across six hospital wards in a Danish hospital between February and August 2023. Results Four primary themes emerged. (1) Lack of Common Ground - differing expectations and unclear task boundaries; (2) Them and Us - a perception of A and B teams; (3) Hopes and Fears - optimism about improved patient care but concerns over loss of nursing identity and responsibility; and (4) Implementation Gap - variation in local execution due to communication and leadership challenges. Nurses reported difficulties in maintaining a clinical overview and concerns about diluted responsibility, while therapists questioned their professional scope. Although the model improved task coverage and patient activity levels, professional boundaries remained a significant barrier. Conclusion Professional boundaries and identity emerged as barriers to task-shifting. This study sheds light on factors shaping task-shifting dynamics in a rapidly changing healthcare system, offering insights for improving interprofessional cooperation.