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Delivery-of-care systems using clinical nursing assistants: making it work.

This article describes a systems approach for effectively implementing a delivery model of care using unlicensed support personnel, unlicensed workers trained in assistive tasks of clinical care under the direct supervision of the RN. The approaches described derive from practice, research, and consultant experiences. Successful implementation requires an ongoing, multisystems approach to the development of a change plan, development of roles, development of staff, and development of rituals of practice that promote successful differentiated practice and team functioning.