Shortage of healthcare personnel in Malawi has posed great challenges to the health care delivery system. It is not possible for a few nurses to provide quality care to a large number of hospitalised patients. Patient guardians provide care to inpatients without the support of nurses. The purpose of this concept analysis was to clarify the concept of patient guardian in relation to their role in the healthcare delivery system. Walker and Avant's strategic method of concept analysis was used to analyse patient guardian concept. In this paper, a patient guardian has been defined as; usually a female family member or close friend, who is legally responsible for the intimate care of a patient who is unable to look after him or herself, by performing a wide range of activities of daily living for the patient and is recognised by the healthcare providers as an extension of the hospital support system but is not supported by the healthcare providers and lives on the hospital premises during the entire period of patient's hospitalisation. The empirical referents for a patient guardian are, a patient must be hospitalised and a family member who is legally capable of caring for the patient and willingly stays on the hospital premises during the entire period of hospitalisation. The role of patient guardians in the care of hospitalised patients needs to be clearly stipulated in order to bring a meaningful collaboration and partnership that will improve delivery of quality healthcare services in Malawi despite the shortage of nurses.