Josefsson Karin, Sonde Lars, Wahlin Tarja-Brita Robins
Department of Health Sciences, Orebro University, Sweden.
Int J Nurs Stud. 2008 Mar;45(3):428-41. doi: 10.1016/j.ijnurstu.2006.09.009. Epub 2006 Nov 9.
Skilled and specialist registered nurses (RNs) are central to evolving elderly care. The past decades' organisational and structural changes have altered RNs' roles and work situations in municipal elderly care in Sweden. This calls for appropriate educational preparation. However, a substantial proportion of RNs in municipal elderly care lack adequate specialist competence.
The focus of this study was to describe RNs' perceptions of needs and possibilities for competence development in municipal elderly care and compare the perceptions of RNs' who work solely in dementia care (DC) with those who work in general elder care (GC) where older persons have diverse diagnoses.
A non-experimental, descriptive and comparative design was used.
Sixty special housing with subunits in a large city in the middle of Sweden.
Participating RNs were a total of 213, with a response rate of 62.3%. Of the 213 RNs, 95 (44.6%) worked in DC and 118 (55.4%) in GC.
A structured questionnaire that was specifically designed for this study and focused on needs and possibilities for competence development in nursing.
The RNs were on average not lacking or were hardly lacking knowledge in examined domains. However, RNs in GC lacked knowledge of dementia, falls, and fall injures to a greater extent than RNs in DC. RNs in DC perceived greater possibilities for competence development at work. Most RNs requested a better organisation for competence development, especially in GC. The majority of RNs had no supervision. The use of RNs' competence was high, although they used their highest competence about half of the working hours. The employers' financial contribution to RNs' continuing education was poor.
A better organisation and greater possibilities for RNs' competence development is needed. The employers need to make a greater contribution financially to RNs' continuing education. It is essential to provide RNs with supervision.
技术娴熟的专科注册护士对于不断发展的老年护理至关重要。过去几十年的组织和结构变革改变了瑞典市政老年护理中注册护士的角色和工作环境。这就需要进行适当的教育准备。然而，市政老年护理中有很大一部分注册护士缺乏足够的专业能力。
本研究的重点是描述注册护士对市政老年护理中能力发展的需求和可能性的看法，并比较仅从事痴呆症护理（DC）的注册护士与从事一般老年护理（GC）（老年人有多种诊断）的注册护士的看法。
采用非实验性、描述性和比较性设计。
瑞典中部一个大城市的60个设有子单元的特殊住房。
共有213名注册护士参与，回复率为62.3%。在这213名注册护士中，95名（44.6%）从事DC工作，118名（55.4%）从事GC工作。
一份专门为本研究设计的结构化问卷，重点关注护理中能力发展的需求和可能性。
注册护士在平均水平上在所检查的领域并不缺乏或几乎不缺乏知识。然而，GC组的注册护士在痴呆症、跌倒和跌倒伤害方面的知识比DC组的注册护士缺乏的程度更大。DC组的注册护士认为工作中有更大的能力发展可能性。大多数注册护士要求有更好的能力发展组织，特别是在GC组。大多数注册护士没有得到监督。注册护士的能力使用率很高，尽管他们在大约一半的工作时间里使用了自己最高水平的能力。雇主对注册护士继续教育的资金投入很少。
需要有更好的组织和更大的注册护士能力发展可能性。雇主需要在经济上对注册护士的继续教育做出更大贡献。为注册护士提供监督至关重要。
