Taylor Janice, Sims Jane, Haines Terry P
Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia.
J Adv Nurs. 2014 Dec;70(12):2767-78. doi: 10.1111/jan.12425. Epub 2014 Apr 15.
To explore mobility care as provided by care staff in nursing homes.
Care staff regularly assist residents with their mobility. Nurses are increasingly reliant on such staff to provide safe and quality mobility care. However, the nature of care staff decision-making when providing assistance has not been fully addressed in the literature.
A focused ethnography.
The study was conducted in four nursing homes in Melbourne, Australia. Non-participant observations of residents and staff in 2011. Focus groups with 18 nurses, care and lifestyle staff were conducted at three facilities in 2012. Thematic analysis was employed for focus groups and content analysis for observation data. Cognitive Continuum Theory and the notion of 'situation awareness' assisted data interpretation.
Decision-making during mobility care emerged as a major theme. Using Cognitive Continuum Theory as a guide, nursing home staff's decision-making was described as ranging from system-aided, through resident- and peer-aided, to reflective and intuitive. Staff seemed aware of the need for resident-aided decision-making consistent with person-centred care. Habitual mobility care based on shared mental models occurred. It was noted that levels of situation awareness may vary among staff.
Care staff may benefit from support via collaborative and reflective practice to develop decision-making skills, situation awareness and person-centred mobility care. Further research is required to explore the connection between staff's skills in mobility care and their decision-making competence as well as how these factors link to quality mobility care.
探讨养老院护理人员提供的移动护理服务。
护理人员经常协助居民进行移动。护士越来越依赖这些人员来提供安全且高质量的移动护理。然而，文献中尚未充分探讨护理人员在提供协助时决策的性质。
聚焦人种志研究。
该研究在澳大利亚墨尔本的四家养老院进行。2011年对居民和工作人员进行非参与式观察。2012年在三家机构对18名护士、护理和生活方式工作人员进行焦点小组访谈。对焦点小组访谈采用主题分析法，对观察数据采用内容分析法。认知连续体理论和“情境意识”概念辅助数据解读。
移动护理过程中的决策成为一个主要主题。以认知连续体理论为指导，养老院工作人员的决策被描述为从系统辅助，到居民和同伴辅助，再到反思性和直觉性决策。工作人员似乎意识到需要与以人为主的护理相一致的居民辅助决策。基于共享心理模型的习惯性移动护理出现了。值得注意的是，工作人员的情境意识水平可能存在差异。
护理人员可能会从协作和反思性实践的支持中受益，以培养决策技能、情境意识和以人为主的移动护理。需要进一步研究来探索工作人员在移动护理方面的技能与其决策能力之间的联系，以及这些因素如何与高质量的移动护理相关联。
