Dahlke Sherry, Baumbusch Jennifer
Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.
School of Nursing, University of British Columbia, Vancouver, BC, Canada.
J Clin Nurs. 2015 Nov;24(21-22):3177-85. doi: 10.1111/jocn.12961. Epub 2015 Aug 27.
To offer an explanation of how registered nurses' are providing care to hospitalised older adults in nursing teams comprised of a variety of roles and educational levels.
Around the globe economic pressures, nursing shortages and increased patient acuity have resulted in tasks being shifted to healthcare workers with less education and fewer qualifications than registered nurses. In acute care hospitals, this often means reducing the number of registered nurses and adding licensed practical nurses and care aides (also referred to as unregulated healthcare workers) to the nursing care team. The implications of these changes are not well understood especially in the context of hospitalised older adults, who are complex and the most common care recipients.
Thematic analysis of data that were collected in a previous grounded theory study to provide an opportunity in-depth analysis of how nurses provided care to hospitalised older adults within nursing teams.
Data collected in western Canada on two hospital units in two different health authorities were analysed in relation to how nursing teams provide care. Hand coding and thematic analysis were employed.
The themes of scrutinised skill mix and working together highlighted how the established nursing value of reciprocity is challenging to enact in teams with a variety of scopes of practice. The value of reciprocity both aided and hindered the nursing team in engaging in team behaviours to effectively manage patient care.
Educators and leaders could assist the nursing care team in re-thinking how they engage in teamwork by providing education about roles and communication techniques to support teams and ultimately improve nursing care.
The value of reciprocity within nursing teams needs to be re-examined within the context of team members with varying abilities to reciprocate in kind.
解释注册护士如何在由不同角色和教育水平人员组成的护理团队中为住院老年人提供护理。
在全球范围内，经济压力、护理人员短缺以及患者病情严重程度增加，导致任务被转移到教育程度和资质低于注册护士的医护人员身上。在急症护理医院，这通常意味着减少注册护士数量，并在护理团队中增加执业护士和护理助理（也称为非正规医护人员）。这些变化的影响尚未得到充分理解，尤其是在住院老年人这一复杂且最常见的护理对象背景下。
对先前扎根理论研究中收集的数据进行主题分析，以便有机会深入分析护士如何在护理团队中为住院老年人提供护理。
对在加拿大西部两个不同卫生当局的两个医院科室收集的数据进行分析，内容涉及护理团队如何提供护理。采用手工编码和主题分析方法。
仔细审视技能组合和协作的主题突出表明，在具有不同执业范围的团队中，既定的护理互惠价值难以实现。互惠价值既有助于也阻碍护理团队采取团队行为来有效管理患者护理。
教育工作者和领导者可以通过提供关于角色和沟通技巧的教育来支持团队，从而协助护理团队重新思考他们开展团队合作的方式，最终改善护理服务。
在团队成员回报能力各异的背景下，需要重新审视护理团队内部的互惠价值。
