Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.
School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
J Clin Nurs. 2018 Nov;27(21-22):4066-4076. doi: 10.1111/jocn.14548. Epub 2018 Jul 23.
To describe how home health nurses plan their daily work schedules and what challenges they face during the planning process.
Home health nurses are viewed as independent providers and value the nature of their work because of the flexibility and autonomy they hold in developing their work schedules. However, there is limited empirical evidence about how home health nurses plan their work schedules, including the factors they consider during the process and the challenges they face within the dynamic home health setting.
Qualitative descriptive design.
Semi-structured interviews were conducted with 20 registered nurses who had >2 years of experience in home health and were employed by one of the three participating home health agencies in the mid-Atlantic region of the United States. Data were analysed using conventional content analysis.
Four themes emerged about planning work schedules and daily itineraries: identifying patient needs to prioritise visits accordingly, partnering with patients to accommodate their preferences, coordinating visit timing with other providers to avoid overwhelming patients, and working within agency standards to meet productivity requirements. Scheduling challenges included readjusting the schedule based on patient needs and staffing availability, anticipating longer visits, and maintaining continuity of care with patients.
Home health nurses make autonomous decisions regarding their work schedules while considering specific patient and agency factors, and overcome challenges related to the unpredictable nature of providing care in a home health setting. Future research is needed to further explore nurse productivity in home health and improve home health work environments.
Home health nurses plan their work schedules to provide high quality care that is patient-centered and timely. The findings also highlight organisational priorities to facilitate continuity of care and support nurses while alleviating the burnout associated with high productivity requirements.
描述家庭保健护士如何规划他们的日常工作计划，以及他们在规划过程中面临的挑战。
家庭保健护士被视为独立的提供者，由于他们在制定工作计划时具有灵活性和自主权，因此重视工作的性质。然而，关于家庭保健护士如何规划工作计划，包括他们在该过程中考虑的因素以及在动态家庭保健环境中面临的挑战，几乎没有经验证据。
定性描述性设计。
对 20 名在家庭保健方面有超过 2 年经验并受雇于美国中大西洋地区的三个参与家庭保健机构之一的注册护士进行了半结构化访谈。使用常规内容分析对数据进行分析。
关于规划工作计划和日常行程，出现了四个主题：确定患者的需求，以便相应地优先考虑访问；与患者合作，以适应他们的偏好；协调访问时间与其他提供者，以避免使患者不堪重负；并在机构标准内工作，以满足生产力要求。调度挑战包括根据患者需求和人员配备情况调整日程安排，预测更长的访问时间，并与患者保持护理的连续性。
家庭保健护士在考虑特定患者和机构因素的情况下，对其工作计划做出自主决策，并克服了在家庭保健环境中提供护理的不可预测性质相关的挑战。需要进一步研究家庭保健中的护士生产力问题，并改善家庭保健工作环境。
家庭保健护士规划他们的工作计划，以提供以患者为中心且及时的高质量护理。研究结果还强调了组织重点，以促进连续性护理并为护士提供支持，同时减轻与高生产力要求相关的倦怠感。
