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跨专业团队合作、老年护理质量与离职意愿:55 家急性老年病单位的横断面研究。

Interprofessional teamwork, quality of care and turnover intention in geriatric care: A cross-sectional study in 55 acute geriatric units.

机构信息

Department of Geriatric Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.

Department of Geriatric Medicine, St. Jan Hospital Bruges, Bruges, Belgium.

出版信息

Int J Nurs Stud. 2019 Mar;91:94-100. doi: 10.1016/j.ijnurstu.2018.11.011. Epub 2018 Dec 31.

Abstract

BACKGROUND AND OBJECTIVES

The complex health problems of older persons require that health professionals closely work together, in particular when an acute decline necessitates admission at an acute geriatric unit. These working conditions may cause additional stress in staff. This study aims to identify the relation between interprofessional teamwork, the quality of care and turnover intention in acute geriatric units.

DESIGN, SETTING, PARTICIPANTS AND METHODS: Perceptions of interprofessional teamwork, quality of care and turnover intention among team members of 55 acute geriatric units were measured using validated questionnaires. A multilevel linear regression model was built for quality of care and logistic regression for turnover intention, with random intercept for acute geriatric unit.

RESULTS

The overall response rate was 60%. Of the 890 respondents, 71% were nursing professionals, 20% allied health professionals, 5% physicians, and 4% administrative staff. Twenty-three percent reported poor to fair quality of care in their unit; 19% was not sure that patients or families had been given enough means to organise care after discharge. Fifteen percent reported turnover intention (18%, 8%, 9% and 11% among nursing professionals, allied health professionals, physicians and administrative workers respectively, p = 0.005). Higher perceived interprofessional teamwork was related to higher quality of care (estimated coefficient 0.05, p < 0.001) and lower turnover intention in nursing professionals only (estimated OR 0.94, p < 0.001).

CONCLUSION

Creating a care environment of good interprofessional teamwork can help acute geriatric units to retain nursing professionals in the job and achieve higher quality of care.

摘要

背景与目的

老年人的复杂健康问题需要卫生专业人员密切合作,尤其是在急性衰退需要入住急性老年科病房时。这些工作条件可能会给员工带来额外的压力。本研究旨在确定急性老年科病房中跨专业团队合作、护理质量和离职意愿之间的关系。

设计、地点、参与者和方法:使用经过验证的问卷测量了 55 个急性老年科病房的团队成员对跨专业团队合作、护理质量和离职意愿的看法。建立了一个多水平线性回归模型来测量护理质量,使用逻辑回归来测量离职意愿,急性老年科病房的随机截距。

结果

总的回应率为 60%。在 890 名受访者中,71%为护理专业人员,20%为辅助卫生专业人员,5%为医生,4%为行政人员。23%的人报告其所在单位的护理质量差或一般;19%的人不确定患者或家属在出院后是否有足够的手段来组织护理。15%的人报告有离职意愿(护理人员、辅助卫生专业人员、医生和行政人员的离职意愿分别为 18%、8%、9%和 11%,p=0.005)。感知到的跨专业团队合作程度越高,护理质量越高(估计系数为 0.05,p<0.001),仅护理专业人员的离职意愿越低(估计比值比为 0.94,p<0.001)。

结论

营造良好的跨专业团队合作的护理环境可以帮助急性老年科病房留住护理人员,提高护理质量。

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