Division of Occupational Therapy, Department NVS, Karolinska Institutet, Stockholm, Sweden.
J Clin Nurs. 2019 Aug;28(15-16):2760-2768. doi: 10.1111/jocn.14884. Epub 2019 May 13.
To explore and describe how daily work at a nursing home had been influenced by a quality improvement project, from the perspective of direct care staff.
Deficiencies in nursing home care are widely reported, often with a focus on lack of competence among direct care staff. The present trend in quality development in nursing homes brings direct care staff's perspectives into focus through participatory action research approaches. Still, little is known about how staff experience the impact of such projects on their everyday work.
The study was designed as an interpretive descriptive study, based on interviews with nursing home staff. The methods were conducted in accordance with the SRQR guidelines.
The analysis revealed that the participants reasoned on whether the improvement project contributed to their possibilities perform their work at the unit for the benefit of the residents. This was strongly connected to their professional pride. The participants reflected on this through three changes generated by the project: (a) participating in project activities-supporting or threatening daily work at the unit, (b) from performing individual duties towards a shared responsibility and (c) confirming and strengthening competence that brings the everyday situation of residents into focus.
The importance of professional pride identified in this study points towards a need for reducing barriers for direct care staff to express and develop competences they regard as part of their professional identity. The findings also shed some light on competence that brings the everyday situation of residents into focus as a driving force behind lack of compliance and resistance to change.
The findings indicate a call for quality development designs to reduce barriers for care staff to express and develop knowledge that they regard as part of their professional identity.
从直接护理人员的角度探讨和描述养老院的日常工作如何受到质量改进项目的影响。
养老院护理的缺陷得到了广泛的报道,通常集中在直接护理人员缺乏能力上。目前,养老院质量发展的趋势通过参与式行动研究方法将直接护理人员的观点聚焦。尽管如此,对于工作人员如何体验这些项目对他们日常工作的影响,我们知之甚少。
该研究设计为解释性描述性研究,基于对养老院工作人员的访谈。方法是根据 SRQR 指南进行的。
分析表明,参与者考虑了改进项目是否有助于他们为了居民的利益在单位履行工作的可能性。这与他们的职业自豪感密切相关。参与者通过项目产生的三个变化来思考这一点:(a) 参与项目活动——支持或威胁单位的日常工作,(b) 从履行个人职责转变为共同责任,以及 (c) 确认和加强使居民日常情况成为焦点的能力。
本研究确定的职业自豪感的重要性表明,需要减少直接护理人员表达和发展他们认为是其职业身份一部分的能力的障碍。研究结果还揭示了使居民日常情况成为焦点的能力是违反规定和抵制变革的驱动力。
研究结果表明,需要进行质量改进设计,以减少护理人员表达和发展他们认为是其职业身份一部分的知识的障碍。