Caspar Sienna, Brassolotto Julia M, Cooke Heather A
University of Lethbridge, Lethbridge, AB, Canada.
University of British Columbia, Vancouver, BC, Canada.
Int J Older People Nurs. 2021 Jan;16(1):e12345. doi: 10.1111/opn.12345. Epub 2020 Sep 15.
Consistent assignment (CA) is the practice within long-term care (LTC) by which care staff work with the same residents almost every shift for an indefinite period of time. CA is considered by many to be essential to person-centred care.
This paper explores how staff assignment practices impact the caregiving experience from the perspectives of resident care aides (RCAs), residents and family members and, by doing so, describe the nuanced conditions under which CA may or may not be beneficial to all, and why.
Data are drawn from 40 in-depth interviews conducted as part of a larger institutional ethnography exploring the social organisation of care in three purposively selected LTC homes in Western Canada. Data analysis was based on the principles of constant comparison.
RCAs, residents and family members described the primary benefit of CA as being able to 'get to know' each other well and form meaningful relationships. However, the RCAs also indicated that CA can contribute to feelings of isolation, which has negative effects on worker comfort and satisfaction, care team dynamics and communication, and resident care.
Management initiatives are needed to ensure that the implementation of CA does not result in the unintended consequences of decreasing RCAs' experience of teamwork, decreasing RCAs' exchange of individualised resident care information, or negatively impacting RCAs' ability and desire to care for each other as well as the residents.
The staffing practice of consistent assignment in long-term care homes provides increased opportunities for the development of stronger staff-resident and staff-family member relationships. Findings from this study enable us to offer several, evidenced-based recommendations for ensuring the successful implementation of consistent assignment, such that it may be beneficial to all.
持续分配（CA）是长期护理（LTC）中的一种做法，即护理人员几乎每个班次都与相同的居民合作，且时间不限。许多人认为持续分配对于以患者为中心的护理至关重要。
本文从居民护理助理（RCA）、居民及其家庭成员的角度探讨员工分配做法如何影响护理体验，并据此描述持续分配可能对所有人有益或可能无益的细微差别情况及其原因。
数据来自40次深度访谈，这些访谈是作为一项更大规模的机构人种志研究的一部分进行的，该研究旨在探索加拿大西部三个经过有目的挑选的长期护理机构中的护理社会组织。数据分析基于持续比较的原则。
居民护理助理、居民及其家庭成员将持续分配的主要益处描述为能够相互“深入了解”并建立有意义的关系。然而，居民护理助理也指出，持续分配可能导致孤立感，这会对员工的舒适度和满意度、护理团队的动态和沟通以及居民护理产生负面影响。
需要采取管理举措，以确保持续分配的实施不会产生意外后果，即不会减少居民护理助理的团队合作体验、减少居民护理助理之间个性化居民护理信息的交流，或对居民护理助理相互照顾以及照顾居民的能力和意愿产生负面影响。
长期护理机构中的持续分配人员做法为建立更牢固的员工与居民以及员工与家庭成员关系提供了更多机会。本研究的结果使我们能够提供一些基于证据的建议，以确保持续分配的成功实施，使其对所有人都有益。
