护士对老年患者出院后护理服务人员配备充足程度的评估。
Nurses' assessments of staffing adequacy in care services for older patients following hospital discharge.
机构信息
Norwegian Social Research (NOVA), Oslo Metropolitan University, Oslo, Norway.
出版信息
J Adv Nurs. 2021 Feb;77(2):805-818. doi: 10.1111/jan.14636. Epub 2020 Nov 22.
AIMS
To explore community nurses' assessments of staffing adequacy in care provision for older patients following hospital discharge and analyse the extent to which their assessments are associated with characteristics of the system level of municipality and vertical coordination between hospital and community care services.
DESIGN
Nation-wide cross-sectional survey.
METHODS
Web-based survey conducted in 2017 among 3,461 nurses working with older persons (65+) in homecare services, residential care and nursing homes in Norway. Responses from individual homecare nurses were linked with municipal-level register data (age structure, economic flexibility, service profiles). Stratified multilevel analyses were used to analyse the association of staffing adequacy with municipal characteristics and perceived quality of vertical coordination.
RESULTS
Almost half of the nurses experienced inadequate staffing in general, whereas a similar share indicated that staffing was adequate. Nursing home nurses showed the least positive ratings of staffing adequacy. Most nurses indicated that there were too many unqualified care workers at their workplace. More positive assessments of staffing adequacy were associated with better vertical coordination. Average ratings of staffing adequacy were lower in larger municipalities and municipalities with an older population.
CONCLUSION
Healthcare providers, nurse managers and policy makers may benefit from a stronger focus on rebalancing skill-mix and on new models of vertical coordination in addressing current and future nurse staffing shortages in care services for older people following hospital discharge.
IMPACT STATEMENT
This study adds to the scarce national and international research literature on nurse staffing in community care services, addressing the pressing challenges of staffing and skill- mix in long-term care provision. Findings support the development of nurse-led models of care coordination for older patients following hospital discharge and stimulate future research on the effects of recruitment and retainment strategies in different municipalities and different models of vertical coordination.
目的
探讨社区护士对出院后老年患者护理提供的人员配备充足程度的评估，并分析其评估与市县级系统水平特征和医院与社区护理服务之间垂直协调的程度之间的关系。
设计
全国性横断面调查。
方法
2017 年，在挪威的家庭护理服务、养老院和护理院中，对从事老年人（65 岁以上）护理工作的 3461 名护士进行了基于网络的调查。个别家庭护理护士的回复与市县级登记数据（年龄结构、经济灵活性、服务概况）相关联。使用分层多水平分析来分析人员配备充足度与市县级特征和感知的垂直协调质量之间的关系。
结果
近一半的护士普遍认为人员配备不足，而同样比例的护士认为人员配备充足。养老院护士对人员配备充足度的评价最低。大多数护士表示，他们工作场所的非合格护理人员太多。对人员配备充足度的评价越积极，垂直协调越好。在人口较多的较大的市县级，人员配备充足度的平均评分较低。
结论
医疗保健提供者、护士管理人员和政策制定者可能会受益于更加强调重新平衡技能组合和新的垂直协调模式，以解决出院后老年患者护理服务中当前和未来的护士人员配备短缺问题。
意义
本研究补充了关于社区护理服务中护士人员配备的稀缺的国家和国际研究文献，解决了长期护理服务中人员配备和技能组合的紧迫挑战。研究结果支持为出院后的老年患者开发以护士为主导的护理协调模式，并激发了对不同市县级和不同垂直协调模式的招聘和保留策略的影响的未来研究。
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