Halcomb Elizabeth, Fernandez Ritin, Ashley Christine, McInnes Susan, Stephen Catherine, Calma Kaara, Mursa Ruth, Williams Anna, James Sharon
School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, New South Wales, Australia.
Illawarra Health & Medical Research Institute, Wollongong, New South Wales, Australia.
J Adv Nurs. 2022 May;78(5):1327-1336. doi: 10.1111/jan.15046. Epub 2021 Sep 23.
To validate the 'safe and effective staffing tool' and explore the impact of COVID-19 on the quality of Australian primary health care (PHC).
A national survey was conducted from October to December 2020.
The online survey was distributed via social media and professional organisations to PHC nurses.
Three-hundred fifty-nine PHC nurses participated. A two-factor solution was found with factors named; 'Perception of quality of care provided' and 'Personal satisfaction with care delivered'. Cronbach's alpha demonstrated good internal consistency for the total scale (α = .915) and each subscale (α = .879/α = .864). Nearly three-quarters of participants (71.3%) were satisfied with the quality of care they delivered. Participants working in general practice, and those with more nursing experience had significantly higher scores in the factor 'perceptions of quality of care provided' and the total 'quality and satisfaction with care'. A lack of time, inadequate supervision and support, and performing non-nursing duties were reported to be impacting care quality. Most participants (80.5%) reported that COVID-19 had impacted negatively on the detection and management of non-COVID related health conditions.
The 'safe and effective staffing tool' is a valid and reliable measure of perceived quality of care and satisfaction with care delivered. Many PHC nurses perceive that there has been an overall reduction in the quality of care delivered due to COVID-19 and feel that there is a lack of adequate supervision and workplace support. Given the limited baseline data, further research is required to understand the extent that COVID-19 impacts these findings. However, this study demonstrates that strategies need to be implemented to support PHC nurses to provide high-quality care to optimise health outcomes and maintain nurse satisfaction.
This is the first attempt to evaluate care quality in Australian PHC. Policymaking requires this evidence to drive changes to better support PHC nurses.
验证“安全有效的人员配置工具”，并探讨新冠疫情对澳大利亚初级卫生保健（PHC）质量的影响。
于2020年10月至12月进行了一项全国性调查。
通过社交媒体和专业组织向初级卫生保健护士发放在线调查问卷。
359名初级卫生保健护士参与了调查。发现了一个双因素解决方案，因素分别命名为“对所提供护理质量的认知”和“对所提供护理的个人满意度”。克朗巴哈系数显示整个量表（α = 0.915）和每个子量表（α = 0.879/α = 0.864）具有良好的内部一致性。近四分之三的参与者（71.3%）对他们提供的护理质量感到满意。在全科医疗工作的参与者以及那些有更多护理经验的人在“对所提供护理质量的认知”因素和“护理质量与满意度”总分方面得分显著更高。据报告，时间不足、监督和支持不足以及执行非护理职责正在影响护理质量。大多数参与者（80.5%）报告称，新冠疫情对非新冠相关健康状况的检测和管理产生了负面影响。
“安全有效的人员配置工具”是对感知护理质量和对所提供护理满意度的有效且可靠的衡量标准。许多初级卫生保健护士认为，由于新冠疫情，所提供的护理质量总体下降，并且感到缺乏足够的监督和工作场所支持。鉴于基线数据有限，需要进一步研究以了解新冠疫情对这些结果的影响程度。然而，本研究表明需要实施策略来支持初级卫生保健护士提供高质量护理，以优化健康结果并维持护士满意度。
这是首次对澳大利亚初级卫生保健中的护理质量进行评估。政策制定需要此证据来推动变革，以更好地支持初级卫生保健护士。
