注册护士在市政家庭医疗保健中提升针对老年人的领导力所面临的挑战及改进建议。
Registered nurses' challenges and suggestions for improvement of their leadership close to older adults in municipal home healthcare.
作者信息
Lillsjö Erica, Bjuresäter Kaisa, Josefsson Karin
机构信息
Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, 651 88, Karlstad, Sweden.
Faculty for Nursing and Health Science, NORD University, 8026, Bodø, Norway.
出版信息
BMC Nurs. 2023 Mar 23;22(1):80. doi: 10.1186/s12912-023-01215-x.
BACKGROUND
Worldwide people are living longer. The need for healthcare for older adults is increasing. The trend is towards advanced home healthcare, where registered nurses are key figures. This implies challenges for municipal home healthcare, as well as for registered nurses' leadership. The aim is to explore registered nurses' perceptions of challenges and suggestions for improvements in their leadership close to older adults in municipal home healthcare.
METHODS
The present study is part of a larger web-based questionnaire survey with a cross-sectional design. The design is inductive, analysing data using qualitative content analysis and descriptive statistics. A questionnaire with open-ended and closed-ended questions was used. A total of n = 70 registered nurses leading close to older adults participated in seven municipalities in two geographic areas in Sweden.
RESULTS
The results show registered nurses' perceptions of challenges as leaders close to older adults in terms of 11 categories. The categories are motivating for care, adjusting and coordinating nursing care to the older adult, relating to next of kin, managing communication difficulties, relating to social situations in the home, managing demands, working alone, having lack of time, collaborating with physicians, and care staff having low competence. The registered nurses suggested improvements for their leadership close to older adults in terms of nine categories. The categories are adjusting the work to the older adult, clarifying registered nurses' responsibility, balancing demands and resources, setting time aside, improving staffs' competence, ensuring staff's competence development, improving the work environment, and cooperation between professions in the municipality, as well as between healthcare organizations.
CONCLUSION
The results show that registered nurses' leadership in municipal home healthcare implies a wide range of challenges. There is a need for strategies to improve the organizational preconditions to reduce challenges in registered nurses' leadership in order to promote positive patient outcomes for safe and quality care.
背景
全球范围内，人们的寿命越来越长。老年人对医疗保健的需求日益增加。目前的趋势是朝着先进的家庭医疗保健发展，注册护士是其中的关键人物。这对市政家庭医疗保健以及注册护士的领导力都意味着挑战。本研究旨在探讨注册护士对市政家庭医疗保健中接近老年人的领导力挑战的看法以及改进建议。
方法
本研究是一项基于网络的大型横断面问卷调查的一部分。该设计具有归纳性，使用定性内容分析和描述性统计方法分析数据。使用了一份包含开放式和封闭式问题的问卷。瑞典两个地理区域的七个城市中，共有n = 70名负责照顾老年人的注册护士参与了调查。
结果
结果显示，注册护士作为接近老年人的领导者，在11个类别方面面临挑战。这些类别包括激励护理工作、根据老年人情况调整和协调护理、与近亲沟通、应对沟通困难、处理家庭中的社交情况、应对各种要求、独自工作、时间不足、与医生协作以及护理人员能力低下。注册护士就接近老年人的领导力提出了九个类别的改进建议。这些类别包括根据老年人调整工作、明确注册护士的职责、平衡需求和资源、留出时间、提高员工能力、确保员工能力发展、改善工作环境、市政当局内各专业之间以及医疗保健组织之间的合作。
结论
结果表明，市政家庭医疗保健中注册护士的领导力面临广泛挑战。需要采取策略来改善组织前提条件，以减少注册护士领导力方面的挑战，从而为安全和高质量护理促进积极的患者结果。
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