Fineczko Julia, Chu Charlene H, Cranley Lisa, Wills Aria, McGilton Katherine S
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.
J Nurs Manag. 2023 Nov 6;2023:8200746. doi: 10.1155/2023/8200746. eCollection 2023.
To identify and examine the structures and processes that support the director of nursing role in long-term care homes.
The director of nursing in long-term care homes is central to overseeing and supporting the workforce and delivery of safe, quality resident care. With ongoing health human resource challenges and an aging population requiring care from long-term care homes, it is important to understand what individual and organizational factors support the director of nursing leadership in these settings. . This review was guided by Cooper's five stages of the integrative review process. Donabedian's structure-process-outcome framework was applied to synthesize the literature. . Five individual-level structures (years of experience, level of education, demonstrated leadership capabilities, completed certification and/or established linkages with a professional association, and completed continuing education); three organizational-level structures (physical presence of leadership across the organization, a clear job description, and salary); and four processes (nursing home administrators and the director of nursing relationship, availability of onsite continuing education opportunities targeting directors of nursing and support for continuing education, cultivating relationships and enhancing networks beyond the long-term care home, and orientation to the role) were identified across 11 articles to support the director of nursing role in long-term care homes. . The findings indicate that there are individual characteristics that support the director of nursing in their role. Notably, there are organizational structures and processes that can be modified at the practice and policy level to better recruit, retain, and support the performance of directors of nursing. . There are actionable steps that leaders and decision-makers can take to support nursing leadership across long-term care homes and directly address health human resource challenges.
识别并审视在长期护理机构中支持护理主任角色的结构和流程。
长期护理机构中的护理主任对于监督和支持员工队伍以及提供安全、优质的居民护理至关重要。鉴于持续存在的卫生人力资源挑战以及需要长期护理机构护理的老龄化人口，了解在这些环境中支持护理主任领导力的个人和组织因素非常重要。 本综述以库珀综合综述过程的五个阶段为指导。应用唐纳贝迪安的结构-过程-结果框架来综合文献。 在11篇文章中确定了五个个人层面的结构（工作年限、教育水平、展现出的领导能力、完成认证和/或与专业协会建立联系以及完成继续教育）；三个组织层面的结构（整个组织中领导的实际存在、明确的工作描述和薪资）；以及四个流程（疗养院管理人员与护理主任的关系、针对护理主任的现场继续教育机会的可用性以及对继续教育的支持、在长期护理机构之外培养关系和加强网络以及角色定位），以支持长期护理机构中护理主任的角色。 研究结果表明，存在支持护理主任履行其职责的个人特征。值得注意的是，在实践和政策层面可以对组织结构和流程进行修改，以更好地招聘、留住和支持护理主任的工作表现。 领导者和决策者可以采取切实可行的步骤来支持长期护理机构中的护理领导工作，并直接应对卫生人力资源挑战。
