Staffing adequacy, supervisory support and quality of care in long-term care settings: staff perceptions.
ABSTRACT This paper is a report of a study to explore relationships between perceived care quality, self-assessed professional skills, and the perceptions of the quality-related factors.
The work in long-term care is more demanding than in the past. The quality of care is strongly related to the well-being and job satisfaction of staff. Those emerge in part through a perception of resources allocated to caring and also through a perception of the quality achieved.
Data were collected in Finland in 2002 using a questionnaire sent to the nursing staff working in 112 wards in 40 long-term care institutions monitoring their care with the Resident Assessment Instrument System. Institutions were invited to participate the survey. The response rate was 70.2% (n = 1262). The respondents represented 3.8% of nursing personnel working in long-term care institutions.
Staff members who perceived staffing levels as inadequate and supervisory support as insufficient had lower perceptions of their own professional skills and the quality of care. Perceptions of empowering support behaviour were more strongly associated to self-assessed skills and to perceived care quality than perceptions of skills-oriented support activities. Staff members with short professional training, older staff members and staff members with long work experience in the unit had lower perceptions of their professional skills than other groups.
The perception of adequate staffing and of sufficient supervisory support, especially empowering support increases the probability of perceiving the care quality as good. If supervisors concern themselves with staff members' perceptions, they can better identify the staffing needs and also the support needs of personnel.
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ABSTRACT: AIM(S) OF THE STUDY: This study is part of a larger research project (1995-1998) aiming at quality improvement by means of clinical supervision (CS). The purpose of the study is to ascertain the conceptions of five ward teams having CS of its effects on the quality of care. The quality of nursing care has been debated since at least the 1980s. An extensive literature and research reports describe a variety of interventions and methods to improve the quality of care. One of the interventions is CS. However, the amount of empirical research exploring the effects of CS especially on the quality of care is limited. Data were collected using group interviews and analysed using the method of phenomenography. The following categories describing the conceptions related to CS and to the quality of care emerged: knowledge, change and 'I and we as providers of quality'. Conceptions of the effects varied between and within the teams and sometimes contradicted each other. The importance of knowledge was underlined on three of the five wards. The patient's point of view emerged only on one ward. It can be concluded that CS has effects on the quality of care and it can be considered a quality improving intervention in nursing practice. However, the knowledge of the different conceptions produced in this study also gives proof that team supervision is a challenge for supervisors.Journal of Advanced Nursing 03/2001; 33(4):492-502. · 1.53 Impact Factor
- Quality in Health Care 07/2001; 10(2):65-6.
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ABSTRACT: Definitions and uses of the concept of empowerment are wide-ranging: the term has been used to describe the essence of human existence and development, but also aspects of organizational effectiveness and quality. The empowerment ideology is rooted in social action where empowerment was associated with community interests and with attempts to increase the power and influence of oppressed groups (such as workers, women and ethnic minorities). Later, there was also growing recognition of the importance of the individual's characteristics and actions. Based on a review of the literature, this paper explores the uses of the empowerment concept as a framework for nurses' professional growth and development. Given the complexity of the concept, it is vital to understand the underlying philosophy before moving on to define its substance. The articles reviewed were classified into three groups on the basis of their theoretical orientation: critical social theory, organization theory and social psychological theory. Empowerment seems likely to provide for an umbrella concept of professional development in nursing.Journal of Advanced Nursing 02/2000; 31(1):235-41. · 1.53 Impact Factor