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: This article explores how registered nurses (RNs) in long-term care (LTC) understand their role as charge nurses. Data are derived from 16 charge nurses employed in 8 facilities in Ontario, Canada. Qualitative methods are used to analyze audiotapings of interviews. The findings reveal a range of dimensions and subdimensions. Charge nurses experience their work as highly complex and unpredictable. Themes that captured the following dimensions of the supervisor role in LTC include (a) against all odds, getting through the day; (b) stepping in work; and (c) leading and supporting unregulated care workers. In addition, analysis within each category reveals a complex intersection between the nurses’ perceptions of the context and their consequent work strategies. The emerging demands placed on supervisors due to the growing complexity of residents, increasing government regulations, and staffing shortages have caused the role of the charge nurse to evolve with little reflection on its impact.Journal of Applied Gerontology 11/2009; 28(6):723-742. DOI:10.1177/0733464809336088
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ABSTRACT: Although the importance of nurse leadership stability and participation in decision making in nursing homes is well established, scarce literature exists on determinants of intent to leave among directors of nursing (DONs) in nursing homes. : The purpose of this study was to examine factors associated with DON intent to leave in nursing homes. We examined potential factors associated with DON intent to leave at three levels: individual DON characteristics, facility, and county-level market factors. A survey of nurse supervisors in Texas nursing homes, the 2003 Texas Nursing Facility Medicaid Cost Report, and the Area Resource File were merged. We only included respondents who identified themselves as DONs in this study (572 observations). We examined bivariate differences in individual DON characteristics on the basis of facility ownership (for-profit versus not-for-profit homes) and geographic location (urban versus rural location). We constructed three alternative logit models to explore the relationships between DON intent to leave and DON, facility, and market characteristics. DONs working in for-profit homes were more inclined to leave, less satisfied with their job, and had lower levels of perceived empowerment in terms of autonomy. Educational level and intention to leave were significantly higher for DONs working in urban areas. Job satisfaction was significantly and inversely associated with intent to leave in all three models. Higher perceived salary competitiveness and level of empowerment were associated with reduced odds of intending to leave. Higher educational levels were associated with higher odds of intentions to leave. Nursing homes should focus on improving DON job satisfaction, empowerment in decision making, and salary competitiveness when designing retention strategies for DONs.Health care management review 01/2010; 35(3):246-55. DOI:10.1097/HMR.0b013e3181dc826d
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ABSTRACT: to explore the challenges and barriers faced by Palestinian maternal health-care providers (HCPs) to the provision of quality maternal health-care services through a case study of a Palestinian public referral hospital in the Occupied Palestinian Territory. descriptive qualitative study. The data are from a broader study, conducted in 2005 at the same hospital as part of a baseline assessment of maternal health services. 31 maternal HCPs; nine midwives and 14 nurses and eight doctors. the quality of care provided for women and infants at this Palestinian public hospital is substandard. The maternal HCPs work within a difficult and resource-constrained environment. ISSUES INCLUDE: high workload, poor compensation, humiliation in the workplace, suboptimal supervision and the absence of professional support and guidance. Midwives are perceived to be at the bottom of the health professional hierarchy. there is a need for managers and policy makers to enable maternal HCPs to provide better quality care for women and infants during childbirth, through facilitating the roles of midwives and nurses and creating a more positive and resourceful environment. Palestinian midwives need to increase their knowledge and use evidence-based practices during childbirth. They need to unite and create their own circle of professional support in the form of a Palestinian midwifery professional body.Midwifery 09/2009; 27(2):154-9. DOI:10.1016/j.midw.2009.05.007