An investigation into the effect of a staffing strategy on patient care in a selected hospital in Kwazulu-Natal

[摘要] The South African Nursing Council believes that 'quality nursing practice is based onadequate knowledge, skills or competencies, ethically and scientifically basedcomprehensive and holistic patient care, timely, accurate and complete or comprehensiverecording (SANC, n.d.). The aim of professional regulation is to protect the public fromunsafe practices and to ensure quality services (SANC, n.d.).A shortage of nursing staff resulted in the implementation of a staffing strategy of increasingthe work hours of nurses by ten hours a week. Patient complaints and unacceptable patientincidences resulted in it becoming essential to evaluate the effect of this strategy on patientcare. As a goal of this study, the researcher decided to investigate the quality of patient carebefore the implementation of the strategy and the effect of the strategy on patient care afterthe implementation.The objectives of the study were set to determine whether• The patients were assessed according to activities of daily living and psychosocialdata;• The nursing diagnosis was done• Nursing interventions are prescribed for each problem identified• The patients' records were utilised to enhance individualised patient care and toensure responsibility and accountability for patient care• The evaluation of patient progress was done according to the different prescriptionsand interventions at least twice in 24 hours• A written final report for discharge criteria and health education was provided• A comparison of the quality of nursing care delivered before and after theimplementation of the staffing strategy existResearch questionWhat is the effect of an implemented staffing strategy in a selected hospital in KwaZulu-Natalon the quality of care delivered?Research methodology A non-experimental, descriptive design with a quantitative approach was applied.Population and samplingThe target population for the study was patient care records of patients who werehospitalised during 2003.A non-probability convenience sample for a retrospective audit of a total of 372 patient carerecords over a period of 12 months was audited. An evaluation of the records was done anda comparison was drawn between the results obtained before and after the implementationof the staffing strategy. For both periods, 186 patient records were audited. The pilot studyincluded the audit of 40 files.Reliability and validity were assured with a pilot study and the use of experts in nursingmanagement, quality assurance, research methodology and statistics. The researcheraudited the patient files personally.Ethical approval was obtained from Stellenbosch University and the ethics committee of thehospital. All principles related to ethics, such as confidentiality and anonymity, weremaintained. Neither patient names were used nor the name of the hospital or wards fromwhich the records were used. Codes were used to identify the hospital wards. The hospitalwas informed in the letter requesting consent to conduct the research, that the researcherintends publishing the findings of the research.Data analysis and interpretationStatistical associations using Chi-square tests were carried out to determine the significancebetween the various variables. The results of this study were presented in percentages,tables and histograms. Findings obtained showed that the quality of nursing declined afterthe strategy. Documentation of patient records was incomplete and did not meet legalrequirements.RecommendationsThe implementation and maintenance of a quality assurance programme, human resourcemanagement, the on-going use of the nursing process and record keeping should beemphasised in the clinical practice environment and in the formal education environment.

[发布机构] Stellenbosch University