专业护理机构人员短缺:来源、策略以及对留下来的员工的影响。

IF 3.1 2区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Natalie E Leland, Rachel A Prusynski, Amanda D Shore, Michael P Cary, Jason Falvey, Tracy Mroz, Debra Saliba
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引用次数: 0

摘要

目的:研究熟练护理设施(SNF)在 COVID-19 大流行期间各岗位人员短缺的情况。我们旨在从领导者的角度了解人员短缺的广度及其对整个大流行期间留守员工的影响,从而为今后加强专业护理机构员工队伍的政策和实践提供建议:在这项定性研究中,我们在 2021 年 1 月至 2022 年 12 月期间对 SNF 领导者(n = 94)进行了有目的性的全国抽样一对一访谈:通过有目的的抽样(即医疗保险和医疗补助中心的质量评级、地区、所有权)来捕捉 SNF 组织的差异,我们进行了深入的半结构化定性访谈,事先以医学研究所的医疗保健系统框架模型为指导。访谈通过电话进行,并进行了录音和转录。采用严格的快速定性分析来确定新出现的主题、模式和关系:SNF领导一致描述了所有岗位的人员短缺情况,包括直接护理(如活动、护理、社会服务)、支持服务(如洗衣、食品、环境服务)、行政人员和领导。造成人员短缺的原因是多方面的(如薪酬竞争、家庭护理需求、职业倦怠)。所有留下来的工作人员都感受到了人员短缺的影响。除了现有的工作职责外,留下来的工作人员还经历了重新分配基本的日常业务任务(如洗衣)和分配新的 COVID-19 大流行病相关活动(如筛查)。交叉培训涵盖了广泛的工作职责,包括病人护理:除直接护理人员外,还需要制定相关政策,为 SNF 员工提供跨角色支持。这些政策必须解决造成人员短缺的全系统驱动因素(如薪酬差异、职业倦怠),并充分利用大流行病中出现的策略(如交叉培训、工作角色灵活性),以确保能够满足患者需求的可持续 SNF 员工队伍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Skilled nursing facility staffing shortages: Sources, strategies, and impacts on staff who stayed.

Objective: To examine skilled nursing facility (SNF) staffing shortages across job roles during the COVID-19 pandemic. We aimed to capture the perspectives of leaders on the breadth of staffing shortages and their implications on staff that stayed throughout the pandemic in order to provide recommendations for policies and practices used to strengthen the SNF workforce moving forward.

Study setting and design: For this qualitative study, we engaged a purposive national sample of SNF leaders (n = 94) in one-on-one interviews between January 2021 and December 2022.

Data source and analytic sample: Using purposive sampling (i.e., Centers for Medicare & Medicaid quality rating, region, ownership) to capture variation in SNF organizations, we conducted in-depth, semi-structured qualitative interviews, guided a priori by the Institute of Medicine's Model of Healthcare System Framework. Interviews were conducted via phone, audio-recorded, and transcribed. Rigorous rapid qualitative analysis was used to identify emergent themes, patterns, and relationships.

Principal findings: SNF leaders consistently described staffing shortages spanning all job roles, including direct care (e.g., activities, nursing, social services), support services (e.g., laundry, food, environmental services), administrative staff, and leadership. Ascribed sources of shortages were multidimensional (e.g., competing salaries, family caregiving needs, burnout). The impact of shortages was felt by all staff that stayed. In addition to existing job duties, those remaining staff experienced re-distribution of essential day-to-day operational tasks (e.g., laundry) and allocation of new COVID-19 pandemic-related activities (e.g., screening). Cross-training was used to cover a wide range of job duties, including patient care.

Conclusions: Policies are needed to support SNF staff across roles beyond direct care staff. These policies must address the system-wide drivers perpetuating staffing shortages (i.e., pay differentials, burnout) and leverage strategies (i.e., cross-training, job role flexibility) that emerged from the pandemic to ensure a sustainable SNF workforce that can meet patient needs.

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来源期刊
Health Services Research
Health Services Research 医学-卫生保健
CiteScore
4.80
自引率
5.90%
发文量
193
审稿时长
4-8 weeks
期刊介绍: Health Services Research (HSR) is a peer-reviewed scholarly journal that provides researchers and public and private policymakers with the latest research findings, methods, and concepts related to the financing, organization, delivery, evaluation, and outcomes of health services. Rated as one of the top journals in the fields of health policy and services and health care administration, HSR publishes outstanding articles reporting the findings of original investigations that expand knowledge and understanding of the wide-ranging field of health care and that will help to improve the health of individuals and communities.
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