基线的苏格兰安全人员配置法:定量调查结果。

IF 2.9 3区 医学 Q1 NURSING
Eileen T. Lake, Azwa Shamsuddin, Siân Kiely, Lindsey Lee, Daniela Golinelli, Domenique Villani, Iain Atherton
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引用次数: 0

摘要

导言:在全球护士人员配置危机中,苏格兰于2019年立法了《卫生与护理(人员配置)(苏格兰)法》,以应对卫生保健人员的挑战。该法案不像其他地方那样要求病人与护士的比例,而是要求根据指导原则、职责和共同的人员配备方法来决定人员配备。在基线上衡量医院遵守法案规定的变化,对于决策者评估法案要求和目标的实现情况非常重要。结果将告知决策者哪些规定在基线上实现了,哪些规定需要支持雇主实现。该研究的目的是在2024年4月实施该法案时建立苏格兰护士人员配备标准的基线。测量护士报告的质量、安全性和离职意向,以补充对实施状况的评估。设计/方法:采用横断面研究设计。通过专业组织和工会招募注册护士和护理辅助人员作为方便样本。护士被邀请在2024年5月1日至7月31日期间完成一项在线调查。调查内容包括人口统计和专业特征、国际护理指标、法案规定和工作意向。通过描述性统计来描述样本、法案规定和护士的工作意向。结果:样本包括1870名护士,其中93%是注册护士,来自所有地区,反映了苏格兰护理人员的特点。关于该法案的规定,9%的人报告说,护理人员配备适合每班提供安全、高质量的护理。同样,很少有护士报告护理质量优秀(17%)或将安全性评为A(10%)。大多数护士不同意目前的人员配备水平符合八项指导原则。大多数护士报告说,关于实时人员配置决策的共同人员配置方法和职责最多偶尔被遵循。近一半的护士(45%)打算在明年继续从事目前的工作。在那些打算离开目前工作的人中,大约有一半的人计划通过退休或另一个未指明的工作改变而离开这个行业。另一半则计划寻找另一份类似的护理工作或升职。结论:很少有护士报告说该法案的总体目标在实施时得到了满足。尽管大多数护士将护理工作视为一项长期职业,但由于常规人员流动、晋升或退休,预计会出现劳动力中断,因此需要制定劳动力保留政策。该法案的复杂条款能否实现及其目标能否实现,可能无法扭转护士离职的趋势。这种做法的复杂性将对实现安全人员配置的目标构成挑战。因此,这种实现安全人员配置的方法可能过于复杂,不值得广泛推荐。这些仍然是苏格兰政策制定者、护士领袖和研究人员迫切需要解决的问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The Scottish Safe Staffing Act at Baseline: Quantitative Findings

The Scottish Safe Staffing Act at Baseline: Quantitative Findings

The Scottish Safe Staffing Act at Baseline: Quantitative Findings

The Scottish Safe Staffing Act at Baseline: Quantitative Findings

The Scottish Safe Staffing Act at Baseline: Quantitative Findings

Introduction

Amid a global nurse staffing crisis, in 2019 Scotland legislated the Health and Care (Staffing) (Scotland) Act to address health care workforce challenges. Instead of requiring patient-to-nurse ratios as legislated elsewhere, this act requires staffing decisions according to guiding principles, duties, and a common staffing method. Measuring variation in hospitals' adherence to the act's provisions at baseline is important for policymakers to evaluate fulfillment of the act's requirements and goals. Results will inform policymakers about which provisions are achieved at baseline and which require support for employers to achieve. The purpose of the study was to establish the baseline of nurse staffing standards in Scotland at April 2024 implementation of the Act. Nurse reports of quality, safety, and their intent to leave were measured to complement assessment of the implementation status.

Design/Methods

A cross-sectional study design was used. A convenience sample of registered nurses and nursing support workers was recruited through professional organizations and trade unions. Nurses were invited to complete an online survey between May 1 and July 31, 2024. The survey content included demographic and professional characteristics, international nursing metrics, the Act's provisions, and job intentions. Descriptive statistics were calculated to describe the sample, act's provisions, and nurses' job intentions.

Results

The sample comprised 1870 nurses, of whom 93% were registered nurses, from all regions with characteristics reflecting the Scottish nursing workforce. Regarding the act's provisions, 9% reported that nursing staffing is appropriate to provide safe, high-quality care every shift. Similarly, few nurses reported that the quality of care was excellent (17%) or graded safety an A (10%). Most nurses disagreed that current staffing levels met the eight guiding principles. Most nurses reported that the common staffing method and duties regarding real-time staffing decisions were followed at best occasionally. Nearly half of nurses (45%) intend to stay in their current job over the next year. Among those intending to leave their current job, about half plan to leave the profession through retirement or another unspecified job change. The other half plan to seek another similar nursing job or promotion.

Conclusion

Few nurses report that the act's overarching goal is being met at the point of implementation. Although most nurses see nursing as a long-term career, workforce disruption is anticipated through routine turnover, promotion, or retirement, requiring workforce retention policies. Whether the act's complex provisions can be achieved and its goals fulfilled may not reverse the trend of exiting nurses. The complexity of the approach will be a challenge to achieving the objective of safe staffing. Therefore, this approach to achieving safe staffing may be too complex to be recommended widely. These remain urgent questions for Scottish policymakers, nurse leaders, and researchers.

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来源期刊
CiteScore
6.30
自引率
5.90%
发文量
85
审稿时长
6-12 weeks
期刊介绍: This widely read and respected journal features peer-reviewed, thought-provoking articles representing research by some of the world’s leading nurse researchers. Reaching health professionals, faculty and students in 103 countries, the Journal of Nursing Scholarship is focused on health of people throughout the world. It is the official journal of Sigma Theta Tau International and it reflects the society’s dedication to providing the tools necessary to improve nursing care around the world.
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