Relationship between quality of care, staffing levels, skill mix and nurse autonomy: literature review

Abstract

Quality of care is a complex, multi-dimensional concept which presents researchers with a challenge when attempting to evaluate it. Traditional nursing assessment tools have fallen out of use, partly because they have failed to provide opportunities to engage with and access the views of patients or nurses. There is also evidence that patient satisfaction as an indicator of quality is compromised on a number of fronts. There is conflicting information on how nurses and patients think about quality. Research looking at the relationship between the selected organizational variables and perceptions of quality also suffers from a number of limitations. We argue that there is a requirement for more patient-centred research exploring perceptions of quality and differences in nurse staffing, skill mix and autonomy.

Perceptions of Patients Regarding Quality Nursing Care (QNC) at a Tertiary Care Hospital, Karachi, Pakistan

“…Quality in healthcare is a complex, multi-faceted, and multi-dimensional phenomenon [7]. Healthcare professionals define quality in relation to patient outcomes, standards of practice, and predetermined criteria used to measure quality [8].…”

Workforce planning incorporating skills: State of the art

“…Brucker et al [27], Burke et al [33] and Pastor and Corominas [96] also incorporate the preferences of the workers to work shifts that require their primary skills. Buchan and Dal Poz [30], Currie et al [46] and Branson et al [26] consider the problem of skill dilution and conclude that obtaining a cheaper skill mix with downgrading may be no more cost effective because of the various hidden costs. For example, querulous employees tend to have higher absence and turnover rates [45].…”

PENGARUH LINGKUNGAN KERJA PERAWAT TERHADAP PELAKSANAAN PRAKTEK KEPERAWATAN DI RUMAH SAKIT UMUM Dr. SAIFUL ANWAR MALANG TAHUN 2006

“…Perawat melalui otonomi yang dimilikinya dalam kendali terhadap praktek akan memperoleh keleluasaan dan bertanggung jawab atas pelaksanaan, keberhasilan atau kegagalan suatu pekerjaan, sehingga menimbulkan rasa diberdayakan (13). Selain itu bahwa manfaat dari otonomi yang dimiliki oleh perawat melalui kendali terhadap prakteknya adalah dapat meningkatkan partisipasi dalam pembuatan keputusan, meningkatkan ketrampilan klinik, memfasilitasi kerja tim multidisiplin yang lebih efektif dan tentunya akan berdampak pada peningkatkan kualitas asuhan keperawatan yang diberikan pada klien (14). Hal ini selaras dengan penemuan dalam penelitian ini yang menunjukan ada pengaruh yang positif dari kendali yang dimiliki oleh perawat terhadap prakteknya pada pelaksanaan praktek keperawatan.…”