Working with national quality registries in older people care: A qualitative study of perceived impact on assistant nurses’ work situation

Abstract

Aim The aim was to investigate assistant nurses’ perceptions of how working with national quality registries affected their work situation in care of older people. Design Qualitative interview study. Methods Sixteen semi‐structured interviews were conducted at four special housing units in Sweden, and a conventional content analysis, with elements of thematic analysis, was applied. Results The introduction of national quality registries contributed to role clarifications and the development of new formal work procedures in terms of documentation and arenas and routines for communication. The increased systematics and effectiveness gained from these changes had a perceived positive effect on the work situation, workload, work satisfaction, staff interactions and learning and reflection.

Nurses experience increased clinical and organisational competence by working with a medical quality register, RevNatus – a qualitative study

“…They need to decide each team member's role and responsibility for collecting and entering data. Although other studies have shown that registry work could lead to increased collaboration across professions, [15,35] the current study did not.…”

“…For example, when patients had an appointment rescheduled without notifying the nurses, the registrations in RevNatus were missing. When this occurred, the nurses often had to enter data in retrospect based on the patient's record, confirming the findings from other studies that the workload increases if the register work is not integrated into the daily routines [15,21,36,37]. If the web-based forms have not completely replaced paper forms, the data-entry workload will be dual [21,36,37].…”

“…Another study aiming to explore assistant nurses' perceived impact on their work situation found that performing assessments and registrations in registries added a timeconsuming task to their regular work routines, which also required certain computer skills. But the registry work also led to a perception of a decreased workload and reduced stress because the registry work contributed to clarification of work roles [15]. This study further shows that the nurses were dedicated, as they demonstrated by taking the main responsibility for making RevNatus a register with high-quality data.…”

“…There are over 50 national medical quality registries in Norway [14]. The medical quality registries in general aim to facilitate quality improvement [14,15], elucidate professional roles and improve clinical care [15]. Furthermore, medical quality registers are a structured collection of medical information about the assessment, treatment and follow-up of patients [14].…”

“…It is, however, recommended that register work is implemented as part of the daily routines in the clinic [21,23]. Nurses are often responsible for entering data in the registries [15,21], but the role of a nurse is complex and the tasks are not always clearly defined [24]. There has been a shift in nurses' tasks from patient-oriented bedside duties to more organizational tasks where nurses have to manage both good patient care and organizational efficiency and productivity [25], often referred to as 'the invisible work of nurses' [24].…”