An investigation into the effect of a staffing strategy on patient care in a selected hospital in Kwazulu-Natal
Date
2008-03
Authors
McIntosh, Jane
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : University of Stellenbosch
Abstract
The South African Nursing Council believes that “quality nursing practice is based on
adequate knowledge, skills or competencies, ethically and scientifically based
comprehensive and holistic patient care, timely, accurate and complete or comprehensive
recording” (SANC, n.d.). The aim of professional regulation is to protect the public from
unsafe practices and to ensure quality services (SANC, n.d.).
A shortage of nursing staff resulted in the implementation of a staffing strategy of increasing
the work hours of nurses by ten hours a week. Patient complaints and unacceptable patient
incidences resulted in it becoming essential to evaluate the effect of this strategy on patient
care. As a goal of this study, the researcher decided to investigate the quality of patient care
before the implementation of the strategy and the effect of the strategy on patient care after
the implementation.
The objectives of the study were set to determine whether
• The patients were assessed according to activities of daily living and psychosocial
data;
• The nursing diagnosis was done
• Nursing interventions are prescribed for each problem identified
• The patients’ records were utilised to enhance individualised patient care and to
ensure responsibility and accountability for patient care
• The evaluation of patient progress was done according to the different prescriptions
and 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 the
implementation of the staffing strategy exist
Research question
What is the effect of an implemented staffing strategy in a selected hospital in KwaZulu-Natal
on the quality of care delivered?
Research methodology A non-experimental, descriptive design with a quantitative approach was applied.
Population and sampling
The target population for the study was patient care records of patients who were
hospitalised during 2003.
A non-probability convenience sample for a retrospective audit of a total of 372 patient care
records over a period of 12 months was audited. An evaluation of the records was done and
a comparison was drawn between the results obtained before and after the implementation
of the staffing strategy. For both periods, 186 patient records were audited. The pilot study
included the audit of 40 files.
Reliability and validity were assured with a pilot study and the use of experts in nursing
management, quality assurance, research methodology and statistics. The researcher
audited the patient files personally.
Ethical approval was obtained from Stellenbosch University and the ethics committee of the
hospital. All principles related to ethics, such as confidentiality and anonymity, were
maintained. Neither patient names were used nor the name of the hospital or wards from
which the records were used. Codes were used to identify the hospital wards. The hospital
was informed in the letter requesting consent to conduct the research, that the researcher
intends publishing the findings of the research.
Data analysis and interpretation
Statistical associations using Chi-square tests were carried out to determine the significance
between the various variables. The results of this study were presented in percentages,
tables and histograms. Findings obtained showed that the quality of nursing declined after
the strategy. Documentation of patient records was incomplete and did not meet legal
requirements.
Recommendations
The implementation and maintenance of a quality assurance programme, human resource
management, the on-going use of the nursing process and record keeping should be
emphasised in the clinical practice environment and in the formal education environment.
Description
Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2008.
Keywords
Staffing strategy, Quality of care, Patient care, Nursing -- Manpower -- South Africa -- Kwazulu Natal, Nursing services -- South Africa -- Kwazulu Natal, Hospitals -- Personnel management, Nurse and patient -- South Africa, Dissertations -- Nursing, Theses -- Nursing, Assignments -- Nursing