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The impact of an educational intervention for elderly care nurses on care recipients' and family relatives' ratings of quality of care: A prospective, controlled intervention study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
2008 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 45, no 2, 166-179 p.Article in journal (Refereed) Published
Abstract [en]

Background: Low competence levels among nursing staff have been associated with lower quality of elderly care. However, interventions aimed at improving nursing staff competence have not always been evaluated for their possible impact on the quality of elderly care. An educational intervention in the form of a workplace "toolbox" was shown to have positive effects on nursing staff competence and work satisfaction. It was therefore of interest to investigate whether the intervention had any effect on residents' and/or their family members' ratings of the quality of elderly care. Objectives: The aim of this study was to evaluate the possible effects of an educational intervention for nursing staff on care recipients' and their relatives' ratings of the quality of elderly care. Design: The study was a prospective, non-randomized, controlled intervention. Participants and settings: Care recipients and their relatives in two elderly care organisations in Sweden. Methods: Practical instruments and educational materials for improving staff competence and work practices were collated in a workplace "toolbox", which was introduced in the intervention organisation in February of 2003. Care recipients and their relatives' ratings of the quality of care were measured pre and post-intervention by questionnaire and compared to quality ratings in a reference organisation, where no toolbox was introduced. Results: Neither care recipients' nor relatives' ratings of the quality of care changed significantly over time in the intervention organisation. Furthermore, there were no significant interaction effects over time between organisations for quality of care ratings. Methodological weaknesses, such as low response rates, may have influenced results. Conclusions: The results of this study raise questions regarding the alleged positive association between staff competence and work satisfaction and care recipients' perceptions of the quality of care.

Place, publisher, year, edition, pages
2008. Vol. 45, no 2, 166-179 p.
Keyword [en]
elderly care, intervention, nursing staff, staff training, work satisfaction
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-95256DOI: 10.1016/j.ijnurstu.2006.09.001ISI: 000253141000002PubMedID: 17069817OAI: oai:DiVA.org:uu-95256DiVA: diva2:169398
Available from: 2006-12-12 Created: 2006-12-12 Last updated: 2011-01-12Bibliographically approved
In thesis
1. Nursing Staff Competence, Psychosocial Work Environment and Quality of Elderly Care: Impact of an Educational Intervention
Open this publication in new window or tab >>Nursing Staff Competence, Psychosocial Work Environment and Quality of Elderly Care: Impact of an Educational Intervention
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Effekter av en utbildningsintervention på personalens kompetens, psykosociala arbetsmiljö samt vårdkvalitet inom kommunal äldreomsorg
Abstract [en]

Insufficient competence among nursing staff is a major concern in elderly care worldwide as the healthcare needs of the elderly become increasingly complex. In previous research, insufficient competence has been associated with work dissatisfaction and stress among elderly care nurses, and with lower quality of care. This thesis describes the development, implementation and evaluation of an educational intervention for nursing staff in elderly care. In a prospective, controlled study, evaluation of the educational toolbox was based on nursing staff ratings of their competence and psychosocial work environment, as well as on care recipients’ and family relatives’ ratings of the quality of elderly care.

Paper I validated a questionnaire measuring care recipient relatives’ perceptions of quality of care. Paper II compared self-rated competence, work strain, stress, and work satisfaction between staff working in home-based care and nursing homes. Papers III and IV evaluated the impact of the educational intervention on staff perceptions of their competence and psychosocial work environment (Paper III) and on care recipients’ and relatives’ perceptions of the quality of care (Paper IV).

The results showed that staff ratings of their competence and psychosocial work environment, including work satisfaction and work stress, improved significantly over time in the intervention municipality, compared to the reference group. Neither care recipients’ nor relatives’ ratings of the quality of care changed significantly over time in the intervention organization. Furthermore, there were no significant interaction effects over time between the intervention and reference groups for quality ratings. These results indicate that an educational toolbox that can be used according to local workplace needs may be an effective and sustainable intervention for improving staff competence and the psychosocial work environment. However, further studies are needed to investigate whether, and under what conditions, improved staff competence and work environment have an impact on quality of care.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2006. 83 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 210
Keyword
Social medicine, elderly care, home care, nursing home, nursing staff, care recipient, family members, quality of care, the psychosocial work environment, competence development, Socialmedicin
Identifiers
urn:nbn:se:uu:diva-7383 (URN)91-554-6750-4 (ISBN)
Public defence
2007-01-11, Rudbecksalen, Rudbeck laboratoriet, Dag Hammarskjölds väg 20, Uppsala, 09:15
Opponent
Supervisors
Available from: 2006-12-12 Created: 2006-12-12Bibliographically approved

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