SciELO - Scientific Electronic Library Online

 
vol.32 número2 índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados

Artigo

Indicadores

Links relacionados

  • Em processo de indexaçãoCitado por Google
  • Em processo de indexaçãoSimilares em Google

Compartilhar


Curationis

versão On-line ISSN 2223-6279
versão impressa ISSN 0379-8577

Curationis vol.32 no.2 Pretoria  2009

 

RESEARCH ARTICLE

 

Effect of a staffing strategy based on voluntary increase in working hours on quality of patient care in a hospital in KwaZulu-Natal

 

 

J McintoshI; EL StellenbergII

IRN M Cur. Division of Nursing, Stellenbosch University
IIRN D Cur. Division of Nursing, Stellenbosch University

Correspondence

 

 


ABSTRACT

Two of the issues facing the South African Health Care System are the shortage of nursing staff and a lack of adequate skills to provide quality patient care. The hospital under study experienced a critical shortage of applications from professional registered nurses, consequently a staffing strategy was implemented to overcome the shortage of nurses and to maintain quality patient care. The strategy introduced encouraged nurses to voluntarily work an additional ten hours per week with remuneration.
A non-experimental, descriptive design with a quantitative approach was applied to investigate the effect of a staffing strategy aimed at improving the quality of care in a hospital in Kwa-Zulu Natal based on voluntarily increasing staff working hours. The investigation compared the quality of nursing care before and after the implementation of the staffing strategy through retrospective audits of randomly selected patient files 372 (11%) of the total population of 3400 files were audited. Arandom sample of 4 boxes each containing a 100 patient files, of a total of 34 boxes, was selected from the hospital filing system. Descriptive statistical analyses were performed and correlations between various variables using the Chi-square test. No statistically significant differences (p<0.05) were found between the quality of nursing care before and after the implementation of the management strategy, even though deterioration of results after the implementation was observed. The study shows that the quality of nursing care in most wards deteriorated after implementation. The staffing strategy failed to improve or maintain the quality of nursing care.
RECOMMENDATIONS INCLUED: Strict control of nurses working extra hours per week, preventing the use of "moonlighters" . Introduction o f a quality assurance committee to monitor the quality of patient care developing critical analytical thinking skills of staff to improve patient care and standardization of the nursing process documentation.

Kev words: safe staffing; accountability; quality patient care; record keeping


 

 

“Full text available only in PDF format”

 

 

References

BERRETTA, R 2003: Assessment: The foundations of good practice (In Hinchliff, S Norman, S & Schober, J cds. 2003: Nursing practice and health care. London: Arnold, pp. 122)        [ Links ]

BOOYENS, SW & MINNAAR, A 2004: The control of quality (In Booyens, SW, ed. 2004: Introduction to health services management. Pretoria: Juta, pp.303-339)        [ Links ]

BURNS, N & GROVE, SK 2007: Understanding nursing research. Building an evidence - based practice. 4th ed. St Louis: Saunders Elsevier.         [ Links ]

DE POY, E & GITLIN, LN 2005: Introduction to research: understanding and applying multiple strategies. Chicago: Mosby.         [ Links ]

DONABEDIAN, A 1969: Medical care appraisal-quality and utilization. A guide to Medical Administration. New York: American Public Health Association.         [ Links ]

FRANK, B; ECKRICH, H & ROHR, J 1997: Quality nursing care: leadership makes the difference. JONA. 27(5): 13-14, May        [ Links ]

FRYER, N 2003: Principles of Professional Practice (In Hinchliff, S Norman, S & Schober, J eds. 2003 : Nursing practice and health care. London: Arnold. pp. 31)        [ Links ]

GEYER, N 2006: The high risk of low staffing. Nursing Update. 30(4): 46, April        [ Links ]

McINTOSH, J 2008: An Investigation into a Staffing Strategy in a selected Hospital in Kwa-Zulu Natal. Stellenbosch: University of Stellenbosch (Thesis - M-Cur).         [ Links ]

MULLER, M 2004: Nursing Dynamics. Pretoria: Heinemann Publishers (Pty) Ltd.         [ Links ]

MULLER, M; BEZUIDENHOUDT, M & JOOSTE, K 2006: Healthcare Service Management. Cape Town: Juta.         [ Links ]

NEVHUTALU, K 2004: The state of nursing in South Africa: a time to reflect. Nursing Update, 28(5):30-31, May        [ Links ]

INTERNATIONAL COUNCIL OF NURSES 2007a: Occupational Health and Safety Management Programme for Nurses. http://www.icn.ch/guidelines.htm. Accessed June 14, 2008        [ Links ]

INTERNATIONAL COUNCIL OF NURSES.2007b: Nurses and Overtime. http://www.icn.ch/matters_overtime.htm. Accessed June 14,2008        [ Links ]

PATIENT RIGHTS CHARTER: http://www.doh.gov.za/docs/lepislation/patientsright/chartere.html Accessed 24 November 2007.         [ Links ]

PRONOVOST, P; ANGUS, DC; DORM AN, T et al. 2002: (In Occupational Health and Safety Management Programme for Nurses. International Council of Nurses. 2007a: http://www.icn.ch/guidelines.htm. Accessed June 14, 2008        [ Links ]

SEARLE, C 2000: Professional practice: a South African nursing perspective. Pretoria: Heinemann Publishers (Pty) Ltd.         [ Links ]

SOUTH AFRICA (REPUBLIC) 1997: The Basic Conditions of Employment Act, (Act 75 of 1997) Pretoria: Government Printer.         [ Links ]

SOUTH AFRICA (REPUBLIC) 1996: Constitution of South Africa, (Act 108 of 1996) Pretoria: Government Printer.         [ Links ]

SOUTH AFRICA (REPUBLIC) 1978: The Nursing Act, (Act 50 of 1978, as amended) Pretoria: Government Printer.         [ Links ]

SOUTH AFRICA (REPUBLIC) 2005: The Nursing Act (Act 33 of 2005). Pretoria: Government Printer.         [ Links ]

SOUTH AFRICA (REPUBLIC) 1997: White paper on Transforming Public Service Delivery: (Batho Pele White Paper), 18340(388). Pretoria: Government Printer.         [ Links ]

TROSKIE, R 2005: Organizing facilities, equipment and supplies, (In Booyens, SW, ed. 2nd Ed. 2005: Introduction to health services management. Pretoria: Juta, pp.260 - 283)        [ Links ]

THE SOUTH AFRICAN NURSING COUNCIL Undated: Standards for Nursing practice. South African Nursing Council policy statements.         [ Links ]

THE SOUTH AFRICAN NURSING COUNCIL 1984: Regulation 2598 as amended. Regulations relating to the Scope of Practice of persons who are registered or enrolled under the Nursing Act No 50 of 1978. Pretoria: South African Nursing Council.         [ Links ]

THE SOUTH AFRICAN NURSING COUNCIL 1985: Regulation 387 as amended. Regulations relating to the Acts and Omissions of persons who are registered or enrolled under the Nursing Act No 50 of 1978. Pretoria: South African Nursing Council.         [ Links ]

VERSCHOOR, T; FICK, GH; JANSEN, RM & VILJOEN, DJ 2005: Nursing and the Law. Cape Town: Juta.         [ Links ]

YOUNG, A; VAN NIEKERK, CF & MOGOTLANE, S eds. 2003: Juta's manual of nursing. Cape Town: Juta.         [ Links ]

ZONDAGH, C 2004: Safe and adequate nurse staffing. Nursing Update. 28(5):20-24. May        [ Links ]

 

 

Correspondence:
Ethelwynn L Stellenberg
Division of Nursing
Stellenbosch University
Tel: (021) 938-9244; Fax: (021)932-6588
Email: elstel@sun.ac.za

Creative Commons License Todo o conteúdo deste periódico, exceto onde está identificado, está licenciado sob uma Licença Creative Commons