[Nurses' perception of specific nursing activities that can be delegated to other health care personnel].
In order to understand the nurses' perception of the activities specific to nursing care, and to assess what they are ready to delegate to other health care workers, a complex activity of analysis was started. Head nurses and nurses representative of the different NHS hospital and district services (hospital wards, home care and district, preventive services, psychiatric services and first aid services in the district, operating theatre and clinics) of the Medio Friuli area (North of Italy) were asked to identify a. the main activities performed in the patients' care, b. the nature of the activities (whether administrative, hotel, health, support-non health), c. their level of standardization (i.e. whether their performance required discretionality and the tailoring of the activity to the patient's situation) and d. if they considered it delegable and to whom (doctors, support personnel, secretary, other health care personnel). Final aim of the work was to acquire elements in order to reorganize the nursing care. In order to leave the nurses free to identify areas that better allowed the description of their activities, (and due to the large and different numbers of sectors and areas involved), no strict instructions were given. Therefore the model used and level of detail in the description of activities and processes varied from group to group. Sixty nurses participated in the work. On average, from 38.9% (Operating Theatre and clinics) to 55.7% (Psychiatric services) of the activities identified were perceived as delegable to nurses aids and/or secretaries. The 89.2% of delegable activities (183/205) were considered highly standardized. Up to 23.4% (39/166) were classified as health care activities (i.e. prevention of pressure sores with mobilization, risk assessment with standardized scales, application of ointments, the care for patients during mobilization etc.). The remaining were classified as administrative or support activities. Although this does not necessarily imply that with the introduction in the health care team of a secretary and of the nurse-aid half of the time of the nurse could be freed, nurses perceive that on average half of their routine and basic activities could be well delegated to other figures.
Silvestro
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Servizio Infermieristico Azienda USL Medio Friuli, Udine.
D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D006801:Humans; D007587:Job Description; D016294:Models, Nursing; D015401:Nursing Administration Research; D009728:Nursing Assistants / Q000193:education / Q000458:organization & administration*; D009741:Nursing Staff, Hospital / Q000458:organization & administration* / Q000523:psychology*; D009745:Nursing, Supervisory / Q000458:organization & administration*; D009746:Nursing, Team / Q000458:organization & administration*; D017009:Professional Autonomy; D011795:Surveys and Questionnaires