Effects of Nonnursing Assistance on Home Visit Nurses’ Time Spent In Japan: One Group Repeated Pretest-Posttest Trial

Abstract

To determine means of improving the efficiency of home nursing services, we conducted an experimental pretest-posttest study to compare the time spent by home visiting nurses (HVNs) on providing care with or without assistance. HVNs’ job-related satisfaction levels were also compared. Forty-four clients in six visiting nursing offices in Fukuoka prefecture were selected for this study, which was conducted between July 2009 and January 2010. With assistance, HVNs’ total care time and time spent performing trivial tasks decreased and time spent on communicating or teaching increased. Furthermore, HVNs were more satisfied with providing care than with their usual visits. We conclude that introduction of a skill mix might improve home visiting nursing service efficiency through shortening the HVNs’ length of stay at a client’s home.

Keywords

home visiting nursing nonnursing assistant job-related satisfaction skill mix service efficiency time study

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References

Social Statistics Division Japan. Survey of Institutions and Establishments for Long-term Care, 2010. Available at: http://www.e-stat.go.jp/SG1/estat/List.do?lid=000001086111. Accessed July 20, 2012.

Duffield

Gardner

Catling-Paull

. Nursing work and the use of nursing time. J Clin Nurs. 2008;17:3269-3274.

Finfgeld-Connett

. Meta-synthesis of caring in nursing. J Clin Nurs. 2008;17:196-204.

Ben-Zur

Breznitz

. The effect of time pressure on risky choice behavior. Acta Psychol. 1981;47:89-104.

Ching-I

Feng-Ju

Tin-An

. Nurse-perceived time pressure and patient-perceived care quality. J Nurs Manag. 2010;18: 275-284.

Naruse

Taguchi

Kuwahara

Nagata

Watai

Murashima

. Relationship between perceived time pressure during visits and burnout among home visiting nurses in Japan. Jpn J Nurs Sci. In press.

James

Mario

RDP

. Skill mix in the health care workforce: reviewing the evidence. Bull World Health Organ. 2002; 80:79-85.

Lawrence

David

. A question of delegation, unlicensed assistive personnel and the professional nurse. J Gerontol Nurs. 2010;36:18-21.

Japan Visiting Nurse Foundation. 24 jikan houmon kango service teikyo no arikatani kansuru tyosa kenkyu jigyo houkokusho [Study on the round-the clock care system in Japanese home visiting nursing services]. In: Health Labor Sciences Research Report. Department of Community Health Nursing, University of Tokyo:Tokoyo, Japan. 2011:80-81.

10.

Katz

Ford

Moskowitz

Jackson

Jaffe

. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. J Am Med Assoc. 1963;185:914-919.

11.

Juliann

Karen

. The nurse in home health and hospice program management. In: Marcia

Jeanette

, eds. Public Health Nursing. 7th ed. Philadelphia, PA: Elsevier’s Health Sciences Rights Department; 2008:957-980.

12.

Japan Academy of Nursing Science. Kangokoui yougo bunrui [The definition of nursing activities in Japan]. Tokyo, Japan: Publishers Association of Japan Academy of Nursing Science; 2005.

13.

Groenewegen

Hutten

JBF

. Workload and job satisfaction among general practitioners: a review of the literature. Soc Sci Med. 1991;32:1111-1119.

14.

Meijman

Mulder

. Psychological aspects of workload. In: Drenth

PJD

Thierry

eds. Handbook of Work and Organizational Psychology. Vol. 2: Work psychology. Hove, UK: Psychology Press. 1998;5-33.

15.

Bakker

Demerouti

. The job demands-resources model: state of the art. J Manag Psychol. 2007;22:309-328.

16.

Zwygart-Stauffacher

Lindquist

Savik

. Development of health care delivery systems that are sensitive to the needs of stroke survivors and their caregivers. Nurs Admin Q. 2000;24:33-42.

17.

Cohen

Pringle

LeDuc

. Dementia caregiving: the role of the primary care physician. Can J Neurol Sci. 2001;1:S72-S76.

18.

Mangan

Taylor

Yabroff

Fleming

Ingham

. Caregiving near the end of life: unmet needs and potential solutions. Palliat Support Care. 2003;1:247-259.

19.

Murashima

. Fukusu-no homon kango suteishon niyoru chiikitanni no 24jikan houmonkaigo, kango no koukateki kouritutekina jisshi houho-no kaihatsu kenkyu. [Development of effective and efficient care system: the collaboration of visiting nurse offices for the around the clock in-home care]. In: Health Labor Sciences Research Report. Tokyo, Japan: Department of Community Health Nursing, University of Tokyo; 2010:61-104.