Nurses and personal care workers in government owned aged care facilities report lower levels of missed care than their counterparts in the private sector, a study finds.
The research, published in the latest edition of Australian Journal of Social Issues and funded by the Australian Nurses and Midwifery Federation, aimed to identify the frequency of missed care by staff in private-not-profit, for-profit and government facilities.
Missed care refers to required resident care that is omitted or delayed because of multiple demands, inadequate staffing, lack of materials and resources or communication breakdown. It includes answering call bells, attending to toileting or moving patients who can’t walk.
A total of 3,206 nurses and personal care workers completed the MISSCARE survey, a two-part tool that measures the reasons for missed care.
The survey, which was available online between 15 December 2015 and 5 February 2016, was made up of 68 questions, 28 related to demographic and workplace factors and 37 on care tasks that may have been missed.
The level of missed care was found to be higher in privately owned facilities.
Employees working in government owned facilities reported lower levels of missed care than privately owned facilities in the following 6 activities:
- moving patients who cannot walk
- assisting residents’ toileting within 5 mins of request
- assisting resident mouth care
- assessing skin integrity
- answering call bells within 5 minutes
- wound care
The most commonly missed tasks among all facilities was responding to call bells and to toileting needs within five minutes.
Lead researcher and Flinders University research associate at the Southgate Institute for Health, Society and Equity Dr Julie Henderson said unscheduled tasks were most likely to be missed.
“This may be due to workload as care workers have set tasks to complete each shift, leaving limited time for other tasks and few staff available to undertake unscheduled tasks,” Ms Henderson told Australian Ageing Agenda.
In the survey, staff cited lack of staff, complexity of resident needs, inadequate skill mix of nursing and care work staff and unbalanced resident allocations as reasons care was missed.
Staff members were delivering care to more residents, which meant they had less time with each resident to complete care tasks, she said.
Another reason for missed care was changes in staff at the facilities, she said.
Ms Henderson said privately owned facilities were replacing enrolled nurses with care workers and employing recently graduated registered nurses over more experienced registered nurses.
The levels of missed care may also be affected by funding changes, she said.
“Recent changes to aged care funding have shifted some burden of funding aged care to the user of services,” Ms Henderson said.
Implementing mandated staffing levels may assist with the issue of missed care among aged care residents across all facilities, she said.
“At the moment there are no mandated staffing levels for residential aged care with the standards only stipulating that adequate staffing be provided. This allows aged care facilities to reduce running costs through cutting staffing levels.
“Given that lack of staff was the most commonly cited reason for missed care, the establishment of mandated staff levels may counter this,” Ms Henderson said.
Access the paper, The impact of facility ownership on nurses’ and care workers’ perceptions of missed care in Australian residential aged care here.
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