Abstract
Purpose: The purpose of this study was to clarify the nursing activities undertaken at elderly long-term care settings and to identify delegation of nursing activities.
Methods: The first step for the development of research tools was to examine the literature to produce 158 primary questions. Then, the feasibility of items was verified by a group of experts in the second step to produce 119 secondary questions. In the third step, the feasibility was verified by a group of working professionals to finally select a total of 100 questions, which were used to survey a total of 140 nurses who are working for long-term care hospitals in B City, from July 26, 2013 to November 23, 2013.
The statistics of data collected through the analysis of data were processed through data coding and data cleaning, and analyzed using the SPSS (Statistical Package for Social Science) v. 18.0 Statistics Package Program.
Results: 1. The nursing activities of long-term care hospitals included 100 activities in 34 categories, including 82 activities in 23 categories of direct nursing activities and 18 activities in 11 categories of indirect nursing activities.
2. Delegation of nursing assistants in direct nursing activities varied from as low as 4 points to as high as 67 and the average level of delegation was 39.52 points. In indirect nursing activities, the average level of delegation was 2.85, from as low as 0 to as high as 8 points.
3. As a result of analyzing whether there is a difference in the level of delegation according to the character of long-term care hospitals, there were statistically significant differences according to the level of education and the presence of algorithms/protocols for delegation of the nursing activities (p<.01).
Conclusion: In conclusion, 95 nursing activities of long-term care hospitals, excluding ‘nursing diagnosis’, ‘checking records’, ‘training staff’, ‘decision-making’, and ‘checking achievement of goal’, in various ranges between 0 points and 67 points without clear classification, are performed by nurses or delegated to nursing assistants . They are even partially delegated to caregivers. This may make the liability issues ambiguous in case of legal disputes and lower the quality of nursing, so it would be necessary to develop certain procedures, methods, regulations, and guidelines for the delegation of nurses considering the legal and systemic basis of delegation in long-term care hospitals and the quality of authorized services of nurses.