Abstract
D.Cur.
Limited funds for the delivering of health and social services necessitate the cost-effective utilization of all categories of nursing personnel in old age homes. Professional nurses are being retrenched and supervision over weekends and after hours is being scaled down due to a lack of guidelines for the cost-effective utilization of nursing personnel in old age homes. A combined quantitative-qualitative approach had been applied in this empirical study to explore and describe the utilization of nursing personnel in old age homes. The goal of the study was to compile guidelines for the cost-effective utilization of nursing personnel in old age homes. Data collection and data analysis were conducted
during three phases. A survey of the population of old age homes in South Africa was first conducted to determine the composition of the residents and nursing personnel in these old age homes and to explore the cost implications of the personnel composition. The contents of job descriptions of professional nurses working in old age homes were analysed on a computer by the researcher using NUDtIST software during the second phase of the study. The third phase consisted of conducting and analysing focus groups with professional nurses regarding. their expectations of their own duties, tasks and responsibilities and those of nursing auxiliaries and lay caregivers in old age homes. The three phases were conducted simultaneously and the results of the three phases were triangulated and subjected to a limited literature control. The results were verified during visits to nursing homes in the USA, Canada and the UK. A conceptual framework and guidelines for the cost-effective utilization of nursing personnel in old age homes were developed from the findings of this study. Respondents from the first phase of the study and experts verified the guidelines for being applicable, important, clear and accessible.
The findings indicated that most of the residents of the old age homes are very old and are in need of 24 hours nursing/care due to their level of frailty. The nursing personnel budget forms a significant portion of the operating budget of the old age homes and managers are of the opinion that professional nurses are expensive but an essential component of the nursing personnel. The duties, tasks and responsibilities of professional nurses were identified as well as those which are shared with nursing auxiliaries and lay caregivers in old age homes. The conceptual framework which was established from the results of the study indicates that the goal, costeffective utilization of nursing personnel, is reached when quality care has been delivered within the constraints of the budget limitations. The process has been described as the compiling of guidelines for all categories of nursing personnel regarding clinical nursing, nursing management and nursing education as well as the handling of non nursing tasks while considering the personnel standards and job descriptions. The role players are the manager, all categories of nursing personnel, lay caregivers, family and volunteers which perform within the restrictions of the personnel composition and the appropriate code of conduct regulations. The context for the utilization of nursing personnel is the old age home where nursing/care giving is delivered on a continuum and the dynamics which influence the cost-effective utilization of nursing personnel include applicable legislation and policies of government departments and non government organizations.