Isolement, parcellisation du travail et qualité des soins en gériatrie

Activités

关键词: participatory ergonomics;    geriatric care;    burnout;    emotional sharing;    quality of care;   

DOI  :  10.4000/activites.2516

来源: DOAJ

【 摘 要 】

The organisation of work and space have a major impact on how health workers do their job. The core of their occupation is to provide basic care for residents of nursing homes and patients in geriatric departments who are often very dependent. This participatory ergonomics analysis set out to understand why prescribed work does not always tally with actual work, with a view to suggesting improvements that will benefit both health workers and patients.A real-time task analysis of 40 full days worked by nursing assistants (NAs, n = 26) and registered nurses (RNs, n = 14) was carried out by ergonomists and health workers taking part in the research.In theory, the geriatric nurses and nursing assistants should be supporting and stimulating patients, often at the end of their lives, and giving them appropriate prescribed treatment. The real-time task analysis showed that they could only stay with patients for short periods (for NAs, 68 periods and 44 % of their working time ; for RNs, 51 periods and 22 % of their working time). NAs spend very little time at the nurses’ workstation (5.9 % compared to 41.5 % for RNs) which means they have few opportunities for discussion with RNs. On average, NAs spend only 1.8 % of their working time in discussion with RNs, even though it is the NAs who spend the most time talking to patients. Little use seems to be made of their observations in adapting the "life projects" of patients – in contradiction with the certification criteria.Moreover, they seldom have time to share their emotional burden with their colleagues.Because of the way health workers’ tasks are organised, they devote a large amount of time to indirect care such as preparation and cleaning. For the RNs, this means administrative tasks and walking from one ward to another. As a result, there is a danger of loneliness and a high risk of professional burnout.This method suggests improvements to working conditions, cooperation between the occupations concerned and the quality of patient care, as part of a multidisciplinary group.

【 授权许可】

Unknown