Nurses' perceptions of patient allocation as a system of organisation of nursing care

Abstract

Nursing care delivery in Malta is undergoing rapid changes in an effort to move away from task allocation towards a patient allocation system of care. Thus, the way nurses perceive their new roles is salient since the way nursing staff are organised may influence the type of care patients receive (Thomas & Bond 1990). The present small scale explorative study is an attempt to explore nurses' perceptions of patient allocation as a system of organisation of nursing care. A convenience sample of 20 registered nurses consisting of l 0 males and l 0 females from 7 surgical wards excluding baccalaureate, diploma and certified nurses was used. A self-administered, semi-structured questionnaire based on 4 components from a classification system for nurses' work methods (Bowman et al 1991) was completed by all respondents achieving a l 00% response rate. Findings revealed that although nurses lacked continuing education, nurses' perceptions on patient allocation ranged from primary nursing, team nursing, holistic nursing, adequate nurse-patient ratio to task allocation. Moreover, the majority (14) identified patient allocation as allocation or assignment of a nurse/s to a number or a group of patients. Furthermore, several factors were identified which seem to hinder patient allocation such as staff shortage, mismanagement of nurses and lack of resources, overcrowding of patients on the wards, inadequate patient dependency mix and decreased information on the ward which creates isolation for nursing staff. The study suggests that patient allocation system of care is part of various modalities of care and although it attempts to shift nursing care delivery from task-centred towards patient centred care, task allocation can still remain concealed (Reed 1988). Consequently the organisation of nursing care delivery continues to pose a constant challenge for all times, thus further research is required.