Abstract
BackgroundIn the future, elderly care workers need to have competence of various different conditions due to greater amount of multimorbid elderly. Further, knowledge of national level guidelines is important since they are closely linked to improving quality of care and implementing better practices at work places. The impact of national level guidelines on quality of care at care units is, however, not widely examined in the Finnish context. In this study, the aim was to find out if worker’s experience of his/her own competence is associated with quality of care. Secondly, we aimed to see how common is addressing national guidelines and policies at workplaces, and if they are associated with quality of care. Thirdly, we aimed to see whether there are differences between different occupational statuses in competence and addressing national guidelines and policies.MethodsTotal number of respondents was 1997 from 273 different units. Xtreg procedure was used for examining the associations of age, occupational status, unit type, professional competence and addressing the guidelines and policies with quality of care.ResultsHigher grade for QoC was associated with age, supervisor position, working in institutionalized care, better competence in supporting the self-determination of a person with memory disorders and falls prevention and addressing the act for elderly care and memory policy.ConclusionThis study demonstrated that national policies and guidelines are not widely addressed among Finnish elderly care workers. The study also showed that experienced competence of workers and discussion of policies and guidelines are related to quality of care. Especially competence related to memory disorders was associated with higher QoC. However, the relationship between quality of care and things influencing it seems complex and a major part of the variation in QoC remained unexplained. Although the relationships between guidelines, competences and quality of care are weak, national policies and competences seem to have impact on actual care provided. Therefore, sufficient time to address the guidelines should be provided at workplace and competences developed, which can be seen as a supervisor’s task. With knowledge about the guidelines, workers are able to change their practices at work places.
Highlights
In the future, elderly care workers need to have competence of various different conditions due to greater amount of multimorbid elderly
Statistical methods Multilevel approach was chosen and Xtreg procedure of STATA version 13.1 was performed to examine whether age, occupational status, self-assessed competence and addressing national policies and guidelines affected the self-rated quality of care provided (QoC)
The aim of this study was to see whether higher self-assessment of own professional competence and addressing national guidelines and policies at workplace are associated with higher self-rated quality of care (QoC) provided in the work unit
Summary
Elderly care workers need to have competence of various different conditions due to greater amount of multimorbid elderly. A study from Karlsted, et al [10] reported that nurses who work within elderly care have the need for further education especially in areas of drugs and older people, palliative and dementia care and in rehabilitation and function disability. Bing-Jonsson et al [11] found in their study that there were several areas where competence should have been improved in order to secure safe care for the elderly in home care and nursing homes When comparing those carers who had completed courses related to care with carers who had no care related education at all, results showed that those who had completed courses had higher values in factors measuring quality of care. Training and an improvement in competence was seen to be associated with better patient outcomes and higher quality of care [13]
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