On-line version ISSN 0379-8577
MCINTOSH, J and STELLENBERG, EL. Effect of a staffing strategy based on voluntary increase in working hours on quality of patient care in a hospital in KwaZulu-Natal. Curationis [online]. 2009, vol.32, n.2, pp. 11-20. ISSN 0379-8577.
Two of the issues facing the South African Health Care System are the shortage of nursing staff and a lack of adequate skills to provide quality patient care. The hospital under study experienced a critical shortage of applications from professional registered nurses, consequently a staffing strategy was implemented to overcome the shortage of nurses and to maintain quality patient care. The strategy introduced encouraged nurses to voluntarily work an additional ten hours per week with remuneration. A non-experimental, descriptive design with a quantitative approach was applied to investigate the effect of a staffing strategy aimed at improving the quality of care in a hospital in Kwa-Zulu Natal based on voluntarily increasing staff working hours. The investigation compared the quality of nursing care before and after the implementation of the staffing strategy through retrospective audits of randomly selected patient files 372 (11%) of the total population of 3400 files were audited. Arandom sample of 4 boxes each containing a 100 patient files, of a total of 34 boxes, was selected from the hospital filing system. Descriptive statistical analyses were performed and correlations between various variables using the Chi-square test. No statistically significant differences (p<0.05) were found between the quality of nursing care before and after the implementation of the management strategy, even though deterioration of results after the implementation was observed. The study shows that the quality of nursing care in most wards deteriorated after implementation. The staffing strategy failed to improve or maintain the quality of nursing care. RECOMMENDATIONS INCLUED: Strict control of nurses working extra hours per week, preventing the use of "moonlighters" . Introduction o f a quality assurance committee to monitor the quality of patient care developing critical analytical thinking skills of staff to improve patient care and standardization of the nursing process documentation.
Keywords : safe staffing; accountability; quality patient care; record keeping.