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Kom verder. Saxion.
De orthopedisch verpleegkundige en de wereld
Onderzoek naar de betrokkenheid in BPU van verpleegkundigen van de afdeling orthopedie
Naadloze Zorg voor de Oudere Orthopedische Patiënt
Kom verder. Saxion.
The orthopaedic ward nurse and the world
Study regarding involvement in BPU development of orthopaedic ward nurses
Seamless care for the elderly orthopaedic patient
Kom verder. Saxion.
The orthopaedic ward nurse and the world
Nitie Mardjan
Saxion research center for health, social work and technologyprof Joy Notter
Saxion research center innovation and entrepreneurship prof Jos van der Werf
Seamless care for the elderly orthopaedic patient
Kom verder. Saxion.
The orthopaedic ward nurse and the world
Aim
Theoretic framework
Method
Findings
Conclusions
Recommendations
Seamless care for the elderly orthopedic patient
Kom verder. Saxion.
aim
1. A systems theory perspective on organizational performance in relation to professional empowerment
2. Qualitative baseline establishment for development of the BPU
to explore how nurses of the orthopaedic ward of the MST hospital manage the concurrent demands by the patients, the organization’s management and their professional standards
3. Follow up
lifeworldsystem
theoretic framework
Habermas, 1988
Kunneman & Slob, 2007
theoretic framework
Habermas, 1988
Kunneman & Slob, 2007
system
lifeworld
Kom verder. Saxion.
theoretic framework
N=1
N=x
Weggeman, 2007van der Werf, 2010
Targets must be achieved!
Hello, I am here for my patients!
… and what about me!?
A1Professional autonomy
A2Client attention
EEconomy
Van der Werf, 2008
EA2
Kom verder. Saxion.
Research was limited
• MST hospital in Enschede• the orthopedic ward• nursing population• phenomenon
method
A1
Professional autonomy
A2
Client attention
E
Economy
Kom verder. Saxion.
method
1. interpretative research (hermeneutic phenomenology)
2. topic interviews
Exploratory research
The phenomenon in its context
no generalized statements
Kom verder. Saxion.
method
1. systems theory
2. interpretative research (hermeneutic phenomenology)
3. topic interviews
Exploratory research
Method fits method:
• organized searching and learning in the social context
• designing smart new ways based on experience
Principles of engaged scholarship
van der Ven, 2007
Kom verder. Saxion.
Baseline 20092 focusgroup interviews9 individual interviews1 interview with management
Follow-up 20122 focusgroup interviews1 individual interview 1 interview with management
Literature research
method
Kom verder. Saxion.
Patient pillarNursing pillarOrganization pillar
Santeonexcellent care
1. Working with other nurses who are clinically competent
2. Good nurse-physician relationships and communication
3. Nurse autonomy and accountability
4. Supportive nurse manager/supervisor
5. Control over nursing practice and practice environment
6. Support for education
7. Adequate nurse staffing
8. Concern for the patient is paramount
8 essentials
Empowerment
… the effort to obtain a relative degree of ability to influence the world
Staples, 1990
Empowerment
Kom verder. Saxion.
conclusion
At baseline no marked difference was found in lived experience between BPU main group and other nurses
At follow-up no marked difference was found in lived experience between BPU main group and other nurses on general issues
At follow-up marked difference was found in lived experience regarding BPU process and results
Kom verder. Saxion.
‘We’ve become more of a team’
‘We achieved a lot, I am actually proud of ourselves’
‘BPU has made us being heard’
BPU focus group
results
Kom verder. Saxion.
‘It’s been nice, but I expected more out of it’
‘Some things have changed, but it waters down’
‘What I brought back from England is not put to use’
non-BPU focus group
results
Kom verder. Saxion.
1. Working with other nurses who are clinically competent
2. Good nurse-physician relationships and communication
3. Nurse autonomy and accountability
4. Supportive nurse manager/supervisor
5. Control over nursing practice and practice environment
6. Support for education
7. Adequate nurse staffing
8. Concern for the patient is paramount
√
√
√
√
√
√
Kom verder. Saxion.
‘… you are dealing with patients you know, […]
you don’t work in a factory’
results
Kom verder. Saxion.
‘A quiet moment is often only ½ hour and that is insufficient time
to work something out’
results
Kom verder. Saxion.
‘All that paperwork. What is it about?
Paperwork is partly based on distrust’
A1
Professional autonomy
A2
Client attention
E
Economy
results
Kom verder. Saxion.
‘It is always running or standstill’
results
Kom verder. Saxion.
‘Nearness’
‘Distance’
conclusion
Kom verder. Saxion.
Balancing nearness and distance in relation to patients requires
empowerment in regards to both professional issues as well as
organizational issues
conclusion
Kom verder. Saxion.
Periodically and structurally share relevant figures in relation to the nurses’ efforts
Involving nurses in the re-design of care processes (paths) including surgery planning could enhance flow and efficiency
recommendations
Make clear the relationship between administrative processes and their purposes
Attention for the involvement of all stakeholders
Somehow organizational [E] issues would make an interesting BPU topic
Kom verder. Saxion.
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