Quality of institutional care of older people as evaluated by nursing staff.

AIMS: The aim of this paper was to report on the quality of institutional nursing of older people as evaluated by nursing staff in 2001 and to compare the responses with those obtained in 1998. BACKGROUND: The healthcare division of one Finnish city authorised an outside survey of long-term geriatric care in the hospitals providing such care in 1998. Based on the results, recommendations concerning the development of care of older people were issued. A re-survey was conducted in 2001, using the same criteria of quality assessment. METHODS: A survey research method was used. All the seven institutions providing long-term geriatric care, including a total of 53 wards, participated. In 1998, a total of 607 questionnaires was returned. The response percentage was 78.6%. In 2001, a total of 573 questionnaires was returned. The response percentage was 76.8%. RESULTS: The staff considered their possibilities to help geriatric patients best in the domain of physical care and slightly less good in the domain of psychosocial care. The differences in staff estimates between the two years were very small. More than 90% of the respondents considered their knowledge of physical care adequate. The nursing staff's evaluations were roughly similar in 1998 and 2001. More than 98% of the respondents considered the helping of older people important or moderately important in the other subdomains except sexual expression. According to the nursing staff, intentional or unintentional negligence in care was more common than physically or psychically offensive conduct. Observations concerning maltreatment had increased from 1998 to 2001. The staff reported both physical and mental fatigue. Nevertheless, the nursing staff appeared to be quite content with their current workplaces. RELEVANCE TO CLINICAL PRACTICE: The findings indicated that geriatric care mostly aims to respond to the physical needs of older people. Nursing should, therefore, be developed and improved because mere satisfaction of physical needs is not enough to guarantee a good quality of life for older people in long-term institutional care.

Family members' experiences of the quality of geriatric care.

The quality of institutional geriatric care is a topical issue in Finland. The study to be described here is part of a Finnish project on the quality assessment and development of long-term geriatric care provided by the City of Helsinki. The health care division of the City of Helsinki authorized an outside survey of long-term geriatric care in the hospitals providing such care in 1998. Based on the results, recommendations concerning the development of geriatric care were issued. In the years 1999-2000, a further education programme was arranged for ward nurses, chief nurses and heads of profit centres concerning leadership in long-term geriatric nursing. A re-survey was conducted in 2001, using the same criteria of quality assessment. The purpose of this paper is to report on the quality of institutional geriatric nursing as evaluated by family members in 2001 and to compare the responses to those obtained in 1998. The results are presented as frequency and percentage distributions, means and medians and cross-tabulations. The responding family members were generally content with the care of their elderly relatives: 92% said they were very satisfied or satisfied with the care, and the average of the marks given for geriatric care was 8.3 (range 4-10). Family members were more content now than in 1998, when the corresponding figures were 86% and 7.3 (range 4-10). Nevertheless, the results still highlight certain aspects that should be improved and developed.