Final draft All together
Title
IMPROVING THE QUALITY OF LIFE OF NURSING STAFF WORKING IN LONG TERM CARE FACILITIES IN THE UAE
Student ID
Submission date
Word count
Supervisor
Acknowledgements
Abstract
Table of Content ( NOT ORIGINAL )
Table of Contents
Acknowledgements…………………………………………………………………….….2
Abstract………………………………………………………………………………………3
List of Abbreviations………………………………………………………………………7
List of Tables ……………………………………………………………………………….8
List of Figures……………………………………………………………………………….8
1. Chapter 1….……………………………………………………………………………….9
1. Introduction………………………………………………………………………………..9
1.2 Description of the issue……………………………………………………………….9
1.3 Identify the need for change…………………………………………………………10
1.3.1 Contextualisation of the key themes……………………………………………11
1.3.2 Theme 1 Person-Centred Planning………………………………………………12
1.3.3 Theme 2 Quality of Life……………………………………………………………13
1.3.4 Theme 3 Education………………………………………………………………….14
1.4 Summary and conclusion……………………………………………………………14
2.Chapter 2 Methodology of the Literature Review…………………………………15
2.1 Introduction……………………………………………………………………………15
2.2 Purpose……………………………………………………………………..……….….15
2.3 Study Design……………………………………………………………………………15
2.3.1 Identifying the Research Question……………………………………….….….17
2.3.2 Statement of Aims……………………………………………………………….….17
2.3.3 Identifying Relevant Studies………………………………………….….……….17
2.3.3.1 Search Strategy……………………………………………………….….………18
2.3.3.2 Study Selection……………………………………………………………………18
2.3.3.3 Charting the Data…………………………………………………………………18
2.3.4 Collating, Summarising and Reporting the Results.…………………………19
2.4 Summary and conclusion……………………………………………………………19
3. Chapter 3 Literature Review………………………………………………………….20
3.1 Introduction……………………………………………………………………………20
3.2 Literature Search………………………………………………………………………20
3.3 Theme 1 Person-Centred Planning (PCP)……….…………………………….…20
3.3.1 PCP Approaches………………………………………….……………….…….…21
3.3.2 Challenges of PCP…………………………………………………………………..22
3.3.3 Culture impact on PCP…………………………………………………….………24
3.4 Theme 2 Quality of Life (QOL)………………………………………………………25
3.4.1 Measurement of QOL………………………………………………………………26
3.4.2. Interaction between PCP andQOL………………………………………………27
3.5 Theme 3 Education……………………………………………………………………28
3.5.1 Structured Programme……………………………………………………………29
3.6 Summary and conclusion……………………………………………………………31
4. Chapter 4 Change Roadmap………………………………………………………….32
4.1 Introduction……………………………………………………………………………32
4.2 Contextualisation of the review findings…………………………………………32
4.3 Conceptual model/framework from the literature review………………………33
4.3.1 Rational for model………….……………………………………………………….35
4.3.2. Rational for model in a specific context……………………………………….35
4.4. Change Roadmap and Narrative………………………………………………….36
4.4.1. Define………………………………………………………………………………..37
4.4.2 Design…………………………………………………………………………….…38
4.4.3 Deliver………………………………………………………………………………..38
4.4.4 Rational for who should be involved and operational details………….….39
4.5 Evaluation………………………………………………………………………………41
4.6 Risk Assessment and timeframe……………………………………………….…44
4.7 Gaps and limitations in leadership…………….………………………………….46
4.8 Summary and conclusion……………………………….………………….………47
5. Discussion and Conclusion…………………………………………………………48
5.1 Introduction……………………………………………………………………………48
5.1.1. The project aims and objectives and how these have been
answered……………………………………….………………………….……………….48
5.1.1.1 Training……………………………………………………………………………49
5.1.1.2 PCP Implementation…………………………………………………………….50
5.1.1.3 Evaluation…………………………………………………………………………51
5.2 The key contributions of the study to enable implementation………………52
5.3 The importance and impact of change……………………………………………53
5.4 Limitations and/weaknesses of this study………………………………………54
5.5 Areas for future research……………………………………………………………54
References…………………………………………………………………………………55
Appendices…………………………………………………………………………………69
Appendix 1 – Literature Searches………………………………………………………69
Appendix 2 – Schalock QOL Questionnaire……………………………………………75
Appendix 3 – Terms of Reference for PCP Committee…………………………….78
Appendix 4 – Belbin Team Profile Questionnaire (1981)…………………………..80
Appendix 5 – Multifactor Leadership Questionnaire (MLQ) Form………………..86
Appendix 6 – Training on PCP………………………………………………………….87
List of Abbreviations
List of Tables
( PICO study)
( Search criteria)
( SWOT analysis)
( Risk Assessments)
Firgues
( other samples of process maps)
( PRISMA Flow statement)
( Change models ** to search for )
( Hierarchy of needs** to search for )
Introduction
Discription of the issue
Identifying the need for change
Key themes in context
Theme 1
Theme 2
Theme 3
Summary and conclusion
Chapter 1,
Introduction
Alhanouf Alhammadi
Title:
Change management framework to improve ( ing) the quality of life and wellbeing in nursing staff working in long term care facilities in UAE to improve healthcare delivery.
( add all tools of measuring wellbeing ) /// Remove QoL maybe?
SMART relevant to my point.. is good wellbeing = no obsentiesm
1.3. IDENTIFY THE NEED FOR CHANGE ( What made me write this entire research ///) staffing went down, trend of absentism.. ) maybe increase neglect ))
( Problem statement )
add one more objective at least
SMART
Need for change
Context of planning
*Identify no structural change
Enhancing long-term health services in the United Arab Emirates (UAE) is an important aspect that highlights the need to focus the overall well-being of nursing personnel in the UAE. This is since nursing staff has a substantial influence on the treatment that patients receive and the results that follow( Reference needed ). Within the parameters of this setting, this systematized review intends ( unless sum and conclusion of chapters that includes the systematized rev) to search for interventions that could facilitate the improvement in the quality of long-term healthcare services by placing a key emphasis on the overall well-being of nursing practitioners and create a change management framework( What you are going to use in the project , using PDSA OR HSE ( healthcare personaell done )change model whatever,,justify the rationale of using the tools ( justify to stay safe) . Several pieces of evidence highlight the significance of the connection that exists between the health and happiness of nursing personnel and the essential aspects of patient safety and the quality of care that is provided.
The review comprises tactics that are specifically built to cultivate a loving atmosphere for the nursing professionals. These strategies may involve the implementation of targeted programs with the objective of increasing mental well-being. This would ensure a comprehensive investigation of the various challenges that are faced by healthcare workers working in environments that provide long-term care. Considering the extraordinary circumstances that have arisen because of external forces and global healthcare emergencies, and how to increase resilience in staff to be ready to battle challenges. Conducting a comprehensive analysis of the occupational health and wellbeing provisions that are currently available in healthcare settings is an essential component of the intervention that is being implemented.
The objective of this evaluation ?? ( Put in general ) is to provide nursing staff with a full understanding of the support systems that are available to them. If specific modifications and changes are necessary, this will make the process of developing change plans easier(WHAT IS THIS )). A durable, resilient, and supportive environment for nursing practitioners is the goal of the change management framework ( should make the idea doable , I don’t have to state this, don’t add change management with the framework, IDEAS TO ACTIONS ), which will be accomplished through the integration of these components. Consequently, not only will this improve the well-being of these professionals on an individual level, but it will also improve the standard of long-term healthcare services that are provided on a national level in UAE. It is consistent with the overarching goal to enhancing patient care by recognizing that a strong and well-supported nursing staff is essential for achieving high standards in the provision of healthcare. ( CITATION NEEDED)
( WHY DID YOU PUT THIS HERE? EXPLAIN , …) when word count is a problem, add from a systematic review to conclude ) ))Long-term care facilities and acute care facilities are distinct from one another, and the distinctions between the two types of facilities have a substantial impact on a variety of areas of the delivery of healthcare. Individuals with chronic illnesses or impairments, which require ongoing assistance over extended periods of time, are the target population for long-term care facilities, which are purposefully designed to serve these individuals. For a lengthy period, the primary focus of these settings is to maintain and improve functional abilities and quality of life of the residents receiving care. One of the essential aspects of the nature of care, which is characterized by a dedication to establishing long-lasting ties with residents, is the recognition of the value of long-term engagement for the general well-being of individuals who are under their care. On the other hand, acute care facilities are distinguished by the fact that they provide patients who are suffering from critical or severe health conditions with the urgent and intense medical interventions that are necessary for their treatment. Acute care facilities are characterized by a dynamic atmosphere and multiple high-stress scenarios, which require rapid and precise decision-making to attend to urgent medical requirements.
Although, acute care facilities are characterized by being a high stress environment( Numbers and fast paced, support with evidence ), interpersonal relationships are rapidly lost due to the duration spent by patients in acute care facilities, unlike long term care facilities, nursing staff face hard time letting go of their long-known residents, that might harm their mental wellbeing in case of unfortunate situations, where guilt and lack of confidence are common. ( length of stay )
It is important to note that the essential competencies required of healthcare workers in each context are significantly different from one another. Long-term care necessitates the possession of a comprehensive and continuing set of care management skills. These skills include the ability to manage chronic diseases, provide palliative care, and provide psychosocial support to residents and their families. In contrast to this, the acute care setting necessitates that medical practitioners possess the ability to make rapid clinical decisions and to carry out acute medical operations with precision, efficiency, and effectiveness. Fundamentally, the differences between acute care and long-term care go beyond the simple conditions of patients and influence the entire structure of care delivery. As a result, it is necessary to possess specialized skills that are tailored to the specific difficulties and complexities of each healthcare environment. One of the most important requirements for individuals working in the healthcare industry is the ability to comprehend and acknowledge the various customer expectations. With this kind of knowledge, they can confidently navigate the complexity of their roles and deliver exceptional patient-centered treatment within the specific contexts of acute and long-term care facilities. ( what is the importance of knowing this ?? )Omit from chapter 1, put in chapter 3 ) wellbeing and skills, it is really impactful??
A considerable effort has been made to address the pressing issue of enhancing long-term healthcare services in the United Arab Emirates, and this comprehensive evaluation, which has been meticulously carried out, is a noteworthy accomplishment.( REVISW FROM LONG DRAFT )
The main purpose of the review is to strategically concentrate on the execution of change management strategies that specifically target increasing the welfare( STANDARIZE THE WORDS) of nursing professionals and efficiently managing their balance between their personal and professional lives. Considering the increased recognition of the essential relevance that nursing professionals bring to the delivery of exceptional healthcare services, the critical importance of this framework is brought into sharper focus.
With the primary purpose of examining the potential of change management methods as effective instruments for reducing absenteeism among nursing staff owing to mental health difficulties, the primary objective of this review is to analyze the effectiveness of these strategies. Following the implementation of the change plan, the objective ( IS TO REDUCE NOT AIM ))) aim for reduction of 30% in absenteeism and the total improvement in happiness and wellbeing ( Are the two different things or the same?to 60%( TIME BOUND ). The review offers a thorough technique to analyze complex resolves that aid in the construction of a resilient strategy for changeThis is accomplished through the synthesis ( dissect , analysis, review, critically analyse) of a wide range of scholarly works. The examination of the influence of medical cyber-physical systems on healthcare service provision, as described by Sony et al. (2022), and the case management programs for integrated care that were offered by Hudon et al. (2022) are both significant variables that should be taken into consideration. The compilation of a wide range of perspectives contributes to a better understanding of the complex interrelationships that exist between the factors that influence the health and work-life balance of individual nursing staff members.
Furthermore, the evaluation goes into the realm of organizational dynamics by analyzing scholarly investigations about the moderating influences of organizational support on job satisfaction and organizational commitment in the context of nursing professionals, as explained by Chang (2014). Furthermore, it investigates the intricate relationship that exists between work-life imbalance, role ambiguity, and stress linked to the job, with a specific emphasis on the impact that these factors have on the intention of healthcare workers to leave their current employment, as Alblihed and Alzghaibi (2022) have noted. The purpose of this inquiry is to further investigate the correlation between absenteeism and insomnia among nursing teams, as stated by Sadeghniiat-Haghighi et al. (2021). The purpose of this investigation is to recognize the holistic component of the well-being of nursing staff by acknowledging the complicated interrelationship that exists between sleep patterns, mental health, and workplace attendance.
In accordance with the findings of Parveen et al. (2021), the review takes a holistic approach by investigating the gender component as well as the numerous elements that have an impact on the work-life balance of female healthcare staff. building a supportive and equal workplace environment. In addition to this, it incorporates the findings of Alameddine et al. (2023) to evaluate the work-life balance that is prevalent within the health industry. The utilization of a methodology that is both all-encompassing and comprehensive not only improves the dependability and accuracy of the results, but it also makes it easier to have a comprehensive understanding of the intricate challenges and potential solutions that are associated with the health and happiness of nursing personnel as well as the balance between their personal lives and their professional lives. The construction of benchmarks and indicators that can lead the evaluation and improvement of work-life balance in healthcare contexts is strongly dependent on this dimension.
Lastly, this comprehensive evaluation represents a significant step forward in the direction of boosting the quality of long-term healthcare services in the United Arab Emirates. This research endeavors to provide a contribution to the development of evidence-based approaches and interventions by means of the investigation and incorporation of evidence in management frameworks. As a result, it intends to provide invaluable views on the significant impact that change management strategies can have. In conclusion, the findings of this evaluation can promote favorable transformations, thereby establishing an environment that is nurturing and resilient for nursing workers and, an improvement in the overall quality of long-term healthcare services in the UAE.
CHANGE ALL WORDS OF (EVALUATION) TO RESEARCH PAPER)
(chapter3 )
Don’t use evaluation, use in chapter 3 systematic review or paper….
themes suggested ….
Challenges?
Tools of measuring
Tools of improving
Electronic referece Zotero, on time references (there is a way to link PDF of reference with zotero and work on highlighting the link and take all extracted text in one document .. check similarities.
( REFERENCES )))))
IMPROVING THE QUALITY OF LIFE OF NURSING STAFF WORKING IN TERM CARE FACILITIES IN THE UAE
First Draft of Chapter 2,3
Alhanouf Alhammadi
January 2024
Table of Contents
Chapter 2. Methodology of the Literature Review 12
2.1 Introduction 12
2.2 Purpose 13
2.3 Study Design 13
2.4 Summary and conclusion of chapter 16
Figure 1: PRISMA flow diagram 17
Chapter 3. Results of the Literature Review 17
3.1 Introduction 17
3.2 Literature Search Characteristics 18
3.3 Nurses’ Environment of Work 18
3.3.1 Age and Employment 18
3.3.2. Education and Intermediate Title 19
3.3.3. Nurses’ Disorders and Adverse Events 20
3.4 Burnout 20
3.4.1 Burnout and Conditions of Work 20
3.4.2. Burnout and Nursing Staff’s Quality of Life 21
3.4.3. Burnout and performance 21
3.5 Improving Nursing Staff Members’ QOL 21
3.5.1 Individual Level 22
3.5.2. Leadership Level Interventions 22
3.5.3. Organization Level Interventions 22
3.6 Summary and Conclusion 23
Reference List 23
Chapter 2. Methodology of the Literature Review
2.1 Introduction
This literature review focuses on improving the quality of life of nursing staff working within long-term care facilities in the UAE. It should be understood that the most significant challenge facing today’s societies is the increasing demand for healthcare services. With the intensifying incidents of chronic ailments and an aging population has led to the manifestation of a constantly increasing number of patients in need of health care staff. Nursing specialists are particularly impacted as, despite their reduced numbers in the current professional environment, the remaining professionals must uphold the demands for quality healthcare in the expanding long-term care environment. Care homes are also regarded as long-term care facilities and include the residential and the nursing homes. In the setting, the most significant volume of care is offered by the care support workers, but the nursing homes require at least a single nurse who resides in the setting and can be accessed at all times. However, with the intensifying nursing work and a severe lack of nursing staff at an international level, the stability of the nursing industry, the quality of nursing services, and the general well-being of the nurses are negatively impacted.
2.2 Purpose
The purpose of this study is to review recent studies that focus on nursing staff’s conditions of work to identify the factors associated with, and strategies that can help enhance their work-life quality within the UAE long-term care environment.
2.3 Study Design
For this research paper, the systematic review design is employed in examining evidence on change management strategies that improve the quality of life of staff working in long-term care facilities in the UAE. As a systematic review, the research paper collates evidence that meets a pre-specified eligibility criteria to respond to the research question. Advanced documentation of systemic methods and a protocol reduces the likelihood of bias (Ranganathan & Aggarwal, 2020). The approach was selected because traditional narrative reviews do not have a systemic literature search process. Informal methods are used to identify the primary studies associated with the topic, summarized in the final review. The at-will selection of studies and lack of clearly defined criteria enhance bias as the studies that favor the researcher’s views are prominently selected.
2.3.1 Identifying the Research Question
What is the relationship between the nurses’ environment of work and the quality of care provided to residents in LTCFs?
With the increase in the sum of resident patients in LTCFs, what is the impact of the consequent burnout on the perceived quality of life among nurses?
What are the most effective strategies to enhance the quality of life of nursing staff in long-term care facilities?
2.3.2 Statement of Aims
The research aim is to ascertain the interventions that help improve the overall well-being of nursing practitioners in a quest for improved quality of long-term healthcare services in the UAE.
2.3.3 Identifying Relevant Studies
2.3.3.1 Search Strategy
A systematic internet search for study resources was conducted, anticipating that quality-of-life improvement programs for nurses in LTCFs would be reported. The peer-reviewed journal articles were sought from the Medline, CINAHL, and PsycINFO databases. To find the most appropriate resources, it was prudent to formulate search terms associated with the research topic and question. As such, ‘Nursing Staff Quality of Life’, ‘Improving nurses’ wellbeing’, ‘Nursing Challenges in Long-Term-Care-Facilities’, ‘Change strategies for nurse wellbeing’, ‘LTCF Nurses’ Mental Health Improvement’, and ‘Nursing Staff Conditions of Work’ were used as the search terms. To retrieve the literature resources, it sufficed to include resources on care homes, government health facilities, and long-term residential health facilities. As such, search terms such as ‘Nursing Residential Home’, ‘Nursing Residential Facilities’, ‘Institutional Health Care’, ‘Nursing Care Facilities’, ‘Nurse Burnout’, ‘Nurse Mental Health’, and ‘Chronic Ailments and Nursing’ were used.
2.3.3.2 Study Selection
In the course of the search, a total of 75 literature resources were obtained. And since the research aimed for twenty literature resources, it was prudent to specify further the resources that will provide the most significant insight into the topic and research question. The specifications of eligibility were meant to ascertain which research studies are the most relevant to the review inquiry to minimize the risk of bias. As such, the databases were searched by limiting the results to literature resources published from 2011 to 2023. For the articles to be included, they had to have ‘Nursing Staff Quality of Life,’ ‘Nursing Improvement in LTCFs,’ and ‘Work-Life Balance among Nurses’ as part of their research questions, topics, or objectives. They also must have described change initiatives to enhance the quality of care by upholding nurse well-being or approaches to improve the work environment of nurses.
It also sufficed to include articles that described specific strategies for quality improvement, including the QI collaboratives and Plan-do-study-act (PDSA) cycles. Due to the psychological effects of end-of-life care and care for the chronically ill, it also was prudent to include the literature resources that considered the impacts of the experiences and recommended strategies that help enhance the nurse’s well-being (Ranganathan & Aggarwal, 2020). The excluded articles included those whose publication dates were not within the specified years, those suggesting projects meant for temporary residents, or those accessing intermediate care. Other excluded literature resources focused on learning disabilities and care homes for children to focus on LTCF for adults and gertiatrics. It also sufficed to exclude resources that sought to generate knowledge on the specific clinical intervention as the first reviewer conducted the title and abstract screening.
2.3.3.3 Charting the Data
The articles were randomly divided among three second reviewers who selected them based on the complete article and conducted data extraction with the help of the first reviewer. A summary table for all selected resources had to be created collaboratively, illustrating the primary information of the sources. The information included the author, reference, and key findings relevant to the review topic and question. It also sufficed to maintain an audit trail because each research team member could independently and sequentially conduct an initial data extraction for all accepted and included literature resources (Ranganathan & Aggarwal, 2020). To guarantee conformity, testing was done by considering the form created for extraction and cross-checking data by two individuals selected to aid in the process.
2.3.4 Collating, Summarizing, and Reporting the Results
The data extraction forms were created to facilitate the collation processes. It first sufficed to consider information provided regarding the strategy for quality improvement such as its name, the sum of staff members involved, their occupational groupings, care homes involved, and measures reported. Secondly, it sufficed to consider the number of resident-level intervention participants,’ the descriptors of the interventions, controls, and outcome measures (Ranganathan & Aggarwal, 2020). While quality appraisal was not part of the criterion selection, it sufficed to capture and discuss the emergent methodological weaknesses. A thematic analysis will be conducted on all extracted data by synthesizing data evaluating the change management strategy at the staff, team, and organizational levels. Also, the information on the impacts and outcomes of the strategies in the resident context will be synthesized.
2.4 Summary and conclusion of chapter
This chapter discusses the methodology employed to conduct the study. In the chapter, the study’s purpose is to review recent studies that focus on nursing staff’s conditions of work to identify the factors associated with and strategies that can help enhance their work-life quality within the UAE long-term care environment. The systematic review design is selected to aid in examining evidence on change management strategies that improve the quality of life of staff working in long-term care facilities in the UAE. As a systematic review, the research paper collates evidence that meets a pre-specified eligibility criteria to respond to the research question. Alongside the design and purpose, the search strategy is defined alongside the selection criteria and search terms that correlate with the highlighted study question. The PRISMA approach is employed in formulating the strategy. The consequent chapter analyzes data obtained through three primary identified themes.
Figure 1: PRISMA flow diagram
Chapter 3. Results of the Literature Review
3.1 Introduction
The methodology defined in the previous section helped identify resources with relevant information to facilitate the study. Consequent processing of titles and abstracts of the identified studies was conducted to eliminate all duplicates and discard those deemed irrelevant. The data extraction process was independently conducted by three reviewers, and a comparison of data was done to identify errors in the extraction process. In this step, the results of the literature review are thematically discussed. The themes are formulated from the research questions, and each is discussed as per the information presented in the selected articles. The thematic analysis method allows for the identification, analysis, and reporting of patterns identified in the data linked to the improvement of nurse staff’s quality of life within long-term care facilities. The analysis approach was selected because of its effectiveness in deducting evidence from comprehensive and reproducible sums of data. It is helpful in the review study because it enabled the identification and synthesis of patterns across the sum of identified studies, ensuring that the research questions are informed.
3.2 Literature Search Characteristics
Among the seventy-five studies identified, the selection and collating process identified 20 research articles that provided more significant insight into the research topic. The most significant sum of study resources (10) discussed the association between nurses’ work environment in LTCFs and the quality of life they lead. To most of the authors, the balance between work and life is a critical aspect of the quality of life led by nurses; as one of the most significant professional groups in the healthcare setting, especially the LTCFs, their quality of life is a critical driver for their effectiveness in practice. They show that enhancing the quality of nurses’ work environment can enhance their job satisfaction and promote organizational efficiency. Based on the second theme, five (5) of the selected articles discuss the significance of interventions against burnout in enhancing the nursing staff’s quality of life and, consequently, enhancing the quality of care provided to residents in the LTCFs. The authors focus on nurses being among the healthcare professional groups that work with a significant sum of individuals, including families, patients, and other workers. As a result, they are highly vulnerable to burnout, which impacts their quality of life. The third group of studies, a total of five (5), discusses the interventions that can be implemented to enhance the quality of life led by nursing staff members in LTCFs. The studies provide insight into the most effective strategies to enhance the quality of life of nursing staff in long-term care facilities.
3.3 Nurses’ Environment of Work
3.3.1 Age and Employment
Based on the studies, there is a significant association between the quality of life of nurses and their age. As such, nurse managers can meet the needs of every nurse in the long term care facilities, depending on their age, by examining their Quality of Work Life (Wang et al., 2020). It is also critical to enhance their satisfaction and ensure a stable and harmonious team is built. Also, the Quality of life of the employed nurses is highlighted as significantly lower than that of those working on an intermediate basis (Moradi et al., 2014). While the Equal-pay-for-Equal work approach is often implemented to enhance the equivalence in the amount of work and wages received, the finding of reduced QOL among the employed nurses often fails to disappear. As such, it suffices for hospital administrators to consider and focus on the needs of employed nursing staff members in LTCFs to enhance their sense of belonging. Such focus will also help create a harmonious and inclusive work environment, which includes improved wages and welfare resources.
3.3.2. Education and Intermediate Title
The quality of life of nurses with little professional titles and academic qualifications is often lower than all other subgroups of professionals (Gifford et al., 2018). The primary reason for the phenomenon is that nurse promotion opportunities are often limited and have significantly high requirements. As such, care managers must display a more significant interest in creating opportunities for educational qualification improvements for middle-title nurses (Aluttis et al., 2014; An et al., 2011). The title, ability, and the respective nurse’s education in an LTCF can be enhanced by optimizing the nursing human resources, promoting the distribution and rationalization of personnel, planning for post-level management, and creating an effective skill improvement program that facilitates long-term career planning, In addition to education on different environments than LTCFs, to prepare them for all type of situations, and to build resilience.
3.3.3. Nurses’ Disorders and Adverse Events
Nurses with significant adverse event experiences report lower quality of life scores than those without exposure to such events. The nursing staff members working in long-term care facilities often face adverse events because of the nature of the patients they help within the settings (Liang et al., 2023; Smrekar et al., 2022). As such, lack of or insufficient resources alongside the significantly high pressure in the work environment intensifies the prevalence of adverse events in the nursing practice. For this reason, the hospital manager must acknowledge the association between their nursing staff members’ work stress, sleep disorders due to shift work, and their consequent quality of life (Kheiri et al., 2022; Zeng et al., 2013). Approaches suggested for use in addressing the problem include adopting flexible scheduling mechanisms for a reasonable arrangement of nurses’ working periods, enhancing the departmental environment through effective communication and decision-making paths, expanding the nursing teams, and conducting frequent psychological evaluations and helpful interventions for nurses.
3.4 Burnout
3.4.1 Burnout and Conditions of Work
The significant levels of burnout among nursing staff members in LTCFs, as illustrated in the reviewed articles, are associated with the challenging work conditions and the environment in general. For example, the constantly changing shifts, low nurse-to-patient ratios, poor collaboration and engagement with other health professionals in the setting are the most impactful aspects of the work environment that bring about burnout (Aryankhesal et al., 2019). Nevertheless, the different burnout levels illustrated in the studies can be due to the differences in work environments at the LTCFs. Some individuals work in the wards, while others have different shifts that translate to differentiated workloads (Hwang, 2022). For example, nurses who typically work at night can report more significant levels of burnout than those who take regular shifts. They also are often associated with sleep problems, reducing the uniformity in the levels of burnout.
3.4.2. Burnout and Nursing Staff’s Quality of Life
It is concluded in the articles that burnout among nurses and its subscales often will negatively impact the individuals’ quality of life. There also is a significant correlation between work-related quality of life and burnout among nurses (Hwang, 2022). While some do not establish a significant correlation between burnout among nurses and their QOL, they agree with the findings that moderate to high burnout levels manifest alongside reduced quality of life (Shdaifat et al., 2023). The inverse relationship between the QOL and burnout is founded on the diminished job satisfaction among nurses in LTCFs. The environment of work and high workload are due to the increasing number of patients in the LTCFs.
3.4.3. Burnout and performance
The study resources also highlight burnout as a significant indicator of change management necessity in an LTCF. It is associated with the performance of employees within the work setting, an issue consequently reflected in the quality of care provided to patients (Meng et al., 2023). Burnout typically causes emotional and psychological exhaustion, feelings of failure, negativity towards the job, and a reduction in the ability of the individuals to effectively respond to unavoidable stressors. The burnout effects should be investigated by considering the personal and organizational elements (Meng et al., 2023). Such investigations will help ascertain the negative impacts of burnout on the care provided to patients and the quality of life led by the nurses due to dissatisfaction, possible job terminations, and the manifestation of an array of mental health disorders due to reduced coping capabilities.
3.5 Improving Nursing Staff Members’ QOL
3.5.1 Individual Level
Changes in the work environment by enhancing the patient-to-staff ratios over time will help enhance the nurses’ QOL. The authors state that incidents of missed nursing care are indicators of poor quality of care and patient experiences (Schalk et al., 2016). In this regard, the examined health facilities significantly improved the nurse’s effectiveness due to enhanced satisfaction and decreased absenteeism. The e-mental health approaches also help reduce specific mental health complaints, mainly when provided alongside personalized feedback (Maddigan et al., 2023). Individual-level interventions emphasize the new nurses alongside the supporting transition and development programs (Halter et al., 2017). In LTCFs, one-to-one guidance during preceptorship and support programs such as residency, internships, and orientations will likely enhance the quality of life of nursing staff working in the LTCFs. The mentorship programs lasting for three months are reported to be critical in ensuring new RNs are retained.
3.5.2. Leadership Level Interventions
Two of the reviews address the leadership-level interventions, which include the provision of training to the management on leadership styles and behavior and supervisory support (Aust et al., 2023). The interventions are associated with an increased desire to work among the nurses.
3.5.3. Organization Level Interventions
Two of the reviews highlight the group or organizational-level interventions. Because of the impacts of factors such as burnout on nurses’ QOL and consequent patient care, comprehensive interventions are suggested because of their primacy in sustaining the healthcare environment (Kim & Yang, 2023). The suggested interventions include salary increments, reduced working hours, and provision of counseling sessions and education on how to effectively manage the stress that manifests in the place of work (De Vries et al., 2023). Also, social and managerial supports are suggested as critical in enhancing the nurses’ QOL.
3.6 Summary and Conclusion
This chapter discusses the characteristics of literature resources used in the study. Alongside their characteristics, the information obtained is synthesized and categorized into three primary themes. They include Nurses’ Environment of Work, Burnout, and Improving Nursing Staff Members’ QOL. From the thematic analysis, the most significant sum of studies discusses the work environment and how it impacts nurses’ QOL. They also emphasize the need to address burnout at the facilities because of its impact on the quality of care provided to patients in LTCFs.
Reference List
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