| ObjectivesTo identify the key stakeholders in the nursing staff industry.To investigate the satisfaction of the core stakeholders to the work of the nursing assistants in the tertiary hospitals in Sichuan Province and analyze the influencing factors,and to lay the foundation for improving the satisfaction of the core stakeholders to the work of the nursing assistants,improving the service quality and standardizing the management of nursing assistants.Methods1.The Mitchell scoring method were used to determine the core stakeholders of nursing staff industry.2.Through literature review,group discussion and Delphi expert consultation,the questionnaire of doctors and nurses' job satisfaction to nursing assistants and questionnaire of patients and family members' job satisfaction to nursing assistants with good reliability and validity were formed.By combining random sampling with convenient sampling,four kinds of core stakeholders(nurses,doctors,patients and family members)from 15 tertiary hospitals in five regions of Sichuan Province were selected to investigate their satisfaction to nursing assistants.The influencing factors of satisfaction were analyzed by unconditional binary Logistic regression analysis.3.Ten nursing assistants managers(including company managers and nursing managers)were selected for semi-structured interview by adopting the maximum difference method.Subject coding was carried out by QSR Nvivo 12.0 plus software.Results1.The core stakeholders in the nursing staff industry mainly included doctors,nurses,patients,family members,nursing managers,company managers and health administrative departments.2.Results showed that 41.76% of nurses and 31.02% of doctors were satisfied with nursing assistants.Nurses and doctors were the most satisfied with nursing assistants' professional cognition and the least satisfied with hospital infection prevention.And 75.57% of the patients were satisfied with the work of nursing assistants,and the most satisfied with familiar with the hospital environment and the least satisfied with professional knowledge.3.The results of unconditional binary Logistic regression analysis showed:(1)The eastern region(P=0.001,OR=0.168),southern region(P<0.001,OR=0.101),tertiary hospitals(P<0.001,OR=0.218),pilot hospitals(P<0.001,OR=0.035)and nursing assistants sharing the work of nurses(P<0.001,OR=0.464)were the protective factors for nurses' dissatisfaction with nursing assistants.With the increase of the average age of nursing assistants in the wards,the risk of nurses' dissatisfaction with nursing assistants decreased(P=0.004,OR=0.956).With the increase of the number of bad behaviors of nursing assistants,the risk of nurses' dissatisfaction with nursing assistants increased(P<0.001,OR=2.072).(2)Tertiary hospital(P<0.001,OR=0.254)and pilot hospital(P<0.001,OR=0.196)were the protective factors for doctors' dissatisfaction with nursing assistants.With the increase of the average age of the nursing assistants,the risk of doctors' dissatisfaction with nursing assistants reduced(P=0.03,OR=0.936).With the increase of the number of bad behaviors of nursing assistants,the risk of dissatisfaction increased(P<0.001,OR=3.59).(3)The eastern region(P=0.002,OR=4.169)and paying attention to the price of nursing assistants(P=0.001,OR=7.35)were the risk factors of patients and family members' dissatisfaction with nursing assistants.With the increase of cost,the risk of patients/family members' dissatisfaction with nursing assistants increased(P=0.007,OR=2.776).With the increase of the proportion of certified nursing assistants,the risk of patients/family members' dissatisfaction with nursing assistants decreased(P= 0.002,OR=0.303).(4)The following five themes were presented in the interview: the disadvantages of nursing assistants,the skill and service quality needed to be improved,poor communication,kindness and forbearance,appeal and expectation.Conclusions1.There are seven core stakeholders in the nursing assistant industry,in the process of standardized management reform of nursing assistants,we should focus on the seven types of core stakeholders in addition to the nursing assistants themselves.2.Nurses and doctors were less satisfied with the work of nurses.Patients and family members' satisfaction with nursing assistants' work was at a medium level.There were many factors influencing satisfaction,such as region,hospital level and pilot hospitals.Managers should pay attention to these influencing factors and to encourage nursing assistants to cooperate with nurses,sharing the work of nurses.We should continue to promote standardized training and management of nursing assistants to restrict their behaviors,increase the proportion of certified nursing assistants,set reasonable price,and pay attention to patients or family members who pay attention to price so as to improve the satisfaction of the core stakeholders.3.The influencing factors of nursing assistants managers' satisfaction included the disadvantages of nursing assistants,the skill and service quality needed to be improved,poor communication,kindness and forbearance.There were both negative and positive factors.In addition,we should pay attention to these influencing factors and actively explore the measures to improve the satisfaction of nursing assistants managers. |
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