Sk. Sikma et Hm. Young, Balancing freedom with risks: The experience of nursing task delegation incommunity-based residential care settings, NURS OUTL, 49(4), 2001, pp. 193-201
Background: In 1995, Washington State implemented low reforming the state's
long-term care system, favoring provision of service in less restrictive,
lower-cost settings.
Purpose: The purpose was to systematically evaluate one facet of the new la
w regarding the implementation of a policy authorizing delegation of design
ated nursing tasks by registered nurses in community-based residential care
settings.
Method: This was a descriptive study driven by the inductive process of gro
unded theory. Qualitative data sources included interviews, public forums,
document review, and open-ended survey questions to facility operators, nur
ses, nursing assistants, and inspectors.
Discussion: The study identified an overarching social process, balancing f
reedom with risks involving tension at the intersections, which is evident
from 3 main perspectives: consumer, professional, and the health care syste
m.
Conclusions: The study has implications for regulatory consistency, nursing
practice and education, collaboration between overlapping providers of ski
lled nursing services in residential settings, and subsequent health policy
.