Delegation: Preparedness, attitude and practices among nurses in selected hospitals in Iloilo

Abstract

This is a descriptive-correlational study was conducted in order to determine the preparedness, attitude and practices on delegation among nurses in selected hospitals in Iloilo. Specifically, it sought to determine the personal characteristics of the respondents in terms of age, sex, type of hospital, highest educational attainment, length of work experience, area of assignment, and nurse-patient ratio. It also sought to determine whether there is a significant relationship between the personal characteristics of the respondents and their preparedness, attitude and practices on delegation. Moreover, it tried to determine whether there is a relationship between the preparedness and attitude towards delegation, preparedness and practices on delegation as well as attitude and practices on delegation and a relationship between preparedness and practices on delegation controlling the attitude of the respondents. The data gathering instrument used for the study was a researcher-made questionnaire and analysis of data involved the use of both descriptive and inferential statistical tools. Findings revealed that most of the nurses were 20 - 33 years old (mean age of28.22), female, with bachelor’s degree only, had less than 2 years work experience (mean length of work experience of4.54 years), and assigned at the special areas taking care of 5 or more patients. Preparedness on delegation among nurses in general was high although less than half are not highly prepared. Most nurses would still prioritize safe and quality nursing care as evidenced by always assessing patient’s condition and needs prior to delegation. Most nurses considers to prioritize the right circumstance, followed by the right task then the right person, having the right direction or communication and lastly, supervision or evaluation prior to delegating. Attitude towards delegation among nurses was highly unfavorable. Most nurses still find themselves doing most of the task they have delegated, they feel that when the individual they have delegated does an incompetent job, they will be severely criticized and gets upset when they give clear instructions and the job does not get done right. Still, they believe that effective delegation improves staff development and satisfaction. Also, they are familiar with their legal responsibilities when delegating. Practices on delegation among nurses in general was good although less than half does not have good practices. Safe and quality nursing care is still a priority for nurses when practicing delegation as evidenced by always assessing patient’s condition and needs prior to delegation. Most nurses considers to prioritize the right circumstance, followed by the right person then the right direction or communication, having the right tasks and lastly, supervision or evaluation when delegating. The personal characteristics of nurses such as age, sex, type of hospital, highest educational attainment, length of work experience, area of assignment, and nurse-patient ratio has no bearing on the preparedness and attitude of nurses on delegation. Only the area of assignment has a bearing on the practices of nurses on delegation. Majority of the nurses in the general wards practices delegation since most of the procedures done are less technical and mainly routine. Also, there is less risk involved and complexity of patients. The preparedness of nurses on delegation has no significant bearing with the attitude of nurses towards delegation. The preparedness of nurses on delegation has a significant bearing on the practices of nurses on delegation. Whereby, most nurses who are highly prepared to delegate had good practices on delegation, while those with low preparedness results to poor practices on delegation. Thus, those who are prepared to delegate are most likely to practice delegation. The attitude of nurses towards delegation has a significant bearing on the practices of nurses on delegation. Whereby, most nurses who have favorable attitude towards delegation had good practices on delegation. Having a favorable attitude influences the nurses’ course of action to practice delegation. The preparedness and the practices on delegation has no bearing controlling their attitude towards delegation among nurses. Whether having favorable or unfavorable attitude, preparedness still influence practices on delegation. Lastly, the barriers among nurses which hinders effective delegation includes a combination of internal and external factors. Most of which are personal in nature which involves the development of confidence and trust. Also environmental factors affects effective delegation especially having increased workload. While the benefits to delegation among nurses leads to better outcomes for both the individual and the unit involved thus enhances collaboration and teamwork resulting to increase quality of patient care. Recommendations centered on increasing the awareness of the importance of delegation. Thus, seminars and in-service trainings should be conducted to enhance the preparedness, attitude and practices of nurses on delegation especially on values formation. Nurses should also be given the support and motivation coming from the nursing service especially supervisors and head nurses to improve and develop the positive attitude of nurses towards delegation and further develop practice. Whereby, the preparedness of nurses on delegation can be further enhanced by focusing on improving the supervision or evaluation aspect of delegation through the nursing service. Validation and being outcomes based with the staff nurses if he or she is capable of performing the task delegated through a proper feedback system should be encouraged. The nurse should be taught also how to assess the available resources needed prior to delegation and made sure to explain clearly why there is a need for delegation. Also, to develop a favorable attitude, it is recommended that nurses should be made to realize that delegation has its benefits which leads to improved staff development and furthermore the development of work satisfaction. Also developing the nurses’ self-awareness focusing on feelings and perception on delegation through conducts of in-service trainings and discussions through verbalizations in staff meetings would lessen the negative perception of nurses on delegation and further enhance practice. In terms of practice on delegation, further improvement should still focus on supervision and evaluation. There is a need to always supervise the task delegated and to ensure that there are clear expected results as to the outcome of the task delegated. A feedback system is also highly encouraged following delegation. The nursing service through the supervisors and head nurses should be made aware about the possible personal and environmental barriers encountered during delegation especially having the fear of committing mistakes and on work overload. As much to avoid if not minimize these barriers for the improvement of practice on delegation. The Commission on Higher Education (CHED), Department of Health (DOH), Philippine Nurses Association (PNA) and Association of Nursing Service Administrators of the Philippines (ANSAP) be given a copy of this study to further investigate and validate the results of this study. And lastly, this study be replicated among nurses in other hospitals in Western Visayas or other areas to further validate results of this study.