Improvement of the Professional Activity of Mid-Level Medical Personnel of the Inpatient Branch of Psychiatric Services Based on the Resource-Potential Approach

The dissertation is devoted to the improvement of the professional activity of mid-level medical personnel of the inpatient branch of psychiatric services based on the resource-potential approach. The study focuses on the assessment of the staff potential of nurses as a key factor determining the quality of psychiatric care and is aimed at developing measures for optimizing the system of management of the quality of their professional activity.

The work examines the socio-hygienic and professional-industrial characteristics of mid-level medical personnel of inpatient psychiatric institutions, analyzes the state of quality of their professional activity, and identifies the factors determining it. The scientific novelty lies in the primary assessment of the staff potential of mid-level medical personnel of psychiatric services as a factor of activity quality and in the scientific substantiation of a complex of measures for improving the resource-potential approach to ensuring the quality of nursing care. The results of the study have been implemented in the practice of psychiatric institutions of the Ivanovo Oblast and in the educational process of specialized educational institutions.

Relevance of the Study

At the current stage of development of domestic healthcare, the nurse is regarded by the state and society as a unique individual capable of independently performing a range of defined duties at a high professional level (Glotova I.G., 2000; Kalininskaya A.A. et al., 2000; Pavlenko T.N., 2001; Sadreeva S.Kh., 2001; Yakubova E.V., 2002; Ivanyushkin A.Ya., Labodina A.F., 2004). In this regard, heightened requirements are placed on the professional activity of mid-level medical personnel, and in light of these requirements new approaches are being sought to improving the quality and assessing the efficiency of their work (Kicha D.I., 1992; Lapotnikov V.A., Karaseva L.A., Samoylenko V.V., 2000; Demysheva E.V., 2001; Zykova V.K., Bashkirova G.A., 2002; Dvoynikov S.I., Penzina O.F., 2004; Grekov I.G., 2004; Gadzhiev R.S., Sadradtsinova N.O., 2005; Ryabchikova T.V., 2005; Vishnyakova V., 2006).

The formation of a qualitatively new level of nursing care for the population is based on the improvement of nursing practice, the development of scientific research in this field, and the use of their results in practical healthcare (Sarkisova V.A., 1999; Ivanova N.V., Kostyleva T.V., 2001; Chupakhin N.N., Belokhvostikova T.V., 2001; Blinova N.I., Khokhlova I.A., 2001; Zorina T.A., 2001; Vlasova T.V., 2002; Svetlichnaya T.G., Lisishnikova L.P., 2002; Tulupova L.G., 2004; Lozhkina T.Yu., Bozunova E.F., 2004; Komarevceva N.B., Erlina L.V., 2005).

One of the fundamental concepts of the American and Western European model of nursing is the nursing process, which enables the systematization of nurses' work, the selection of priority directions, the planning and execution of actions, and the assessment of their results together with the patient (Nightingale F. 1859; Liule D., Carnevali D., 1976; Morris W., 1978; Winslow E.N., 1985; Gordon M. 1987; Abbyasov I.Kh., 2005).

In recent times, new nursing technologies are being widely implemented in domestic practical healthcare: organized medical-social assistance for geriatric and severely ill patients at home (Suslin S.A., 2001; Trukhina V.F., 2002; Korshunova T.A., 2005; Kochkareva N.M., 2005; Rozkovskaya Z.I., 2006); a self-control school for patients with diabetes mellitus (Lengin Yu.A. et al., 2001), a school for patients with bronchial asthma (Kolodkina O.F. et al., 2002; Fedoseeva E.I. et al., 2002), a health school for patients with allergic diseases (Markus Yu.S., Verevkina M.P., 2006).

Nursing technologies are widely implemented in specialized departments: gynecological (Ivanova N.B., Rakova L.P., 2004); neurological (Tarnovskaya I.I., 2000; Arkhipov V.V. et al., 2001; Trofimova G.A., 2004); proctological (Mysikova G.P., 2002); urological (Sverchkova L.S., Zangerova E.Yu., 2005); surgical (Kuzminikh E.Ya., Pigalin A.L., 2002; Ivanova N.V., Kostyleva T.V., 2001; Chernysheva V.A., 2002; Gonchar R.A., 2004); endocrinological (Zorina E.V., 2001); cardiological (Leplyaeva A.K., 2004); burn treatment (Aganina E.N., Vedernikova O.P., 2002).

The literature contains references to the implementation of nursing technologies in outpatient polyclinic services (Zabrodina L.E., 2003; Zhokhova Z.P. et al., 2004; Popova Z.V., Pepentseva O.Yu., 2005), inpatient medical-social care departments (Ronzhova L.G., 2005), children's social welfare institutions (Plaksina V.A. et al., 2004), and oncological dispensaries (Levina I. et al., 2006).

Improving the activity of nursing personnel and the effective use of its professional potential is impossible without conducting a systemic analysis of its staff potential, as well as optimizing the system of management of nursing personnel and the system of management of the quality of nursing activity (Bilsberri D., 1999; Vlasova T.V., 1999; Heifets A.S., 2000; Karavaeva T.I., 2000; Dvoynikov S.I., Karaseva L.A., 2001; Shishkova M.M., 2001; Karneev A.A., 2003, Izumova I.V., 2004; Blokhina M.V., 2005; Chesnokova O.V., Kudrina T.V., 2005; Nazarenko V.T., Rolko V.T., 2005; Yadreeva N.I., 2005).

In many countries of the world, nurses in the field of mental health are the sole specialists on whom the well-being and health status of the patient depend (Ritter S., 1993). Therefore, the reform of domestic psychiatric care is also associated with the growing role of mid-level medical personnel in the context of the development of nursing practice and society's need for quality service and care (Polyakov I.V., Chernov V.N., 2001). Despite the widespread adoption of nursing innovations in practical healthcare, the specifics of the nursing process in psychiatric services remain insufficiently studied and are not taken into account in the system of professional training, which, in the opinion of I.L. Leontyev (2001), leads on the one hand to an insufficiently high level of care for patients with mental disorders, and on the other — to the emergence of psychopathological issues among medical personnel. Previously conducted studies of nursing care in psychiatric services have addressed the organization of care for mentally ill patients with their first lifetime hospitalization (Golenkov A.V., Averin A.V., 2004) and the organization of nursing care for elderly patients with mental disorders (Golenkov A.V. et al., 2004). Studies containing results of the assessment of the staff potential of mid-level medical personnel of the inpatient branch of psychiatric services, and proposals for optimizing the system of management of the quality of their professional activity, are absent, which served as the basis for conducting the present study and determined its relevance.

In light of the above, the goal of the study was the development of measures for improving the professional activity of mid-level medical personnel of the inpatient branch of psychiatric services based on the assessment of their staff potential.

Research objectives:

1. To determine the socio-hygienic characteristics of mid-level medical personnel of the inpatient branch of psychiatric services.

2. To determine the professional-industrial characteristics of mid-level medical personnel of the inpatient branch of psychiatric services.

3. To determine the state of quality of professional activity of mid-level medical personnel of the inpatient branch of psychiatric services and the factors determining it.

4. To provide an assessment of the staff potential of mid-level medical personnel of the inpatient branch of psychiatric services as a factor determining the state of quality of their professional activity.

5. To develop a complex of proposals for improving approaches to ensuring the quality of professional activity of mid-level medical personnel of the inpatient branch of psychiatric services.

The scientific novelty of the study lies in the fact that for the first time:

— the features of the socio-hygienic and professional-industrial characteristics of mid-level medical personnel of the inpatient branch of psychiatric services have been identified;

— the state of quality of professional activity of mid-level medical personnel of the inpatient branch of psychiatric services has been determined;

— an assessment of the staff potential of mid-level medical personnel of the inpatient branch of psychiatric services as a factor determining the quality of their professional activity has been provided;

— a complex of measures for improving the resource-potential approach to ensuring the quality of professional activity of mid-level medical personnel of the inpatient branch of psychiatric services has been scientifically substantiated.

Practical significance of the work:

1. A system of management of the staff potential of mid-level medical personnel of the inpatient branch of psychiatric services has been proposed.

2. New organizational-methodological approaches to ensuring the quality of professional activity of mid-level medical personnel of the inpatient branch of psychiatric services have been piloted, including the proposed system for assessing the volume and result using the developed system of information support of the nursing process.

Implementation of research results in practice:

The results of the conducted study formed the basis of the information letter of the Ivanovo Oblast "Characteristics of the Staff Potential of Mid-Level Medical Personnel of the Inpatient Branch of Psychiatric Services" (Ivanovo, 2006) for deputy chief physicians in charge of nursing personnel, chief and senior nurses of psychiatric services.

The results of the study have been implemented in the educational process at the Department of Rehabilitation Medicine, Psychiatry, Psychotherapy, Narcology and Pediatric Narcology of the State Educational Institution of Higher Professional Education "Ivanovo State Medical Academy of Roszdrav," as well as in the lecture course "Nursing in Psychiatry" of the State Educational Institution of Secondary Professional Education "Kineshemsky Medical College."

Proposals for assessing the volume and quality of professional activity of mid-level medical personnel of the inpatient branch of psychiatric services have been implemented in the practice of the work of the State Healthcare Institution Professional Medical Board "Bogorodskoye."

Main provisions for defense:

1. The quality of nursing care in the inpatient branch of psychiatric services is determined by a complex of resource-potential factors, including the state of staff potential, and can be assessed based on the proposed methodology.

2. The basis for improving the quality of professional activity of mid-level medical personnel of the inpatient branch of psychiatric services can be an approach oriented toward the optimization of information support of the nursing process, staff potential, and the system of assessment of the results of professional activity, the directions and tactics of implementation of which have been developed in the course of the study.