Table 2 Facilitators and barriers to the delivery of dignified care at the organisational, ward and individual level
Facilitators | n | Barriers | n | |
|---|---|---|---|---|
Organisational level | ||||
Time | “Having time to allow patients to express their thoughts/fears” (p. 28) | 42 | “Not enough time!” (p . 23) | 47 |
Staffing levels | “Better staffing on the wards!” (p. 131) | 34 | “Inadequate staffing levels” (p. 13) | 37 |
Staff training and experience | “Putting training into practice and delivering dignified care” (p. 11) | 26 | “Poorly trained/incompetent nurses” (p. 133) | 11 |
Organisational support/values | “Having the right culture within the organisation with regard to values” (p. 42) | 7 | “The quantity of patient turnover and meeting target times that often appears more important to certain staff (i.e. managers)” (p. 33) | 13 |
Resources | “Having the right resources to provide the right support and care (staff and equipment)” (p. 42) | 19 | “Lack of equipment” (p. 68) | 19 |
Specific Dignity measures | “Protected meal times” (p. 89) | 6 | “Staff entering curtained area despite ‘privacy peg’” (p. 32) | 11 |
Ward level | ||||
Ward environment | “Mobilising equipment to toilet/bathroom wherever possible rather than using commodes/bed pans” (p. 30) | 23 | “Lack of appropriate facilities such as quiet rooms to discuss confidential issues” (p. 29) | 26 |
Colleagues/team | “Excellent teams within care of the elderly. Consultants are very proactive as are senior nurses and ward staff” (p. 61) | 21 | “Poor staff mix” (p. 182) | 2 |
Staff attitudes | “Other members of staff participation in dignified care, everyone having the same ‘goal’” (p. 16) | 13 | “Non empathetic nurses” (p. 74) | 8 |
Work load | “Less workload” (p. 58) | 7 | “Pressure to do things in a hurried manner can lead to a loss of dignity” (p. 179) | 30 |
Support | “Support from colleagues” (p. 133) | 19 | “Not being supported by staff” (p. 45) | 7 |
Communication | “Good communication between myself and members of the multi-disciplinary team” (p. 19) | 4 | “Staff not communicating well” (p. 130) | 8 |
Individual level | ||||
Addressing patients needs | “An understanding of specific patient needs or beliefs” (p. 94) | 17 | “Sometimes feel we are box-filling and patients/carers may not feel this is individualised” (p. 73) | 8 |
Involving family/carers | “Involving family/carers—this also provides an opportunity to gain insight into patient circumstances” (p. 5) | 3 | n/a | |
Reflection | “Having the time to reflect on my own practice and prejudices and challenge my thinking about what ageing is about” (p. 101) | 1 | n/a | |
Dealing with an emergency | n/a | “Emergency situations when the focus is on saving lives (if in patients best interest)—sometimes it is difficult to prevent exposure/timely communication” (p. 7) | 3 | |
Religion | n/a | “Religion can prevent you from providing dignified care although it shouldn’t. For example a muslim woman cannot be cared for by a male nurse because of their faith” (p. 53) | 1 | |
Neglect | n/a | “Staff not answering patients buzzers resulting in wetting the bed due to long wait” (p. 173) | 1 | |