Decisions and Dilemmas: The Context of Prioritization Dilemmas and Influences on Staff Members' Prioritization Decisions in Residential Aged Care. (June 2021)

• Record Type: Journal Article
• Authors: Ludlow, Kristiana; Churruca, Kate; Ellis, Louise A.; Mumford, Virginia; Braithwaite, Jeffrey
• Is Part Of: Qualitative health research. Volume 31:Number 7(2021)
• Page Start: 1306
• Page End: 1318
• Publication Date: 2021-06
• Subjects: older people -- work environment -- decision-making -- health care -- teamwork -- long-term -- geriatrics -- Australia -- Australians -- qualitative methods -- content analysis -- qualitative; Health -- Periodicals; Health behavior -- Periodicals; Health -- Research -- Methodology -- Periodicals; Health behavior -- Research -- Methodology -- Periodicals; 610.7205
• DOI: 10.1177/1049732321998294
• Languages: English
• ISSNs: 1049-7323

Abstract

Staff members in residential aged care facilities (RACFs) make prioritization decisions to determine which aspects of care are most important and thus should be attended to first. Prioritization can potentially result in substandard care if lower priority tasks are delayed or left undone, known as "missed care." This study investigated the contexts in which prioritization dilemmas arise in RACFs and the influences on prioritization decision-making . Thirty-two staff members participated in a think-aloud task during a prioritization activity, a demographic questionnaire, a post-sorting interview, and a semi-structured interview. Data were analyzed using inductive content analysis. Prioritization dilemmas occurred in response to high workloads, inadequate staffing, unexpected events, and conflicting demands. Seven influences on prioritization decision-making were identified. In some instances, these influences were seen to be in conflict, making prioritization decision-making challenging. Efforts to prevent missed care should consider the influences on staff members' decision-making and aim to reduce prioritization dilemmas.