Aim: Nurses in home care service-providers
suffer from high physical and psychosocial
work load. It is the aim of this article to investigate
whether a professional assessment instrument
like the Resident Assessment Instrument
(RAI) can help to reduce such work load.
Method: In a cluster-randomized controlled
trial RAI was implemented in 29 of 69 home
care services. Nurses were asked to evaluate
their physical and psychosocial work load
and work satisfaction three times during the
study. Because of a different degree of implementation
two additional subgroups were
created and analyzed to distinguish between
optimal and suboptimal users.
Results: In general, there is no relevant improvement
of work load and job satisfaction of
nurses in the treatment group. Even a temporary
decline was investigated during the study.
Some of the optimal users show good initial
values and tend to improve over the course
of the study, whereas suboptimal users start
with worse values. It appears that suboptimal
users show always a worsening in work load
and job satisfaction (begin vs. end of the study).
Conclusions: Success or disappointment of
the implementation of RAI seems to depend
on the degree of implementation. On the one
hand it appears that a suboptimal implementation
of RAI involves the risk of a decline and
on the other hand an optimal implementation
might tend to provoke better outcomes
in terms of work load and satisfaction.
