The effect on quality of care is obvious - residents wait longer to have their care needs attended to as nurses are washing dishes and cleaning toilets. Based on nurses' comments, the QNU believes this contributes to increased workloads and is an ongoing barrier to quality of care for consumers. In aged care, documentation is more often driven in style by validation requirements than by professional nursing models. It has become the practice in many facilities for nurses to document well beyond professional nursing and legal requirements in order to protect the nursing home's funding income. As a result some nurses are spending in excess of four hours a day on documentation, although no funding allocation is available for this activity.
Validation occurs by a rigorous and often subjective examination of the nurse's documentation.
How the residential aged care system works with other service sectors including community care. The QNU has been advised by members in public and private hospitals of an increase in hospital admissions of nursing home and hostel residents for illnesses or injuries which previously would have been cared for in their aged care facility. Members believe these increases are due to the reduction in the numbers of qualified nursing staff in nursing homes. This not only results in cost shifting, but is a direct negation of the government philosophy of 'ageing in place' - which was originally put forward to reduce the 'shunting' of older people between facilities. In the community sector, the award of Community Aged Care Packages to aged care facility providers appears to be contributing to nurses' workloads.