Nurses' culturally mediated practices influencing pain care provision for older people in acute care: Ethnographic study

2019 ◽  
Vol 48 ◽  
pp. 22-29 ◽  
Author(s):  
Joanne Harmon ◽  
Peter Summons ◽  
Isabel Higgins
Keyword(s):  
Older People ◽  
Acute Care ◽  
Ethnographic Study ◽  
Care Provision ◽  
Pain Care

scholarly journals Digital Innovations for Aged Care: Impacts in the COVID-19 Pandemic

2021 ◽  
Author(s):  
Alan Taylor ◽  
Jennifer Tieman ◽  
Anthony Maeder
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Older People ◽  
Acute Care ◽  
Digital Technology ◽  
Healthcare Services ◽  
Aged Care ◽  
Care Provision ◽  
Remote Interaction ◽  
Healthcare Interventions

This paper describes the extent to which remote interaction healthcare interventions supported by digital technology are currently being used, or have recently been newly developed for use, in the care of older people in Australia within the context of the existing Australian aged care system and in conjunction with the COVID-19 pandemic. We place emphasis on those interventions associated with primary care provision, and associated healthcare services such as allied health, rather than outreach from jurisdictional health services and acute care. The primary purpose of this study was to gain an indication of the extent and range of such interventions, and provide a pragmatic commentary on their usage. This has enabled the understanding of some characteristics for success, and drivers for rapid adoption of further digital technology interventions, in the aged care sector.

scholarly journals Validation and psychometric evaluation of the Dutch person-centred care of older people with cognitive impairment in acute care (POPAC) scale

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Annette Keuning-Plantinga ◽  
Evelyn J. Finnema ◽  
Wim Krijnen ◽  
David Edvardsson ◽  
Petrie F. Roodbol
Keyword(s):  
Factor Analysis ◽  
Cognitive Impairment ◽  
Quality Of Care ◽  
Confirmatory Factor Analysis ◽  
Older People ◽  
Root Mean Square ◽  
Acute Care ◽  
Mean Square ◽  
Confirmatory Factor

Abstract Background Person-centred care is the preferred model for caring for people with dementia. Knowledge of the level of person-centred care is essential for improving the quality of care for patients with dementia. The person-centred care of older people with cognitive impairment in acute care (POPAC) scale is a tool to determine the level of person-centred care. This study aimed to translate and validate the Dutch POPAC scale and evaluate its psychometric properties to enable international comparison of data and outcomes. Methods After double-blinded forward and backward translations, a total of 159 nurses recruited from six hospitals (n=114) and via social media (n=45) completed the POPAC scale. By performing confirmatory factor analysis, construct validity was tested. Cronbach’s alpha scale was utilized to establish internal consistency. Results The confirmatory factor analysis showed that the comparative fit index (0.89) was slightly lower than 0.9. The root mean square error of approximation (0.075, p=0.012, CI 0.057–0.092) and the standardized root mean square residual (0.063) were acceptable, with values less than 0.08. The findings revealed a three-dimensional structure. The factor loadings (0.69–0.77) indicated the items to be strongly associated with their respective factors. The results also indicated that deleting Item 5 improved the Cronbach’s alpha of the instrument as well as of the subscale ‘using cognitive assessments and care interventions’. Instead of deleting this item, we suggest rephrasing it into a positively worded item. Conclusions Our findings suggest that the Dutch POPAC scale is sufficiently valid and reliable and can be utilized for assessing person-centred care in acute care hospitals. The study enables nurses to interpret and compare person-centred care levels in wards and hospital levels nationally and internationally. The results form an important basis for improving the quality of care and nurse-sensitive outcomes, such as preventing complications and hospital stay length.

An innovative approach to targeting pain in older people in the acute care setting

2010 ◽  
Vol 35 (2) ◽  
pp. 221-233 ◽  
Author(s):  
Caroline Phelan ◽  
Isabel Higgins ◽  
Peter Summons ◽  
Jeanene Douglas ◽  
Pauline M Dobson ◽  
...  
Keyword(s):  
Older People ◽  
Acute Care ◽  
Care Setting ◽  
Innovative Approach ◽  
Acute Care Setting

Caring relationships and efficient social care provision

2015 ◽  
Vol 35 (5/6) ◽  
pp. 419-436 ◽  
Author(s):  
Sue Hollinrake ◽  
Will Thomas
Keyword(s):  
Older People ◽  
Service Providers ◽  
Care Provision ◽  
Care Providers ◽  
Budget Cuts ◽  
Caring Relationships ◽  
Content Type ◽  
Support Mechanism ◽  
Practical Implications ◽  
Insight Into

Purpose – The purpose of this paper is to understand the nature of support that helps older people continue living in their own homes for as long as they wish to. Design/methodology/approach – The research made use of a participatory approach in which service users, service providers and commissioners were involved in the design of the approach in addition to contributing to the research as participants in their own right. Findings – This paper presents analysis from the research which focuses on the importance of caring relationships for providing a support mechanism. The authors question whether budget cuts and efficiency drives within statutory care providers preclude the notion of caring relationships. Practical implications – The authors suggest, in the light of the evidence presented, that statutory service providers should acknowledge the role that caring relationships play in providing support for older people. Whilst budget cuts make providing support for caring relationships more challenging, the authors suggest that there is scope for delivering services and support in ways which promote the types of interactions which better support older people living independently. Originality/value – The analysis presented here provides a distinctive, timely and thoughtful insight into support for older people at a time when public sector budgets are under increasing pressure.

Good practice in health and social care provision for LGBT older people in the UK

2017 ◽  
pp. 145-158
Author(s):  
Sue Westwood ◽  
Andrew King ◽  
Kathryn Almack ◽  
Yiu-Tung Suen ◽  
Louis Bailey
Keyword(s):  
Older People ◽  
Social Care ◽  
Good Practice ◽  
Care Provision ◽  
Health And Social Care ◽  
The Uk

scholarly journals 171 Programme Theory to Guide the Adoption of Assisted Decision Making with Older People in Acute Healthcare: Realist Evaluation

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Carmel Davies ◽  
Deirdre O'Donnell ◽  
Éidín Ní Shé ◽  
Sarah Donnelly ◽  
Francesco Fattori ◽  
...  
Keyword(s):  
Decision Making ◽  
Older People ◽  
Acute Care ◽  
Professional Training ◽  
Legal Framework ◽  
Realist Evaluation ◽  
Shared Responsibility ◽  
Programme Theory ◽  
Key Informants ◽  
People With Dementia

Abstract Background In Ireland, the Assisted Decision-Making (ADM) (Capacity) Act and emerging Codes of Practice provide a legal framework for Healthcare Professionals (HCPs) to enable ADM for patients with impaired capacity. ADM ensures that a person’s will and preference is at the centre of all decisions related to their care. This study conducted a realist evaluation and developed a Programme Theory (PT) to highlight how ADM for older people can be operationalised within an Acute Care (AC) context. Methods Key informants with interest in ADM informed this evaluation. Interviews were conducted in two Acute Care (AC) sites with multidisciplinary HCPs working within older person services (n=20). Interviews with informants that recently received care within an AC setting involved older people (n=3) people with dementia (n=4) and family carers (n=5). Ethnographic observations from AC multidisciplinary team meetings also informed the review. The framework that guided the qualitative analysis was from a PT informed by literature on ADM implementation in healthcare (O'Donnell, Ní Shé, Davies et al.2018). Results The refined PT is supported by credible evidence that is informed by authentic experiences of decision making support in the AC setting. Validation groups (n=4) with the key informants verified the PT. Three mechanisms were identified as a positive climate and receptive environment for the adoption of formal ADM. These are: AC settings that adopt inter-professional accountability and shared responsibility for patient care that is guided by a clear policy process. Acute care and practice that is informed by a shared commitment to person-centred care and shared decision making. HCPs that operate within an AC setting where organisational learning informs practice through inter-professional training, mentorship and peer support. Conclusion Involving stakeholders in PT development enhances the utility, feasibility and applicability of the results. This PT provides a framework for those planning ADM implementation within the AC settings.

scholarly journals An analysis of equity in treatment of hip fractures for older patients with dementia in acute care hospitals: observational study using nationwide hospital claims data in Japan

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shinichi Tomioka ◽  
Megumi Rosenberg ◽  
Kiyohide Fushimi ◽  
Shinya Matsuda
Keyword(s):  
Hip Fracture ◽  
Older People ◽  
Acute Care ◽  
Waiting Time ◽  
Older Patients ◽  
Acute Care Hospitals ◽  
Care Quality ◽  
Severe Dementia ◽  
People With Dementia ◽  
Acute Care Settings

Abstract Background Globally, and particularly in countries with rapidly ageing populations like Japan, there are growing concerns over the heavy burden of ill health borne by older people, and the capacity of the health system to ensure their access to quality care. Older people with dementia may face even greater barriers to appropriate care in acute care settings. Yet, studies about the care quality for older patients with dementia in acute care settings are still few. The objective of this study is to assess whether dementia status is associated with poorer treatment by examining the association of a patient’s dementia status with the probability of receiving surgery and the waiting time until surgery for a hip fracture in acute care hospitals in Japan. Methods All patients with closed hip fracture were extracted from the Diagnosis Procedure Combination (DPC) database between April 2014 and March 2018. After excluding complicated cases, we conducted regressions with multilevel models. We used two outcome measures: (i) whether the patient received a surgery or was treated by watchful waiting; and (ii) number of waiting days until surgery after admission. Results Two hundred fourteen thousand six hundred one patients discharged from 1328 hospitals were identified. Among them, 159,173 patients received surgery. Both 80–89 year-olds (OR 0.87; 95% CI, 0.84, 0.90) and those 90 years old and above (OR 0.67; 95% CI, 0.65, 0.70) had significantly lower odds ratios for receiving surgery compared to 65–79 year-olds. Those with severe dementia had a significantly greater likelihood of receiving surgery compared to those without dementia (OR 1.21; 95% CI, 1.16, 1.25). Patients aged 90 years old and above had shorter waiting time for surgery (Coef. -0.06; 95% CI, − 0.11, − 0.01). Mild dementia did not have a statistically significant impact on the number of waiting days until surgery (P = 0.34), whereas severe dementia was associated with shorter waiting days (Coef. -0.08; 95% CI, − 0.12, − 0.03). Conclusions These findings suggest physicians may be taking proactive measures to preserve physical function for those with severe dementia and to avoid prolonged hospitalization although there are no formal guidelines on prioritization for the aged and dementia patients.

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