Compassionate Care Delivery for Elderly Patients: Nurses’ Perception

When setting up patient pathways that cross health care sectors, professionals in emergency units strive to fulfill system requirements by creating efficient patient pathways that comply with standards for length of stay. We conducted an ethnographic field study, focusing on health professionals’ collaboration, of 10 elderly patients with chronic illnesses, following them from discharge to their home or other places where they received health care services. We found that clock time not only governed the professionals’ ways of collaborating, but acceleration of patient pathways also became an overall goal in health care delivery. Professionals’ efforts to save time came to represent a “monetary value,” leading to speedier planning of patient pathways and consequent risks of disregarding important issues when treating and caring for elderly patients. We suggest that such issues are significant to the future planning and improvement of patient pathways that involve elderly citizens who are in need of intersectoral health care delivery.

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The role of nursing leadership in supporting the delivery of compassionate care during NHS mergers and acquisitions

British Journal of Healthcare Management ◽

10.12968/bjhc.2020.0137 ◽

2021 ◽

Vol 27 (7) ◽

pp. 186-193

Author(s):

Helen Rogers

Keyword(s):

Mergers And Acquisitions ◽

Lived Experience ◽

Care Delivery ◽

Nursing Leadership ◽

Compassionate Care ◽

Structured Interviews ◽

Nurse Leadership ◽

Role Of Nursing ◽

The Impact

Background/Aims This qualitative study explores the role of nursing leadership in supporting the delivery of compassionate care in a hospital that experienced both an acquisition and merger within 5 years. It aimed to understand the impact that NHS mergers and acquisitions have on a nursing team's capacity to deliver compassionate care to patients and to explore how nursing leadership can support the delivery of compassionate care during these periods. Methods Semi-structured interviews were undertaken with seven members of purposively recruited staff, who had lived experience of working at a hospital during an acquisition by a larger NHS trust, followed by a merger with another large NHS trust 5 years later. Results Staff valued authentic, honest and visible nurse leadership that was understanding of the context in which they were delivering care. Ward managers and matrons acted as ‘shock absorbers’ to protect their teams from the negative aspects of the change process. However, this came at an emotional cost and demonstrates the need for continued support structures. Conclusions This case study shows that staff value being able to deliver compassionate care; it gives meaning to their work, especially the ‘small things’. However, the context of care delivery can affect their ability to do this. There remains a great need for emotional support for staff to sustain their resilience in the face of changing staff, policies, practices and clinical models.

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Actions, style and practices: how leaders ensure compassionate care delivery

BMJ Leader ◽

10.1136/leader-2020-000235 ◽

2020 ◽

Vol 4 (2) ◽

pp. 48-52 ◽

Cited By ~ 1

Author(s):

Timothy J Vogus ◽

Laura E McClelland

Keyword(s):

Patient Outcomes ◽

Leadership Style ◽

Care Provider ◽

Care Delivery ◽

Well Being ◽

Compassionate Care ◽

Prosocial Motivation ◽

Growing Body ◽

Organisational Structures ◽

Acute Crisis

Demands for more patient-centred care necessitate that leadership creates the conditions for more compassionate care that is sustainable even in periods of acute crisis. We draw on a growing body of empirical research in health services, management and medicine to highlight how the combination of interpersonal acts, leadership style and organisational structures underpins leading with compassion. We further detail how this benefits care provider well-being and patient outcomes through fostering integrative thinking and prosocial motivation. We conclude with implications for practice.

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Compassionate Care Delivery: Elderlies’ Perception

Research in Psychology and Behavioral Sciences ◽

10.12691/rpbs-9-1-4 ◽

2021 ◽

Vol 9 (1) ◽

pp. 24-32

Author(s):

Eman Moustafa Ibrahim ◽

Aziza Mahmod ◽

Abeer Elmaghwry ◽

Hanan Elzeblawy Hassan

Keyword(s):

Care Delivery ◽

Compassionate Care

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The Clinical Learning Experiences of Nursing Students Caring for Elderly Schizophrenia Inpatients

International Journal of Studies in Nursing ◽

10.20849/ijsn.v4i4.660 ◽

2019 ◽

Vol 4 (4) ◽

pp. 42

Author(s):

Chia-Shan Wu ◽

Jiin-Ru Rong ◽

Wen-Kuei Liao ◽

Hsun-Wen Chang ◽

Wei-Na Hsu

Keyword(s):

Nursing Students ◽

Elderly Patients ◽

Student Perceptions ◽

Care Delivery ◽

Learning Experiences ◽

Phenomenological Approach ◽

Psychiatric Nursing ◽

Clinical Learning ◽

Process Of Care ◽

Nursing College

Aims: Young nursing students who are engaged in psychiatric nursing practice for the first time have many difficulties. In order to help students learn how to care for elderly patients with mental illness, this study explored student perceptions, evaluated clinical learning experiences using qualitative research methods, and assessed the experiences of student nurses in caring for elderly patients with schizophrenia in Taiwan.Methods: The data presented in this study were derived from an qualitative study based on a phenomenological approach. The 20 participants were selected from the students of a nursing college in Taiwan. Individual in-depth interviews were held with nursing students, these students were selected from the fourth-years of nursing college of associate degree. The mean age of all of the participants were 18.7(±0.46).Results: Colaizzi's analysis method was used to analyze the data. Six main themes were obtained: (1) Assessing clinical problems associated with psychiatric disorders and geriatric diseases; (2) Preparing for and engaging with the clinical internship environment; (3) Establishing relationships with elderly patients; (4) Participating in clinical learning and applying nursing knowledge and skills; (5) Shaping a good attitude towards elderly schizophrenia patients; (6) Gaining confidence in the internship process.Conclusions: Although nursing students lack clinical knowledge and situational experience in geriatric psychiatric nursing, nursing teachers need to help students be more perceptive and evaluate their clinical learning experiences, and to express themselves and reflect on the process of care delivery to hospitalized elderly patients with schizophrenia.

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Challenges and Barriers to Providing Care to Older Adult Patients in the Intensive Care Unit: A Qualitative Research

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.846 ◽

2019 ◽

Vol 7 (21) ◽

pp. 3682-3690 ◽

Cited By ~ 2

Author(s):

Abbas Heydari ◽

Mohammadhesam Sharifi ◽

Ahmad Bagheri Moghaddam

Keyword(s):

Intensive Care Unit ◽

Qualitative Research ◽

Intensive Care ◽

Quality Of Care ◽

Data Analysis ◽

Elderly Patients ◽

Care Delivery ◽

Elderly Care ◽

Care Of Elderly

BACKGROUND: Enhancing the quality of care for elderly patients needs an understanding of the challenges and obstacles experienced by the intensive care unit (ICU) staff in providing care. AIM: To explore the most challenging issues experienced by ICU staff, in particular, nurses, in the care of elderly patients in the general adult ICU. DESIGN: A qualitative research design was employed. The Standards for Reporting Qualitative Research (SRQR) were followed. METHODS: Based on theoretical sampling, we carried out 34 in-depth semi-structured interviews from two medical adult ICUs. Data analysis was carried out using qualitative conventional content analysis. RESULTS: Data analysis led to the identification of three interrelated categories and 12 subcategories. Three main categories were factors related to nurses’ attitude in elderly care, factors related to the system of care, and factors related to the models of patient care delivery. These categories came under the main theme of "Inappropriate and unfair system for elderly care". CONCLUSION: The findings of this study increase scholarly understanding of challenges and barriers to providing care to elderly patients in the general adult ICU. We found that the provision of care to elderly patients is inappropriate and unfair. Various obstacles must be overcome to improve the care of these patients. For example, negative attitudes toward elder care, inappropriate environments, lack of resources, lack of knowledge and skills, a specialized model of care delivery, respect for humanity, care without considering patient age, and separating professional conflicts from patient care. These findings may be used by ICU’s caregivers and managers to improve the quality of care. IMPLICATIONS FOR PRACTICE: Various obstacles were documented that need to be overcome by hospital administrators, nursing managers, clinical nurses, nursing educators, nursing researchers to improve the care of elderly patients admitted to ICU.

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Reshaping healthcare delivery for elderly patients: the role of community paramedicine; a systematic review

BMC Health Services Research ◽

10.1186/s12913-020-06037-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Julia van Vuuren ◽

Brodie Thomas ◽

Gina Agarwal ◽

Sean MacDermott ◽

Leigh Kinsman ◽

...

Keyword(s):

Systematic Review ◽

Elderly Patients ◽

Healthcare System ◽

Care Delivery ◽

Healthcare Delivery ◽

Aged Care ◽

Residential Aged Care ◽

Community Paramedicine ◽

Aged Care Facilities ◽

Residential Aged Care Facilities

Abstract Background Healthcare systems are overloaded and changing. In response to growing demands on the healthcare systems, new models of healthcare delivery are emerging. Community paramedicine is a novel approach in which paramedics use their knowledge and skills beyond emergency health response to contribute to preventative and rehabilitative health. In our systematic review, we aimed to identify evidence of the community paramedicine role in care delivery for elderly patients, with an additional focus on palliative care, and the possible impact of this role on the wider healthcare system. Methods A systematic review of peer-reviewed literature from MEDLINE, Embase, CINAHL, and Web of Sciences was undertaken to identify relevant full-text articles in English published until October 3, 2019. Additional inclusion criteria were studies focussing on extended care paramedics or community paramedics caring for elderly patients. Case studies were excluded. All papers were screened by at least two authors and underwent a quality assessment, using the Joanna Briggs Institute appraisal checklists for cross sectional, qualitative, cohort, and randomised controlled trial studies to assess the methodological quality of the articles. A process of narrative synthesis was used to summarise the data. Results Ten studies, across 13 articles, provided clear evidence that Community Paramedic programs had a positive impact on the health of patients and on the wider healthcare system. The role of a Community Paramedic was often a combination of four aspects: assessment, referral, education and communication. Limited evidence was available on the involvement of Community Paramedics in palliative and end-of-life care and in care delivery in residential aged care facilities. Observed challenges were a lack of additional training, and the need for proper integration and understanding of their role in the healthcare system. Conclusions The use of community paramedics in care delivery could be beneficial to both patients’ health and the wider healthcare system. They already play a promising role in improving the care of our elderly population. With consistent adherence to the training curriculum and effective integration within the wider healthcare system, community paramedics have the potential to take on specialised roles in residential aged care facilities and palliative and end-of-life care.

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The process of end-of-life care delivery to the families of elderly patients according to the Family Health Strategy

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692013000100013 ◽

2013 ◽

Vol 21 (1) ◽

pp. 380-387 ◽

Cited By ~ 3

Author(s):

Lucía Silva ◽

Kátia Poles ◽

Michelle Freire Baliza ◽

Mariana Cristina Lobato dos Santos Ribeiro Silva ◽

Maiara Rodrigues dos Santos ◽

...

Keyword(s):

Elderly Patients ◽

End Of Life ◽

End Of Life Care ◽

Care Delivery ◽

Family Health ◽

The Elderly ◽

Life Care ◽

Health Strategy ◽

The Family ◽

Family Health Strategy

OBJECTIVE: To understand the process of end-of-life care delivery to the families of elderly patients according to a Family Health Strategy (FHS) team, to identify the meanings the team attributes to the experience and to build a theoretical model. METHOD: Symbolic Interactionism and Grounded Theory were applied. Fourteen professionals working in an FHS located in a country town in the state of São Paulo were interviewed. RESULTS: Through comparative analysis, the core category overcoming challenges to assist the family and the elderly during the dying process was identified, and it was composed of the following sub-processes: Identifying situational problems, Planning a new care strategy, Managing the care and Evaluating the care process. CONCLUSION: the team faces difficulties to achieve better performance in attending to the biological and emotional needs of families, seeking to ensure dignity to the elderly at the end of their lives and expand access to healthcare.

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Impact of a compassionate care leadership programme

British Journal of Nursing ◽

10.12968/bjon.2019.28.11.708 ◽

2019 ◽

Vol 28 (11) ◽

pp. 708-714 ◽

Cited By ~ 1

Author(s):

Mohamad M Saab ◽

Jonathan Drennan ◽

Nicola Cornally ◽

Margaret Landers ◽

Josephine Hegarty ◽

...

Keyword(s):

Personal Development ◽

Care Delivery ◽

Learning Experience ◽

Compassionate Care ◽

Care Programme ◽

Evaluation Questionnaire ◽

Outcomes Evaluation ◽

Care Outcomes ◽

Long Term Impact ◽

The Impact

Compassionate care delivery enhances patient satisfaction and quality of life and reduces nurse burnout. This study measured the perceptions of nursing and midwifery leaders regarding the impact of the ‘Leaders for Compassionate Care Programme’ on their personal development, learning experience, service and care delivery, programme quality, and satisfaction with the programme. Seventy-nine leaders were surveyed using the Leaders for Compassionate Care Outcomes Evaluation Questionnaire and the Leaders for Compassionate Care Evaluation Questionnaire. Participants' perceived ability to support peer learning, manage conflict, and build trust with patients increased significantly following the programme (P≤0.001). Over 80% of participants reported that they were able to apply to practice what they had learnt from the programme and reported an increase in their motivation to lead in compassionate care delivery. Various strategies are needed to improve compassionate care leadership and further research is needed to explore the long-term impact of the programme.

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Calling on the Patient’s Perspective in Emergency Medicine: Analysis of 1 Year of a Patient Callback Program

Journal of Patient Experience ◽

10.1177/2374373518805542 ◽

2018 ◽

Vol 6 (4) ◽

pp. 318-324 ◽

Cited By ~ 2

Author(s):

Shaw Natsui ◽

Emily L Aaronson ◽

Tony A Joseph ◽

Andrew J Goldsmith ◽

Jonathan D Sonis ◽

...

Keyword(s):

Patient Experience ◽

Care Delivery ◽

Tertiary Care ◽

Wait Time ◽

Discharge Process ◽

Compassionate Care ◽

Negative Experience ◽

Patient Reported ◽

Reported Data ◽

Ed Crowding

Background: Patient-centered approaches in the evaluation of patient experience are increasingly important priorities for quality improvement in health-care delivery. Our objective was to investigate common themes in patient-reported data to better understand areas for improvement in the emergency department (ED) experience. Methods: A large urban, tertiary-care ED conducted phone interviews with 2607 patients who visited the ED during 2015. Patients were asked to identify one area that would have significantly improved their visit. Transcripts were analyzed using content analysis, and the results were summarized with descriptive statistics. Results: The most commonly cited themes for improvement in the patient experience were wait time (49.4%) and communication (14.6%). Related, but more nuanced, themes emerged around the perception of ED crowding and compassionate care as additional important contributors to the patient experience. Other frequently cited factors contributing to a negative experience were the discharge process and inability to complete follow-up plan (8.0%), environmental factors (7.9%), perceived competency of providers in the evaluation or treatment (7.4%), and pain management (7.4%). Conclusions: Wait times and perceptions of ED crowding, as well as provider communication and compassionate care, are significant factors identified by patients that affect their ED experience.

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