scholarly journals How nurse practitioners working in rural communities can reduce the barriers to access primary health care services for older adults

2021 ◽  
Author(s):  
◽  
Elizabeth Enes
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Primary Health Care ◽  
Rural Communities ◽  
Literature Review ◽  
Nurse Practitioners ◽  
Emergency Department Visits ◽  
Future Research ◽  
Primary Health ◽  
Barriers To Access

Due to the aging population worldwide, need to access primary health care (PHC) services is increasing. Older adults are at a heightened risk of developing chronic diseases, poor health outcomes, and increased emergency department visits. Living in rural communities also increases the risk of chronicity for older adults due to a lack of PHC resources. However, there is limited information available to provide insight into how healthcare providers can reduce barriers to access to PHC for older adults. As PHC providers, nurse practitioners are in a position to implement strategies to reduce barriers older adults in rural communities face with accessing PHC services. An integrative literature review was conducted to identify barriers nurse practitioners within rural communities can reduce to improve older adults’ access to PHC services. An analysis of the literature revealed the complexity of barriers that prevent older adults from accessing PHC services in rural communities. Environmental, systemic, and individual barriers were reviewed alongside programs and interventions relevant to reducing barriers in the findings. Findings from the literature review suggested strategies to reduce these barriers, which nurse practitioners can promote in the PHC setting. These strategies include virtual care, home visits, nurse practitioner-models of care, interdisciplinary teamwork, and role clarification. In addition to these strategies, implications for practice, limitations of the study and suggestions for future research are discussed.

Improving Primary Health Care for Residents Living in Assisted Living: Evidence for Practice and Policy

2021 ◽  
pp. 1-10
Author(s):  
Patricia Cann ◽  
Rose McCloskey
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Primary Health Care ◽  
Nurse Practitioners ◽  
Assisted Living ◽  
Health Care Systems ◽  
Health Care Reforms ◽  
Term Care ◽  
Complex Needs ◽  
Primary Health

ABSTRACT The fact that there is a large and growing number of older Canadians has generated a sense of urgency in improving seniors’ access to health and long-term care services. Many provincial health care systems have engaged in a range of reforms to help older adults remain healthy and independent. Although many transformational changes have taken place across Canada to improve primary care, variations exist across provinces and territories in terms of older adults’ access to primary health care. Opportunities exist for provinces to learn from successful reforms implemented in other Canadian jurisdictions. Residents of assisted living (AL) facilities are an ideal group to whom to target primary health care reforms, given the important role these facilities play in the care continuum and the complex needs of their residents. Allowing practitioners to practice to their full scope and assume greater responsibility within the health care system is a strategy adopted in some jurisdictions with success. This article reports on reforms that have been made to expand the scopes of practice of nurse practitioners and paramedics in some provinces, but also have the potential to improve access to primary health care for those living in AL across the entire country, including those living in smaller provinces such as New Brunswick.

scholarly journals Cohort study of ageing from Bagé (SIGa-Bagé), Brazil: profile and methodology

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elaine Thumé ◽  
Marciane Kessler ◽  
Karla P. Machado ◽  
Bruno P. Nunes ◽  
Pamela M. Volz ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cohort Study ◽  
Primary Health Care ◽  
Rio Grande ◽  
Cognitive Testing ◽  
Rio Grande Do Sul ◽  
Primary Health ◽  
The Impact

Abstract Background The Bagé Cohort Study of Ageing is a population-based cohort study that has recently completed the first follow-up of a representative sample of older adults from Bagé, a city with more than 100,000 inhabitants located in the state of Rio Grande do Sul, Brazil. This is one of the first longitudinal studies to assess the impact of primary health care coverage on health conditions and inequalities. Our aim is to investigate the prevalence, incidence and trends of risk factors, health behaviours, social relationships, non-communicable diseases, geriatric diseases and disorders, hospitalisation, self-perceived health, and all-cause and specific-cause mortality. In addition, we aim to evaluate socioeconomic and health inequalities and the impact of primary health care on the outcomes under study. Methods/design The study covers participants aged 60 or over, selected by probabilistic (representative) sampling of the urban area of the city of Bagé, which is covered by Primary Health Care Services. The baseline examination included 1593 older adults and was conducted from July 2008 to November 2008. After eight to nine years (2016/2017), the first follow-up was conducted from September 2016 to August 2017. All participants underwent an extensive core assessment programme including structured interviews, questionnaires, cognitive testing (baseline and follow-up), physical examinations and anthropometric measurements (follow-up). Results Of the original participants, 1395 (87.6%) were located for follow-up: 757 elderly individuals (47.5%) were re-interviewed, but losses in data transfer occurred for 22. The remaining 638 (40.1%) had died. In addition, we had 81 (5.1%) refusals and 117 (7.3%) losses. Among the 1373 older adults who were followed down, there was a higher proportion of female interviewees (p=0.042) and a higher proportion of male deaths (p=0.001) in 2016/2017. There were no differences in losses and refusals according to gender (p=0.102). There was a difference in average age between the interviewees (68.8 years; SD ±6.5) and non-interviewees (73.2 years; SD ±9.0) (p<0.001). Data are available at the Department of Social Medicine in Federal University of Pelotas, Rio Grande do Sul, Brazil, for any collaboration.

scholarly journals The effect of preceptorship on nurses' training and preparation with implications for Qatar: A literature review

2018 ◽  
Vol 8 (7) ◽  
pp. 44 ◽  
Author(s):  
Hajer Arbabi ◽  
Jessie Johnson ◽  
Daniel Forgrave
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Literature Review ◽  
Organizational Support ◽  
Care Delivery ◽  
Health Centers ◽  
Primary Health ◽  
Newly Graduated Nurses ◽  
Level Of Training ◽  
High Level

Background and objective: The Primary Health Care Corporation in Qatar was established in 2012 and is comprised of 23 Health Centers. One of its goals is to create excellence in its workforce. A preceptorship program needs to be initiated at the Primary Health Care Corporation to ensure a high level of training for its nurses. The purpose of these preceptorship programs is to ensure nurses are equipped to carry out Qatar’s National Health Strategy and in doing so the Primary Health Care Corporation has this as its goal. This study amis to assess the effectiveness of preceptorship program models that can eventually be used for adoption as training programs for nurses in Health Centers in Qatar.Methods: A literature review of twenty articles published between 2006 and 2017 that focused on different models of preceptorship programs was conducted. The Mixed Methods Appraisal Tool was used to assess the quality of these studies. The data was analyzed by categorizing the included articles in a matrix sheet based on study design.Results and conclusions: Preceptorship programs are effective in four key areas: increasing nursing knowledge, supporting effective and safe care delivery by newly graduated nurses, increasing organizational support, and decreasing turnover rate and cost. 

scholarly journals Literature review to identify standardized scales of assessment of suicidal risk in adults seen in primary health care

Medwave ◽  
2018 ◽  
Vol 18 (05) ◽  
pp. e7246-e7246
Author(s):  
Carolina Abarca ◽  
Cecilia Gheza ◽  
Constanza Coda ◽  
Bernardita Elicer
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Literature Review ◽  
Suicidal Risk ◽  
Primary Health

scholarly journals Integrating Mental Health Services into the Primary Health Care System: The Need for Reform in Iran

2021 ◽  
Author(s):  
Ahmad Hajebi ◽  
Vandad Sharifi ◽  
Maryam Abbasinejad ◽  
Ali Asadi ◽  
Nahid Jafari ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Literature Review ◽  
Financial Resources ◽  
Primary Health Care System ◽  
Primary Health ◽  
Integrated Mental Health

Objective: The main objective of this study was to review aspects of the current situation and structure of the integrated mental health care services for planning a reform. Aspects of the newly designed infrastructure, along with specification of duties of the various human resources, and its relation with Iran’s Comprehensive Mental and Social Health Services (the SERAJ Program), will also be presented Method: This is a study on service design and three methods of literature review, deep interview with stakeholders, and focused group discussions. In the literature review, national and international official documents, including official reports of the World Health Organization (WHO) and consultant field visits, were reviewed. Deep semi-structured interviews with 9 stakeholders were performed and results were gathered and categorized into 3 main questions were analyzed using the responsibility and effectiveness matrix method. The Final results were discussed with experts, during which the main five-domain questions were asked and the experts’ opinions were observed. Results: In this study, the main gaps of the public mental health care (PHC) services in Iran were identified, which included reduction of risk factors for mental disorders, training the general population, early recognition and treatment of patients with mental disorders, educating patients and their families, and rehabilitation services. The new model was then proposed to fill these gaps focusing on increasing access, continuity of care, coordination in service delivery, and comprehensiveness of care. A mental health worker was placed besides general healthcare workers and general practitioners (GPs). Services were prioritized and the master flowchart for mental health service delivery was designed. Conclusion: A reform was indeed necessary in the integrated mental health services in Iran, but regarding the infrastructure needed for this reform, including human and financial resources, support of the senior authorities of the Ministry of Health (MOH) is necessary for the continuity and enhancement of services. In this model, attention has been given to the principles of integrating mental health services into primary health care. Current experience shows that the primary health care system has been facing many executive challenges, and mental health services are not exclusion to this issue. Monitoring and evaluation of this model of service and efforts for maintaining sustainable financial resources is recommended to make a reform in this system and to stabilize it.

scholarly journals District nurses’ experiences of using a clinical decision support system and an assessment tool at elderly care units in primary health care: a qualitative study

2021 ◽  
Vol 22 ◽  
Author(s):  
Annica Lagerin ◽  
Lena Törnkvist ◽  
Johan Fastbom ◽  
Lena Lundh
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Primary Health Care ◽  
Decision Support ◽  
Clinical Decision Support System ◽  
Elderly Care ◽  
Medication Use ◽  
Clinical Decision ◽  
Primary Health ◽  
District Nurses

Abstract Aim: The present study aimed to describe the experience of district nurses (DNs) in using a clinical decision support system (CDSS) and the safe medication assessment (SMA) tool during patient visits to elderly care units at primary health care centres. Background: In Swedish primary health care, general practitioners (GPs) prescribe and have the responsibility to regularly review older adults’ medications, while DN (nurses specialised in primary health care) play an important role in assessing older adults’ ability to manage their medications, detecting potential drug-related problems and communicating with patients and GPs about such problems. In a previous feasibility study, we found that DNs who use a combination of a CDSS and the SMA tool identified numerous potentially harmful or dangerous factors and took a number of nursing care actions to improve the safety and quality of patients’ medication use. In telephone interviews, patients indicated that they were positive towards the assessment and interventions. Methods: Individual interviews with seven DNs who worked at six different primary health care centres in Region Stockholm were carried out in 2018. In 2019, an additional group interview was conducted with two of the seven DNs so they could discuss and comment on preliminary findings. Qualitative content analysis was used to analyse the interview transcripts. Findings: Using the tools, the DNs could have a natural conversation about medication use with older adults. They could get a clear picture of the older adults’ medication use and thus obtain information that could facilitate collaboration with GPs about this important component of health care for older adults. However, for the tools to be used in clinical practice, some barriers would have to be overcome, such as the time-consuming nature of using the tools and the lack of established routines for interprofessional collaboration regarding medication discussions.

Sign in / Sign up

Export Citation Format

Share Document