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Ingelson B, Dahlke S, O'Rourke H, Hunter KF. Nurses' knowledge and beliefs on pain management practices with hospitalised persons living with dementia: A qualitative descriptive study. J Clin Nurs 2024; 33:3224-3235. [PMID: 38590077 DOI: 10.1111/jocn.17164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/18/2024] [Accepted: 03/29/2024] [Indexed: 04/10/2024]
Abstract
AIM To understand nurses' knowledge, beliefs and experiences affect pain management practices in hospitalised persons living with dementia (PLWD). DESIGN Naturalistic inquiry using qualitative descriptive design. METHODS Semi-structured interviews were conducted with 12 registered nurses who worked in one acute care hospital in Southern California from October to November 2022. Data were analysed using content analysis to identify themes. RESULTS Two themes were developed: improvising pain assessment, which included how pain was documented, and administration hesitancy referring to nurse's concerns about PLWD's confusion. Nurses described the challenges of assessing pain in hospitalised PLWD particularly if they were non-verbal and/or demonstrating responsive behaviours. Nurse's years of experience, dementia stigma, and their unconscious biases affected nurses' pain management practices. CONCLUSIONS The study findings highlight the complex challenges of pain management in hospitalised PLWD that are exacerbated by nurses' knowledge deficits, negative stereotypical beliefs, dementia stigma and unconscious biases towards older people that contributes to undermanaged pain in hospitalised PLWD. IMPLICATIONS A comprehensive strategy using an implementation framework is needed to address nurse's knowledge gaps, unconscious bias, dementia stigma and techniques that enhance communication skills is suggested. Building a foundation in these areas would improve pain management in hospitalised PLWD. IMPACT Improving pain management in hospitalised PLWD would improve the quality of life, decrease hospital length of stay, prevent readmissions, and improve nurse satisfaction. REPORTING METHOD The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ). PATIENT CONTRIBUTIONS Improving pain management in hospitalised PLWD would prevent long term confusion, episodes of delirium and improve quality of life as they recover from their acute illness for which they required hospital care.
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Affiliation(s)
- Beverly Ingelson
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Hannah O'Rourke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Dahlke S, Butler JI, Devkota R, Hunter KF, Fox MT, Davidson S, Chasteen AL, Moody E, Martin LS. Student nurses' views on an E-Learning module on comfort, safety, and mobility with older adults: a cross-sectional study. GERONTOLOGY & GERIATRICS EDUCATION 2024:1-8. [PMID: 39045814 DOI: 10.1080/02701960.2024.2378454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
BACKGROUND Nursing students often receive insufficient training in older adults' care. PURPOSE Examine nursing students' perceptions of an e-learning module developed to enhance their knowledge about the comfort, safety, and mobility of older adults. METHODS A cross-sectional survey was administered to third-year baccalaureate nursing students at a Canadian university after they had completed the comfort, safety, and mobility module. The survey assessed students' perceptions of the e-learning module using four 5-pointLikert-type items. The survey also contained demographic questions and one open-ended question that invited participants to make any comments they wished. Descriptive statistics were used to summarize participants'demographic characteristics. Responses to the open-ended quesiton were summative content analyzed. RESULTS The survey was completed by 119 participants, who reported that the module increased their confidence, perceptions and knowledge in working with older adults. Participants also found the method of instruction to be convenient, interactive, and enjoyable. CONCLUSIONS Results suggest that the learning module has the potential to facilitate student nurses' learning about comfort, safety, and mobility.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Jeffrey I Butler
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Rashmi Devkota
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Mary T Fox
- School of Nursing, York University Centre for Aging Research & Education, York University, Toronto, Ontario, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, NW, Calgary, Alberta, Canada
| | - Alison L Chasteen
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Elaine Moody
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lori Schindel Martin
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Ontario, Canada
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Butler JI, Fox MT. 'Our Voices Aren't Being Heard': A qualitative descriptive study of nurses' perceptions of interprofessional collaboration in care supporting older people's functioning during a hospital stay. Scand J Caring Sci 2024; 38:398-408. [PMID: 38323707 DOI: 10.1111/scs.13243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/10/2024] [Accepted: 01/26/2024] [Indexed: 02/08/2024]
Abstract
INTRODUCTION Older people admitted to hospital are highly susceptible to functional decline and related complications. Care supporting their functioning is complex and requires healthcare professionals working in concert, with nurses playing a central role. Yet, little is known about nurses' perceptions of interprofessional collaboration (IPC) in care supporting functioning in acutely admitted older people. To fill this knowledge gap, we elucidate the perspectives of nurses in Ontario, Canada, on IPC in care supporting older people's functioning during a hospital stay. METHODS We employed a qualitative methodology in conjunction with a qualitative descriptive design. Thirteen focus groups were held with a purposeful, criterion-based sample of 57 acute care nurses practising in a range of acute care settings (e.g. Emergency, General Medicine, General Surgery, Intensive Care, Coronary Care). Data were thematically analysed. RESULTS We identified two overarching themes: (1) IPC is improving, but nurses are excluded from decision-making and (2) nurse advocacy causes friction with other professionals. The first theme captures nurses' perception that IPC in older people's care is improving, but nurses are marginalised in interprofessional decision-making. As a result, nurses perceive that their knowledge is devalued, and their contributions to care supporting older people's functioning are undermined. The second theme underlines a tension between interprofessional team practices and patient- and family-centred care, while also demonstrating nurses' increasing willingness to act as patient and family advocates. CONCLUSIONS Findings can be used to enhance IPC in care supporting the functioning of acutely hospitalised older people. To improve IPC, clinical and administrative leaders should cultivate more egalitarian team relationships that encourage nurses to contribute to decision-making and advocate on behalf of older patients and their families.
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Affiliation(s)
- Jeffrey I Butler
- Faculty of Health, School of Nursing, York University, Toronto, Ontario, Canada
- York University Centre for Aging Research and Education, Toronto, Ontario, Canada
| | - Mary T Fox
- Faculty of Health, School of Nursing, York University, Toronto, Ontario, Canada
- York University Centre for Aging Research and Education, Toronto, Ontario, Canada
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Onebunne O, Dahlke S, Devkota R, Butler JI, Hunter KF, Fox MT, Chasteen AL, Moody E. Nursing Students' Views on an e-Learning Activity About Health Promotion for Older Adults: A Cross-Sectional Study. J Gerontol Nurs 2024; 50:19-24. [PMID: 38417075 DOI: 10.3928/00989134-20240207-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
PURPOSE Nurses are graduating ill-prepared to work with older adults across care contexts. The education nursing students receive about older adults often focuses on managing illnesses rather than promoting health. To expand the education that nursing students receive regarding health promotion and older adults, we examined nursing students' perceptions of an e-learning activity on health promotion with older adults. METHOD We used a cross-sectional survey design. We included first-year baccalaureate nursing students (N = 260) at a Canadian university. Students were required to complete the module, but only those who wanted to participate in the study completed the survey (n = 167; response rate = 64.2%). We used a feedback survey to assess students' perceptions of the e-learning activity using four 5-point, Likert-type items. We also asked one open-ended question to solicit participants' feedback and suggestions for improving the e-learning activity. Descriptive statistics (frequency, mean [SD]) were used to summarize participants' perceptions and demographic characteristics. Content analysis was used to explore responses to the open-ended question. RESULTS Participants reported that the module increased their knowledge about health promotion, as well as their perceptions and confidence in working with older adults. Participants also found the method of instruction interactive and enjoyable. CONCLUSION Our e-learning activity on health promotion was perceived by nursing students as helpful in sensitizing them to their role in promoting health among older adults. [Journal of Gerontological Nursing, 50(3), 19-24.].
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Tate K, Guney S, Lai C, Van Son C, Kennedy M, Dahlke S. Gerontological nursing competencies: A scoping review. NURSE EDUCATION TODAY 2024; 133:106034. [PMID: 37988828 DOI: 10.1016/j.nedt.2023.106034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/25/2023] [Accepted: 11/05/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Despite decades of advocates striving to enhance gerontological content in baccalaureate nursing programs, nurses are still graduating with inadequate knowledge and skills to work with older adults. Scholars suggest that incorporating entry-to-practice gerontological competencies could be one way to improve graduating nurses' knowledge about older adults. AIM To examine the state of gerontological entry to practice competencies and standards for baccalaureate-prepared nurses around the world. DESIGN We conducted a scoping review of the literature using the Joanna Briggs Institute (JBI) framework and followed PRISMA-ScR guidelines to report findings. METHODS We performed searches from inception to June 20th 2022 in Medline and EMBASE via OVID, CINAHL via EBSCOhost, Scopus, and Cochrane Library via Wiley. We conducted a search on GOOGLE for grey literature. We included literature that examined 1) baccalaureate nursing programs, 2) gerontological competencies/standards, and 3) older people/adults. RESULTS We found 8 literature sources, 4 of which were academic papers and 4 documents describing gerontological entry-to-practice standards and competencies from national nursing associations. Gerontological competencies highlight providing person-centered care to older people and their families across many care contexts. This care includes relational and cultural competence, exhibiting professional values and screening for potential elder abuse. Scholars in two papers relayed their experiences incorporating gerontological competencies into their curricula and two studied student nurses' gerontological competency. CONCLUSIONS There is interest and some progress in developing and incorporating gerontological competencies in various countries but not enough. A coordinated approach to sharing information and expertise among nations is needed to develop international gerontological competencies to facilitate improved nursing care with older adults.
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Affiliation(s)
- Kaitlyn Tate
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy 11405-87 Ave NW, Edmonton, AB T6G 1C9, Canada.
| | - Seda Guney
- Faculty of Nursing, Koç University, Health Sciences Campus, Davutpaşa Caddesi, No: 4 34010 Topkapı, Istanbul, Turkey.
| | - Claudia Lai
- School of Nursing, The Hong Kong Polytechnic University, Yuk Choi Road, Hung Hom, Hong Kong.
| | | | - Megan Kennedy
- John W Scott Health Sciences Library, University of Alberta 2K.28 Walter C Mackenzie Health Sciences Centre, Edmonton, AB T6G 2R7, Canada.
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy 11405-87 Ave NW, Edmonton, AB T6G 1C9, Canada.
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Hunter KF, Dahlke SA. Fast thinking: How unconscious bias and binary language contribute to rationing of care to older persons. Int J Older People Nurs 2023; 18:e12538. [PMID: 37013362 DOI: 10.1111/opn.12538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 02/08/2023] [Accepted: 03/20/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Binary or categorical thinking is a way of thinking in which the brain unconsciously sorts the masses of information it receives into categories. This helps us to quickly process information and keeps us safe through pattern recognition of possible threats. However, it can also be influenced by unconscious and conscious biases that inform our judgements of other people and situations. OBJECTIVES To examine nursing practice with older people through the lens of unconscious bias. METHODS In this critical analysis, using Kahneman's fast and slow thinking, we argue that nurses working with hospitalised older people often rely on thinking quickly in hectic work environments, which can contribute to unconscious and conscious bias, use of binary language to describe older persons and nursing tasks, and ultimately rationing of care. RESULTS Binary language describes older persons and their care simplistically as nursing tasks. A person is either heavy or light, continent or incontinent, confused or orientated. Although these descriptions are informed in part by nurses' experiences, they also reflect conscious and unconscious biases that nurses hold towards older patients or nursing tasks. We draw on explanations of fast (intuitive) and slow (analytical) to explain how nurses gravitate to thinking fast as a survival mechanism in environments where they are not supported or encouraged to think slow. CONCLUSIONS Nurses survival efforts in getting through the shift using fast thinking, which can be influenced by unconscious and conscious biases, can lead to use of shortcuts and the rationing of care. We believe that it is of paramount importance that nurses be encouraged and supported to think slowly and analytically in their clinical practice. IMPLICATIONS FOR PRACTICE Implications Nurses can engage in journaling and reflecting on their practice with older people to examine possible unconscious bias. Managers can support reflective thinking by supporting nurses through staffing models and encouraging conversations about person-centered care in unit practices.
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Affiliation(s)
- Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sherry Ann Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Adetunji O, Bishai D, Pham CV, Taylor J, Thi NT, Khan Z, Bachani AM. Patient-centered care and geriatric knowledge translation among healthcare providers in Vietnam: translation and validation of the patient-centered care measure. BMC Health Serv Res 2023; 23:379. [PMID: 37076905 PMCID: PMC10116792 DOI: 10.1186/s12913-023-09311-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 03/20/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND People are living longer, and the majority of aging people reside in low- and middle-income countries (LMICs). However, inappropriate healthcare contributes to health disparities between populations of aging people and leads to care dependency and social isolation. Tools to assess and evaluate the effectiveness of quality improvement interventions for geriatric care in LMICs are limited. The aim of this study was to provide a validated and culturally relevant instrument to assess patient-centered care in Vietnam, where the population of aging people is growing rapidly. METHODS The Patient-Centered Care (PCC) measure was translated from English to Vietnamese using forward-backward method. The PCC measure grouped activities into sub-domains of holistic, collaborative, and responsive care. A bilingual expert panel rated the cross-cultural relevance and translation equivalence of the instrument. We calculated Content Validity Indexing (CVI) scores at both the item (I-CVI) and scale (S-CVI/Ave) levels to evaluate the relevance of the Vietnamese PCC (VPCC) measure to geriatric care in the Vietnamese context. We piloted the translated instrument VPCC measure with 112 healthcare providers in Hanoi, Vietnam. Multiple logistic regression models were specified to test the a priori null hypothesis that geriatric knowledge is not different among healthcare providers with perception of high implementation compared with low implementation of PCC measures. RESULTS On the item level, all 20 questions had excellent validity ratings. The VPCC had excellent content validity (S-CVI/Ave of 0.96) and translation equivalence (TS- CVI/Ave of 0.94). In the pilot study, the highest-rated PCC elements were the holistic provision of information and collaborative care, while the lowest-rated elements were the holistic attendance to patients' needs and responsive care. Attention to the psychosocial needs of aging people and poor coordination of care within and beyond the health system were the lowest-rated PCC activities. After controlling for healthcare provider characteristics, the odds of the perception of high implementation of collaborative care were increased by 21% for each increase in geriatric knowledge score. We fail to reject the null hypotheses for holistic care, responsive care and PCC. CONCLUSION The VPCC is a validated instrument that may be utilized to systemically evaluate the practice of patient-centered geriatric care in Vietnam.
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Affiliation(s)
- Oluwarantimi Adetunji
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - David Bishai
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cuong Viet Pham
- Center for Injury Policy and Prevention Research (CIPPR), Hanoi University of Public Health, Hanoi, Vietnam
| | | | - Ngan Tran Thi
- Center for Injury Policy and Prevention Research (CIPPR), Hanoi University of Public Health, Hanoi, Vietnam
| | - Zainab Khan
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Abdulgafoor M Bachani
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Devkota R, Dahlke S, Fox MT, Davidson S, Hunter KF, Butler JI, Shrestha S, Chasteen AL, Moody E, Martin LS, Pietrosanu M. E-learning modules to enhance student nurses' perceptions of older people: a single group pre-post quasi-experimental study. Int J Nurs Educ Scholarsh 2023; 20:ijnes-2023-0059. [PMID: 38029314 DOI: 10.1515/ijnes-2023-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/10/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVES To examine whether e-learning activities on cognitive impairment (CI), continence and mobility (CM) and understanding and communication (UC) improve student nurses' knowledge and attitudes in the care of older adults. METHODS A quasi-experimental single group pre-post-test design was used. We included 299 undergraduate nursing students for the CI module, 304 for the CM module, and 313 for the UC module. We administered knowledge quizzes, Likert scales, and a feedback survey to measure student nurses' knowledge, ageist beliefs, and feedback on the modules respectively. RESULTS Participants demonstrated significantly more knowledge and reduced ageist attitudes following the e-learning activities. CONCLUSIONS Findings suggest that e-learning activities on cognitive impairment, continence and mobility, and understanding and communication improve knowledge and reduce ageist attitudes among nursing students.
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Affiliation(s)
- Rashmi Devkota
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Mary T Fox
- School of Nursing, York University Centre for Aging Research & Education, York University, Toronto, ON, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | | | - Jeffrey I Butler
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Shovana Shrestha
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Alison L Chasteen
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Elaine Moody
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Lori Schindel Martin
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON, Canada
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The experiences of nurse educators in establishing a teaching practice in the care of older persons: A focused ethnography study. J Prof Nurs 2022; 40:1-12. [DOI: 10.1016/j.profnurs.2022.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 11/18/2022]
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Lim XM, Lim ZHT, Ignacio J. Nurses' experiences in the management of delirium among older persons in acute care ward settings: A qualitative systematic review and meta-aggregation. Int J Nurs Stud 2021; 127:104157. [PMID: 35033990 DOI: 10.1016/j.ijnurstu.2021.104157] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 12/06/2021] [Accepted: 12/09/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Delirium is a multifactorial syndrome closely associated with negative hospitalisation outcomes. Given the global growth of the ageing population, delirium becomes increasingly prevalent among older persons. Nurses play a pivotal role in delirium management and receive direct impacts of delirious presentations. Yet, there is a dearth of literature reviewing nurses' experiences. OBJECTIVE To synthesise the best available evidence exploring nurses' experiences in managing delirium of older persons in acute care wards. DESIGN Systematic review of qualitative studies and meta-aggregation. DATA SOURCES Published and unpublished literature between January 2010 and December 2020 were identified from PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, PsycINFO and ProQuest. REVIEW METHODS A systematic search strategy was applied in October 2020, with an update in January 2021. Two reviewers independently screened the titles and abstracts and selected the eligible studies after reading the full texts. This review included studies focusing on licensed nurses providing care to patients aged 65 and above, having any type of delirium during their hospitalisation stays in acute care settings. Studies included are qualitative papers with research designs such as phenomenology, ethnography, qualitative descriptive and grounded theory. The eligible studies were appraised independently using The JBI Critical Appraisal Checklist for Qualitative Research. Data of included studies were extracted by two independent reviewers using a standardised form. Findings were synthesised by the meta-aggregative approach. RESULTS Thirty-one papers that considered nurses' (n = 464) experiences in managing older persons' delirium were included. A total of 375 findings were extracted, aggregated into 23 categories, and developed 5 synthesised findings: (i) delirium detection could be hindered when nurses possess a narrowed view of delirium, (ii) nurses navigate through complexity when providing multi-faceted care, (iii) nurses carry personal emotions, assumptions, and identities, (iv) various stakeholders have double-edged influences, and (v) nurses display preferences in their learning needs. CONCLUSION This review informed about nurses' perceptions of delirium, delirious older persons, and their nursing management which were specific to older persons and acute care settings. Nurses should practise self-awareness regarding their own knowledge and attitudes while performing delirium management in older adults. Meanwhile, healthcare professionals and policymakers should make a concerted effort in cultivating a better working environment. Future research of delirium care that specifically investigates with a geriatric perspective would better contribute to the improvement of evidence-based nursing practices for older persons.
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Affiliation(s)
- Xin Min Lim
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Block MD11 Level 2, 10 Medical Drive, Singapore 117597, Singapore.
| | - Zhi Hui Trina Lim
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Block MD11 Level 2, 10 Medical Drive, Singapore 117597, Singapore.
| | - Jeanette Ignacio
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Block MD11 Level 2, 10 Medical Drive, Singapore 117597, Singapore.
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Dahlke S, Hunter KF, Fox MT, Davidson S, Perry N, Watts LT, Martin LS, Butler JI, Raymond C, Chasteen AL, McCleary L, Boscart V, Moody E. Awakening Canadians to ageism: a study protocol. BMC Nurs 2021; 20:192. [PMID: 34627234 PMCID: PMC8502289 DOI: 10.1186/s12912-021-00713-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/24/2021] [Indexed: 12/02/2022] Open
Abstract
Background Making fun of growing older is considered socially acceptable, yet ageist humour reinforces negative stereotypes that growing old is linked with physical and mental deterioration, dependence, and less social value. Such stereotypes and discrimination affect the wellbeing of older people, the largest demographic of Canadians. While ageism extends throughout professions and social institutions, we expect nurses—the largest and most trusted group of healthcare professionals—to provide non-ageist care to older people. Unfortunately, nurses working with older people often embrace ageist beliefs and nursing education programs do not address sufficient anti-ageism content despite gerontological nursing standards and competencies. Methods To raise awareness of ageism in Canada, this quasi-experimental study will be supported by partnerships between older Canadians, advocacy organizations, and academic gerontological experts which will serve as an advisory group. The study, guided by social learning theory, will unfold in two parts. In Phase 1, we will use student nurses as a test case to determine if negative stereotypes and ageist perceptions can be addressed through three innovative e-learning activities. The activities employ gamification, videos, and simulations to: (1) provide accurate general information about older people, (2) model management of responsive behaviours in older people with cognitive impairment, and (3) dispel negative stereotypes about older people as dependent and incontinent. In Phase 2, the test case findings will be shared with the advisory group to develop a range of knowledge mobilization strategies to dispel ageism among healthcare professionals and the public. We will implement key short term strategies. Discussion Findings will generate knowledge on the effectiveness of the e-learning activities in improving student nurses’ perceptions about older people. The e-learning learning activities will help student nurses acquire much-needed gerontological knowledge and skills. The strength of this project is in its plan to engage a wide array of stakeholders who will mobilize the phase I findings and advocate for positive perspectives and accurate knowledge about aging—older Canadians, partner organizations (Canadian Gerontological Nurses Association, CanAge, AgeWell), and gerontological experts.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada.
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada
| | - Mary T Fox
- School of Nursing, Faculty of Health, York University Centre for Aging Research and Education, HNES suite 343, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, 2800 University Way N.W., 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Nicole Perry
- National Programs, HelpAge Canada, 1300 Carling Avenue, Ottawa, ON, K1Z 7L2, Canada
| | - Laura Tamblyn Watts
- CanAge, Factor - Inwentash Faculty of Social Work, University of Toronto 246 Bloor St West, Toronto ON M5S 1V4, Toronto, ON, M5S 1V4, Canada
| | - Lori Schindel Martin
- Canadian Gerontological Nursing Association, PO Box 64009, Royal Bank Plaza, Toronto, ON, M5J 2T6, Canada
| | - Jeffrey I Butler
- School of Nursing, York University Centre for Aging Research and Education, Faculty of Health, York University; Faculty of Nursing, University of Alberta, HNES suite B05, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Christy Raymond
- Faculty of Nursing, MacEwan University, 5-111C, Robbins Health Learning Centre, 10910-104 Ave NW, Edmonton, AB, T5J 4S2, Canada
| | - Alison L Chasteen
- Department of Psychology, University of Toronto, 100 St. George Street, Toronto, ON, M5S 3G3, Canada
| | - Lynn McCleary
- Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
| | - Veronique Boscart
- School of Health and Life Sciences, Conestoga College Institute of Technology and Advanced Learning, 299 Doon Valley Drive, Kitchener, ON, N2G 4M4, Canada
| | - Elaine Moody
- School of Nursing, Dalhousie University, Room N19 Forrest Bldg., Dalhousie University, University Avenue, PO Box 15000 5869, Halifax, NS, B3H 4R, Canada
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Nurit GY, Ksenya S, Juliana S, Matanes B, Efrat S, Anna Z. Perceptions of staff and family responsibility to provide hospitalized older adults with basic activities care and emotional support. Geriatr Nurs 2021; 42:1247-1252. [PMID: 34555566 DOI: 10.1016/j.gerinurse.2021.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 01/26/2023]
Abstract
Many older adults need help with Activities of Daily Living (ADL) and emotional support during hospitalization. Hospital staff is officially responsible for care, but most older adults are accompanied by family members who provide at least some of the support. In this study, we asked physicians, nurses, nursing assistants, and relatives about hospital staff versus family responsibility for providing ADL care and emotional support, and about actual levels of help provision by the hospital staff in Israel. Staff members (except physicians) tended to see staff as more responsible for ADL care than family, while emotional support was a shared responsibility. Nursing assistants were the most likely to report that staff provided high levels of support, and all participants reported that staff provided more ADL care than emotional support. It is important for family members and hospital staff to have open discussions of their expectations and responsibilities when older adults are hospitalized.
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Affiliation(s)
- Gur-Yaish Nurit
- Oranim Academic College of Education, Kiryat Tiv'on, Israel; Center for research and study of aging, University of Haifa, Israel.
| | - Shulyaev Ksenya
- The Cheryl Spencer Department of Nursing, University of Haifa, Israel
| | - Smichenko Juliana
- The Cheryl Spencer Department of Nursing, University of Haifa, Israel
| | | | - Shadmi Efrat
- The Cheryl Spencer Department of Nursing, University of Haifa, Israel
| | - Zisberg Anna
- The Cheryl Spencer Department of Nursing, University of Haifa, Israel
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Nurse and Health Care Aide Knowledge of Urinary Continence Promotion and Management In Hospitalized Older People. J Wound Ostomy Continence Nurs 2021; 48:435-439. [PMID: 34495935 DOI: 10.1097/won.0000000000000794] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aims of this study were to determine if there was a change in medical unit nursing staffs' knowledge about lower urinary tract symptoms following an education presentation and whether the education session met their learning needs. DESIGN Single-group, before-after study. SUBJECTS AND SETTING The study sample comprised 21 licensed nurses and 16 health care aides from 3 medical units in a tertiary care hospital in western Canada. METHODS Participants completed pre- and post-true/false questionnaires developed for the project to assess lower urinary tract symptom knowledge, and a questionnaire to determine whether the education session met staff learning needs. RESULTS Knowledge was moderate on the pretest in both groups, with licensed nurses showing a significant improvement after the education intervention. Health care aides did not have a significant change in knowledge; they persisted in their belief that incontinence is a normal change of aging. CONCLUSIONS Health care aides need targeted education and enhanced care processes to shift their knowledge and thinking about continence.
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Dahlke S, Hunter KF, Pietrosanu M, Kalogirou MR. Testing and e-learning activity designed to enhance student nurses understanding of continence and mobility. Int J Nurs Educ Scholarsh 2021; 18:ijnes-2021-0033. [PMID: 34289268 DOI: 10.1515/ijnes-2021-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/06/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to test if the e-learning activity that we developed could improve student nurses' knowledge of continence and mobility and whether or not students would find the style of learning beneficial. METHODS A quasi-experimental pre-post-test design was used to test if the continence and mobility e-learning activity could improve student nurses' knowledge about assessing and managing the needs of continence and mobility. An 18-item true/false knowledge of continence quiz was completed by 116 student nurses and a Likert style feedback learning survey was completed by 135 nursing students. RESULTS There was a statistically significant increase in students' knowledge about continence and its relationship to mobility following the e-learning activity. The e-learning activity also enhanced students' knowledge, confidence and perceptions about older people. CONCLUSIONS The e-learning activity we developed has the potential to improve nursing students' knowledge about continence and mobility in an enjoyable manner.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew Pietrosanu
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Maya R Kalogirou
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Tonkikh O, Zisberg A, Shadmi E. The role of nurse staffing in the performance of function-preserving processes during acute hospitalization: A cross-sectional study. Int J Nurs Stud 2021; 121:103999. [PMID: 34242978 DOI: 10.1016/j.ijnurstu.2021.103999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 05/28/2021] [Accepted: 06/02/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Performance of function-preserving hospitalization processes related to patient mobility, use of continence aids and food intake is significantly associated with outcomes in older adults. Nurses are the front-line personnel responsible for promoting performance of such processes. The degree to which nurse staffing is related to this performance is unclear. OBJECTIVE To identify nurse-staffing characteristics and nursing-related care needs associated with older patients' mobility, continence care and food intake during acute hospitalization. DESIGN Cross-sectional study using survey data from the Hospitalization Process Effects on Functional Outcomes and Recovery (HoPE-FOR) cohort study combined with day-level administrative nurse staffing data and clinical day-level aggregated data for all patients hospitalized during the HoPE-FOR study period. SETTING Internal medicine units in two medical centers in Israel. PARTICIPANTS Eight hundred seventy-three older adults. METHODS Mobility, continence care and food intake were assessed within 2 days of admission using validated questionnaires. Nurse-to-patient ratios and nursing-skill mix (i.e. registered nurses (RNs), nurse aides, nurses with advanced clinical training and RNs with an academic degree) were assessed using administrative data. Decision trees were developed for mobility, continence care and food intake, applying classification and regression-tree analysis. RESULTS The mobility decision tree identified three characteristics subdividing patients into six nodes: pre-admission functioning, pre-admission activity level and percentage of nurses with advanced training. The percentage of nurses with advanced training classified low-functioning patients into those walking in corridors versus walking or sitting only inside the room. The continence-care classification decision tree identified two characteristics that subdivided the patients into four nodes: pre-admission functioning and bladder control. Nurse-to-patient-ratio variables and patients' nursing-related care needs did not contribute to this classification. The food-intake decision tree identified four characteristics-pre-admission functioning, gender, percentage of nurses with advanced training and percentage of nurse aides-subdividing patients into eight nodes. Low-functioning patients exposed to a higher percentage of nurses with advanced training had food-intake scores 14% higher than patients exposed to a lower percentage of nurses with advanced training. Independent men exposed to a higher percentage of nurse aides had a 14% higher habitual daily in-hospital food-intake score than independent men exposed to a lower percentage of nurse aides. CONCLUSIONS A higher percentage of nurses with post-graduate education is associated with better performance of mobility and food intake of hospitalized older adults. To maintain the potential benefits of highly trained staff, education levels should be considered in scheduling and assignment decision-making processes in internal medicine units. Tweetable abstract: A higher percentage of nurses with post-graduate education is associated with better mobility and food intake of hospitalized older adults.
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Affiliation(s)
- Orly Tonkikh
- The Cheryl Spencer Department of Nursing, University of Haifa, Mount Carmel, Haifa 3498838, Israel.
| | - Anna Zisberg
- The Cheryl Spencer Department of Nursing, University of Haifa, Mount Carmel, Haifa 3498838, Israel.
| | - Efrat Shadmi
- The Cheryl Spencer Department of Nursing, University of Haifa, Mount Carmel, Haifa 3498838, Israel.
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Petty J, Whiting L, Fowler C, Green J, Mosenthal A. Exploring the knowledge of community-based nurses in supporting parents of preterm babies at home: A survey-based study. Nurs Open 2021; 9:1883-1894. [PMID: 34009710 PMCID: PMC8994940 DOI: 10.1002/nop2.937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/21/2021] [Accepted: 04/28/2021] [Indexed: 12/02/2022] Open
Abstract
Aim This study aimed to investigate the confidence levels, knowledge base and learning needs of community‐based nurses relating to the care of preterm babies and parents, to explore what education is required and in what format. Design An online survey methodology was used. Methods A 32‐item questionnaire was distributed via social media platforms to community‐based nurses in Australia. Results Descriptive analysis was undertaken relating to knowledge base, confidence levels, previous training, learning and resource needs and barriers to education. It was deemed vital to expand confidence and knowledge in this area. Gaps in learning resources were identified and a need for more training in topics such as developmental outcomes, feeding, expected milestones, weight gain, growth trajectories and supporting parents. Online resources were the preferred format to teach key knowledge to community‐based health professionals, tailored to the specific features of preterm babies and support needs of parents.
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Affiliation(s)
- Julia Petty
- Children's Nursing, University of Hertfordshire, Hatfield, Hertfordshire, UK
| | - Lisa Whiting
- Children's Nursing, University of Hertfordshire, Hatfield, Hertfordshire, UK
| | | | - Janet Green
- School of Nursing, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - Alison Mosenthal
- Children's Nursing, University of Hertfordshire, Hatfield, Hertfordshire, UK
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"EduKation demenz® Nursing" in the acute hospital setting : Evaluation of a dementia training program: a pilot study. Z Gerontol Geriatr 2021; 54:659-666. [PMID: 33433665 DOI: 10.1007/s00391-020-01838-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND An increasing number of people with dementia (PwD) are being hospitalized due to acute conditions. The surrounding conditions and procedures in acute hospitals are not oriented to the special needs of this vulnerable patient group. The behavior of PwD poses particular challenges and burdens for nursing staff. OBJECTIVE The aim of this pilot study was to evaluate the effectiveness of a 2-day dementia training program with a self-reflection component compared to a standard 1.5‑h training of nursing staff caring for PwD in acute hospitals. METHODS A nonrandomized pretest-posttest study with a control group was conducted in three German acute hospitals. Through a questionnaire, nursing staff caring for PwD were examined for potential changes in attitude, strain and confidence levels. The intervention group (n = 32) received a 2-day training program, "EduKation demenz® Nursing", the control group (n = 36) participated in a short,1.5‑h dementia training. RESULTS Compared to the control group, the intervention group demonstrated statistically significant improvement in perceived strain (p = 0.007) and in confidence in caring for PwD (p < 0.001). There were positive but not significant changes in attitude (p = 0.176). CONCLUSION "EduKation demenz® Nursing", a 2-day training program with a self-reflection component, could provide more effective support for nursing staff in acute hospitals caring for PwD than a 1.5‑h training. Results indicate, however, that general conditions in acute hospitals should be changed to allow nursing staff to apply the knowledge gained.
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Launonen M, Vehviläinen-Julkunen K, Repo M, Kvist T. Nurses' perceptions of care quality for older patients suffering cancer in acute care settings: A descriptive study. Scand J Caring Sci 2020; 35:1309-1321. [PMID: 33369755 DOI: 10.1111/scs.12952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/22/2020] [Accepted: 12/05/2020] [Indexed: 12/25/2022]
Abstract
AIMS To describe the quality of care for older cancer patients in acute care settings as perceived by the responsible nursing staff. METHODS A cross-sectional study design was used. Data were collected using a questionnaire completed by 90 nursing staff at a university hospital and a city hospital. Quality of care was measured using the Revised Humane Caring Scale. Descriptive statistics, reliability analysis, nonparametric tests and linear regression analysis were used to analyse the data. FINDINGS Generally, the nursing staff perceived the quality of care as good; however, university hospital nursing staff perceived the quality of care to be better than city hospital nursing staff. Compared with other age groups, nursing staff in the 30- to 40-year age group more frequently indicated that patients' information and participation need improvement. Moreover, supplemental education in cancer care was found to have no significant impact on the quality of care. Altogether, nursing staff disagreed the most about their perceptions of staffing, sufficient time and an unhurried atmosphere. CONCLUSION Nursing staff should focus more on patients' personal needs, particularly with regard to patients' provision of information and participation in care. Younger nurses need more support and mentoring about complex care from their experienced colleagues when performing their work. Leaders should guarantee availability of the adequate number of competent staff in hospital wards.
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Affiliation(s)
- Minna Launonen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Katri Vehviläinen-Julkunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.,Kuopio University Hospital, Kuopio, Finland
| | - Marita Repo
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.,HUS Comprehensive Cancer Center, Helsinki, Finland
| | - Tarja Kvist
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Yang YY, Hsiao CH, Chang YJ, Ma SC, Wang JJ. Exploring dementia care competence of nurses working in acute care settings. J Clin Nurs 2020; 31:1972-1982. [PMID: 31971304 DOI: 10.1111/jocn.15190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 12/21/2019] [Accepted: 01/10/2020] [Indexed: 12/15/2022]
Abstract
AIMS AND OBJECTIVES To examine the current status of dementia care competence of nurses working in acute care settings as well as the relationship between competence and demographic attributes. BACKGROUND Most people with dementia are older individuals when they are admitted to unfamiliar acute care settings for treatment, and they are prone to displaying BPSD. If nurses working in acute care settings are not sufficiently competent in dementia care, providing proper patient care is difficult. DESIGN The study used a one-sample descriptive-correlation design. METHODS This study enrolled nurses at two medical centres in southern Taiwan as the research participants and performed a stratified random sampling according to the units where they served. The Dementia Care Competence Scale was used for data collection. An independent samples t test, ANOVA and Pearson's product-moment correlation were performed for data analysis (See STROBE). RESULTS A total of 308 valid questionnaires were collected. The results showed that dementia care competence of nurses working in acute care settings was moderate. In particular, they had insufficient knowledge of the special needs related to dementia and lacked the skills and patience necessary for identifying, preventing and managing BPSD. Additionally, although the nurses tended to have a positive attitude, they seldom communicated with people with dementia. This study also found that dementia care competence was better in nurses who were older, who had more seniority, who had taken care of people with dementia for a longer period of time and who had received training in dementia care. CONCLUSIONS Dementia care training topics for nurses working in acute care settings should include palliative care for dementia, skills for managing behavioural and psychological symptoms of dementia and communication techniques for improving person-centred care. Nurses should also be encouraged to maintain a warm, friendly attitude when providing patient care. RELEVANCE TO CLINICAL PRACTICE Continuing education in managing behavioural and psychological symptoms of dementia is necessary for currently practicing acute care nursing staff and should be developed according to the staff's educational background and needs.
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Affiliation(s)
- Yueh-Ying Yang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Chun-Hui Hsiao
- Department of Nursing, Chi-Mei Hospital, Tainan City, Taiwan
| | - Ying-Ju Chang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan.,Department of Nursing, National Cheng Kung University Hospital, Tainan City, Taiwan
| | - Shu-Ching Ma
- Department of Nursing, Chi-Mei Hospital, Tainan City, Taiwan
| | - Jing-Jy Wang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
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Hunter KF, Dahlke S, Negrin K, Kalogirou MR, Fox M, Antonio N, Buckborough N, Morgan A, Wagg A. The feasibility of implementing education on older person care to practice on medical units: Nurses' perceptions and the influence of practice context. Int J Older People Nurs 2019; 14:e12265. [PMID: 31441244 DOI: 10.1111/opn.12265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 06/03/2019] [Accepted: 07/16/2019] [Indexed: 11/26/2022]
Abstract
AIM As part of a larger primary study on evidence-informed practice with hospitalised older people, we aimed to (a) examine nursing staffs' perceptions of the interactive geriatric educational intervention and to explore how perceptions of their work context may influence their ability to enact the evidence-informed assessment and care approaches discussed during the educational sessions and (b) compare differences in perceptions of context between RNs, LPNs and HCAs. METHOD A survey-based evaluation that used both closed and open-ended questions was conducted as part of an interactive educational intervention on cognitive impairment and managing responsive behaviours. Data were gathered on participants' perceptions of the education intervention and organisational context. RESULTS Findings from this study suggest when education is tailored to nurses' articulated educational needs, it is well received; however, barriers to implementation exist. Assessment of the context by using a standardised survey tool to get the nursing staffs' perceptions of organisational context revealed strengths in leadership support and day-to-day interactions with other nurses and healthcare professionals, but potential barriers related to lack of facilitation to transfer new knowledge into practice existed. CONCLUSION Providing evidence-based education related to care of older patients and evaluating nursing staffs' perceptions of the education and their context has laid the groundwork for a long-term relationship with the managers and nursing staff on the participating medical units. Further investigation about how best to incorporate the facilitator role into the medical units to support evidence-based practices with older patients is warranted. IMPLICATIONS FOR PRACTICE: While nurses are receptive to new knowledge, the unpredictable workload of acute care creates challenges to implementing this new knowledge. Assessment of contextual factors that influence evidence-informed practice facilitates planning for implementation of new knowledge and support practice change.
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Affiliation(s)
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Kelly Negrin
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | | | - Mary Fox
- York University, Toronto, ON, Canada
| | | | | | - Angela Morgan
- University of Alberta Hospital, Edmonton, AB, Canada
| | - Adrian Wagg
- Division of Geriatric Medicine, University of Alberta, Edmonton, AB, Canada
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