Alera Bowden, Valerie Wilson, Jessica Bresolin, Jessica Nealon, Victoria Traynor
{"title":"Exploring Post-Anaesthesia Care Unit Nurses' Experiences Post Participation in a Delirium Care for Older People Education Intervention: A Qualitative Study","authors":"Alera Bowden, Valerie Wilson, Jessica Bresolin, Jessica Nealon, Victoria Traynor","doi":"10.1111/opn.70022","DOIUrl":"10.1111/opn.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To explore the learning experiences of post-anaesthesia care unit nurses after their participation in a delirium care for older people education intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Post-operative delirium is a common, yet major complication for people 65 years or older who have undergone surgery. Yet, post-operative delirium in older people continues to go undetected, has delayed detection or is entirely misdiagnosed. Inadequate delirium recognition and management is in part due to the lack of knowledge, competence and confidence of post-anaesthesia care unit nurses caring for older people. Multimodal education opportunities significantly contribute to nurses' improved knowledge, skills, confidence and competence in delirium care, as well as improvements in patient clinical outcomes. However, knowledge of which aspects of the learning experience that make the most impact to post-anaesthesia care unit nurses' clinical practice is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Qualitative descriptive design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Post-anaesthesia care unit nurses participated in a four-module multimodal delirium education intervention, which was co-designed by expert clinicians and tailored to the contextual needs of post-operative care. Nurses who participated in the educational intervention were invited to submit their completed learner workbooks. Qualitative data (<i>n</i> = 66 learner workbooks) were collected via 12 open-ended learner workbook questions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Content analysis of 655 open-ended participant responses generated three categories and seven sub-categories: gains in knowledge (Category 1), emotional responses to learning (Category 2) and clinical practice changes (Category 3).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Multimodal education interventions are beneficial for post-anaesthesia care unit nurses caring for older people with delirium. Learning outcomes include changes in knowledge, attitudes and clinical practices. The use of simulation-based education is particularly impactful on positive learning experiences of post-anaesthesia care unit nurses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Practice</h3>\u0000 \u0000 <p>Nurse educators are encouraged to utilise simulation-based education to enhance nurses' knowledge, competence and confidence of","PeriodicalId":48651,"journal":{"name":"International Journal of Older People Nursing","volume":"20 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rouven Brenner, Myrta Kohler, Shauna L. Rohner, Heidrun Gattinger
{"title":"‘Home, Instead of Nursing Home’—Improving the Quality of Care for Older People Receiving Short-Term Care: Development of a Person-Centred, Resource-Oriented Programme","authors":"Rouven Brenner, Myrta Kohler, Shauna L. Rohner, Heidrun Gattinger","doi":"10.1111/opn.70020","DOIUrl":"https://doi.org/10.1111/opn.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Worldwide, healthcare systems continue to evolve approaches to acute care delivery for older people. The Swiss healthcare system, for example, utilises Diagnosis-Related Groups (Swiss DRG) to structure hospital stays. This system creates opportunities to enhance post-acute care services that support functional recovery and independence. The ‘Home, Instead of Nursing Home’ project collaboratively developed an integrated programme that combines staff education with structured care delivery processes to enhance person-centred, rehabilitative care for older people in acute transitional care, emphasising autonomy and quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The development process consisted of four steps: inter-professional workshops with healthcare professionals, interviews with residents of nursing homes providing acute transitional care and their relatives, data synthesis and programme development. Participants (<i>N</i> = 38) were individuals from three nursing homes, including healthcare professionals, residents and relatives. We conducted a thematic analysis to identify essential workshop and interview themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis identified four main themes: promoting a person-centred, resource-oriented culture; implementing person-centred, resource-oriented care; fostering movement competence and developing a champion role. The derived programme for person-centred and resource-oriented care (PCC&ROC) consists of four pillars: PCC&ROC care culture, PCC&ROC care planning, movement promotion and coaching and consulting. We adapted the programme to the individual circumstances of the three nursing homes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The programme integrates international best practices with a salutogenic perspective and the inclusion of residents and their relatives. It addresses the critical need for person-centred and resource-oriented care in the context of nursing home short-term care for older individuals, promoting autonomy and improving their quality of life. This research emphasises the importance of involving relevant stakeholders in evidence-based programme development to develop a programme tailored to the needs and challenges of the intended population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48651,"journal":{"name":"International Journal of Older People Nursing","volume":"20 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/opn.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dympna Tuohy, Teresa Tuohy, Margaret Graham, Jane McCarthy, Jill Murphy, Jacinta Shanahan, Irene Cassidy
{"title":"Older People's Views of Participating in an Intergenerational Café With Student Nurses","authors":"Dympna Tuohy, Teresa Tuohy, Margaret Graham, Jane McCarthy, Jill Murphy, Jacinta Shanahan, Irene Cassidy","doi":"10.1111/opn.70019","DOIUrl":"https://doi.org/10.1111/opn.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Global ageing is increasing. Most older people live independently but at times require nursing care as they age. This care is provided in a variety of settings including acute, primary, community and residential care services. In such instances, it is important that older people feel comfortable and listened to, and it is imperative that student nurses are educated to competently care for and nurse older people in collaborative partnerships. Intergenerational initiatives promote shared learning and help break down barriers among different age cohorts. An online intergenerational café was developed to provide a learning opportunity for older people and student nurses to meet as equals and connect socially in a protected place and time. This paper reports on older people's views of their participation in an online intergenerational café.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ethical approval was granted for this survey design research. Older people living in the community (<i>n</i> = 49) participated in online intergenerational cafés with student nurses. Following the online café, participants were invited to voluntarily participate in the study through completion of an anonymous online survey. Consent was indicated through the return of the survey questionnaire. All agreed to complete the survey. Likert scale quantitative data was analysed using descriptive statistical analysis (SPSS, version 21). Responses to the open-ended questions were thematically analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The cafés supported intergenerational learning, and participants felt comfortable participating. Participants discovered some but not all key points of interest about students. In many ways, they were quite similar to students. Participants felt students would be respectful, empathetic and advocate for them in a care situation. Many agreed that the cafés were well organised, but some would have liked more clarity on the discussion topics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This café initiative has merit as it helped reduce barriers and facilitated intergenerational learning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Practice</h3>\u0000 \u0000 <p>Participation in Intergenerational cafés can help reduce barriers by faciliating understanding and mutual respect . They can provide a forum for discussion on nursing care expectations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48651,"journal":{"name":"International Journal of Older People Nursing","volume":"20 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/opn.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Get Ready, Get Set, Write! Foundations of Effective, Anti-Ageist Writing","authors":"Sarah H. Kagan","doi":"10.1111/opn.70021","DOIUrl":"https://doi.org/10.1111/opn.70021","url":null,"abstract":"<p>Effective writing is the sum of a balanced calculation. To write effectively requires that authors know their subject, understand their audience, and portray their message to achieve greater good. Puzzlingly, effective writing is a skill frequently downplayed or misrepresented throughout nursing. Our very identity is tied to relationships and communication. We nurses should love to write but most often do not. It is time to replace our paradoxical distaste for writing with confidence and skill. We gerontological nurses need to add our writing voices to the global campaign to end ageism as we strive to improve health, well-being and healthcare for older people and their care partners. That means we cannot afford to be ambivalent about our writing!</p><p>Nurses fretting about writing always feel ironic to me. Here are professionals who can talk about someone's most intimate concerns with ease, whose savvy assessments and interventions restore function, create comfort and save lives. But sit down and write something that they can happily share with colleagues and the public? The very thought quashes all confidence for many of us. Added to this stressful pressure is the implicit social obligation that we, as gerontological nurses, hold to actively dismantle ageism. The World Health Organisation underscores that education and policy are two of the three primary means to combat ageism (World Health Organization <span>2021</span>). In our hands, effective writing becomes a tool with a dual purpose. We can achieve our primary aim in writing—whether that be a research report for submission to the <i>International Journal of Older People Nursing</i> (<i>IJOPN</i>), a policy for our workplace, or a blog for our community—and take down ageism at the same time.</p><p>Like any skill we learn as nurses, effective writing is achievable given the right circumstances. Any writing task needs a clearsighted approach, a context conducive to the writing task, useful resources, a specific plan, and dedicated practice. Undertaking writing in a haphazard or disjointed way will deliver disappointing or frustrating results in the same way that nursing care undertaken in the same fashion returns patient dissatisfaction or worse. Likening writing to our more familiar world of clinical nursing care allows us to successfully realise effective writing, making it an integral part of our professional repertoire.</p><p>As an experienced nurse, author, peer reviewer and editor, I know that belief and self-confidence are keys to writing success. We need to believe that writing is a necessary part of our professional skill set. Imagining that writing is ‘not our thing’ strips away our scope and our power to do good. After all, if we aim to improve health and well-being and advance social and health care, then we need to educate varied public and professional audiences through our writing to achieve those changes. Once we believe that writing is an integral nursing skill, we need t","PeriodicalId":48651,"journal":{"name":"International Journal of Older People Nursing","volume":"20 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/opn.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Line Constance Holmsen, Bodil Tveit, Ane-Marthe Solheim Skar, Marit Helene Hem
{"title":"Building a Community Among Multicultural Healthcare Teams in Nursing Homes: A Qualitative Study of the International Caregiver Development Programme (ICDP)","authors":"Line Constance Holmsen, Bodil Tveit, Ane-Marthe Solheim Skar, Marit Helene Hem","doi":"10.1111/opn.70018","DOIUrl":"https://doi.org/10.1111/opn.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Healthcare workers in nursing homes are an educationally, experientially, culturally and linguistically diverse workforce who face increasing challenges in their working conditions. Studies indicate positive results with regard to cooperation and care from experiencing a sense of community in diverse healthcare teams.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This qualitative study aimed to explore healthcare workers' experiences of being part of a team in nursing homes before, during and after their participation in a psychosocial competence building intervention, the International Caregiver Development Programme (ICDP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifteen focus group interviews of five ICDP group courses were conducted before, during and after participation in ICDP with 31 cross-cultural healthcare workers in nursing homes. The findings emerged through hermeneutic analysis. The results were compared with the open responses in an anonymous written evaluation. Consolidated Criteria for Reporting Qualitative Research (COREQ) served as a framework for reporting this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Before ICDP, the participants reported a lack of communication regarding priorities, challenges in interactions with the residents and cultural and linguistic diversity among the healthcare workers. During participation in ICDP, they described increased knowledge and understanding of one another in addition to inspiring each other and acknowledging each other's diversity as healthcare workers. After completing ICDP, they experienced a sense of relational and practical community, a sense of pride in the team, increased self-confidence related to practice and increased job satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study indicated that ICDP has the potential to create a community of psychosocial practice in multicultural healthcare teams, which may be strengthened by experiences of mastery, confidence and pride. The participants in this study developed a common conceptual framework for understanding, prioritising and practising psychosocial care. The community seemed to facilitate cooperation between them and increase their job satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Practice</h3>\u0000 \u0000 <p>Healthcare workers in nursing homes need time and spa","PeriodicalId":48651,"journal":{"name":"International Journal of Older People Nursing","volume":"20 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/opn.70018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Caroline Ashton-Gough, Jennifer Lynch, Claire Goodman
{"title":"Supportive Interventions Involving Family Carers of Patients With Delirium Superimposed on Dementia in Hospital: A Scoping Review","authors":"Caroline Ashton-Gough, Jennifer Lynch, Claire Goodman","doi":"10.1111/opn.70016","DOIUrl":"https://doi.org/10.1111/opn.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>People with dementia admitted to hospital are at risk of developing delirium. Patients with delirium superimposed on dementia (DSD) have higher mortality rates, longer hospital stays and further cognitive loss. The role of family is often recommended as a resource to inform and support how patients with dementia's needs are understood. This review focuses on ward-based interventions that enable family carers and health care professionals to work together to improve patient experience and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To review evidence on ward-based approaches involving family (or their proxies) and staff working together to prevent and manage delirium for patients living with dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We undertook a scoping review including all types of research. Six electronic databases were searched (CINAHL, MEDLINE (run twice), EMBASE, Cochrane, PsycINFO and PubMed). The search was limited to papers written in English and published from 2009 to 2019. The search was updated in 2023. Papers were independently read by two researchers. Findings were presented through narrative synthesis (Prospero CRD42019130369).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen papers were included. Studies focused on educational and system change to improve the care of people with DSD. Family involvement ranged from enabling baseline assessment of delirium, commenting on different resources and measures designed to support their involvement in care or simulate their presence. The evidence of effectiveness was varied. Interventions to support personalised care and give family carers and staff confidence were positively evaluated in some studies but not all included both family carers and staff. Benefits to patients over time were less clearly demonstrated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This review identified the potential of family to mitigate the risk of delirium and improve patient outcomes. Further research is needed to understand how system and practitioner changes to enable family involvement in the support of people with DSD benefit patients in the short and long term.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Relevance to Clinical Practice</h3>\u0000 \u0000 <p>The review findings provide evidence for clinical practice when selecting existing interventions and approache","PeriodicalId":48651,"journal":{"name":"International Journal of Older People Nursing","volume":"20 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/opn.70016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bianca Berger, Fabian Graeb, Manfred Baumann, Reinhold Wolke
{"title":"Becoming Bedridden and Being Bedridden: Implications for Nursing and Care for Older People in Long-Term Care: A Scoping Review","authors":"Bianca Berger, Fabian Graeb, Manfred Baumann, Reinhold Wolke","doi":"10.1111/opn.70015","DOIUrl":"https://doi.org/10.1111/opn.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>An increasing number of individuals aged 60 and older will rely on healthcare services, particularly due to increased physical limitations and mobility restrictions. This implies an increase in permanently immobile, often bedridden people who require targeted care. Mobility impairments progress gradually, leading to loss of autonomy and self-care skills, physical decline, functional deterioration, disability, etc. This review synthesises research findings on the implications of becoming and being bedridden for nursing care of older people in long-term care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this scoping review was to explore the current state of research on the topic of bedriddenness in older people in the context of long-term care and to identify research gaps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed English and German language peer-reviewed publications from the electronic databases MEDLINE (PubMed), CINAHL, LIVIO and Scopus. Publications from 1998 to 2023 were included if they addressed ‘bedriddenness’, the ‘process of becoming bedridden’, ‘prevention’ and the ‘consequences of bedriddenness’, and the ‘care of bedridden people’. The PRISMA-ScR guidelines were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 250 publications based on the defined inclusion criteria. We included 47 in detail condensing their content and organising them according to developed categories, bedriddenness and its prevention, development, consequences and care, which were the subject of intensive research. Although researchers have focused on risk factors for the development of immobility and its negative consequences for those affected, they paid little attention to self-determination and the organisation of life in bed, which enables those affected to participate. Different ideas regarding the term ‘bedriddenness’ indicate the need for a consensus definition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our review shows that articles strongly focus on the process of becoming bedridden. Many publications examine bedridden people's care by emphasising the perspective of (informal) caregivers and the challenges they face. The perspective of bedridden people, together with the consideration of psychosocial dimensions of bedriddenness and the promotion of opportunities for participation, should be focused on in further research. Appropriate concepts for training and nursi","PeriodicalId":48651,"journal":{"name":"International Journal of Older People Nursing","volume":"20 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/opn.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exploring Care Home Workers' Perceptions of Implementing ECHO: A Qualitative Study","authors":"Michelle Beattie, Kevin Muirhead, Nicola Carey","doi":"10.1111/opn.70017","DOIUrl":"https://doi.org/10.1111/opn.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To ensure older people living in care homes receive optimal care, care home workers (CHWs) require access to specialist support and education. Extension for Community Healthcare Outcomes (ECHO) uses existing videoconferencing to connect CHWs to specialists using case-based learning. There is evidence in other settings to suggest that ECHO can improve practitioner knowledge and patient outcomes. There is a dearth of evidence regarding strategies for effective implementation of ECHO with CHWs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To establish the experiences of ECHO, and the barriers and enablers to implementation, from the perspective of CHWs in Scotland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Qualitative online focus groups (<i>n</i> = 4) with CHWs (<i>n</i> = 13) who had participated in at least one care home ECHO session and with facilitators/presenters (<i>n</i> = 6). Transcripts were thematically analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Findings were grouped into three areas: perceived impact, inhibitors and enablers. CHWs reported the positive impact of ECHO including key benefits to enhance residents' care, satisfaction with the sessions and feeling valued. Inhibitors included limited digital skills, workforce challenges and the pitch and duration of ECHO sessions. Enablers included administrative and technical support, scheduling and the structure of the ECHO approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ECHO allows CHWs to access specialist support, enabling learning and development, with the potential to improve residents' care. Benefits to residents' care included CHWs' enhanced understanding of choices around death and dying, and insights and understanding of causation of challenging behaviours in older people and how to manage these. Adaptations to ECHO to suit a care home context are recommended.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Practice</h3>\u0000 \u0000 <p>CHWs require technical support to build competence and confidence in IT skills. This study highlights the potential for ECHO to support CHWs to access specialist support and learning for older adults in a care home context.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48651,"journal":{"name":"International Journal of Older People Nursing","volume":"20 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/opn.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Preetha Krishnan, Susan McClement, Genevieve Thompson, Marie Edwards, Philip St. John
{"title":"‘Getting Everyone on the Same Page’: Long-Term-Care Nurses' Experiences With Advance Care Planning","authors":"Preetha Krishnan, Susan McClement, Genevieve Thompson, Marie Edwards, Philip St. John","doi":"10.1111/opn.70013","DOIUrl":"https://doi.org/10.1111/opn.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Much of the literature examining the experiences of advance care planning (ACP) in long-term care (LTC) has been from the perspectives of residents and their families. Largely absent from the literature are the perspectives of LTC nurses, who are key members of the healthcare team most involved with LTC residents/families and well positioned to facilitate the ACP process. The purpose of this study was to develop an inductively derived empirical model to address this gap in empirical knowledge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A constructivist grounded theory (CGT) methodology was used in this study of 25 nurses working in 18 different LTC facilities in central Canada. Data were collected using a demographic questionnaire; in-depth, semi-structured, audio-recorded and face-to-face/telephone interviews; field notes; and memos. Descriptive statistics and specific CGT coding procedures were used to analyse the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The basic social process that emerged from the data was that of nurses trying to identify an ACP level and craft a corresponding care plan that they believed would optimise residents' comfort in LTC during both acute medical events and at the end-of-life (EOL). The empirically derived theoretical model that captured the experiences, processes and strategies of nurses to address the identified social process was <i>orchestrating comfort: getting everyone on the same page</i>. This model encompassed two main processes, downgrading and upgrading ACP levels, and two preconditions, piecing together the big picture and selling the big picture.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ensuring comfort for LTC residents at the end-of-life or during acute events by getting everyone on the same page is a complex process. The ability of nurses to downgrade or upgrade the ACP level to orchestrate comfort for LTC residents involves many factors related to the resident, family, healthcare providers and the context in which the ACP discussions take place.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications of Practice</h3>\u0000 \u0000 <p>Providing ACP/dementia information in LTC admission packages and through informational sessions can raise family awareness of these topics and dementia's complications. Clinical rotations in LTC facilities for medical, nursing, and paramedic students could also improve their understanding of the sector's complexities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48651,"journal":{"name":"International Journal of Older People Nursing","volume":"20 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nursing Practice for Early Detection of Long-Term Care Resident Deterioration: A Qualitative Study","authors":"Hirofumi Ogawara, Hiroki Fukahori, Yuriko Mashida, Sachiko Matsumoto, Katsumi Nasu, Ardith Z Doorenbos","doi":"10.1111/opn.70014","DOIUrl":"https://doi.org/10.1111/opn.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In long-term care (LTC) facilities, nurses play a key role in detecting changes in residents' health conditions and preventing avoidable emergency transfers and hospitalisations through multidisciplinary collaboration. This study aimed to explore how nurses detect changes that indicate the deterioration in LTC residents' conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted with 23 nurses from 14 LTC facilities. Data from these interviews were qualitatively analysed using coding and constant comparison methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The three main categories were ‘preparing’, ‘assessing’ and ‘judging’. Nurses worked closely with care workers who spent a considerable amount of time with the residents, and by sharing information, the nurses could rapidly respond to changes in the residents' conditions. They also evaluated the risk of residents experiencing changes by leveraging their clinical experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study found that LTC nurses should collaborate with care workers to enhance their health assessment skills, enabling them to detect changes in residents' conditions. Findings from this study can be used to promote collaboration between nurses and care workers and to develop effective educational interventions to improve nursing practice in LTC facilities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Practice</h3>\u0000 \u0000 <p>This study underscores the necessity of nurses' ability to identify early deterioration in LTC residents. The findings reveal key symptoms and warning signs that nurses should prioritize in their assessments. By leveraging clinical experience and close observation, nurses can make timely and effective decisions to address residents' health changes, preventing further deterioration and enhancing their quality of life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48651,"journal":{"name":"International Journal of Older People Nursing","volume":"20 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/opn.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}