Статті в журналах з теми "Aged care nurse practitioner"
Щоб переглянути інші типи публікацій з цієї теми, перейдіть за посиланням: Aged care nurse practitioner.
Оформте джерело за APA, MLA, Chicago, Harvard та іншими стилями
Ознайомтеся з топ-50 статей у журналах для дослідження на тему "Aged care nurse practitioner".
Біля кожної праці в переліку літератури доступна кнопка «Додати до бібліографії». Скористайтеся нею – і ми автоматично оформимо бібліографічне посилання на обрану працю в потрібному вам стилі цитування: APA, MLA, «Гарвард», «Чикаго», «Ванкувер» тощо.
Також ви можете завантажити повний текст наукової публікації у форматі «.pdf» та прочитати онлайн анотацію до роботи, якщо відповідні параметри наявні в метаданих.
Переглядайте статті в журналах для різних дисциплін та оформлюйте правильно вашу бібліографію.
1
Clark, Shannon, Rhian Parker, Brenton Prosser, and Rachel Davey. "Aged care nurse practitioners in Australia: evidence for the development of their role." Australian Health Review 37, no. 5 (2013): 594. http://dx.doi.org/10.1071/ah13052.
Повний текст джерелаАнотація:
Aim To consider evidence surrounding the emerging role of nurse practitioners in Australia with a particular focus on the provision of healthcare to older people. Methods Methods used included keyword, electronic database and bibliographic searches of international literature, as well as review of prominent policy reports in relation to aged care and advanced nursing roles. Results This paper reports on evidence from systematic reviews and international studies that show that nurse practitioners improve healthcare outcomes, particularly for hard to service populations. It also maps out the limited Australian evidence on the impact of nurse practitioners’ care in aged care settings. Conclusions If Australia is to meet the health needs of its ageing population, more evidence on the effectiveness, economic viability and sustainability of models of care, including those utilising nurse practitioners, is required. What is known about the topic? Australia, like many industrialised countries, faces unprecedented challenges in the provision of health services to an ageing population. Attempts to respond to these challenges have resulted in changing models of healthcare and shifting professional boundaries, including the development of advance practice roles for nurses. One such role is that of the nurse practitioner. There is international evidence that nurse practitioners provide high-quality healthcare. Despite being established in the United States for nearly 50 years, nurse practitioners are a relatively recent addition to the Australian health workforce. What does this paper add? This paper positions a current Australian evaluation of nurse practitioners in aged care against the background of the development of the role of nurse practitioners internationally, evidence for the effectiveness of the role, and evidence for nurse practitioners in aged care. Recent legislative changes in Australia now mean that private nurse practitioner roles can be fully implemented and hence evaluated. In the face of the increasing demands of an ageing population, the paper highlights limitations in current Australian evidence for nurse practitioners in aged care and identifies the importance of a national evaluation to begin to address these limitations. What are the implications for practitioners? The success of future healthcare planning and policy depends on implementing effective initiatives to address the needs of older Australians. Mapping the terrain of contemporary evidence for nurse practitioners highlights the need for more research into nurse practitioner roles and their effectiveness across Australia. Understanding the boundaries and limitations to current evidence is relevant for all involved with health service planning and delivery.
2
Bail, Kasia, Paul Arbon, Marlene Eggert, Anne Gardner, Sonia Hogan, Christine Phillips, Nicole van Dieman, and Gordon Waddington. "Potential scope and impact of a transboundary model of nurse practitioners in aged care." Australian Journal of Primary Health 15, no. 3 (2009): 232. http://dx.doi.org/10.1071/py09009.
Повний текст джерелаАнотація:
Aged care is a growing issue in Australia and other countries. There are significant barriers to meeting the health needs of this population. Current services have gaps between care and lack communication and integration between care providers. Research was conducted in the Australian Capital Territory to investigate the potential role of the aged care nurse practitioner in health service delivery in aged care settings. A multimethod case study design was utilised, with three student nurse practitioners (SNP) providing care to aged care clients across three sectors of health service delivery (residential aged care facilities, general medical practices and acute care). Data collection consisted of in-depth interviews and journal entries of the SNP, as well as focus groups and surveys of multidisciplinary staff and patients over the age of 65 years in the settings frequented by the SNP. The aged care SNP were found to cross professional and organisational boundaries, cross intra- as well as interorganisational boundaries and to contribute to more seamless patient care as members of a multidisciplinary aged care team. The aged care nurse practitioner role consequently has the potential to function in a networked rather than a hierarchical manner, and this could be a key element in addressing gaps in care across care locales and between disciplines.
3
Clark, Shannon J., Rhian M. Parker, and Rachel Davey. "Nurse Practitioners in Aged Care." Qualitative Health Research 24, no. 11 (September 2, 2014): 1592–602. http://dx.doi.org/10.1177/1049732314548691.
Повний текст джерела
4
Allen, Jacqueline, and Anne Marie Fabri. "An evaluation of a community aged care nurse practitioner service." Journal of Clinical Nursing 14, no. 10 (November 2005): 1202–9. http://dx.doi.org/10.1111/j.1365-2702.2005.01199.x.
Повний текст джерела
5
Peters, Micah D. J., and Casey Marnie. "Nurse practitioner models of care in aged care: a scoping review protocol." JBI Evidence Synthesis 20, no. 8 (June 20, 2022): 2064–70. http://dx.doi.org/10.11124/jbies-21-00286.
Повний текст джерела
6
Arendts, Glenn, Pamela Deans, Keith O’Brien, Christopher Etherton-Beer, Kirsten Howard, Gill Lewin, and Moira Sim. "A clinical trial of nurse practitioner care in residential aged care facilities." Archives of Gerontology and Geriatrics 77 (July 2018): 129–32. http://dx.doi.org/10.1016/j.archger.2018.05.001.
Повний текст джерела
7
Hungerford, Catherine, Brenton Prosser, and Rachel Davey. "The Key Role of Nurse Researchers in the Evaluation of Nurse Practitioner Models of Practice." Research and Theory for Nursing Practice 29, no. 3 (2015): 214–25. http://dx.doi.org/10.1891/1541-6577.29.3.214.
Повний текст джерелаАнотація:
The Nurse Practitioner–Aged Care Models of Practice Program involved diverse models of practice comprising multiple stakeholders located in more than 30 locations across Australia, in remote, rural, urban, and metropolitan settings. Funded by the Australian government, the aims of the program included supporting development of effective, economically viable, and sustainable aged care nurse practitioner models of practice; and enabling improvements in access to primary health care for people aged older than 65 years.This article describes the process by which a framework was developed to support the evaluation of this program. A particular challenge for the nurse researchers involved in the evaluation was to ensure the unique values of the nursing profession were upheld alongside economic, biomedical, and empirical imperatives in the diverse processes involved in collecting and interpreting data. The evaluation framework developed provides an important means of enabling research teams who undertake complex evaluations of diverse nursing models of practice to maintain a common goal—to unify the various stakeholders involved, while at the same time upholding what is most important to the profession of nursing. This article highlights how nurses can play an influential role when involved in the multidisciplinary evaluation of new and innovative approaches to practice.
8
Coates, Kaye, Marianne Wallis, Alison Craswell, and Amanda Glenwright. "A Nurse Practitioner candidate : A model for change in aged care." Journal for Nurse Practitioners 13, no. 7 (July 2017): e351. http://dx.doi.org/10.1016/j.nurpra.2017.05.082.
Повний текст джерела
9
Webber, Louise, Julie Aitken, and Lynne Jones. "Developing a private nurse practitioner model of care in an aged care setting." Journal for Nurse Practitioners 13, no. 7 (July 2017): e343. http://dx.doi.org/10.1016/j.nurpra.2017.05.063.
Повний текст джерела
10
Roberts, Lisa, Kelvin CY Leung, and Carmelle Peisah. "The role of palliative care nurse practitioner in promoting end-of-life care in residential care facilities." Journal of Nursing Education and Practice 12, no. 10 (May 31, 2022): 7. http://dx.doi.org/10.5430/jnep.v12n10p7.
Повний текст джерелаАнотація:
Background and objective: The neglect of older people at the end of life in residential care documented in the Australian Royal Commission into Aged Care and Quality and Safety mandates urgent solutions to improve care. This integrative literature review aimed to explore the potential role of the palliative care nurse practitioner (PC-NP) in promoting quality end of life in residential care.Methods: Databases Medline, Emcare, PsychINFO and CINAHL were searched from January 2010 to April 2022. Full text of primary articles meeting inclusion criteria encompassing residents living in residential care settings, the role of the PC-NP in supporting quality dying were obtained and independently screened to determine final studies for review. Findings were thematically analysed. Two reviewers independently extracted data and assessed level of evidence and quality ratings for both quantitative and qualitative studies.Results: Of 12 articles meeting eligibility criteria, four specifically focused on the PC-NP or the palliative care nurse in residential care, seven examined the generic nurse practitioner role, and one the aged care nurse role in supporting palliative care. Themes common to all roles including positive patient outcomes, advance care planning, hospital avoidance, staff education and enhanced communication with families. Themes specific to the PC-NP included meeting end-of-life needs, end-of-life prescribing, and enhancing the role of the General Practitioner.Conclusions: Although reflected in only a handful of studies, this integrative review has provided preliminary insights into potential contributions of the PC-NP to quality end-of-life care for residential care residents.
11
Jennings, Natasha, Grainne Lowe, and Kathleen Tori. "Nurse practitioner locums: a plausible solution for augmenting health care access for rural communities." Australian Journal of Primary Health 27, no. 1 (2021): 1. http://dx.doi.org/10.1071/py20103.
Повний текст джерелаАнотація:
With 2020 being designated the Year of the Nurse and Midwife, it is opportune to acknowledge and recognise the role that nurses undertake in primary care environments. Nurses and midwives play a pivotal role in the delivery of high-quality health care, particularly in geographically challenged areas of Australia, where they may be the only provider of care within their communities. Rural and remote health services require strategic planning to develop and implement solutions responsive to the challenges of rural and remote communities. Maintenance of health services in rural and remote areas is a challenge, crucial to the equity of health outcomes for these communities. Many small communities rely on visiting medical officers to provide the on-call care to facility services, including emergency departments, urgent care centres, acute wards and aged care facilities. It is increasingly difficult to maintain the current rural workforce models, particularly the provision of after-hours ‘on-call’ care necessary in these communities. An alternative model of health care service delivery staffed by nurse practitioners (NP) is one proposed solution. NPs are educated, skilled and proven in their ability to provide an after-hours or on-call service to meet the expectations of rural and remote communities. Achievement of high-quality health care that is cost-efficient, safe and demonstrates improved patient outcomes has been reported in NP-led health care delivery impact evaluations. The value of an NP locum service model is the provision of a transparent, reliable service delivering consistent, equitable and efficient health care to rural and remote communities.
12
Craswell, Alison, Kaye Coates, Andrea Taylor, Elizabeth Marsden, Julia Crilly, Amanda Glenwright, and Marianne Wallis. "Streamlining care of older people in residential aged care: Nurse practitioner candidate and emergency department care coordination." Journal for Nurse Practitioners 13, no. 7 (July 2017): e340-e341. http://dx.doi.org/10.1016/j.nurpra.2017.05.057.
Повний текст джерела
13
Bentley, Michael, Melinda Minstrell, Hazel Bucher, Lisa Sproule, Andrew Robinson, and Christine Stirling. "Aged care nurse practitioners working in general practice." Journal of Clinical Nursing 24, no. 23-24 (November 6, 2015): 3745–47. http://dx.doi.org/10.1111/jocn.13066.
Повний текст джерела
14
Basic, David, David Conforti, and Jeffrey Rowland. "Standardised assessment of older patients by a nurse in an emergency department." Australian Health Review 25, no. 4 (2002): 50. http://dx.doi.org/10.1071/ah020050.
Повний текст джерелаАнотація:
The primary aim of this study was to evaluate the ability of a nurse practitioner in geriatrics, working in the emergency department of a tertiary referral hospital, to assess high-risk elderly patients comprehensively. A secondary aim was to explore patient characteristics associated with referral to community aged care services. Of 469 patients assessed by the nurse, 327 (70%) were admitted to the hospital. A comprehensive set of data was obtained for 334 (71%) patients. For 142 patients not admitted, 163 new referrals were made, mostly to the Aged Care Assessment Team. Those referred were more likely to be living alone and non-English speaking. They were also less satisfied with the support they received from family and friends. A single nurse working in a busy emergency department can successfully identify patients with increased care needs, and direct high-risk patients to existing services.
15
Craswell, Alison, Marianne Wallis, Kaye Coates, Elizabeth Marsden, Andrea Taylor, Marc Broadbent, Kim-Huong Nguyen, Colleen Johnston-Devin, Amanda Glenwright, and Julia Crilly. "Enhanced primary care provided by a nurse practitioner candidate to aged care facility residents: A mixed methods study." Collegian 27, no. 3 (June 2020): 281–87. http://dx.doi.org/10.1016/j.colegn.2019.08.009.
Повний текст джерела
16
Forbes, Vicki, Clare Harvey, and Alannah Meyer. "Nurse practitioners in aged care settings: a study of general practitioners’ and registered nurses’ views." Contemporary Nurse 54, no. 2 (March 4, 2018): 220–31. http://dx.doi.org/10.1080/10376178.2018.1484258.
Повний текст джерела
17
Prosser, Brenton, Shannon Clark, Rachel Davey, and Rhian Parker. "Developing a public health policy-research nexus: An evaluation of Nurse Practitioner models in aged care." Evaluation and Program Planning 40 (October 2013): 55–63. http://dx.doi.org/10.1016/j.evalprogplan.2013.05.003.
Повний текст джерела
18
Kennedy-Malone, Laurie M., Karen Amirehsani, Rachel Zimmer, and Joshua Borders. "PROGRESSIVE CARE OF AN AGING WOMAN: INTERACTIVE VIDEO SIMULATION CASES SPANNING 15 YEARS." Innovation in Aging 3, Supplement_1 (November 2019): S974. http://dx.doi.org/10.1093/geroni/igz038.3530.
Повний текст джерелаАнотація:
Abstract As a means of enhancing experiential educational opportunities for adult-gerontology nurse practitioner students who are prepared to manage the complex care of older adults, interactive simulation videos were developed using the eLearning authoring tool H5P to create learning experiences for students that can be used either in face to face classroom experiences or embedded in learning management systems. H5P is a web-based authoring tool that helps faculty build interactive course content. H5P activities provide instant feedback to students, allowing them to self-assess their understanding of the dynamic video simulation case. With funding through the Health Resources and Service Administration Advanced Nursing Education Workforce grant, four video simulation cases were developed that address emerging chronic care conditions in an older women who aged 15 years presenting initially with signs of hypothyroidism, progressed to early frailty, through moderate dementia and eventually along with her daughter face end of life health care issues. Partnering with the university instructional design experts, nurse practitioner faculty created questions that were inserted throughout the video as a means of keeping students engaged in problem-solving and decision making. A faculty handbook that described the case scenario with the interactive questions with suggested discussion questions was developed for each video simulation. The adult-gerontology primary care nurse practitioner competencies addressed in each case are identified in the handbook. Recommendations for the interactive question format will be presented and QR codes with access to direct viewing of the videos will be presented on the poster.
19
Bentley, Michael, Christine Stirling, Andrew Robinson, and Melinda Minstrell. "The nurse practitioner-client therapeutic encounter: an integrative review of interaction in aged and primary care settings." Journal of Advanced Nursing 72, no. 9 (February 15, 2016): 1991–2002. http://dx.doi.org/10.1111/jan.12929.
Повний текст джерела
20
Bousema, Sara, Annemieke J. Verwoerd, Lucas M. Goossens, Arthur M. Bohnen, Patrick J. E. Bindels, and Gijs Elshout. "Protocolled practice nurse-led care for children with asthma in primary care: protocol for a cluster randomised trial." BMJ Open 9, no. 9 (September 2019): e022922. http://dx.doi.org/10.1136/bmjopen-2018-022922.
Повний текст джерелаАнотація:
IntroductionIn children with asthma, daily symptoms and exacerbations have a significant impact on the quality of life of both children and parents. More effective use of asthma medication and, consequently, better asthma control is advocated, since both overtreatment and undertreatment are reported in primary care. Trials in adults suggest that asthma control is better when patients receive a regular medical review. Therefore, protocolled care by the general practitioner may also lead to better asthma control in children. However, such protocolled care by the general practitioner may be time consuming and less feasible. Therefore, this study aims to determine whether protocolled practice nurse-led asthma care for children in primary care provides more effective asthma control than usual care.Methods and analysisThe study will be a cluster-randomised open-label trial with an 18-month follow-up. Practice nurses will be the units of randomisation and children with asthma the units of analysis. It is planned to include 180 children aged 6–12 years. Primary outcome will be average asthma control during the 18-month follow-up measured by the Childhood Asthma Control Test (C-ACT). Secondary outcomes include C-ACT scores at t=3, t=6, t=12 and t=18 months; the frequency and severity of exacerbations; cost-effectiveness; quality of life; satisfaction with delivered care; forced expiratory volume in 1 s and forced expiratory flow at 75% and the association of high symptoms scores at baseline and baseline characteristics. Besides, we will conduct identical measurements in a non-randomised sample of children.Ethics and disseminationThis will be the first trial to evaluate the effectiveness of protocolled practice nurse-led care for children with asthma in primary care. The results may lead to improvements in asthma care for children and can be directly implemented in revisions of asthma guidelines.The study protocol was approved by the Medical Research Ethics Committee of the Erasmus Medical Centre in Rotterdam.Trial registrationNTR6847.
21
McNab, Justin, Janis Paterson, Joanne Fernyhough, and Rod Hughes. "Role of the GP liaison nurse in a community health program to improve integration and coordination of services for the chronically ill." Australian Journal of Primary Health 22, no. 2 (2016): 123. http://dx.doi.org/10.1071/py14089.
Повний текст джерелаАнотація:
This paper explores the role of the General Practitioner Liaison Nurse (GPLN) in improving integration and coordination of services within Primary Health Care. This position can play a major role in care coordination and cultural change. The GPLN within HealthOne Mt Druitt (HOMD) identifies patients’ needs and facilitates communication, case conferencing and care coordination between health and other providers. The priority areas of children and their families at risk or with significant unmet needs, and chronic aged and complex care, were identified as target areas. This paper focuses on the GPLN within the chronic aged and complex care service model. The GPLN within HOMD was able to improve coordination and integration of services for patients of the facility. Activities included organising multidisciplinary services and addressing psychosocial issues. Patients and community health staff identified the importance of the role for improving coordination and integration of services. Decision and policy makers saw the position as vital to the implementation, operation and sustainability of HOMD.
22
Veldhuizen, Jessica Desirée, Misja Chiljon Mikkers, Marieke J. Schuurmans, and Nienke Bleijenberg. "Predictors of district nursing care utilisation for community-living people in the Netherlands: an exploratory study using claims data." BMJ Open 11, no. 9 (September 2021): e047054. http://dx.doi.org/10.1136/bmjopen-2020-047054.
Повний текст джерелаАнотація:
ObjectiveTo explore predictors of district nursing care utilisation for community-living (older) people in the Netherlands using claims data. To cope with growing demands in district nursing care, knowledge about the current utilisation of district nursing care is important.SettingDistrict nursing care as a part of primary care.ParticipantsIn this nationwide study, claims data were used from the Dutch risk adjustment system and national information system of health insurers. Samples were drawn of 5500 pairs of community-living people using district nursing care (cases) and people not using district nursing care (controls) for two groups: all ages and aged 75+ years (total N=22 000).Outcome measuresThe outcome was district nursing care utilisation and the 114 potential predictors included predisposing factors (eg, age), enabling factors (eg, socioeconomic status) and need factors (various healthcare costs). The random forest algorithm was used to predict district nursing care utilisation. The performance of the models and importance of predictors were calculated.ResultsFor the population of people aged 75+ years, most important predictors were older age, and high costs for general practitioner consultations, aid devices, pharmaceutical care, ambulance transportation and occupational therapy. For the total population, older age, and high costs for pharmaceutical care and aid devices were the most important predictors.ConclusionsPeople in need of district nursing care are older, visit the general practitioner more often, and use more and/or expensive medications and aid devices. Therefore, close collaboration between the district nurse, general practitioner and the community pharmacist is important. Additional analyses including data regarding health status are recommended. Further research is needed to provide an evidence base for district nursing care to optimise the care for those with high care needs, and guide practice and policymakers’ decision-making.
23
Kosheleva, Ludmila, and Irene Ngune. "Registered Nurses’ Decisions Around Referral of Residents With Urinary Tract Infections: A Retrospective Cohort Study." Journal of Primary Care & Community Health 11 (January 2020): 215013272095744. http://dx.doi.org/10.1177/2150132720957441.
Повний текст джерелаАнотація:
Background Referral of residents with urinary tract infections (UTIs) in residential aged care facilities (RACFs) to hospital are common. However, there is limited information on what influences Registered Nurses’ (RN) decision-making process. Aim To investigate resident factors that influence RN’s decisions to escalate care. Design A retrospective cohort approach audited electronic clinical records of residents with UTIs. Methods Data were extracted from the electronic database and analyzed using descriptive and regression analysis. Approval was obtained from both the RACFs and University Human Research Ethics Committee. Results There was a higher likelihood of being referred to hospital if residents were female, had had a past fall, had related comorbidity, or had abnormal vital signs. However, being older and having a urinary catheter were protective factors for referral by the RN. Conclusion Referral of residents with UTIs by RNs to hospital is common in RACFs. Resident characteristics such as abnormal vital signs, past falls, and presence of comorbidity influence referrals by RNs. Nurse Practitioners dedicated to the RACFs could complement the role of a general practitioner. UTI-specific escalation protocols can assist RNs to make decisions about referrals. RNs’ related risk factors also need to be examined to understand other influencing factors.
24
Liesch, Shari K., and Kathleen M. Elertson. "Drawing and Dialogue: Youth’s Experiences With the “Face” of Diabetes." Journal of Patient Experience 7, no. 6 (December 10, 2019): 1158–63. http://dx.doi.org/10.1177/2374373519892774.
Повний текст джерелаАнотація:
Objective: The purpose of this qualitative pilot study was to evaluate drawing, narration, color use, and meaning through discussion to increase insight surrounding youth’s lived experience with type 1 diabetes. Methods: This qualitative study reflects a convenience sample of 20 (female = 12, male = 8) youth aged 8 to 15 years with an established diagnosis of type 1 diabetes. During a nonclinic session, 3 drawings—self-portrait, face of diabetes, and future self-portrait—were created. Interviews were completed with an art therapist or clinic nurse practitioner using a standardized script. Results: All “face” of diabetes drawings depicted images separate from self. The most frequent color noted was gray, due to pencil use. No significant difference in disclosures or dialogue were observed between interviews conducted by the art therapist or nurse practitioner. Emerging themes noted: diabetes is unpredictable and stigmatizing, causes fears, and impacts daily life, yet discussions evidenced overall coping and resilience. Conclusions: Drawing during clinic visits enhances communication and understanding of youth’s lived experience. Findings offer clinical benefit when managing care and support for chronic health conditions.
25
Kralik, Debbie, Katherine Trowbridge, and Anne Maddock. "Commentary on An evaluation of a community aged care nurse practitioner service. Journal of Clinical Nursing 14, 1202?1209." Journal of Clinical Nursing 16, no. 2 (February 2007): 419–20. http://dx.doi.org/10.1111/j.1365-2702.2005.01471.x.
Повний текст джерела
26
Sudraba, Velga, and Ieva Briede. "INDIVIDUAL AND PROFESSIONAL VALUES OF NURSE PRACTITIONERS." SOCIETY. INTEGRATION. EDUCATION. Proceedings of the International Scientific Conference 6 (May 20, 2020): 380. http://dx.doi.org/10.17770/sie2020vol6.5033.
Повний текст джерелаАнотація:
Individual and professional values of nurses enhance the psychological wellbeing of healthcare professionals, enabling them to do professional and proficient work and also reducing the risk of burnout. The aim of the study was to investigate individual and professional values of nurse practitioners and the relationship of these values to socio-demographic data. The study involved 163 nurses aged 22–70 years (41.6 + 12.64) with 99.8% women. Respondents were interviewed in two hospitals in Riga in 2019. Permission from Rīga Stradiņš University Ethics Committee was obtained to do the study. Two surveys were used in the research: (1) Rokeach Value Survey and (2) Nurses Professional Values Scale–Three (NPVS–3). There was no statistically significant correlation between socio-demographic data of nurses and their professional values. The most evident professional value group for nurses was care. The Rokeach scale listed physical and mental health as a priority of all terminal values with an average rate 3.8. On the other hand, happiness of others ranks as the last priority in the list of terminal values with an average rating of 14.5. At the top of the instrumental values was honesty with an average rating of 6.3. Intolerance toward the drawbacks of oneself and other people concludes the list with an average rating of 15.0.
27
Qian, Siyu, Ping Yu, and David Hailey. "Nursing staff work patterns in a residential aged care home: a time–motion study." Australian Health Review 40, no. 5 (2016): 544. http://dx.doi.org/10.1071/ah15126.
Повний текст джерелаАнотація:
Objective Residential aged care services are challenged by an increasing number of residents and a shortage of nursing staff. Developing strategies to overcome this challenge requires an understanding of nursing staff work patterns. The aim of the present study was to investigate the work processes followed by nursing staff and how nursing time is allocated in a residential aged care home. Methods An observational time–motion study was conducted at two aged care units for 12 morning shifts. Seven nurses were observed, one per shift. Results In all, there were 91 h of observation. The results showed that there was a common work process followed by all nurse participants. Medication administration, documentation and verbal communication were the most time-consuming activities and were conducted most frequently. No significant difference between the two units was found in any category of activities. The average duration of most activities was less than 1 min. There was no difference in time utilisation between the endorsed enrolled nurses and the personal carers in providing nursing care. Conclusion Medication administration, documentation and verbal communication were the major tasks in morning shifts in a residential aged care home. Future research can investigate how verbal communication supports nursing care. What is known about the topic? The aging population will substantially increase the demand for residential aged care services. There is a lack of research on nurses’ work patterns in residential aged care homes. What does this paper add? The present study provides a comprehensive understanding of nurses’ work patterns in a residential aged care home. There is a common work process followed by nurses in providing nursing care. Medication administration, verbal communication and documentation are the most time-consuming activities and they are frequently conducted in the same period of time. Wound care, physical review and documentation on desktop computers are arranged flexibly by the nurses. What are the implications for practitioners? When developing a task reallocation strategy to improve work efficiency, effort can be put into tasks that can be arranged more flexibly.
28
Irimia, A. M., A. Tennant, A. Waldron, and N. Bashir. "61 Outcomes of An Advanced Nurse Practitioner-Led Pops Service in A District General Hospital." Age and Ageing 50, Supplement_1 (March 2021): i12—i42. http://dx.doi.org/10.1093/ageing/afab030.22.
Повний текст джерелаАнотація:
Abstract Introduction There is an increased need for geriatrician input to older adults outside of the medical wards. There is a lack of geriatricians to contribute to these services. An example includes the Proactive care of older people undergoing surgery (POPS) service where geriatricians perform comprehensive geriatric assessment (CGA) to identify comorbidities and geriatric syndromes which may lead to poor post-operative outcomes. Advanced nurse practitioners (ANP) are highly skilled staff members and are increasingly used to provide the POPS service. We wanted to review the outcomes of our Nurse Led POPS service. Methods Patients aged over 70 admitted as an emergency to upper gastrointestinal and colorectal surgery were assessed by the POPS ANP using CGA. Assessments were completed on a proforma. Data was collected prospectively on a data collection form documenting new issues detected and interventions made. The results were analysed using an Excel spreadsheet. Results 147 patients were reviewed by the ANP between November 2018 and March 2019. All patients were screened for frailty, cognitive impairment and delirium. 37.41% were clinically frail, 17.72% had cognitive impairment and 11.56% had delirium. New issues were identified in 90.47% of these patients; polypharmacy (80.27%), new catheter (53.74%), weight loss (46.94%), incontinence (36.05%), falls (29.25%) and pain (25.17%). Medical issues were also identified including electrolyte abnormalities (47% patients), acute kidney injury (22% patients), cardiac issues (8% patients) and respiratory problems (7% patients). Additional interventions included stopping medication (27.89%), starting new medication (20.41%), requesting further investigations (97.28%), referring to allied health professionals (95.24%) and advanced care planning (15.65%). Conclusions A POPS ANP can effectively conduct CGA identifying new medical issues and geriatric syndromes missed by the surgical teams in an acute setting.
29
Scott, Lauren J., Mairead Murphy, Sarah Price, Rhys Lewis, Rachel Denholm, Jeremy Horwood, Tom Palmer, and Chris Salisbury. "Changes in presentations with features potentially indicating cancer in primary care during the COVID-19 pandemic: a retrospective cohort study." BMJ Open 11, no. 5 (May 2021): e050131. http://dx.doi.org/10.1136/bmjopen-2021-050131.
Повний текст джерелаАнотація:
ObjectivesTo investigate how the COVID-19 pandemic affected the number of people aged 50+ years presenting to primary care with features that could potentially indicate cancer, and to explore how reporting differed by patient characteristics and in face-to-face vs remote consultations.Design, setting and participantsA retrospective cohort study of general practitioner (GP), nurse and paramedic primary care consultations in 21 practices in South-West England covering 123 947 patients. The models compared potential cancer indicators reported in April–July 2019 with April–July 2020.Main outcome measuresPotential indicators of cancer were identified using code lists for symptoms, signs, test results and diagnoses listed in the National Institute for Health and Care Excellence suspected cancer referral guidance (NG12).ResultsDuring April–July 2019, 17% of registered patients aged 50+ years reported a potential cancer indicator in a consultation with a GP or nurse. During April–July 2020, this reduced to 11% (incidence rate ratio (IRR) 0.64, 95% CI 0.62 to 0.67, p<0.001). Reductions in potential cancer indicators were stable across age group, sex, ethnicity, index of multiple deprivation quintile and shielding status, but less marked in patients with mental health conditions than without (IRR 0.75, 95% CI 0.72 to 0.79, interaction p<0.001). Proportions of GP consultations with potential indicators of cancer reduced between 2019 and 2020 for face-to-face consultations (IRR 0.84, 95% CI 0.76 to 0.92, p<0.001) and increased for remote consultations (IRR 1.17, 95% CI 1.07 to 1.29, p=0.001), although it remained lower in remote consulting than face-to-face in April–July 2020. This difference was greater for nurse/paramedic consultations (face-to-face: IRR 0.61, 95% CI 0.44 to 0.83, p=0.002; remote: IRR 1.60, 95% CI 1.10 to 2.333, p=0.014).ConclusionThe number of patients consulting with presentations that could potentially indicate cancer reduced during the first wave of the COVID-19 pandemic. Patients should be encouraged to continue contacting primary care for persistent signs and symptoms, and GPs and nurses should be encouraged to probe patients for further information during remote consulting, in the absence of non-verbal cues.
30
Ndukwe, Henry C., Prasad S. Nishtala, Ting Wang, and June M. Tordoff. "Quality use of antipsychotic medicines inresidential aged care facilities in New Zealand." Journal of Primary Health Care 8, no. 4 (2016): 335. http://dx.doi.org/10.1071/hc15054.
Повний текст джерелаАнотація:
ABSTRACT INTRODUCTION Antipsychotic medicines are used regularly or when required in residential aged care facilities to treat symptoms of dementia, but have been associated with several adverse effects. AIM The aim of this study was to examine ‘quality use’ of antipsychotic medicines in residential aged care facilities in New Zealand, by surveying nurse managers. METHODS A cross-sectional survey was mailed to 318 nurse managers working in a nationally representative sample of aged care facilities. A purpose-developed, pre-tested, 22-item structured questionnaire was used to explore practice related to the quality use of antipsychotic medicines. RESULTS Overall, 31.4% of nurse managers responded to the survey. They mostly (88%) had ≥ 1 year’s relevant work experience and 83% of facilities provided care for those within the range of 21 to 100 residents. Respondents reported that staff education on dementia management occurred early in employment. Two-thirds of participants reported non-pharmacological interventions were commonly used for managing challenging behaviours, while less than half (45%) cited administering antipsychotic medicine. Respondents reported ‘managing behavioural symptoms’ (81%) as one of the main indications for antipsychotic use. Frequently identified adverse effects of antipsychotic medicines were drowsiness or sedation (64%) and falls (61%). Over 90% reported general practitioners reviewed antipsychotic use with respect to residents’ target behaviour 3-monthly, and two-thirds used an assessment tool to appraise residents’ behaviour. DISCUSSION Staff education on dementia management soon after employment and resident 3-monthly antipsychotic medicine reviews were positive findings. However, a wider use of behavioural assessment tools might improve the care of residents with dementia and the quality use of antipsychotic medicines.
31
Chen, Ching-Min, and Baithesda Baithesda. "Primary healthcare utilization by the elderly: a secondary analysis of the 5th Indonesian Family Life Survey." Working with Older People 24, no. 2 (April 6, 2020): 81–94. http://dx.doi.org/10.1108/wwop-01-2020-0001.
Повний текст джерелаАнотація:
Purpose The purpose of this study is to examine different types of primary healthcare utilization and its influencing factors among the elderly in Indonesia. Design/methodology/approach Data were obtained from the 5th Indonesian Family Life Survey, a longitudinal database of demography and health information using multistage stratified sampling of households. Older adults aged at least 60 years were sampled; proxy respondents and incomplete data were excluded from the study. Findings Most of the elderly preferred to visit nurse/midwives practitioner (NP), followed by the community health centers (CHC). Those who lived outside of the Java region were more likely to visit NP; moreover, those without formal education and lived in the rural area were more likely to use CHC. Education level, region and chronic conditions were significant predicting factors for almost all types of primary healthcare use. Social implications Indonesia is moving towards an aged society in the coming decades. However, there are significant barriers to access almost all types of primary health care by the elderly in Indonesia. This shows the possibility of health care inequality for the elderly population. This study provides evidence of the various types of primary healthcare use by the elderly and its influencing factors. It hopes policymakers can use the data to develop an effective strategy to enhance the quality of primary healthcare services provides to the elderly population. Originality/value Indonesian nurses fulfill vital functions in the health system and are often the only human resource for health not only in remote and poor rural areas but also in urban areas. Nurses, as a part of primary care providers, require an adequately trained to contribute to the better primary care system.
32
Minstrell, Melinda, Michael Bentley, Hazel Bucher, Martin Morrissey, Carl Higgs, Andrew Robinson, and Christine Stirling. "Open referral policy within a nurse-led memory clinic: patient demographics, assessment scores, and diagnostic profiles." International Psychogeriatrics 27, no. 6 (December 8, 2014): 967–79. http://dx.doi.org/10.1017/s1041610214002361.
Повний текст джерелаАнотація:
ABSTRACTBackground:Memory clinics, typically led by multidisciplinary teams and requiring health professional referral, are one means of providing diagnosis and care coordination for dementia. Nurse-led clinics may provide an effective and alternative means to dementia diagnosis, and open referral policies may minimize existing barriers to accessing a diagnosis, but evidence is needed.Methods:Patients attending a one-day per week nurse-led memory clinic over a 25-month period during 2011–2013 (n = 106) completed comprehensive cognitive assessments and were diagnosed by an aged care nurse practitioner. Descriptive statistics detail the demographics, assessment scores, and diagnostic profiles of patients. Comparable data from published literature was identified, and the differences were analyzed qualitatively.Results:One hundred and six patients were assessed with the key differences from other data sets being history of falls more common, higher mean Mini-Mental State Examination scores, and fewer dementia diagnoses. Sixty-four patients (60%) were self-referred to the nurse-led memory clinic, of which 19 (30%) were diagnosed with mild cognitive impairment (MCI) or dementia. Overall, forty-eight patients (45%) received diagnoses of MCI or dementia.Conclusions:An open referral policy led to a high proportion of patients being self-referred, and nearly a third of these were diagnosed with cognitive impairment or dementia. Open referral policies and nurse-led services may overcome some of the barriers to early diagnosis that are currently experienced. Considering an aging population worldwide and the associated increases in cognitive impairment, which benefits from early identification and intervention, this paper provides an alternative model of nurse-led assessment.
33
Gibson, Jon, Sharon Spooner, and Matt Sutton. "Determinants of primary care workforce variation in England." British Journal of General Practice 70, suppl 1 (June 2020): bjgp20X711389. http://dx.doi.org/10.3399/bjgp20x711389.
Повний текст джерелаАнотація:
BackgroundThe General Practice Forward View (GPFV) outlined how the government plans to attain a strengthened model of general practice. A key component of this proposal is an expansion of the workforce by employing a varied range of practitioners, in other words ‘skill mix’. A significant proportion of this investment focuses on increasing the number of ‘new’ roles such as clinical pharmacists, physiotherapists, physician associates, and paramedics.AimThe aim of this study is to examine what practice characteristics are associated with the current employment of these ‘new’ roles.MethodThe study uses practice level workforce data (2015–2019), publicly available from NHS Digital. The authors model FTE of specific workforce groups (for example, advanced nurse) as a function of deprivation, practice rurality, patient demographics (total list size and percentage of patients aged >65 years) and FTEs from other staff groups.ResultsAlthough analysis is ongoing, initial estimation suggests that the employment of ‘new’ roles has occurred in larger practices (in terms of list size), in practices with a higher proportion of patients living in deprived areas and practices with a larger proportion of patients aged >65 years. FTE for advanced nurses is negatively associated with GP FTE.ConclusionA negative correlation between advanced nurse FTE and GP FTE is potentially suggestive of substitution between roles, deliberate or otherwise. For example, practices may employ ‘new’ roles if they are unable to recruit GPs or they may recruit staff to free up GP time. Further work is needed to confirm these findings and to explore the reasons behind practice employment decisions.
34
Morcos, Michael, Jonathan Corns, and Jodie Belinda Hillen. "Pharmacist-Initiated Management of a Suspected Case of Risperidone-Induced Neuroleptic Malignant Syndrome in an Aged-Care Resident. The Role of Residential Medication Management Reviews in Medication Safety." Journal of Pharmacy Practice 33, no. 3 (November 14, 2018): 382–85. http://dx.doi.org/10.1177/0897190018806414.
Повний текст джерелаАнотація:
A 70-year-old female aged-care resident was referred by her general practitioner for a residential medication management review after nurses reported difficulties with swallowing, episodes of hyperthermia, elevated blood pressure, and tachycardia. These symptoms were accompanied by increasing confusion and drowsiness. Risperidone had recently been prescribed to treat behavioral and psychological symptoms of dementia. This case study describes the pharmacist-initiated management of the symptoms through a national medication review program. It demonstrates the valuable role collaborative medication reviews play in managing adverse drug reactions in aged-care.
35
Veenstra, Petra, Boudewijn J. Kollen, Gosse de Jong, Frans Baarveld, and JS Peter van den Berg. "Nurses improve migraine management in primary care." Cephalalgia 36, no. 8 (October 20, 2015): 772–78. http://dx.doi.org/10.1177/0333102415612767.
Повний текст джерелаАнотація:
Introduction Migraine is a common disorder with a high burden. Adequate treatment results in improvement of quality of life. Migraine patients are mainly treated by general practitioners (GPs), but there is still room for improvement. This study investigated whether primary care nurses could improve the treatment of migraine patients compared to usual care as provided by the GPs. Participants and methods We conducted a non-randomized controlled prospective trial in 235 patients diagnosed with migraine with or without aura according to ICHD-II criteria, aged between 18 and 65 years. Patients with migraine treated only by their GP were compared to management by a nurse supervised by a GP. Results In the intervention group, fewer migraine patients were referred to a neurologist ( p < 0.001). The reduction in monthly migraine days compared to baseline was more apparent in the intervention group at six ( p = 0.09) and nine months ( p = 0.006). There was no significant change in dichotomized HIT score ( p = 0.076). Change in satisfaction of patients did not differ significantly ( p = 0.070). Conclusions The care administered by a headache nurse in the primary care setting supervised by a GP resulted in fewer referrals to the neurologist and more migraine-free days per month, but no change in HIT score. There was no difference in satisfaction scores between both groups.
36
Bonney, Andrew, Christopher Magee, and Russell Pearson. "Cross-sectional survey of older patients’ views regarding multidisciplinary care for chronic conditions in general practice." Australian Journal of Primary Health 20, no. 1 (2014): 27. http://dx.doi.org/10.1071/py12101.
Повний текст джерелаАнотація:
The ageing population and increasing prevalence of chronic illness have contributed to the need for significant primary care reform, including increased use of multidisciplinary care and task substitution. This cross-sectional study explores conditions under which older patients would accept having health professionals other than their general practitioner (GP) involved in their care for chronic disease management (CDM). Ten practices were randomly sampled from a contiguous major city and inner regional area. Questionnaires were distributed to consecutive patients aged 60 years and over in each practice. Agency theory was used to inform analyses. Statistical analysis was undertaken using Wald’s test, growth modelling and linear regression, controlling for the clustered design. The response rate was 53% (n = 272). Most respondents (79%) had at least one chronic health condition. Respondents were more comfortable with GP than with practice nurse management in the CDM scenario (Wald’s test = 105.49, P < 0.001). Comfort with practice nurse CDM was positively associated with increased contact with their GP at the time of the visit (β = 0.41, P < 0.001), negatively associated with the number of the respondent’s chronic conditions (β = –0.13, P = 0.030) and not associated with the frequency of other health professional visits. Agency theory suggests that patients employ continuity of care to optimise factors important in CDM: information symmetry and goal alignment. Our findings are consistent with the theory and lend support to ensuring that interpersonal continuity of care is not lost in health care reform. Further research exploring patients’ acceptance of differing systems of care is required.
37
Iretiola, Builders Modupe, Joseph Simeon Oyepata, and Bassi Peter Usman. "A Survey of Wound Care Practices by Nurses in a Clinical Setting." International Journal of Healthcare and Medical Sciences, no. 65 (August 8, 2020): 74–81. http://dx.doi.org/10.32861/ijhms.65.74.81.
Повний текст джерелаАнотація:
Background: Nurse practitioners play a vital role in wound care and management because of the prevalence of wounds in the community and hospital setting. Aims and objectives: The purpose was to identify current knowledge and practices of nurses with respect to wound management. Method: A qualitative descriptive research was designed, nineteen nurses in wound care wards in Bingham University teaching hospital were recruited into this study. This was achieved with the aid of a self-administered questionnaire for a two-week period. Results: Three groups of nurses responded to this survey (73.7% males; 31.6% aged 31-40 years). Registered nurses dominated (68.4%), majority of them worked in male ward (36.8%) and private ward (36.8%). Almost on full-time (94.7%), more than half were diploma holders (57.9%) with 1 to 5 years of experience (47.4%). Majority (84.2%) were involved in wound treatment and management, there were significant association between years of experience and wound classification, wound treatment, treatment failure and treatment failure factors. Conclusion: Wound care practices require accurate knowledge and assessment skills, a better understanding of wound management provides comprehensible, rapid patient wound care and minimizes patient mortality as well as reduces health services financial costs.
38
Nilaweera, Irosha, Heather Rowe, Hau Nguyen, Joanna Burns, Frances Doran, and Jane Fisher. "Sri Lankan-born women who have given birth in Victoria: a survey of their primary postpartum health-care needs." Australian Journal of Primary Health 22, no. 2 (2016): 133. http://dx.doi.org/10.1071/py14067.
Повний текст джерелаАнотація:
Women who migrate are vulnerable after giving birth. Normal postpartum adaptive challenges are heightened by separation from family and lack of familiarity with local services. The aim was to investigate primary care needs among Sri Lankan-born women with at least one Victorian-born child aged under 2 years. Health care, information and support needs and unmet needs were assessed in a structured Sinhala or English survey offered in print, online or by telephone. Fifty women provided data. Most (80%) had at least one relative from Sri Lanka to stay for postpartum support. Despite this, many had difficulties settling (62%), feeding (58%) and soothing (42%) their babies. They used significantly fewer health services on average (2.3) than mothers in the general community (2.8) (P < 0.004). Only 32% of primiparous women attended at least one First-Time Parents’ group session. Of women experiencing infant care difficulties, only two-thirds accessed care from a Maternal and Child Health Nurse and only one-third from a General Practitioner. Sri Lankan-born mothers have significant unmet needs for primary care, which are not reduced by informal support. A two-pronged approach is indicated in which women are informed about primary care availability, and the cultural competence and client friendliness of services is strengthened.
39
Cooney, Eamonn, Christina Donnellan, and Binish Baburaj. "291 The Impact of a Frailty Team Liaison Service on Nursing Home Attendances in an Emergency Department." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.185.
Повний текст джерелаАнотація:
Abstract Background Up to 50% of referrals from nursing homes to emergency departments (ED) are considered inappropriate. Interventions such as the introduction of advanced practice registered nurses to nursing homes, and community matrons in other jurisdictions have reduced inappropriate referrals. Methods A liaison service with nursing homes was initiated by a candidate Advanced Nurse Practitioner (cANP) supported by the frailty multidisciplinary team in January 2019. It focused on nursing home residents aged 70 years and older. A single point of contact was provided. ED presentations were assessed if possible, and telephone consultations were also available. A database was maintained and the data from the first 3 months of this service was analysed. Results The service provided from 7th January and 31st March 2019 was studied. Referrals of patients aged 70 years and over from nursing homes to ED for this period in 2018 were 100. In 2019 it was 73, representing a 27% decrease in referrals. The total number of patients referred in 2019 was 51. Twenty one (41%) patients had an assessment by the cANP. Interventions by the cANP and team included rapid access to other specialties, medication reconciliation, and prescription of antibiotics, diagnostics and referral to the Community Intervention Team (CIT). Telephone liaison from nursing homes resulted in referrals to the palliative care service in 2 cases, prescription of antibiotic in another, rapid access comprehensive geriatric assessment in another case and rapid access to ED for catheter change in another, hence admission avoidance's in all of these cases. Conclusion The early experience of this service is that it facilitated more nursing home residents to receive care and support within their care setting. It contributed to reduced referrals of this vulnerable cohort of the population to ED, and also resulted in admission avoidance in some cases.
40
Arbon, Paul, Kasia Bail, Marlene Eggert, Anne Gardner, Sonia Hogan, Christine Phillips, Nicole van Dieman, and Gordon Waddington. "Reporting a research project on the potential of aged care nurse practitioners in the Australian Capital Territory." Journal of Clinical Nursing 18, no. 2 (January 2009): 255–62. http://dx.doi.org/10.1111/j.1365-2702.2008.02452.x.
Повний текст джерела
41
Chapman, Michael, Nikki Johnston, Clare Lovell, Liz Forbat, and Wai-Man Liu. "Avoiding costly hospitalisation at end of life: findings from a specialist palliative care pilot in residential care for older adults." BMJ Supportive & Palliative Care 8, no. 1 (August 5, 2016): 102–9. http://dx.doi.org/10.1136/bmjspcare-2015-001071.
Повний текст джерелаАнотація:
ObjectivesSpecialist palliative care is not a standardised component of service delivery in nursing home care in Australia. Specialist palliative care services can increase rates of advance care planning, decrease hospital admissions and improve symptom management in such facilities. New approaches are required to support nursing home residents in avoiding unnecessary hospitalisation and improving rates of dying in documented preferred place of death. This study examined whether the addition of a proactive model of specialist palliative care reduced resident transfer to the acute care setting, and achieved a reduction in hospital deaths.MethodsA quasi-experimental design was adopted, with participants at 4 residential care facilities. The intervention involved a palliative care nurse practitioner leading ‘Palliative Care Needs Rounds’ to support clinical decision-making, education and training. Participants were matched with historical decedents using propensity scores based on age, sex, primary diagnosis, comorbidities and the Aged Care Funding Instrument rating. Outcome measures included participants’ hospitalisation in the past 3 months of life and the location of death.ResultsThe data demonstrate that the intervention is associated with a substantial reduction in the length of hospital stays and a lower incidence of death in the acute care setting. While rates of hospitalisation were unchanged on average, length of admission was reduced by an average of 3.22 days (p<0.01 and 95% CI −5.05 to −1.41), a 67% decrease in admitted days.ConclusionsThe findings have significant implications for promoting quality outcomes through models of palliative care service delivery in residential facilities.
42
Wang, Hanyuying, Emily Zhao, Jane Fleming, Tom Dening, Kay-Tee Khaw, and Carol Brayne. "Is loneliness associated with increased health and social care utilisation in the oldest old? Findings from a population-based longitudinal study." BMJ Open 9, no. 5 (May 2019): e024645. http://dx.doi.org/10.1136/bmjopen-2018-024645.
Повний текст джерелаАнотація:
ObjectivesThe present study aimed to examine the impact of loneliness on health and social care service use in the oldest old over a 7-year follow-up.DesignProspective study.SettingUK population-based cohort.Participants713 people aged 80 years or older were interviewed at wave 3 of the Cambridge City over-75s Cohort Study. Of these, 665 provided data on loneliness. During 7 years’ follow-up, 480 participants left the study, of which 389 due to death. 162 still in the study answered the loneliness question.Main outcome measureUse of health and social care services, assessed at each wave from wave 3 to wave 5.ResultsAt wave 3, of 665 participants who had data on loneliness, about 60% did not feel lonely, 16% felt slightly lonely and 25% felt lonely. Being slightly lonely at wave 3 was associated with a shorter time since last seeing a general practitioner (β=−0.5, 95% CI: −0.8 to –0.2); when examining the association between time-varying loneliness and health and social care usage, being lonely was associated with three times greater likelihood of having contact with community nurses and using meals on wheels services (community nurse contact: incidence rate ratio (IRR)=3.4, 95% CI: 1.4 to 8.7; meals on wheels service use: IRR=2.5, 95% CI: 1.1 to 5.6). No associations between loneliness and other health and social care services use were found.ConclusionLoneliness was a significant risk factor for certain types of health and social care utilisations, independently of participants’ health conditions, in the oldest old. Study findings have several implications, including the need for awareness-raising and prevention of loneliness to be priorities for public health policy and practice.
43
Keenan, Rawiri, Janet Amey, and Ross Lawrenson. "The impact of patient and practice characteristics on retention in the diabetes annual review programme." Journal of Primary Health Care 5, no. 2 (2013): 99. http://dx.doi.org/10.1071/hc13099.
Повний текст джерелаАнотація:
INTRODUCTION: Despite more than 10 years of the diabetes annual review (DAR) programme, ensuring the annual return of diabetic patients for review remains a challenge for primary care. Regardless of future arrangements for diabetes review programmes, regular review of patients remains clinically important. AIM: To investigate the effect of patient and practice characteristics on the retention of patients continuously enrolled with the same practice in the DAR programme. METHODS: We undertook a retrospective, observational study of a cohort of enrolled diabetic patients who had a DAR in the July 2006 June 2007 reporting year and remained enrolled with the same practice for the following three years. Controlling for death and migration, retention rates were calculated for age, gender, ethnicity, rurality, practice funding type and practice nurse (PN) to general practitioner (GP) ratio. RESULTS: The study included data from 78 practices and 6610 patients with Type 2 diabetes. Non-Maori and those aged 60 years and over were more likely to be retained in the programme. For practice factors, those with a higher PN to GP ratio had a significant retention advantage. Rurality and funding type was not shown to have a significant role in retention. DISCUSSION: Results support the view that both patient and practice factors influence a patients retention within the DAR programme. The PN to GP ratio may be an important factor in the retention of patients in a DAR programme and warrants further research and consideration when planning future primary care models. KEYWORDS: Chronic disease; diabetes mellitus; general practice; nurses; primary health care; rural health
44
Stuart, Keren Louise, Belinda Wyld, Kathryn Bastiaans, Nigel Stocks, Grant Brinkworth, Phil Mohr, and Manny Noakes. "A telephone-supported cardiovascular lifestyle programme (CLIP) for lipid reduction and weight loss in general practice patients: a randomised controlled pilot trial." Public Health Nutrition 17, no. 3 (March 4, 2013): 640–47. http://dx.doi.org/10.1017/s1368980013000220.
Повний текст джерелаАнотація:
AbstractObjectiveTo evaluate a primary prevention care model using telephone support delivered through an existing health call centre to general practitioner-referred patients at risk of developing CVD, using objective measures of CVD risk reduction and weight loss.DesignParticipants were randomised into two groups: (i) those receiving a telephone-supported comprehensive lifestyle intervention programme (CLIP: written structured diet and exercise advice, plus seven telephone sessions with the Heart Foundation Health Information Service); and (ii) those receiving usual care from their general practitioner (control: written general lifestyle advice). Fasting plasma lipids, blood pressure, weight, waist circumference and height were assessed on general practice premises by a practice nurse at Weeks 0 and 12.SettingTwo general practices in Adelaide, South Australia.SubjectsForty-nine men and women aged 48·0 (sd5·88) years identified by their general practitioner as being at future risk of CVD (BMI = 33·13 (sd5·39) kg/m2; LDL cholesterol (LDL-C) = 2·66 (sd0·92) mmol/l).ResultsCLIP participants demonstrated significantly greater reductions in LDL-C (estimated mean (EM)= 1·98 (se0·17) mmol/l) and total cholesterol (EM = 3·61 (se0·21) mmol/l) at Week 12 when compared with the control group (EM = 3·23 (se0·18) mmol/l and EM = 4·77 (se0·22) mmol/l, respectively). There were no significant treatment effects for systolic blood pressure (F(1,45) = 0·28,P= 0·60), diastolic blood pressure (F(1,43) = 0·52,P= 0·47), weight (F(1,42) = 3·63,P= 0·063) or waist circumference (F(1,43) = 0·32,P= 0·577).ConclusionsIn general practice patients, delivering CLIP through an existing telephone health service is effective in achieving reductions in LDL-C and total cholesterol. While CLIP may have potential for wider implementation to support primary prevention of CVD, longer-term cost-effectiveness data are warranted.
45
O’Regan, Andrew, Jane O’Doherty, Ray O’Connor, Walter Cullen, Vikram Niranjan, Liam Glynn, and Ailish Hannigan. "How do multi-morbidity and polypharmacy affect general practice attendance and referral rates? A retrospective analysis of consultations." PLOS ONE 17, no. 2 (February 3, 2022): e0263258. http://dx.doi.org/10.1371/journal.pone.0263258.
Повний текст джерелаАнотація:
Background As prevalence of multimorbidity and polypharmacy rise, health care systems must respond to these challenges. Data is needed from general practice regarding the impact of age, number of chronic illnesses and medications on specific metrics of healthcare utilisation. Methods This was a retrospective study of general practices in a university-affiliated education and research network, consisting of 72 practices. Records from a random sample of 100 patients aged 50 years and over who attended each participating practice in the previous two years were analysed. Through manual record searching, data were collected on patient demographics, number of chronic illnesses and medications, numbers of attendances to the general practitioner (GP), practice nurse, home visits and referrals to a hospital doctor. Attendance and referral rates were expressed per person-years for each demographic variable and the ratio of attendance to referral rate was also calculated. Results Of the 72 practices invited to participate, 68 (94%) accepted, providing complete data on a total of 6603 patients’ records and 89,667 consultations with the GP or practice nurse; 50.1% of patients had been referred to hospital in the previous two years. The attendance rate to general practice was 4.94 per person per year and the referral rate to the hospital was 0.6 per person per year, giving a ratio of over eight attendances for every referral. Increasing age, number of chronic illnesses and number of medications were associated with increased attendance rates to the GP and practice nurse and home visits but did not significantly increase the ratio of attendance to referral rate. Discussion As age, morbidity and number of medications rise, so too do all types of consultations in general practice. However, the rate of referral remains relatively stable. General practice must be supported to provide person centred care to an ageing population with rising rates of multi-morbidity and polypharmacy.
46
Jokanovic, Natali, Terry Haines, Allen C. Cheng, Kathryn E. Holt, Sarah N. Hilmer, Yun-Hee Jeon, Andrew J. Stewardson, et al. "Multicentre stepped-wedge cluster randomised controlled trial of an antimicrobial stewardship programme in residential aged care: protocol for the START trial." BMJ Open 11, no. 3 (March 2021): e046142. http://dx.doi.org/10.1136/bmjopen-2020-046142.
Повний текст джерелаАнотація:
IntroductionAntimicrobial resistance is a growing global health threat, driven by increasing inappropriate use of antimicrobials. High prevalence of unnecessary use of antimicrobials in residential aged care facilities (RACFs) has driven demand for the development and implementation of antimicrobial stewardship (AMS) programmes. The Stepped-wedge Trial to increase antibiotic Appropriateness in Residential aged care facilities and model Transmission of antimicrobial resistance (START) will implement and evaluate the impact of a nurse-led AMS programme on antimicrobial use in 12 RACFs.Methods and analysisThe START trial will implement and evaluate a nurse-led AMS programme via a stepped-wedge cluster randomised controlled trial design in 12 RACFs over 16 months. The AMS programme will incorporate education, aged care-specific treatment guidelines, documentation forms, and audit and feedback strategies that will target aged care staff, general practitioners, pharmacists, and residents and their families. The intervention will primarily focus on urinary tract infections, lower respiratory tract infections, and skin and soft tissue infections. RACFs will transition from control to intervention phases in random order, two at a time, every 2 months, with a 2-month transition, wash-in period. The primary outcome is the cumulative proportion of residents within each facility prescribed an antibiotic during each month and total days of antibiotic use per 1000 occupied bed days. Secondary outcomes include the number of courses of systemic antimicrobial therapy, antimicrobial appropriateness, antimicrobial resistant organisms, Clostridioides difficile infection, change in antimicrobial susceptibility profiles, hospitalisations and all-cause mortality. Analyses will be conducted according to the intention-to-treat principle.Ethics and disseminationEthics approval has been granted by the Alfred Hospital Human Research Ethics Committee (HREC/18/Alfred/591). Research findings will be disseminated through peer-reviewed publications, conferences and summarised reports provided to participating RACFs.Trial registration numberNCT03941509.
47
Gardner, Glenn, Anne Gardner, Sandy Middleton, Julie Considine, Gerard Fitzgerald, Luke Christofis, Anna Doubrovsky, Margaret Adams, and Jane O'Connell. "Mapping workforce configuration and operational models in Australian emergency departments: a national survey." Australian Health Review 42, no. 3 (2018): 340. http://dx.doi.org/10.1071/ah16231.
Повний текст джерелаАнотація:
Objective Hospital emergency departments (ED) in Australia and internationally have been experiencing increased demand, resulting in reduced hospital quality, impaired access and adverse health outcomes. Effective evaluation of new ED service models and their effect on outcomes is reliant on baseline measures of the staffing configuration and organisational characteristics of the EDs being studied. The aim of the present study was to comprehensively measure these variables in Australian EDs. Methods Australian hospital EDs with 24-h medical and nursing cover were identified and invited to participate in the study. Telephone interviews were conducted with nursing or medical department managers to collect data related to hospital characteristics, ED workforce and training and ED service and operational models. Results Surveys were completed in 87% of the population sample (n = 135). Metropolitan EDs were significantly more likely to retain higher full-time equivalents (FTEs) in several medical (staff specialist, registrar, resident and intern) and nursing (nurse practitioner (NP), nurse educator, nurse unit manager and registered nurse) positions. NPs were employed by 52% of Australian EDs overall, but this ranged from 40% to 75% depending on jurisdiction. The most commonly used operational models were FastTrack teams (72% of EDs), short-stay/observational unit (59%) and patient liaison models for aged care (84%) and mental health (61%). EDs that employed NPs were significantly more likely to use FastTrack (P = 0.002). Allied health services most frequently available within these EDs were radiology (60%), social work (69%), physiotherapy (70%) and pharmacy (65%). Conclusions The present study has established a baseline measure of the staffing configuration and organisational characteristics of Australian EDs. What is known about the topic? EDs are overcrowded due, in part, to the combined effect of increased service demand and access block. Innovative service and workforce models have been implemented by health departments aiming to improve service and performance. National uptake of these service and workforce innovations is unknown. What does this paper add? The present study is the most comprehensive to date profiling Australian EDs covering hospital characteristics, workforce configuration, operational models and NP service patterns and practice. What are the implications for practitioners? Information from the present study will assist health service planners to evaluate workforce and service reform models, and to monitor trends in emergency service development.
48
McCabe, Mary S., and Todd Alan Pickard. "Planning for the Future: The Role of Nurse Practitioners and Physician Assistants in Survivorship Care." American Society of Clinical Oncology Educational Book, no. 32 (June 2012): e56-e61. http://dx.doi.org/10.14694/edbook_am.2012.32.107.
Повний текст джерелаАнотація:
Overview: The number of cancer survivors in the United States now approaches 12 million individuals, with an estimated 7.2% of the general population aged 18 years or older reporting a previous cancer diagnosis. These figures highlight a number of questions about the care of survivors—how patients at risk for a known set of health problems should be followed, by whom, and for how long. At the same time that oncologists are developing strategies to provide services to this growing population, there are economic and systems challenges that have relevance to the previous questions, including a predicted national shortage of physicians to provide oncology services. Nurse practitioners (NPs) and physician assistants (PAs) have been identified as members of the health care team who can help reduce the oncology supply and demand gap in a number of ways. The ASCO Study of Collaborative Practice Arrangements (SCPA) in 2011 concluded that oncology patients were aware and satisfied when their care was provided by NPs and PAs; there was an increase in productivity in practices that utilized NPs and PAs; utilizing the full scope of practice of NPs and PAs was financially advantageous; and, physicians, NPs, and PAs are highly satisfied with their collaborative practices. Increasingly, the oncology and health policy literature contains evidence supporting innovative provider models. There is still much work to be done to move beyond pilot data to establish the true value of these models.
49
Lawton, Beverley, Sally Rose, C. Raina Elley, Collette Bromhead, E. Jane MacDonald, and Michael Baker. "Increasing the uptake of opportunistic chlamydia screening: a pilot study in general practice." Journal of Primary Health Care 2, no. 3 (2010): 199. http://dx.doi.org/10.1071/hc10199.
Повний текст джерелаАнотація:
INTRODUCTION: Genitourinary Chlamydia trachomatis infection is common and associated with considerable personal and public health cost. Effective detection strategies are needed. Aim: To assess feasibility of an opportunistic incentivised chlamydia screening programme in general practice over six months. METHODS: This study was designed as a pilot for a randomised controlled trial in primary care. Three general practices were randomly allocated to intervention (two practices) and control groups. The intervention involved practice education, self-sample collection and practice incentives (funding and feedback) for a three-month active intervention period. Feedback and education was discontinued during the second three-month period. Practice-specific nurse- or doctor-led strategies were developed for identifying, testing, treating and recalling male and female patients aged 1624 years. The main outcome measure was the difference between the practices chlamydia screening rates over the six months following introduction of the intervention, controlling for baseline rates from the previous year. RESULTS: Chlamydia testing rates during the year prior to the intervention ranged from 2.9% to 7.0% of practice attendances by 1624-year-olds. The intervention practices had higher rates of screening compared with the control practice (p<0.001) at three months, but both practices reverted to pre-intervention rates by six months. The nurse-led screening strategy was more effective (35% declining to 5.5% over six months) than the doctor-led strategy (15% declining to 1.6% over six months) (p=0.04). DISCUSSION: Incentivised opportunistic chlamydia screening of 1624-year-old patients attending their general practitioner with a programme involving practice education, feedback and self-sample collection can increase screening rates. KEYWORDS: Primary health care; chlamydia; mass screening; randomized controlled trial
50
Bosco, Elliott, Andrew Zullo, Kevin McConeghy, Patience Moyo, Robertus van Aalst, Ayman Chit, Vincent Mor, and Stefan Gravenstein. "LONG-TERM CARE FACILITY VARIATION IN THE INCIDENCE OF PNEUMONIA AND INFLUENZA HOSPITALIZATIONS." Innovation in Aging 3, Supplement_1 (November 2019): S821—S822. http://dx.doi.org/10.1093/geroni/igz038.3029.
Повний текст джерелаАнотація:
Abstract Pneumonia and influenza (P&I) increase morbidity and mortality among older adults, especially those residing in long-term care facilities (LTCFs). Facility-level characteristics may affect P&I risk beyond resident-level determinants. However, the relationship between facility characteristics and P&I is poorly understood. We therefore identified potentially modifiable facility-level characteristics that might influence the incidence of P&I across LTCFs. We conducted a retrospective cohort study using 100% of 2013-2015 Medicare claims linked to Minimum Data Set 3.0 and LTCF-level data. Short-stay (<100 days) and long-stay (≥100 days) LTCF residents aged ≥65 were followed for the first occurrence of hospitalization, LTCF discharge, Medicare disenrollment, or death. We calculated LTCF risk-standardized incidence rates (RSIRs) per 100 person-years for P&I hospitalizations by adjusting for over 30 resident-level demographic and clinical covariates using hierarchical logistic regression. The final study cohorts included 1,767,241 short-stay (13,683 LTCFs) and 922,863 long-stay residents (14,495 LTCFs). LTCFs with lower RSIRs had more Physician Extenders (Nurse Practitioners or Physician’s Assistants) among short-stay (44.9% vs. 41.6%, p<0.001) and long-stay residents (47.4% vs. 37.9%, p<0.001), higher Registered Nurse hours/resident/day among short-stay and long-stay residents (Mean (SD): 0.5 (0.7) vs. 0.4 (0.4), p<0.001), and fewer residents prescribed antipsychotics among short-stay (21.4% (11.6) vs. 23.6% (13.2), p<0.001) and long-stay residents (22.2% (14.3) vs. 25.5% (15.0), p<0.001). LTCF characteristics may play an important role in preventing P&I hospitalizations. Hiring more Registered Nurses and Physician Extenders, increasing staffing hours, and reducing antipsychotic use may be modifiable means of reducing P&I in LTCFs. Funding provided by Sanofi Pasteur.