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Автор: Grafiati

Опубліковано: 10 грудня 2022

Оновлено: 29 січня 2023

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1

O'Connor, Margaret, and Janet Philips. "Challenges of implementing voluntary assisted dying in Victoria, Australia." International Journal of Palliative Nursing 26, no. 8 (December 2, 2020): 425–30. http://dx.doi.org/10.12968/ijpn.2020.26.8.425.

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Background: Staff working in community palliative care services are accustomed to the intimate conversations that a patient being at home can engender. Being at home can provide a safe space for a patient to express difficulties, including expressing a desire for hastened death. With the implementation of voluntary assisted dying in Victoria in mid-2019, palliative care services have needed to review and adapt policies and practices to incorporate this new procedure. While it was anticipated that a small percentage of people would request access to voluntary assisted dying, in the wake of such significant change, there were numerous implications for palliative care services to consider. This paper describes both the organisational and individual changes undertaken by one community-based palliative care service, in anticipation of legalised assistance in dying. The range of responses to the issues raised are discussed, in preparation for, and in the early days of, voluntary assisted dying.

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2

Miller, Elizabeth M., Joanne E. Porter, and Rebecca Peel. "Palliative and End-of-Life Care in the Home in Regional/Rural Victoria, Australia: The Role and Lived Experience of Primary Carers." SAGE Open Nursing 7 (January 2021): 237796082110362. http://dx.doi.org/10.1177/23779608211036284.

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Introduction Palliative support services (generalist or specialist) can provide much-needed assistance to carers who are providing palliative and end-of-life care in their homes, but access to such services in regional and rural areas of Australia is poorly understood. Objectives This study aimed to explore the role and lived experience of primary carers who are providing palliative and end-of-life care in the home in regional/rural Victoria, Australia. Methods Nine female participants, of whom six were bereaved between 7 and 20 months were interviewed using a semistructured interview technique. Each interview was audio-recorded, transcribed verbatim, and analyzed thematically. Results Two themes emerged: “ Negotiating healthcare systems” which described the needs for multidisciplinary supports and “ The caring experience” which discussed daily tasks, relationships, mental and physical exhaustion, respite, isolation, medication management, and grief and loss. Findings show that regional/rural carers have an added burden of travel stress as well as feeling overwhelmed, isolated, and physically and emotionally exhausted. Carers would benefit from greater flexibility for short-term respite care. The engagement of specialist palliative care services assisted the participants to navigate the health care system. Some participants did not understand the value of palliative care, highlighting the need for general practitioners to conduct early conversations about this with their patients. Education is needed to build capacity within the primary palliative care workforce, confirming the importance of timely referrals to a specialist palliative care practitioner if pain or symptom control is not effectively managed. Conclusion Providing palliative and end-of-life care in the home is an exhausting and emotionally draining role for unpaid, primary carers. Multiple supports are needed to sustain primary carers, as they play an essential role in the primary health care system.

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3

Boak, Jennifer, Irene Blackberry, and Tshepo Rasekaba. "Improving Detection of Client Complexity in the Community (Impact): A Study Protocol of a Pragmatic Randomized Controlled Trial." Methods and Protocols 4, no. 4 (October 6, 2021): 70. http://dx.doi.org/10.3390/mps4040070.

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Background: Community-dwelling older clients are becoming increasingly complex. Detecting this complexity in clinical practice is limited, with greater reliance on community nurses’ clinical judgment and skills. The lack of a consistent approach to complexity impacts the level of care and support for older clients to remain in their homes for longer. Objective: To examine the effectiveness of the Patient Complexity Instrument (PCI) in addition to nurses’ clinical judgment to enhance detection of complexity, and subsequent older clients’ resource allocation compared to usual nursing assessment. Design: A pragmatic randomized controlled trial will be conducted within a community nursing service in regional Victoria, Australia. Clients 65 years and over referred to the service who are eligible for Commonwealth Home Support Programme (CHSP) funding will be randomized into Control group: usual nursing assessment or Intervention group: usual nursing assessment plus the PCI. Nurse participants are Registered Nurses currently employed in the community nursing service. Results: This study will explore whether introducing the PCI in a community nursing service enhances detection of complexity and client care resource allocation compared to nurses’ clinical judgment based on usual nursing assessment. Conclusion: This protocol outlines the study to enhance the detection of complexity by nurses delivering care for community-dwelling older people in the regional Australian context. The findings will inform the use of a standardized tool to detect complexity among community-dwelling older Australians.

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4

McSweeney, K., and D. W. O'Connor. "Depression among newly admitted Australian nursing home residents." International Psychogeriatrics 20, no. 4 (August 2008): 724–37. http://dx.doi.org/10.1017/s104161020800700x.

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ABSTRACTBackground: This research concerns the prevalence and course of depression in newly admitted nursing home residents. We attempted to recruit consecutive admissions into the study, irrespective of cognitive status, enabling a comparison of the prevalence and course of depression experienced by cognitively intact residents and those exhibiting all levels of cognitive impairment.Method: Depression was assessed at one month, three months and six months post-admission. The assessment of mood in this study entailed the conduct of a semi-structured clinical interview, which encompassed DSM-IV criteria and Cornell Scale for Depression in Dementia (CSDD) items.Results: Recruitment difficulties resulted in a sample of 51 newly admitted residents, drawn from six nursing homes located in Victoria, Australia. Of particular interest, throughout the duration of the study, only the cognitively impaired were diagnosed with major depression (MD). One month post-admission, 24% of the sample were diagnosed with MD, and a further 20% evidenced a non-major depressive disorder. At the second and third assessments, MD was observed in 14% and 15% of residents, respectively. For residents who completed all three assessments, there was no appreciable change in the proportion diagnosed with a depressive disorder, nor was there a change in the levels of depressive symptomatology.Conclusion: Although subject to limitations, the current study indicated that clinical depression in nursing home facilities most often occurs in residents who also exhibit pronounced cognitive impairment. These depressions are unlikely to remit spontaneously. Accordingly, care staff and general practitioners must be trained in the identification of depression in dementia, and any interventions implemented in these facilities should be tailored to meet the unique needs of this group.

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5

Anderson, Fern, G. Michael Downing, Jan Hill, Lynn Casorso, and Noreen Lerch. "Palliative Performance Scale (PPS): A New Tool." Journal of Palliative Care 12, no. 1 (March 1996): 5–11. http://dx.doi.org/10.1177/082585979601200102.

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The Palliative Performance Scale (PPS), a modification of the Karnofsky Performance Scale, is presented as a new tool for measurement of physical status in palliative care. Its initial uses in Victoria include communication, analysis of home nursing care workload, profiling admissions and discharges to the hospice unit, and, possibly, prognostication. We assessed 119 patients at home, of whom 87 (73%) had a PPS rating between 40% and 70%. Of 213 patients admitted to the hospice unit, 175 (83%) were PPS 20%-50% on admission. The average period until death for 129 patients who died on the unit was 1.88 days at 10% PPS upon admission, 2.62 days at 20%, 6.70 days at 30%, 10.30 days at 40%, 13.87 days at 50%. Only two patients at 60% or higher died in the unit. The PPS may become a basis for comparing drug costs at home and for studying the effects of treatments (e.g. hypodermoclysis) at various levels of physical performance. Validity and reliability testing are currently being undertaken.

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6

Crock, Elizabeth, and Judy-Ann Butwilowsky. "The HIV Resource Nurse Role at the Royal District Nursing Service (Melbourne): Making A Difference for People Living with HIV/AIDS in the Community." Australian Journal of Primary Health 12, no. 2 (2006): 83. http://dx.doi.org/10.1071/py06026.

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The care of people living with HIV/AIDS in the home and community can be complex and challenging, requiring high levels of knowledge, skill, preparedness and, importantly, the ability to engage with people belonging to marginalised groups. In 2003, the Royal District Nursing Service (RDNS) HIV/AIDS Team in Victoria, Australia, developed the new role of HIV Resource Nurse at two RDNS centres in Melbourne serving high numbers of people living with HIV/AIDS. Drawing from two case studies and interviews with two HIV Resource Nurses from one of the centres, this paper describes this practice innovation. Benefits (including a positive impact on client engagement with services, client care, relationships with other health care workers and job satisfaction) are outlined, along with challenges in the implementation and evolution of the role. Strategies to sustain and develop the HIV Resource Nurse role are proposed.

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7

Primejdie, Daniela Petruta, Louise Mallet, Adina Popa, and Marius Traian Bojita. "Description of a systematic pharmaceutical care approach intended to increase the appropriateness of medication use by elderly patients." Medicine and Pharmacy Reports 87, no. 2 (July 1, 2014): 119–29. http://dx.doi.org/10.15386/cjmed-276.

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Background & Aims. The pharmaceutical care practice represents a model of responsible pharmacist involvement in the pharmacotherapy optimization of various population groups, including the elderly, known to be at risk for drug-related problems. Romanian pharmacists could use validated pharmaceutical care experiences to confirm their role as health-care professionals.This descriptive research presents the application in two real and different environments of practice of a structured pharmaceutical care approach conceived as the basis for a medication review activity and aiming at the identification and resolution of the drug related problems in the elderly.Patients and methods. Two patients with similar degree of disease-burden complexity, receiving care in different health-care environments (The Geriatric Ward of the Royal Victoria Hospital from the McGill University Health Centre in Montréal, Québec, Canada, in November 2010, and an urban nursing-home facility in Cluj-Napoca, Romania, in March 2011), were chosen for the analysis. One clinical pharmacist suggested solutions for the management of each of the active drug-related problems identified, using the systematic pharmaceutical care approach and specific published geriatric pharmacotherapy recommendations. The number of the drug-related problems identified and the degree of the care-team acceptance of the pharmacists’ solutions were noted for each patient.Results. The pharmacist found 6 active drug-related problems for the hospitalized patient (72 year-old, Chronic Disease Score 9) and 7 potential ones for the nursing-home resident (79 year-old, Chronic Disease Score 8), involving misuse, underuse and overuse of medications. Each patient had 3 geriatric syndromes at baseline. The therapy changes suggested by the pharmacist were implemented for the hospitalized patient, through collaboration with the health-care team. For the nursing home resident, the pharmacist identified the need for additional 6 medications and safety and efficacy arguments to cease 7 initial therapies, simplifying the therapeutic daily schedule (from 24 daily doses to 15).Conclusion. The pharmacist’s potential contribution to the optimization of the Romanian elderly patients’ pharmacotherapy needs further exploration, as potential drug related problems reported as characteristic for this population were easily identified. The presented structured and validated model of pharmaceutical care approach could be used to this end. Its dissemination and use could be encouraged along with the enhancement of pharmacotherapy information and care team collaboration skills.

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8

Ibrahim, Joseph E., Yingtong Li, Grace McKee, Hagar Eren, Charlotte Brown, Georgia Aitken, and Tony Pham. "Characteristics of nursing homes associated with COVID‐19 outbreaks and mortality among residents in Victoria, Australia." Australasian Journal on Ageing 40, no. 3 (July 19, 2021): 283–92. http://dx.doi.org/10.1111/ajag.12982.

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9

You, Emily Chuanmei, David Dunt, and Colleen Doyle. "Important Case Management Goals in Community Aged Care Practice and Key Influences." Care Management Journals 17, no. 1 (January 1, 2016): 47–60. http://dx.doi.org/10.1891/1521-0987.17.1.47.

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Aim: To investigate important case management goals and key influences on the achievement of the goals in community aged care practice from the perspectives of case managers in Australia.Methods: We surveyed 154 case managers, representing 17.1% of the target population in the State of Victoria, Australia. The key information collected was case managers’ characteristics and their selections of important case management goals. We also conducted 33 interviews with 47 case managers to explore their perceptions of important case-managed community aged care goals and the key influences on the achievement of these goals. Descriptive analysis, logistic regression, and qualitative thematic analysis were performed.Results: The survey findings showed that important case management goals included improving client outcomes, improving care quality, enhancing care coordination and accessibility, and reducing nursing home admissions. The interview findings indicated that important case management goals were divided into client-centered goals (e.g., maintaining clients safely at home), case managers’ personal goals (e.g., gaining professional development), and organizational goals/expectations/values (e.g., expecting case managers to manage budgets wisely). Finally, the mixed research methods determined constraints of organizational resources and policies, clients’ risky decisions, and case managers’ work experience and employment status as key influences or significant factors associated with the achievement of case management goals.Conclusion: Client-centered goals are of particular importance among those important case management goals. Case managers helping clients establish reasonable expectations and organizations developing favorable professional development policies and establishing reasonable job requirements and expectations will facilitate the achievement of case management goals.

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10

Li, Yingtong, Tony Pham, and Joseph E. Ibrahim. "Response to “Response to ‘Characteristics of nursing homes associated with COVID‐19 outbreaks and mortality among residents in Victoria, Australia’”." Australasian Journal on Ageing 41, no. 2 (June 2022): 346–49. http://dx.doi.org/10.1111/ajag.13050.

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11

Rosenberg, Ted, Patrick Montgomery, Vikki Hay, and Rory Lattimer. "Using frailty and quality of life measures in clinical care of the elderly in Canada to predict death, nursing home transfer and hospitalisation - the frailty and ageing cohort study." BMJ Open 9, no. 11 (November 2019): e032712. http://dx.doi.org/10.1136/bmjopen-2019-032712.

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ObjectiveTo assess the value of using frailty measures in primary care for predicting death, nursing home transfer (NHT) and hospital admission.DesignCohort study.Setting and participantsAll 380 people, mean age 88.4, living in the community and receiving home-based primary geriatric care from one practice in Victoria, Canada.Interventions/measurementsA 60 min baseline assessment which included: Clinical Frailty Scale (CFS), EuroQol EQ-5D-5L (EQ-5D), EuroQol Visual Analogue Scale (EQ-VAS) and Gait Speed (Gaitspeed).OutcomesDeath, NHT and hospital admission.ResultsDuring 18 months of follow-up, there were 39 (10.3%) deaths, 48 (12.6%) NHTs and 93 (24.5%) individuals admitted to hospital. All three outcomes were predicted by: CFS Level 6+7/4+5 (HR death 5.92, 95% CI 3.12 to 11.22, NHT 6.00, 95% CI 3.37 to 10.66 and hospital admission 2.92, 95% CI 1.93 to 4.40); EQ-5D Quintile 1/Quintile 5 (death 6.26, 95% CI 2.11 to 18.62; NHT 3.18, 95% CI 1.29 to 7.82 and hospital admission 2.94, 95% CI 1.47 to 5.87); EQ-VAS Q1/Q5 (death 7.0, 95% CI 2.34 to 20.93; NHT 3.38, 95% CI 1.22 to 9.35 and hospital admission 6.69, 95% CI 3.20 to 13.99) and Gaitspeed (death 5.87, 95% CI 1.78 to 19.34; NHT 8.51, 95% CI 3.18 to 22.79 and hospital admission 11.05, 95% CI 5.45 to 22.40). Medical diagnoses, multiple comorbidities and polypharmacy were weaker predictors of these outcomes. Cox regression analyses showed CFS (adjusted HR 2.88, 95% CI 1.23 to 6.68), EQ-VAS (0.96, 95% CI 0.93 to 0.98), estimated glomerular filtration rate (0.97, 95% CI 0.95 to 1.00) and haemoglobin (0.97, 95% CI 0.94 to 0.99) were independently associated with death. Gaitspeed (0.13, 95% CI 0.03 to 0.57), Geriatric Depression Scale (1.39, 95% CI 1.07 to 1.82) and dementia diagnosis (4.61, 95% CI 1.86 to 11.44) were associated with NHT. Only CFS (1.75, 95% CI 1.21 to 2.51) and EQ-VAS (0.98, 95% CI 0.96 to 0.99) were associated with hospital admission. No other diagnoses, polypharmacy nor multiple comorbidities predicted these outcomes.ConclusionsFor elderly people, standardised simple measures of frailty and health status were stronger predictors of death, NHT and hospital admission than medical diagnoses. Consideration should be given to adding these measures into usual medical care for this age group.

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12

Byram, D. M., and Matron Oak. "Nursing home care." Nursing Standard 3, no. 30 (April 22, 1989): 51. http://dx.doi.org/10.7748/ns.3.30.51.s69.

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13

Burger, Sarah. "Nursing Home Care." AJN, American Journal of Nursing 115, no. 2 (February 2015): 12. http://dx.doi.org/10.1097/01.naj.0000460665.42167.59.

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14

FOLTYN, PETER. "Nursing Home Care." Australian Dental Journal 56, no. 2 (May 30, 2011): 239. http://dx.doi.org/10.1111/j.1834-7819.2011.01336_1.x.

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15

Pera, Mary Kay, and E. Joyce Gould. "Home care nursing." Holistic Nursing Practice 3, no. 2 (February 1989): 9–17. http://dx.doi.org/10.1097/00004650-198902000-00005.

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16

Wood, James S. "Nursing Home Care." Clinics in Geriatric Medicine 2, no. 3 (August 1986): 601–15. http://dx.doi.org/10.1016/s0749-0690(18)30873-5.

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17

Schoen, Mary A. "Manual of Home Care Nursing Orientation; Orientation to Home Care Nursing." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 15, no. 5 (May 1997): 365. http://dx.doi.org/10.1097/00004045-199705000-00012.

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18

Tateishi, Akio. "An Invitation to Home Care Medicine: Cretical Care Nursing Versus Home Care Nursing." Journal of Japan Academy of Critical Care Nursing 12, no. 1 (2016): 21–30. http://dx.doi.org/10.11153/jaccn.12.1_21.

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19

Harris, Marilyn D. "Defining home care nursing." Home Healthcare Now 40, no. 1 (January 2022): 49. http://dx.doi.org/10.1097/nhh.0000000000001030.

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20

Foti, Sam. "Nursing home intermediate care." Working with Older People 8, no. 1 (March 2004): 17–20. http://dx.doi.org/10.1108/13663666200400006.

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21

Paulus, Aggie TG, Arno JA van Raak, and Femke B. Keijzer. "Nursing home care: whodunit?" Journal of Clinical Nursing 15, no. 11 (November 2006): 1426–39. http://dx.doi.org/10.1111/j.1365-2702.2005.01504.x.

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22

Kellog, Robah. "Home Care Nursing Handbook." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 5, no. 5 (September 1987): 48. http://dx.doi.org/10.1097/00004045-198709000-00014.

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23

Frantz, Ann. "Prognosis: Home Care Nursing." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 15, no. 12 (December 1997): 876–77. http://dx.doi.org/10.1097/00004045-199712000-00012.

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24

Babalis, Sandra. "Home Care Nursing: Satisfaction." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 16, no. 5 (May 1998): 352. http://dx.doi.org/10.1097/00004045-199805000-00020.

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25

&NA;. "Home Health Care Nursing." AJN, American Journal of Nursing 86, no. 6 (June 1986): 770–71. http://dx.doi.org/10.1097/00000446-198606000-00036.

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&NA;. "Home Health Care Nursing." AJN, American Journal of Nursing 86, no. 6 (June 1986): 770–71. http://dx.doi.org/10.1097/00000446-198686060-00036.

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Rose, Molly A. "Home care nursing practice." Holistic Nursing Practice 3, no. 2 (February 1989): 1–8. http://dx.doi.org/10.1097/00004650-198902000-00004.

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Fortunato, Nancy M. "Home Health Care Nursing." AORN Journal 52, no. 2 (August 1990): 420. http://dx.doi.org/10.1016/s0001-2092(07)68180-0.

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Graham, Barbara A. "Home Health Care Nursing." Family & Community Health 14, no. 1 (April 1991): 80–81. http://dx.doi.org/10.1097/00003727-199104000-00014.

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Samuelson, Darlene. "Home Care Nursing Services." Journal for Nurses in Staff Development (JNSD) 14, no. 3 (May 1998): 160. http://dx.doi.org/10.1097/00124645-199805000-00011.

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Paquette, Cindy. "Rural Home Care Nursing." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 23, no. 7 (July 2005): 472. http://dx.doi.org/10.1097/00004045-200507000-00020.

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Shuster, George F., and Patricia A. Cloonan. "Home Health Nursing Care." Home Health Care Services Quarterly 12, no. 1 (May 6, 1991): 23–36. http://dx.doi.org/10.1300/j027v12n01_04.

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Bowman, C. E., and E. Bynon. "Private nursing home care." BMJ 296, no. 6627 (April 2, 1988): 1000–1001. http://dx.doi.org/10.1136/bmj.296.6627.1000-a.

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Lynch, J. B. "Private nursing home care." BMJ 296, no. 6627 (April 2, 1988): 1001. http://dx.doi.org/10.1136/bmj.296.6627.1001.

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Ariya-Nayagam, P. "Private nursing home care." BMJ 296, no. 6627 (April 2, 1988): 1001. http://dx.doi.org/10.1136/bmj.296.6627.1001-a.

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Philp, I., and W. J. Mutch. "Private nursing home care." BMJ 296, no. 6627 (April 2, 1988): 1001. http://dx.doi.org/10.1136/bmj.296.6627.1001-b.

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Fletcher, P. J., and D. G. MacMahon. "Private nursing home care." BMJ 296, no. 6630 (April 23, 1988): 1195–96. http://dx.doi.org/10.1136/bmj.296.6630.1195-d.

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MacWalter, R. S., and S. Shridhar. "Private nursing home care." BMJ 296, no. 6630 (April 23, 1988): 1196. http://dx.doi.org/10.1136/bmj.296.6630.1196.

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39

Baker, Sonia. "HOME CARE." Nursing Clinics of North America 34, no. 1 (March 1999): 201–12. http://dx.doi.org/10.1016/s0029-6465(22)02370-2.

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40

Helberg, June L. "Factors influencing home care nursing problems and nursing care." Research in Nursing & Health 16, no. 5 (October 1993): 363–70. http://dx.doi.org/10.1002/nur.4770160507.

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Marek, Karen Dorman. "Nursing Diagnoses and Home Care Nursing Utilization." Public Health Nursing 13, no. 3 (June 1996): 195–200. http://dx.doi.org/10.1111/j.1525-1446.1996.tb00240.x.

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Shaw, Penelope Ann. "Nursing Assistants and Quality Nursing Home Care." Journal of the American Medical Directors Association 15, no. 9 (September 2014): 609. http://dx.doi.org/10.1016/j.jamda.2014.06.010.

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NAKAZAWA, H. "Nursing Apparatus for Home Care." JAPANES JOURNAL OF MEDICAL INSTRUMENTATION 62, no. 11 (November 1, 1992): 534–38. http://dx.doi.org/10.4286/ikakikaigaku.62.11_534.

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44

Makin, Andrew. "Care home nursing is undervalued." Nursing Standard 18, no. 3 (October 1, 2003): 30. http://dx.doi.org/10.7748/ns.18.3.30.s44.

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