A clinical trial of nurse practitioner care in residential aged care facilities

Arendts, Glenn; Deans, Pamela; O'Brien, Keith; Etherton‐Beer, Christopher; Howard, Kirsten; Lewin, Gill; Sim, Moira

doi:10.1016/j.archger.2018.05.001

Cited by 31 publications

(56 citation statements)

References 21 publications

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“…What is clear from this research supported by Arendts et al [10] is that a Nurse Practitioner does offer increased support for the PCW care staff and RNs. This coupled with the care guidelines has shown a change in PCW perceptions who indicated that they were now feeling supported and more certain in their role assessing and communicating resident issues.…”

Section: Discussionmentioning

confidence: 77%

“…Relevant information which should accompany the resident has been reported by authors like [22] Results reflected that using a NP model of care, meant returning residents were able to be integrated back into the RACF more successfully. The impact of a Nurse Practitioner clinical support on reducing presentations to the ED is not well defined in the literature, but is supported by [10], where they demonstrated improved resident quality of life with NP intervention compared to a control group.…”

Section: Discussionmentioning

confidence: 99%

“…Other researchers also listed recommendations regarding facility staffing, and improving advance directives [11]. Additional research supports Dwyer et al (11) outlining that the nurse practitioner role has real potential to function in an inter-professional manner, thus addressing the missing link manifesting in gaps in care across registered nurse and care worker roles [10].…”

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confidence: 90%

“…The voices stemming from current evidence clearly highlights the importance of the Nurse Practitioner (NP) role in supporting the growth of clinical confidence for RACF staff [10]. Arendts et al…”

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confidence: 99%

“…What is abundantly clear is that the lack of knowledge and skill mix [3], poor clarity or availability of clinical guidelines [6] the neglect towards the value of early cue recognition, care pathways for the PCWs discussed by Kontos et al [9], and the lack of a NP role as recommended by Arendis et al [10] are all leading to an over utilisation of emergency rooms and hospitals [12]. Amadoru et al [12] through qualitative enquiry suggest a stipulation of appropriately skilled nursing care for all residents as per accreditation requirements.…”

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confidence: 99%

See 4 more Smart Citations

The Residential Aged Care Nurse-Led After-Hours Initiative, Enhancing nurse assessment and decision making.

Moloney

Hunnik²,

Hope³

et al. 2019

Preprint

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Background Current staffing levels and current care standards have been linked to negative clinical outcomes for Residents in living in Residential aged care. Low levels of confidence have impounded a Registered Nurses ability to meet many acute challenges found in this environment. The utilisation of Emergency Department transfers for acute ill residents is an increasing epidemic. This research project aimed to contemporise, adapt, implement and evaluate a set of Clinical Practice Guidelines (CPGs) and a Nurse Practitioner Role in Residential Aged Care adapted with permission from Waitemata District Health Board New Zealand [1, 2]. The purpose of the CPGs was to empower clinical staff in Residential Aged Care Facilities (RACFs), to recognise early clinical deterioration, provide safe evidence based care to residents, and prevent unnecessary transfers of residents to an acute hospital emergency departments.Methods Action research was chosen for this research because it was not only cyclic/participative in nature, but it provided a progressive evaluation of the CPGs implementation and the current context as it related to past, progressive, and post implementation nurse decision making practices. A total of 4 Focus groups with an average of eight respondents were recruited to this study (Total participants, 16 RNs and 16 PCWs).Results Focus group data showed unequivocal evidence of increased confidence among staff in implementing the care guidelines, communicating with fellow professionals, and assessing incidents. The CPGs and NP intervention was successful in engaging staff and developing their confidence with assessment of acute resident issues. Additional longitudinal research is required to better understand the influences of these interventions on ED presentations.Conclusions Research needs to better explore the direct correlation between PCW knowledge, skills, and training, and a failure to rescue residents experiencing an adverse event. This should also encompass more research scrutiny on the impact of poor communication practices between PCWs and the RN. The role NPs play in reducing ED utilisation needs greater long term evaluation to better ascertain clinical care and economic benefits.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

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confidence: 90%

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confidence: 99%