Changing to primary nursing in a nursing home in Finland: experiences of residents, their family members and nurses

Bauer

2006

Int J EB Healthcare

Background Modern healthcare philosophy espouses the virtues of holistic care and acknowledges that family involvement is appropriate and something to be encouraged due to the role it plays in physical and emotional healing. In the aged care sector, the involvement of families is a strong guarantee of a resident's well-being. The important role family plays in the support and care of the older adult in the residential aged care environment has been enshrined in the Australian Commonwealth Charter of Residents' Rights and Responsibilities and the Aged Care Standards of Practice. Despite wide acknowledgement of the importance of family involvement in the healthcare of the older adult, many barriers to the implementation of participatory family care have been identified in past research. For older adults in the healthcare environment to benefit from the involvement of their family members, healthcare professionals need an understanding of the issues surrounding family presence in the healthcare environment and the strategies to best support it. Objectives The objectives of the systematic review were to present the best available evidence on the strategies, practices and organisational characteristics that promote constructive staff-family relationships in the care of older adults in the healthcare setting. Specifically this review sought to investigate how staff and family members perceive their relationships with each other; staff characteristics that promote constructive relationships with the family; and interventions that support staff-family relationships. Search strategy A literature search was performed using the following databases for the years 1990-2005: Ageline, APAIS Health, Australian Family and Society Abstracts (FAMILY), CINAHL, Cochrane Library, Dare, Dissertation Abstracts, Embase, MEDLINE, PsycINFO and Social Science Index. Personal communication from expert panel members was also used to identify studies for inclusion. A second search stage was conducted through review of reference lists of studies retrieved during the first search stage. The search was limited to published and unpublished material in English language. Selection criteria The review was limited to studies involving residents and patients within acute, subacute, rehabilitation and residential settings, aged over 65 years, their family and healthcare staff. Papers addressing family members and healthcare staff perceptions of their relationships with each other were considered for this review. Studies in this review also included those relating to interventions to promote constructive staff-family relationships including organisational strategies, staff-family meetings, case conferencing, environmental approaches, etc. The review considered both quantitative and qualitative research and opinion papers for inclusion. Data collection and analysis All retrieved papers were critically appraised for eligibility for inclusion and methodological quality independently by two reviewers, and the same reviewers collected details of eligible...

Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

“…

The residents did not feel that changed to primary nursing had significantly affected then nursing care. (p. 478) 70 Well there hasn’t been any change in our care . .…”

Section: Resultsmentioning

confidence: 99%

“…it’s the same. (p. 478) 70 Family members noticed a change mainly in nurses’ behaviour, but there were hardly any real changes reported in their cooperation with nurses. (p. 481) 70 …”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Factors associated with constructive staff?family relationships in the care of older adults in the institutional setting

Bauer

2006

Int J EB Healthcare

Effectiveness of staffing models in residential, subacute, extended aged care settings on patient and staff outcomes

Hodgkinson¹,

Cochrane Database of Systematic Reviews

et al. 2011

Effectiveness of staffing models in residential, subacute, extended aged care settings on patient and staff outcomes (Review) Effectiveness of staffing models in residential, subacute, extended aged care settings on patient and staff outcomes. Hodgkinson A B S T R A C T BackgroundA key concern for managers and nurse administrators of healthcare settings is staffing. Determining and maintaining an appropriate level and mix of staff is especially problematic for those working in the long-term aged-care sector, where resident needs are complex and recruitment and retention of staff is challenging. ObjectivesTo identify which staffing models are associated with the best patient and staff outcomes. Search methodsWe searched the Effective Practice and Organisation of Care (EPOC) Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) and the Database of Abstracts of Reviews of Effectiveness (DARE) in The Cochrane Library and the databases MEDLINE, EMBASE, Ageline, CINAHL, and Dissertation abstracts. We also handsearched the reference lists and bibliographies of all retrieved articles. Selection criteriaThis review considered interrupted time series studies and studies with concurrent control designs of care staff or residents of residential or subacute or extended aged-care settings that evaluated the effectiveness of staffing models and skill mixes on resident and care staff outcomes. Data collection and analysisTwo review authors critically appraised all studies that were retrieved based on the screening of titles and abstracts according to the EPOC Group's data collection checklist.The same two review authors independently extracted and summarised details of eligible studies using the data abstraction form developed by EPOC. Main resultsWe included two studies (one interrupted time series and one controlled before-and-after study); both evaluated a primary-care model compared with a either a team-nursing model or a usual-care model. The primary-care model was found to provide slightly better results than the comparator for some outcomes such as resident well-being or behaviour. While nursing staff favoured the primarycare model in one study, neither study found significant improvements in staff outcomes using the primary model compared with the comparator. One study evaluated the uptake of the primary-care model within their facilities and found incorporation of this model into their practice was limited. Authors' conclusionsApart from two small studies evaluating primary care, no evidence in the form of concurrently controlled trials could be identified. While these two studies generally favour the use of primary care, the research designs of both ITS and CBA studies are considered prone to bias, specifically selection and blinding of participants and assessors. Therefore, these studies should be regarded with caution and there is little clear evidence for the effective use of any specific model of care in residential aged care to benefit either residents or care staff. Research in thi...

Staff–family relationships in the care of older people: A report on a systematic review

Bauer

Research in Nursing & Health

2007

This article reports on a systematic review of the strategies, practices, and organizational characteristics that promote constructive staff-family relationships in the care of older adults in the health care setting. Research evidence points to the need to address power and control issues, communication, and collaborative approaches to care. Interventions designed to promote family-staff relationships are more likely to achieve maximum benefit when implemented with accompanying information sharing, education, and managerial support.