Integrated older people care and advanced practice nursing: an evidence‐based review

Abstract

Aim: To critically appraise and synthesize evidence of integrated care stemming from advanced practice nursing in elderly primary care settings throughout the United States and Thailand. Background: Advanced practice nurses are key to accelerating integrated elderly care in the community. Yet, their scope and capacity vary greatly across countries, making impact measurement highly challenging. Methods: A systematic search of PubMed, CINAHL, Scopus and ThaiJo databases was performed. Full-text articles in English or Thai language were reviewed using an inductive thematic approach from the integrated people-centred Health Services framework, adopted by the World Health Organization. Results: A total of 42 articles were appraised according to framework strategies: (1) people and community empowerment/engagement;(2) governance and accountability strengthening; (3) model of care reorientation; (4) service coordination; and (5) enabling environment creation. Collaborative roles and empowerment of older people were associated with higher quality of care. Thai nurses empowered individuals through community networks and resources, incorporating care models (strategy 1). In contrast, US nurses adopted a quality improvement and safety approach, incorporating technology into nursing interventions (strategy 5). Conclusion: Advanced practice nurses employ an array of strategies and approaches in caring for older people. Although their role varies from mostly substitute (US) to supplemental (Thailand), nurses in both countries contribute towards integrated person-centred care. Implication for nursing practice and nursing policy: Preparing advanced practice nurses to work in the community is a prerequisite for meeting ageing population health needs in a sustainable manner. Education, professional development and leadership training opportunities should focus on capacity building in: a) strengthening mutual accountability, b) reorienting the work environment through innovative care models and c) coordinating services through partnerships to achieve universal health and ensure healthy ageing.

Relationships among basic psychological needs, organizational commitment, perceived authentic leadership and turnover intention in Korean nurses: A cross‐sectional study

“…The demand for advanced nursing care continues to increase with the aging of populations and the development of technology (Prajankett & Markaki, 2021); however, the turnover rate is still high at 8.8% to 37.0% (Haddad et al, 2021). Low nurse staffing levels are associated with patient safety risks and poor quality of care (Dewanto & Wardhani, 2018).…”

Information and Communication Technology Based Integrated Care for Older Adults: A Scoping Review

“…Integrated care refers to the management and provision of services to provide people with continuous health promotion, disease prevention, diagnosis, treatment, disease management, rehabilitation guidance and palliative care throughout their lives and to coordinate care at different levels and locations both within and outside the health sector [ 4 ], with the aim of improving the inability of low-quality, inefficient elderly service provision to meet the increasingly complex healthcare needs of older adults. As the ‘lubricant’ and ‘glue’ of integrated care systems, the effective use of ICT can increase access to and flow of information, increase work efficiency, improve care integration and management processes, address COVID-19 concerns and social isolation [ 5 ], and has been identified as an important enabler of integrated care delivery and coordination of primary health care [ 6 7 ].…”

Integrated care for older people based on information and communication technology: a scoping review protocol

“…Information and communication technologies (ICT) refer to various technological tools and resources used to transmit, store, create, share or exchange information, with the advantage of allowing information to be shared across professional and organisational boundaries and have been identified as an important enabler of integrated care and coordinated primary healthcare 14 15. The WHO’s Integrated Care for Older People (ICOPE) programme calls for digitally based integrated care to facilitate the Decade of Healthy Aging by enhancing integration, promoting functional capacity and reducing care dependency 16.…”