Multidisciplinary perceptions of the role of nurses and healthcare assistants in rehabilitation of older adults in acute health care

Abstract

Journal of Clinical Nursing 15, 1418-1425Multidisciplinary perceptions of the role of nurses and healthcare assistants in rehabilitation of older adults in acute health care Aim. This paper describes the perceptions of nurses, healthcare assistants, doctors and therapists of rehabilitation and the role of nurses and healthcare assistants on an acute older adults ward in a London teaching hospital. Background. The role perception, education and training and attitudes towards the older adults have been identified as barriers that have an impact upon the nurses' role within rehabilitation. However, little is known about the role of nurses and healthcare assistants in rehabilitation of older adults in acute health care. Design. Action research study. Method. Twenty-four semi-structured interviews were conducted and audio recorded about healthcare professionals' understanding of rehabilitation, the type of skills needed and their perceptions of the role of nurses and healthcare assistants in rehabilitation. The interview transcripts were analysed using the thematic content analysis. Results. The findings suggest that the therapists relied on nurses and healthcare assistants for therapy carry-over. Healthcare assistants were perceived as the professional group who could deliver therapy carry-over. There was an evidence of role hierarchy as healthcare assistants perceived that they were not actively involved in decision-making or discharge planning. Conclusion. This paper suggests that healthcare assistants and nurses are viewed as the professional group best placed to deliver therapy carry-over. However, whilst there is an acknowledgement of their role, there remains a reluctance to acknowledge healthcare assistants as a professional group and to involve them within decision-making and discharge planning Relevance to clinical practice. Employers must be seen to advocate, support and implement education and training programs for healthcare assistants. However, 1418Ó 2006 Blackwell Publishing Ltd whilst nurses and healthcare assistants have an integral role in rehabilitation, there needs to be more research into the how they are supported by therapy professionals.

Tool validation: Health professionals’ perception of the role for a cardiac rehabilitation program

“…Similar to findings from other studies, this study suggests that nurses, physicians and physiotherapists have all recognized the crucial role of CRP in the holistic care provided to patient after cardiac events [28] .…”

“…thrombolysis, PTCA, CABG). And then discharge occurs while patients are seeking information about the disease and the prospects of life with this new condition [28] . Shorter in-hospital stays also diminish the opportunities to counsel patients about risk reduction and exercise.…”

Nurses’ perceptions of their role in rehabilitation of the older person

“…Globally, the number of people aged over 65 is increasing, but increasing life expectancy is often viewed with pessimism (Atwal et al 2006). The needs of this population group and the provision of services appropriate to their needs must be considered.…”

“…The needs of this population group and the provision of services appropriate to their needs must be considered. Services cannot be implemented without skilled and dynamic nurses (Atwal et al 2006), because care has moved from an illness-orientated to a health and person-centred service (Department of Health and Children (DoHC) 2001). The provision of high quality care in a cost-effective and efficient manner is a priority in Ireland (DoHC 2001(DoHC , 2003, National Council for the Professional Development of Nursing and Midwifery 2008).…”

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“…However, as the increased use of paraprofessionals is now seen as a cost effective method to address the problem of under resourced, over-subscribed health and social care services, there are multiple implications for this group of workers. As support workers shoulder more of the front line work there is an increasing requirement for their systematic development in both health (Atwal, Tattersall et al 2006) and social care (Moss et. al, 2006).…”