Sufficient competence in community elderly care? Results from a competence measurement of nursing staff

Abstract

BackgroundMulti-morbidity, poly-pharmacy and cognitive impairment leave many old patients in a frail condition with a high risk of adverse outcomes if proper health care is not provided. Knowledge about available competence is necessary to evaluate whether we are able to offer equitable and balanced health care to older persons with acute and/or complex health care needs. This study investigates the sufficiency of nursing staff competence in Norwegian community elderly care.MethodsWe conducted a cross-sectional survey of 1016 nursing staff in nursing homes and home care services with the instrument “Nursing Older People – Competence Evaluation Tool”. Statistical analyses were ANOVA and multiple regression.ResultsWe found that nursing staff have competence in all areas measured, but that the level of competence was insufficient in the areas nursing measures, advanced procedures, and nursing documentation. Nursing staff in nursing homes scored higher than staff in home care services, and older nursing staff scored lower than younger nursing staff.ConclusionsA reason for the relatively low influence of education and training on competence could be the diffuse roles that nursing staff have in community elderly care, implying that they have poor standards against which to judge their own competence. Clearer role descriptions for all groups of nursing staff are recommended as well as general competence development in geriatric nursing care.

Økt spesialisering og differensieringi sykehjem

“…Denne problematikken tas også opp i dokumenter som omhandler kompetanseoppbygging etter innføring av Samhandlingsreformen. Det rapporters at kommunene i liten grad har styrket sin kompetanse (Riksrevisjonen, 2016), og at sykehjemmene har et udekket kompetansebehov (Bing-Jonsson, Hofoss, Kirkevold, Bjørk & Foss, 2016;Bruvik, Drageset & Abrahamsen, 2017). Dette kan føre til en ujevn fordeling av personell med spesialisert fagkompetanse ved at noen avdelinger får høyere dekning enn andre.…”

Registered Nurses’ and nurse assistants’ responses to older persons’ expressions of emotional needs in home care

“…Home care for older people involves care performed by nursing staff with different levels of education and training (Bing-Jonsson et al 2016). In Sweden, where this study was carried out, home care services are performed either by nurse assistants (NAs) or by registered nurses (RNs).…”

Not just “sweet old ladies” – Challenges in voluntary work in the municipal long-term care services

“…Recent studies show that service recipients in nursing homes and home care are increasingly frail older people characterised by multi-morbidities, cognitive failure and polypharmacy (Helvik, Engedal, & Selbaek, 2010;Selbaek, Kirkevold, & Engedal, 2008). This development leads to increased job demands and a need for more advanced nursing competence in nursing homes and home care (Bing-Jonsson, Hofoss, Kirkevold, Bjørk, & Foss, 2016;Bing-Jonsson, Bjørk, Hofoss, Kirkevold, & Foss, 2015;Tyrholm, Kvangarsnes, & Bergem, 2016). Seen against a service context that is becoming more task-driven and where nurses are expected to play an extended role in the medical management of residents, including the acute and critically ill, the capacity to meet the social needs of service users has become limited.…”