Baumbusch Jennifer, Leblanc Marie-Eve, Shaw Maureen, Kjorven Mary
School of Nursing, University of British Columbia, Vancouver, BC, Canada.
Vancouver Acute, Vancouver General Hospital Site, Vancouver, BC, Canada.
Int J Older People Nurs. 2016 Jun;11(2):149-59. doi: 10.1111/opn.12109. Epub 2015 Dec 29.
To gain a better understanding of nurses' perspectives on factors that influence their readiness to provide appropriate care for hospitalised older people.
Hospitals have consistently been criticised for failing to address the unique, complex needs of older people. Research suggests that multiple issues have led to this situation, including a lack of educational preparation for nurses, limited attention to environmental factors, and an absence of organisational preparedness that ensures hospitals are adapted to meet the needs of older people.
An exploratory, qualitative approach was used.
Forty-one Registered Nurses participated (24 point-of-care nurses; 17 organisational leaders). Six focus groups and one individual interview were conducted. Thematic data analysis was employed to generate the main study findings.
An overarching theme of 'Poor Fit' emerged. While participants identified the shifting needs of patients towards more complex and relational care, the broader organisational and societal contexts were, largely, unchanging. This resulted in nurses recognising the factors needed to be ready to care for older patients and their families, but working in hospitals that were not suited to these needs.
The findings identify factors at the point-of-care, the organisational level, and in broader societal attitudes that shape nurses' readiness to care for hospitalised older people. However, many of these factors are modifiable and care for older people could be improved through quality improvement initiatives and nursing leadership. This study offers insight into ways to re-imagine nursing care that can be responsive to older people's complex needs in hospitals.
With a growing contingent of hospitalised older people, it is imperative that nurses, who comprise the largest workforce in this setting, be included in the planning and delivery of healthcare services to ensure readiness to meet the needs of this population.
更好地了解护士对影响其为住院老年人提供适当护理准备情况的因素的看法。
医院一直因未能满足老年人独特、复杂的需求而受到批评。研究表明，多种问题导致了这种情况，包括护士缺乏教育准备、对环境因素关注有限以及缺乏确保医院适应老年人需求的组织准备。
采用探索性定性研究方法。
41名注册护士参与研究（24名床边护士；17名组织领导者）。进行了6次焦点小组讨论和1次个人访谈。采用主题数据分析得出主要研究结果。
出现了一个总体主题“不匹配”。虽然参与者认识到患者需求向更复杂和注重关系的护理转变，但更广泛的组织和社会背景在很大程度上没有变化。这导致护士认识到为老年患者及其家属提供护理所需的因素，但却在不适合这些需求的医院工作。
研究结果确定了在床边护理层面、组织层面以及更广泛社会态度中影响护士为住院老年人提供护理准备情况的因素。然而，其中许多因素是可以改变的，通过质量改进举措和护理领导力可以改善对老年人的护理。本研究为重新构想能够响应医院中老年人复杂需求的护理方式提供了见解。
随着住院老年人数量的不断增加，至关重要的是，在规划和提供医疗服务时应纳入护士，因为护士是这一环境中最大的劳动力群体，以确保有能力满足这一人群的需求。
