Nursing staff perceptions of physical function in hospitalized older adults.

Physical function is a common complication of hospitalized older adults, resulting in increased morbidity, mortality, institutionalization, and cost. Nursing staff play a central role in the hospital experience for older adults, including the promotion of physical function. Although quality geriatric care requires an organizational approach, there are no empirically based guidelines to promote the physical function of hospitalized older adults. A first step to develop an organizational intervention is to identify nursing staff perceptions of physical function, defined as basic activities of daily living (eating, dressing, toileting, transferring, bathing, and continence), in hospitalized older adults, including their beliefs about prevalence, risk factors, onset, effective interventions, and institutional barriers and facilitators to promoting physical function. Using purposive sampling, six focus groups yielding 55 participants were conducted at one of two sites, a suburban community hospital in New Jersey and an urban teaching hospital in New York, using a semistructured interview. Each site provided three focus groups composed of nursing staff cohorts as follows: two groups of registered nurses (staff nurses, managers, advanced practice nurses, and educators) and one group of patient care associates. There were important similarities identified in the themes of each group. Participants identified a system-level approach to preventing functional decline, including multimodal interventions and system-level enablers.