Margaret Fry1,2, Casimir MacGregor3,4, Simone Hyland5, Barbara Payne6, Lynn Chenoweth7,8. 1. Northern Sydney Local Health District, Sydney, NSW, Australia. 2. School of Nursing, University of Sydney, Sydney, NSW, Australia. 3. Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia. 4. School of Social Science, Monash University, Melbourne, NSW, Australia. 5. Manly Hospital, Northern Sydney Local Health District, Sydney, NSW, Australia. 6. Mona Vale Hospital, Sydney, NSW, Australia. 7. University of Technology Sydney, Sydney, NSW, Australia. 8. Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia.
Abstract
AIMS AND OBJECTIVES: The study aimed to explore the practice of care among emergency nurses caring for older persons with cognitive impairment and who presented in pain from a long bone fracture, to highlight nurse confidence and self-efficacy in practice. BACKGROUND: Cognitive impairment is an issue increasingly facing emergency departments. Older persons with cognitive impairment have complex care needs, requiring effective clinical decision-making and provision of care. Nurse confidence and self-efficacy are critical to meeting the necessary standards of care for this vulnerable patient group. DESIGN: A multi-centre study. METHODS: The study was undertaken across four emergency departments in Sydney, Australia. Sixteen focus group discussions were conducted with 80 emergency departments of nurses. RESULTS: Four main themes emerged: confidence and self-efficacy through experience; confidence and self-efficacy as a balancing act; confidence and self-efficacy as practice; and confidence and self-efficacy and interpersonal relations. CONCLUSIONS: Our findings demonstrate that confidence, self-efficacy and reflexivity enabled the delivery of appropriate, timely and compassionate care. Further, confidence and self-efficacy within nursing praxis relied on clinical experience and reflective learning and was crucial to skill and knowledge acquisition. RELEVANCE TO CLINICAL PRACTICE: Our research suggests that confidence, self-efficacy and reflexivity need to be developed and valued in nurses' careers to better meet the needs of complex older persons encountered within everyday practice.
AIMS AND OBJECTIVES: The study aimed to explore the practice of care among emergency nurses caring for older persons with cognitive impairment and who presented in pain from a long bone fracture, to highlight nurse confidence and self-efficacy in practice. BACKGROUND:Cognitive impairment is an issue increasingly facing emergency departments. Older persons with cognitive impairment have complex care needs, requiring effective clinical decision-making and provision of care. Nurse confidence and self-efficacy are critical to meeting the necessary standards of care for this vulnerable patient group. DESIGN: A multi-centre study. METHODS: The study was undertaken across four emergency departments in Sydney, Australia. Sixteen focus group discussions were conducted with 80 emergency departments of nurses. RESULTS: Four main themes emerged: confidence and self-efficacy through experience; confidence and self-efficacy as a balancing act; confidence and self-efficacy as practice; and confidence and self-efficacy and interpersonal relations. CONCLUSIONS: Our findings demonstrate that confidence, self-efficacy and reflexivity enabled the delivery of appropriate, timely and compassionate care. Further, confidence and self-efficacy within nursing praxis relied on clinical experience and reflective learning and was crucial to skill and knowledge acquisition. RELEVANCE TO CLINICAL PRACTICE: Our research suggests that confidence, self-efficacy and reflexivity need to be developed and valued in nurses' careers to better meet the needs of complex older persons encountered within everyday practice.
Authors: Li-Fen Wu; Li-Fang Chang; Yu-Chun Hung; Chin Lin; Shiow-Jyu Tzou; Lin-Ju Chou; Hsueh-Hsing Pan Journal: Int J Environ Res Public Health Date: 2020-08-31 Impact factor: 3.390