Kornelia Basinska1, Patrizia Künzler-Heule1,2, Raphaëlle Ashley Guerbaai1, Franziska Zúñiga1, Michael Simon1,3, Nathalie I H Wellens4, Christine Serdaly5, Dunja Nicca1,6. 1. Nursing Science (INS), Department Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland. 2. Department of Gastroenterology/Hepatology and Department of Nursing Development, Cantonal Hospital St. Gallen, St. Gallen, Switzerland. 3. Inselspital Bern University Hospital, Nursing Research Unit, Bern, Switzerland. 4. Department of Public Health and Social Affairs of the Canton of Vaud, Lausanne, Switzerland. 5. serdaly&ankers snc, Conches, Switzerland. 6. Department of Public & Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland.
Abstract
BACKGROUND AND OBJECTIVES: As new models of care aiming to reduce hospitalizations from nursing homes emerge, their implementers must consider residents' and relatives' needs and experiences with acute changes in the residents' health situations. As part of the larger INTERCARE implementation study, we explored these persons' experiences of acute situations in Swiss nursing homes. RESEARCH DESIGN AND METHODS: Three focus groups were conducted with residents and their relatives and analyzed via reflexive thematic analysis. RESULTS: The first theme, the orchestra plays its standards, describes experiences of structured everyday care in nursing homes, which functions well despite limited professional and competency resources. The second theme, the orchestra reaches its limits, illustrates accounts of acute situations in which resources were insufficient to meet residents' needs. Interestingly, participants' perceptions of acute situations went well beyond our own professional view, i.e., changes in health situations, and included situations best summarized as "changes that might have negative consequences for residents if not handled adequately by care workers." Within the third theme, the audience compensates for the orchestra's limitations, participants' strategies to cope with resource limitations in acute situations are summarized. DISCUSSION AND IMPLICATIONS: Our findings suggest differences between care providers' and participants' perspectives regarding acute situations and care priority setting. Alongside efforts to promote staff awareness of and responsiveness to acute situations, care staff must commit to learning and meeting individual residents' and relatives' needs. Implications for the development and implementation of a new nurse-led model of care are discussed.
BACKGROUND AND OBJECTIVES: As new models of care aiming to reduce hospitalizations from nursing homes emerge, their implementers must consider residents' and relatives' needs and experiences with acute changes in the residents' health situations. As part of the larger INTERCARE implementation study, we explored these persons' experiences of acute situations in Swiss nursing homes. RESEARCH DESIGN AND METHODS: Three focus groups were conducted with residents and their relatives and analyzed via reflexive thematic analysis. RESULTS: The first theme, the orchestra plays its standards, describes experiences of structured everyday care in nursing homes, which functions well despite limited professional and competency resources. The second theme, the orchestra reaches its limits, illustrates accounts of acute situations in which resources were insufficient to meet residents' needs. Interestingly, participants' perceptions of acute situations went well beyond our own professional view, i.e., changes in health situations, and included situations best summarized as "changes that might have negative consequences for residents if not handled adequately by care workers." Within the third theme, the audience compensates for the orchestra's limitations, participants' strategies to cope with resource limitations in acute situations are summarized. DISCUSSION AND IMPLICATIONS: Our findings suggest differences between care providers' and participants' perspectives regarding acute situations and care priority setting. Alongside efforts to promote staff awareness of and responsiveness to acute situations, care staff must commit to learning and meeting individual residents' and relatives' needs. Implications for the development and implementation of a new nurse-led model of care are discussed.
Authors: Jana Bartakova; Franziska Zúñiga; Raphaëlle-Ashley Guerbaai; Kornelia Basinska; Thekla Brunkert; Michael Simon; Kris Denhaerynck; Sabina De Geest; Nathalie I H Wellens; Christine Serdaly; Reto W Kressig; Andreas Zeller; Lori L Popejoy; Dunja Nicca; Mario Desmedt; Carlo De Pietro Journal: BMC Geriatr Date: 2022-06-09 Impact factor: 4.070
Authors: Franziska Zúñiga; Raphaëlle-Ashley Guerbaai; Sabina de Geest; Lori L Popejoy; Jana Bartakova; Kris Denhaerynck; Diana Trutschel; Kornelia Basinska; Dunja Nicca; Reto W Kressig; Andreas Zeller; Nathalie I H Wellens; Carlo de Pietro; Mario Desmedt; Christine Serdaly; Michael Simon Journal: J Am Geriatr Soc Date: 2022-02-05 Impact factor: 7.538