International Perspectives of Care for Older Adults in the ED: Voices of Emergency Department Nurses

2.50
Hdl Handle:
http://hdl.handle.net/10755/243425
Category:
Abstract
Type:
Presentation
Title:
International Perspectives of Care for Older Adults in the ED: Voices of Emergency Department Nurses
Author(s):
Cadogan, Mary; Phillips, Linda; Ziminski, Carolyn; Gallagher, Robyn
Author Details:
Cadogan, Mary, DrPH, RN, GNP, mcadogan@sonnet.ucla.edu; Phillips, Linda, PhD; Ziminski, Carolyn, RN, BSN; Gallagher, Robyn , RN, BA, MN, PhD;
Abstract:
Purpose: Although Emergency Departments (ED) are frequent sites of care for older adults and often are associated with post-ED adverse events, little is known from the perspectives of ED nurses about their experience providing care for rapidly increasing numbers of older adults.   As part of two larger studies exploring issues in the care of older adults in the ED, the purpose of this study was to compare the perceptions of ED nurses from two large urban hospitals (in Los Angeles, USA and Sydney, Australia).  Nurses who spoke English and worked in the ED for at least 6 months were eligible to participate. The final sample of 46 nurses (19 USA and 27 Australia) was 28% male, with ED experience ranging from 1-33 years.

 Methods: A qualitative, descriptive methodology was used with focus groups (group size 4=8) to collect data at each site. Interviews were semi-structured focusing on nurses’ expectations and experiences of providing care to elders. Interviews were tape recorded, transcribed verbatim and data analyzed using constant comparative analysis to produce categories and major themes.

 Results: The overarching theme common across sites was the mismatch between expectations and reality. Four subthemes (with some differences between groups) were identified. These included: 1) lack of congruence between perceived nursing role expectations and needs of elders; 2) care complexity related to the co-occurrence of advanced illness, multiple co-morbidities and geriatric conditions; 3) multiple competing agendas resulting from system limitations, needs of older patients and families, and expectations of other ED patients and staff; and 4) increased time demands associated with evaluation and management of non-urgent yet challenging problems. 

Conclusion: ED nurses in two different care systems perceive many similar challenges and constraints in providing care for older adults. New models that support culture change and gerontological innovation within the ED are needed.  

Keywords:
Chronic Care Nursing; Emergency Nursing; Geriatric Nursing
Repository Posting Date:
12-Sep-2012
Date of Publication:
12-Sep-2012
Conference Date:
2012
Conference Name:
23rd International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Brisbane, Australia

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleInternational Perspectives of Care for Older Adults in the ED: Voices of Emergency Department Nursesen_GB
dc.contributor.authorCadogan, Maryen_GB
dc.contributor.authorPhillips, Lindaen_GB
dc.contributor.authorZiminski, Carolynen_GB
dc.contributor.authorGallagher, Robynen_GB
dc.author.detailsCadogan, Mary, DrPH, RN, GNP, mcadogan@sonnet.ucla.edu; Phillips, Linda, PhD; Ziminski, Carolyn, RN, BSN; Gallagher, Robyn , RN, BA, MN, PhD;en_GB
dc.identifier.urihttp://hdl.handle.net/10755/243425-
dc.description.abstract<b>Purpose: </b>Although Emergency Departments (ED) are frequent sites of care for older adults and often are associated with post-ED adverse events, little is known from the perspectives of ED nurses about their experience providing care for rapidly increasing numbers of older adults. &nbsp;&nbsp;As part of two larger studies exploring issues in the care of older adults in the ED, the purpose of this study was to compare the perceptions of ED nurses from two large urban hospitals (in Los Angeles, USA and Sydney, Australia). &nbsp;Nurses who spoke English and worked in the ED for at least 6 months were eligible to participate. The final sample of 46 nurses (19 USA and 27 Australia) was 28% male, with ED experience ranging from 1-33 years. <p>&nbsp;<b>Methods: </b>A qualitative, descriptive methodology was used with focus groups (group size 4=8) to collect data at each site. Interviews were semi-structured focusing on nurses&rsquo; expectations and experiences of providing care to elders.<b> </b>Interviews were tape recorded, transcribed verbatim and data analyzed using constant comparative analysis to produce categories and major themes. <p>&nbsp;<b>Results: </b>The overarching theme common across sites was the mismatch between expectations and reality. Four subthemes (with some differences between groups) were identified. These included: 1) lack of congruence between perceived nursing role expectations and needs of elders; 2) care complexity related to the co-occurrence of advanced illness, multiple co-morbidities and geriatric conditions; 3) multiple competing agendas resulting from system limitations, needs of older patients and families, and expectations of other ED patients and staff; and 4) increased time demands associated with evaluation and management of non-urgent yet challenging problems.&nbsp; <p><b>Conclusion: </b>ED nurses in two different care systems perceive many similar challenges and constraints in providing care for older adults. New models that support culture change and gerontological innovation within the ED are needed. &nbsp;en_GB
dc.subjectChronic Care Nursingen_GB
dc.subjectEmergency Nursingen_GB
dc.subjectGeriatric Nursingen_GB
dc.date.available2012-09-12T09:22:06Z-
dc.date.issued2012-09-12-
dc.date.accessioned2012-09-12T09:22:06Z-
dc.conference.date2012en_GB
dc.conference.name23rd International Nursing Research Congressen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationBrisbane, Australiaen_GB
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