Fry et al 2015(a) AustraliaEmergency nurses'perceptions of the role ofconfidence, self-efficacyand reflexivity inmanaging the cognitivelyimpaired older person inpainExploratory qualitativestudy. PurposivesamplingPart of a multicentrestudy that reportedfindings from 16 focusgroups across 4 EDsTo explore practice ofcare among ED nursescaring for older peoplewith cognitiveimpairment whopresented in pain froma long bone fractureFocus groups (4)Nvivo 9.2Thematic analysisCI is a barrier to painmanagement andoften leads tosuboptimal carebecause of lack ofverbal response. EDnurses need high levelsof confidence and self-Being confident andhaving self-efficacy canhelp ED nurses todevelop a moretherapeuticrelationship with theolder person with CIand their family22with 80 ED nurseparticipantsefficacy (ability to act)to initiate and deliverhigh-quality care forthis groupmembers. Confidenceand self-efficacy iscentral to caring and acompassionateapproach. Need foreducation and clinicalexposure to developconfidence and self-efficacy
Question
Fry et al 2015(a) AustraliaEmergency nurses'perceptions of the role ofconfidence, self-efficacyand reflexivity inmanaging the cognitivelyimpaired older person inpainExploratory qualitativestudy. PurposivesamplingPart of a multicentrestudy that reportedfindings from 16 focusgroups across 4 EDsTo explore practice ofcare among ED nursescaring for older peoplewith cognitiveimpairment whopresented in pain froma long bone fractureFocus groups (4)Nvivo 9.2Thematic analysisCI is a barrier to painmanagement andoften leads tosuboptimal carebecause of lack ofverbal response. EDnurses need high levelsof confidence and self-Being confident andhaving self-efficacy canhelp ED nurses todevelop a moretherapeuticrelationship with theolder person with CIand their family22with 80 ED nurseparticipantsefficacy (ability to act)to initiate and deliverhigh-quality care forthis groupmembers. Confidenceand self-efficacy iscentral to caring and acompassionateapproach. Need foreducation and clinicalexposure to developconfidence and self-efficacy
Solution
The text you provided is a summary of a study conducted by Fry et al in 2015 in Australia. The study is an exploratory qualitative study that used purposive sampling. It was part of a multicentre study that reported findings from 16 focus groups across 4 Emergency Departments (EDs).
The aim of the study was to explore the practice of care among ED nurses caring for older people with cognitive impairment who presented in pain from a long bone fracture. The study used focus groups and Nvivo 9.2 for thematic analysis.
The study found that cognitive impairment is a barrier to pain management and often leads to suboptimal care because of the lack of verbal response. ED nurses need high levels of confidence and self-efficacy (ability to act) to initiate and deliver high-quality care for this group.
Being confident and having self-efficacy can help ED nurses to develop a more therapeutic relationship with the older person with cognitive impairment and their family members. Confidence and self-efficacy are central to caring and a compassionate approach. The study suggests the need for education and clinical exposure to develop confidence and self-efficacy. The study involved 22 participants with 80 ED nurse participants.
Similar Questions
Fry et al 2015(b) AustraliaTitle Emergency nurses'perceptions of the role offamily/carers in caring forcognitively impaired olderpersons in pain: adescriptive qualitativestudyQualitative descriptivestudyPurposive samplingSee above (Fry et al,2015a)To understand EDnurses' perceptions ofthe role offamily/carers for oldercognitively impairedpersons experiencingpain as a result of along bone fractureFocus groups (4)Nvivo 9.2Thematic analysis(Gibbs, 2007)ED nurses perceivethat family members:were valuable inassisting staff to buildthe clinical picture onarrival in the ED; canprovide criticalinformation thatwould otherwise beunknown; reducenegative impact of theED environment onpatientIf family memberswere not present, thisadded to the workloadof nurses who couldnot deliver the carethe person with CIrequiredWorry and stress forfamily members. EDnurses expect familymembers to provideFamily members arethe hidden workforce.Collaboration betweenfamily members andnurses needs furtherexploration. Role offamily members in EDis sometimes unclearMore research neededto determine familymembers' perceptionsof emergency care
Parke et al 2013 CanadaFacilitators and barriers tosafe emergencydepartment transitionsfor community-dwellingolder people withdementia and theircaregivers: a socialecological studyInterpretive,qualitative exploratorydesignPurposive samplingParticipants were: PWDplus familymember/carer (6)Carers (4) ED nurses(10) Nurse practitioners(4)To identify factors thatimpede/facilitate safetransitional care forPWD in the ED. Toidentify potentialsolutions that wouldsupport nurses toprovide sensitive careThree phases:interviews; creation ofa photographicnarrative journal;photo-elicitation focusgroups. Verbatimtranscription. NvivoConstant comparativeanalysisBeing under-triaged;time pressures; lack ofattention to basicneeds; feeling ignored,forgotten andunimportant. Triagesystem in the ED doesnot recognise atypicalpresentations—sets inmotion a cascade ofvulnerability of olderPWD. Family membersvalue the relationalaspects of care—recognition ofvulnerability,communication,interactions withnursesNurses should beadvocates forrelationship-centredcareNurses need supportto carry out bestpracticeDifficult to recruitolder people withdementia to the studybecause of effects ofdiseaseNeed for researchabout contextNeed for research thatfocuses on what workswell and wh
Hunter et al, 2017 CanadaBalancing safety andharm for older adults withdementia in ruralemergency departments:health professionals'perspectivesInterpretative,descriptive exploratorydesign: social ecologicalperspectivePurposive/snowballingsamplingTo understand safetyand harm in rural EDtransitional care forcommunity-dwellingolder adults withdementia fromperspectives of HPs.HPs asked to describetheir experiences ofworking with olderpeople with dementiaand their caregivers inED2 small rural EDs (95inpatient beds/76inpatient beds)12 healthprofessionals: nurses,social worker,occupational therapist,physiotherapist,medicsSemi-structuredinterviewsHP perspectives: ED ischallenging for olderpeople with dementia.Chaotic andovercrowded. Thisgroup not a prioritydue to priorities ofemergency care. HPsometimes too busy togive proper care to thisgroup. Competingpressures in triage.HPs experience moraldistress when theycannot provide carethat they should beable to give. Negativeconsequences: no safespace, no quietenvironment. HPssensitive to familymember situation.Need to look at olderpeople with dementiaand family member asa complete package—obligations to bothSmall ED can be ofbenefit: potential toget older person withdementia out of EDfaster due to goodcommunity links.Disadvantages: makingassumptions orbecoming complacentabout patients whoare well known to HPsMaking things better:more resources,valuing contribution offamily members whocould provide care inED. Changing triageapproach to olderpeople with dementia,getting to know theperson beyond thesuperficial, betterdischarge planning
Patient’s ability to engage in rational discussion about treatment outcomes is partof which elderly assessment? *(-/1 Point)25.IntellectualRationalCognitiveIntuitive
Watkins et al, 2019IrelandAppreciative inquiry:discovery phaseTo generate insightsabout what mattersand is valued by familySingle site, large EDPhase 1: data analysisFamily members (15)EDPhase 1: data analysisFamily members (15)Older people withdementia did not take24Caring for an older personwith dementia in theemergency department(ED): An appreciativeinquiry exploring familymember and ED nurseexperiencesmembers of olderpeople with dementiain the ED and tocapture theexperiences of EDnurses looking afterolder people withdementia in anepisode of careED nurses (12)Participant observation(30 hours)Semi-structuredinterviewsThematic analysisED nurses (12)Participantobservation (30 hours)Semi-structuredinterviewsThematic analysisTwo themes:what matters to familymembers; challengesfor family membersand nurses in ED. Beingtriaged quicklyenhances experiences.Triage nurse underpressure to seeeverybody as fast aspossible. Priority hasto be given to heartattacks/strokes.Cubicle space offerssanctuary. Familymembers fear wayolder person withdementia mightbehave in a chaoticenvironment. Risk ofbecoming a publicspectacle. ‘Conveyorbelt’ nursing. EDnurses remote frompersonal contact.Some ED nursesmanaging to integratepart as in advancedstate of the diseaseModification of triagesystem required toprioritise older peoplewith dementia.Increased educationfor nurses about theneed for familymember insights. EDnurses need to find away to blend technicaland relational aspectsof care. Some EDnurses doing this.Need to find a way tomake this happenmore frequently
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