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Towards Innovation
The development of a person-centred model of care for older people in acute care
Carmel Peek
Service Manager, Division of Medicine, John Hunter Hospital, Hunter New England Health, Armidale NSW
Isabel Higgins
Clinical Nurse Consultant (OPAC), Research and Practice Dev; School of Nursing and Midwifery, University of Newcastle; Center for Practice Opportunity and Dev, John Hunter Hospital, Hunter New England Health, Newcastle NSW
Sally Milson-Hawke
Acting Deputy Service Manager, John Hunter Hospital, Hunter New England Health, NSW
Margaret McMillan
Professor and Deputy Executive Dean, Faculty of Health, University of Newcastle, Newcastle NSW
Deborah Harper
Nursing Unit Manager, John Hunter Hospital, Hunter New England Health, NSW
Abstract
That the population is ageing poses many challenges for health care planners. Some argue that these challenges, exacerbated by limited funding, maintaining increased community expectations and the need for quality health care outcomes, may be overcome by exploring alternate models of care. These ideas have led health planners to re-conceptualise contemporary philosophies of care with the current emphasis on multidisciplinary teams and a person-centred approach to care.
This paper presents a model for the care of older people in the acute care setting. The concepts for the development of the model were derived from the international literature. In the model the care of older people is underpinned by a philosophy of person-centeredness. The complex nature of care is represented along with those factors that enable a person-centred approach to be taken. The functions of the model in practice are highlighted and discussion of how it is being implemented within the acute care sector outlined.
Keywords
person centredness, acute care of older people, older person model of care, innovation
References
Australian Broadcasting Commission (12 Dec 2003) 19 deaths linked to inadequate hospital care, AM. Accessed at http://www.abc.net.au/am/content/2003/s1008621.htm on 4 June 2007.
Australian Broadcasting Commission (2003) Elderly abuse prompts Govt measures, 7.30 Report. Accessed at http://www.abc.net.au/7.30/content/2006/s1592672.htm on 4 June 2007.
Britton AM, Hogan-Doran JJ and Sidiqi N (2006) Multidisciplianry team interventions for the management of delirium in hospitalized patients (protocol). The Cochrane Collaboration, John Wiley & Sons.
Clark A, Hanson E and Ross H (2003) Seeing the person behind the patient: Enhancing the care of older people using biographical approach, Journal of Clinical Nursing 12(5): 697-706.
Cocker E (1998) Does your care plan tell my story? Documenting aspects of personhood in long-term care, Journal of Holistic Nursing 16: 435-452.
Courtney MP, Tong SP and Walsh AB (2000a) Older People in the Acute Care setting: Rural and Metropolitan Nurses' knowledge, attitudes and practices, Australian Journal of Rural Health 4: 102.
Courtney MP, Tong SP, and Walsh AB (2000b) Acute-care nurses' attitudes towards older patients: A literature review, International Journal of Nursing Practice 6: 62-69.
Dow B, Haralambous B, Bremmer F and Fearn M (2006) What is person centred care? A literature review, Victorian Government Department of Human Services, Melbourne Victoria.
Duckett S and Jackson T (2004) Do the elderly cost more? Casemix in the acute settings. In Nay R and Garratt S (eds) Nursing Older people: Issues and Innovations 2nd edn, pp.31- 40, Churchill Livingstone, Sydney.
Dunn A (2006) Nursing older people in hospital. In Redfern S and Moss F (eds) Nursing older people, Ch 8, Churchill Livingstone Elsevier, Melbourne
Farrell MJ (2000) Pain and aging. American Pain Society Bulletin 10(4): 1, 8-11.
Ford P and McCormack B (2000) Keeping the person in the centre of nursing, Nursing Standard 14(46): 40-44.
Fox PL, Parminder R and Jadad AR (1999) Prevalence and treatment of pain in older adults in nursing homes and other long term care institutions: a systematic review, Canadian Medical Association Journal 160(3): 329-333.
Garbett R and McCormack B (2004) A concept analysis of practice development. In McCormack B, Manley K and Garbett R (eds) Practice Development in Nursing, pp.10-32. Blackwell Publishing; Oxford.
Griffiths R and Crookes P (2006) Multidisciplinary teams. In Daly J, Speedy S and Jackson D Contexts of Nursing 2nd edn, pp.184-198, Churchill Livingston, Sydney.
Higgins I, Van der Reit P, Slater L and Peek C (2007) The negative attitudes and behaviours of nurses towards older patients in the acute hospital setting: A qualitative descriptive study. Contemporary Nurse 26(2) (in press).
Inouye S, Leo-Summers L, Zhang Y, Bogardus S, Leslie DL and Agostini MD (2005) A Chart-Based method for identification of delirium: validation compared with interviewer ratings using the confusion assessment method, American Geriatrics Society 53: 312-318.
Kitwood T (1997) Dementia reconsidered: The person comes first. Open University Press; Berkshire United Kingdom.
Manley K and McCormack B (2004) Practice development purpose, methodology, facilitation and evaluation. In McCormack B, Manley K and Garbett R (eds) Practice Development in Nursing, pp.33-50, Blackwell Publishing, Oxford.
McCormack B (2003a) Researching nursing practices: Does person centeredness matter? Nursing Philosophy 4: 179-188.
McCormack B (2003b. A conceptual framework for person-centred practice with older people. International Journal of Nursing Practice 9: 202-209.
McCormack B, Manley K and Garbett R (2004) Practice development in Nursing, Blackwell Publishing Oxford.
Nair B, O'Dea I Lim l and Thakkinstian A (2000) Prevalence of geriatric ‘syndromes' in a tertiary hospital. Australasian Journal on Ageing 19(2): 81-84.
Nay R (2004) Nursing workforce issues in aged care. In Nay R and Garratt S (eds) Nursing Older people: Issues and Innovations 2nd edn, pp.58-73, Churchill Livingstone, Sydney.
Nolan M (2001) Successful ageing: keeping the ‘person' in
person-centred care. British Journal of Nursing 10(7): 450. Accessed at
http://0-proquest.umi.com.library.newcastle.edu.au:80/pqdweb?
did=71678466&Fmt=4&clientld=29744&RQT=309&Vname=PQD
on 4 June 2007.
Nolan M, Davies S, Brown, J, Keady J and Nolan J (2002) Longitudinal study of the effectiveness of education preparation to meet the needs of older people and carers. The AGEIN (Advancing Gerontological Education in Nursing) Project, Final report. English national Board, London.
Standing Nursing and Midwifery Advisory Committee (SNMAC) (2001) Caring for older people: A nursing priority: Integrating knowledge, practice and values. Department of Health, United Kingdom.
Standing Nursing and Midwifery Advisory Committee (SNMAC) (2001) Practice Guidance: Principles standards and indicators: A resource tool: caring for older people: A nursing priority. Department of Health, United Kingdom.
Street P (2004) Acute care of older people: A geriatrician's perspective. In Nay R and Garratt S (eds) Nursing older people: Issues and innovations, pp.134-159, Churchill Livingstone, Sydney.
Stokes J (2004) Developing corporate strategy to develop effective and patient-centred care. In McCormack B, Manley K and Garbett R (eds) Practice Development in Nursing, pp.246-263, Blackwell Publishing, Oxford.
Talerico KA, O'Brien JA and Swafford KL (2003)
Person-centred care, Journal of Psychosocial Nursing & Mental Health Services
41(11): 12 accessed at
http://0proquest.umi.com.library.newcastle.edu.au:80/pqdweb?
did=463628791&Fmt=4&clientld=27944&RQTVName=PQD
on 4 June 2007.
Webster J and Cowart P (1999) An innovative professional nursing practice model, Nursing Administration Quarterly 23(3): 11-16.
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