Critical Thinking

Purpose: This study aimed to determine the core competencies of Chinese gerontological nurse specialists and test the psychometric properties of a core competency self-evaluation instrument. Methods: This study consisted of 2 stages. A literature review, theoretical analysis, and the Delphi methods involving 28 experts were performed to identify the core competencies required of gerontological nurse specialists in China. Then, a self-evaluation instrument developed based on the results of stage I was tested among 225 certified gerontological nurse specialists. An exploratory factor analysis was applied to test the construct validity, and the content validity and reliability were also evaluated. Results: The core competencies of gerontological nurse specialists comprised 3 first-level domains, 9 second-level dimensions, and 69 third-level items. The average scale-level content validity, overall instrument’s Cronbach’s α, and test-retest reliability were 0.963, 0.983, and 0.834, respectively. The results of the exploratory factor analysis indicated that the factors in the 3 first-level domains (attitude, skill, and knowledge) explained 68.579%, 69.599%, and 75.872% of the variance, respectively. Conclusion: The results showed that the core competencies of Chinese gerontological nurse specialists were reliable and that gerontological nurse specialists could use this self-evaluation instrument to assess their core competencies.

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Changing Hospital Care For Older Adults: The Case for Geriatric Hospitals in the United States

Flaherty

Rodin

Morley

2022

Gerontology and Geriatric Medicine

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Hospital care of frail older adults is far from optimal. Although some geriatric models of care have been shown to improve outcomes, the effect size is small and models are difficult to fully implement, sustain and replicate. The two root causes for these shortcomings are competing interests (high revenue generating diseases, procedures and surgeries) and current hospital cultures (for example a culture of safety that emphasizes bed alarms and immobility rather than frequent ambulation). Geriatric hospitals would be hospitals completely dedicated to the care of frail older patients, a group which is most vulnerable to the negative consequences of a hospitalization. They would differ from a typical adult hospital because they could implement evidence based principles of successful geriatric models of care on a hospital wide basis, which would make them sustainable and allow for scaling up of proven outcomes. Innovative structural designs, unachievable in a typical adult hospital, would enhance mobility while maintaining safety. Financial viability and stability would be a challenge but should be feasible, likely through affiliation with larger health care systems with other hospitals because of cost savings associated with geriatric models of care (decreased length of stay, increased likelihood of discharge home, without increasing costs).

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Critical Thinking

Cited by 3 publications

References 11 publications

Continuing care for older patients during the transitional period

Continuing care for older patients during the transitional period

Instrument Development for Evaluation of Gerontological Nurse Specialists Core Competencies in China

Changing Hospital Care For Older Adults: The Case for Geriatric Hospitals in the United States

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