Leadership and registered nurses (<scp>RN</scp>s) working after‐hours in Residential Aged Care Facilities (<scp>RACF</scp>s): A structured literature review

Nhongo, Dorika; Hendricks, Joyce; Bradshaw, Julie; Bail, Kasia

doi:10.1111/jocn.14565

Cited by 18 publications

(21 citation statements)

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“…[1]. States of the heart equipment are needed for the diagnose CHD according to Nhongo, Hendricks, Bradshaw, & Bail, [4], another factor worsening the effect of the disease in Nigeria is the country is far behind in the doctor patient ratio. The novel COVID-19 is another reason for tackling CHD because worst hit victims are those with underlining illness, especially CVDs, but the good news about the disease is that you don't have to compulsorily undergo clinical diagnosis before identifying the disease, since it can be predicted from indicators [5], which is why Machine Learning is used in this field to forecast and diagnose the disease.…”

Section: Fig 1 Coronary-artery-diseasementioning

confidence: 99%

An Improved Coronary Heart Disease Predictive System Using Random Forest

Abdul

Isiaka

Babatunde

et al. 2021

AJRCoS

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Aims: This work aim is to develop an enhanced predictive system for Coronary Heart Disease (CHD). Study Design: Synthetic Minority Oversampling Technique and Random Forest. Methodology: The Framingham heart disease dataset was used, which was collected from a study in Framingham, Massachusetts, the data was cleaned, normalized, rebalanced. Classifiers such as random forest, artificial neural network, naïve bayes, logistic regression, k-nearest neighbor and support vector machine were used for classification. Results: Random Forest outperformed other classifiers with an accuracy of 98%, a sensitivity of 99% and a precision of 95.8%. Feature selection was employed for better classification, but no significant improvement was recorded on the performance of the classifier with feature selection. Train test split also performed better that cross validation. Conclusion: Random Forest is recommended for research in Coronary Heart Disease prediction domain.

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Section: Fig 1 Coronary-artery-diseasementioning

confidence: 99%

An Improved Coronary Heart Disease Predictive System Using Random Forest

Abdul

Isiaka

Babatunde

et al. 2021

AJRCoS

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“…Research on leadership in aged care is still a relatively new concept, and while much has been done on leadership in health care, the unique complexities of the aged care sector and its continued separation from the greater health sector have meant they have had limited success in adopting general health care leadership models (Backman et al., 2017; McGilton et al., 2013). There have also been a limited work undertaken in preparing aged care workers for leadership roles, and a lack of well‐defined standards or strategies developed to evaluate leadership capability in the aged care sector (Nhongo et al., 2018; Pagone & Briggs, 2021).…”

Section: Introductionmentioning

confidence: 99%

Residential aged care leadership in Australia—Time for a compassionate approach: A qualitative analysis of key leader skills and attributes

2021

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Aims To examine the perceptions of leadership by leaders within residential aged care and to identify the crucial requirements for successful leadership in this complex industry. Background As an industry capitalizing on the concept of ‘care’, one of the critical attributes this research has found to be absent in many aged care leadership approaches is compassion. Methods A qualitative methodology using thematic analysis was used to explore the construction of leadership attributes needed within residential aged care, as perceived by leaders in these organisations. Results Senior staff in the aged care industry believe that compassion is both a key component and a gap in the skill set of aged care leadership and leaders. While most studies define good leadership and care in relation to clinical ‘safety’ and ‘efficiency’, this research demonstrates that compassionate caring is central to high‐quality care in residential aged care. Conclusions The aged care industry needs to enhance and encourage compassionate leadership as a cornerstone of humane and dignified care. Implications for Nursing When developing theoretical explanations for the role of leadership in aged care, researchers should contemplate compassion as a key attribute required in residential aged care leaders. Education and training in this industry must incorporate the attributes associated with compassion, including emotional intelligence and person‐centred leadership.

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“…What is apparent is that residential aged care is in crisis and the role standards play needs a rethink [6]. If current staffing levels and current care standards are leading to negative clinical outcomes, surely some welldeveloped guidelines for care should provide support for a positive learning organisation which results in safe, and effective quality care [8,10].…”

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confidence: 99%

“…Research shows that RNs working in the aged care sector have received hampered opportunities to develop and build clinical competencies [8]. Due to this restriction for growth in knowledge and skill evidence from Nhongo et al [8] suggests low levels of confidence impound aged care Registered Nurses and they therefore may be ill prepared to meet many acute clinical challenges found in this environment. The aged care act 1997 have iterated terms such as "appropriate" and "skilled" to determine staffing and skill mix [1].…”

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confidence: 99%

“…Minimal publications have addressed the importance of clinical confidence in this cohort of RNs. The lack of these clinical attributes greatly affects capacity and capability with assessment and care planning thereby leading to failures in individualized care, continuity of care, rescue from deterioration and gaps in essential health care information [1,8]. This gap between planning and delivery also appears to have its origins within the role that PCWs play in assessment and communication of resident issues [9].…”

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The Residential Aged Care Nurse-Led After-Hours Initiative, Enhancing nurse assessment and decision making.

Moloney

Hunnik²,

Hope³

et al. 2019

Preprint

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Background Current staffing levels and current care standards have been linked to negative clinical outcomes for Residents in living in Residential aged care. Low levels of confidence have impounded a Registered Nurses ability to meet many acute challenges found in this environment. The utilisation of Emergency Department transfers for acute ill residents is an increasing epidemic. This research project aimed to contemporise, adapt, implement and evaluate a set of Clinical Practice Guidelines (CPGs) and a Nurse Practitioner Role in Residential Aged Care adapted with permission from Waitemata District Health Board New Zealand [1, 2]. The purpose of the CPGs was to empower clinical staff in Residential Aged Care Facilities (RACFs), to recognise early clinical deterioration, provide safe evidence based care to residents, and prevent unnecessary transfers of residents to an acute hospital emergency departments.Methods Action research was chosen for this research because it was not only cyclic/participative in nature, but it provided a progressive evaluation of the CPGs implementation and the current context as it related to past, progressive, and post implementation nurse decision making practices. A total of 4 Focus groups with an average of eight respondents were recruited to this study (Total participants, 16 RNs and 16 PCWs).Results Focus group data showed unequivocal evidence of increased confidence among staff in implementing the care guidelines, communicating with fellow professionals, and assessing incidents. The CPGs and NP intervention was successful in engaging staff and developing their confidence with assessment of acute resident issues. Additional longitudinal research is required to better understand the influences of these interventions on ED presentations.Conclusions Research needs to better explore the direct correlation between PCW knowledge, skills, and training, and a failure to rescue residents experiencing an adverse event. This should also encompass more research scrutiny on the impact of poor communication practices between PCWs and the RN. The role NPs play in reducing ED utilisation needs greater long term evaluation to better ascertain clinical care and economic benefits.

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Leadership and registered nurses (RNs) working after‐hours in Residential Aged Care Facilities (RACFs): A structured literature review

Abstract: Registered nurses working in the aged care setting after-hours need access to leadership education. Better quality of care, improved resident outcomes and reduced adverse events are associated with sound leadership.

Cited by 18 publications

References 44 publications

An Improved Coronary Heart Disease Predictive System Using Random Forest

An Improved Coronary Heart Disease Predictive System Using Random Forest

Residential aged care leadership in Australia—Time for a compassionate approach: A qualitative analysis of key leader skills and attributes

The Residential Aged Care Nurse-Led After-Hours Initiative, Enhancing nurse assessment and decision making.

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