Long term care nursing competence and related factors among Taiwanese nurses: A national survey for those who completed the LTC training course

Hsieh, Pei-Lun; Chen, Ching Min

doi:10.1016/j.gerinurse.2016.10.010

Cited by 18 publications

(18 citation statements)

References 20 publications

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“…For factors within the health care system, it can be an indication of poor community and residential care quality. Unfortunately, training capacity for related workforce and the overall infrastructure for elderly care still require much improvement 16,17 . Another factor might be the present reimbursement policies that prohibit prolonged admission stays, generating earlier discharge of patients and increased subsequent ED visits.…”

Section: Discussionmentioning

confidence: 99%

Emergency Department Visits and Disease Burden Attributable to Ambulatory Care Sensitive Conditions in Elderly Adults

Hsieh

Chiang

et al. 2019

Sci Rep

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Many countries worldwide are aging rapidly, and the complex care needs of older adults generate an unprecedented demand for health services. Common reasons for elderly emergency department (ED) visits frequently involve conditions triggered by preventable infections also known as ambulatory care sensitive conditions (ACSCs). This study aims to describe the trend and the associated disease burden attributable to ACSC-related ED visits made by elderly patients and to characterize their ED use by nursing home residence. We designed a population-based ecological study using administrative data on Taiwan EDs between 2002 and 2013. A total of 563,647 ED visits from individuals aged 65 or over were examined. All elderly ED visits due to ACSCs (tuberculosis, upper respiratory infection, pneumonia, sepsis, cellulitis and urinary tract infection (UTI)) were further identified. Subsequent hospital admissions, related deaths after discharge, total health care costs and disability-adjusted life years (DALYs) were compared among different ACSCs. Prevalence of ACSCs was then assessed between nursing home (NH) residents and non-NH residents. Within the 12-year observation period, we find that there was a steady increase in both the rate of ACSC ED visits and the proportion of elderly with a visit. Overall, pneumonia is the most prevalent among six ACSCs for elderly ED visits (2.10%; 2.06 to 2.14), subsequent hospital admissions (5.77%; 5.59 to 5.94) and associated mortality following admission (17.37%; 16.74 to 18.01). UTI is the second prevalent ACSC consistently across ED visits (2.02%; 1.98 to 2.05), subsequent hospital admissions (2.36%, 2.25 to 2.48) and mortality following admission (10.80%; 10.28 to 11.32). Sepsis ranks third highest in the proportion of hospitalization following ED visit (2.29%; 2.18 to 2.41) and related deaths after hospital discharge (7.39%; 6.95 to 7.83), but it accounts for the highest average total health care expenditure (NT$94,595 ± 120,239; ≈US$3185.02) per case. When examining the likelihood of ACSC-attributable ED use, significantly higher odds were observed in NH residents as compared with non-NH residents for: pneumonia (adjusted odds ratio (aOR): 5.01, 95% confidence interval (CI) 4.50–5.58); UTI (aOR: 4.44, 95% CI 3.97–4.98); sepsis (aOR: 3.54, 95% CI 3.06–4.10); and tuberculosis (aOR: 2.44, 95% CI 1.63–3.65). Here we examined the ACSC-related ED care and found that, among the six ACSCs studied, pneumonia, UTI and sepsis were the leading causes of ED visits, subsequent hospital admissions, related mortality, health care costs and DALYs in Taiwanese NH elderly adults. Our findings suggest that efficient monitoring and reinforcing of quality of care in the residential and community setting might substantially reduce the number of preventable elderly ED visits and alleviate strain on the health care system.

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Section: Discussionmentioning

confidence: 99%

Emergency Department Visits and Disease Burden Attributable to Ambulatory Care Sensitive Conditions in Elderly Adults

Hsieh

Chiang

et al. 2019

Sci Rep

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“…Professional Role Competence. https://www.nursi ngwor ld.org/ pract ice-polic y/nursi ng-excel lence/ offic ial-posit ionst ateme nts/id/profe ssion al-role-compe tence/ Choi & Kim, 2014;Faraji et al, 2019;Feliciano et al, 2019;Hsieh & Chen, 2017;Karami et al, 2017;Khodadadei et al, 2016;Kim & Choi, 2019;Meretoja et al, 2015;Numminen et al, 2013;Wangensteen et al, 2012 2. Age 8 3,855 0.21 a 0.11-0.31 7 52.04 (<.001) 87.55 Choi & Kim, 2014;Faraji et al, 2019;Khodadadei et al, 2016;Kim & Choi, 2019;Numminen et al, 2013;Wangensteen et al, 2012 3.…”

Section: Clinical Resourcementioning

confidence: 99%

“…Age 8 3,855 0.21 a 0.11-0.31 7 52.04 (<.001) 87.55 Choi & Kim, 2014;Faraji et al, 2019;Khodadadei et al, 2016;Kim & Choi, 2019;Numminen et al, 2013;Wangensteen et al, 2012 3. Marital status 7 1,441 0.18 b 0.13-0.23 6 3.05 (0.801) .00 Feliciano et al, 2019;Hsieh & Chen, 2017;Karami et al, 2017;Kim & Choi, 2019;Mirlashari et al, 2016 4. Educational level 5 1,134 0.19 b 0.13-0.24 4 3.37 (.497) .00 Faraji et al, 2019;Istomina et al, 2011;Kim & Choi, 2019…”

Section: Clinical Resourcementioning

confidence: 99%

Factors Related to the Clinical Competence of Registered Nurses: Systematic Review and Meta‐Analysis

Gunawan

Aungsuroch

Fisher

et al. 2020

J of Nursing Scholarship

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Today's health care is rapidly changing due to issues such as complex changes of disease structures, diverse needs of people, aging populations, low birthrates, and technological developments (Fukada, 2018; Karami, Farokhzadian, & Foroughameri, 2017). These complex conditions are a challenge for health practitioners, including nurses. Regardless of work setting, nurses are expected to increase their competence in nursing practice to ensure patient safety and security, to maintain quality care, and to improve nursing outcomes in their unit (Fukada, 2018). It is unarguable that the clinical competence of registered nurses is a fundamental element in the delivery of nursing care. Although competence has been widely discussed in the literature, there is still a degree of ambiguity in its definition. The number of concept analyses demonstrates the complexity of the concept (Garside & Nhemachena, 2013; Smith, 2012; Valloze, 2009). The definition of competence varies in different countries. In the United Kingdom, competence refers to the ability to do tasks within an occupation (Audenaert, Vanderstraeten, Buyens, & Desmidt, 2014), while in the United States, competence is defined as the individual characteristics and behaviors needed to perform required activities (Spencer & Spencer, 2008).

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“…Preceptorship can be beneficial for nurses’ professional development (Marks‐Maran et al, ; Muir et al, ). Nurses with more LTC experiences had a higher level of nursing competencies (Chuang & Kuo, ; Hsieh & Chen, ). Moreover, attitudes can be learned by imitating other nurses (Price, ).…”

Section: Discussionmentioning

confidence: 99%

“…Preceptorship can be beneficial for nurses' professional development Muir et al, 2013). Nurses with more LTC experiences had a higher level of nursing competencies (Chuang & Kuo, 2018;Hsieh & Chen, 2017).…”

Section: Discussionmentioning

confidence: 99%

Nurses’ perceptions regarding providing psychological care for older residents in long‐term care facilities: A qualitative study

Kuo

Wang

Tsai

et al. 2019

Int J Older People Nursing

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Aims and objectives To explore nurses' perceptions regarding providing psychological health care for older residents in long‐term care facilities (LTCFs). Background Loneliness and depressive symptoms are commonly observed among older residents living in LTCFs. Nurses are expected to provide holistic care including physical, psychological and social care for older residents in LTCFs to fulfil their needs. Therefore, understanding nurses' feelings and thoughts regarding providing care for older residents who feel lonely, sad, unhappy or depressed is important for delivering better care. Design A qualitative research design was employed. The Standards for Reporting Qualitative Research (SRQR) was used to enhance for reporting quality. Methods Purposive sampling and snowball sampling were applied in Northern Taiwan. One‐to‐one in‐depth interviews were conducted using a semi‐structured interview guide. Twenty‐one nurses with a mean age of 38.4 years were interviewed. Content analysis was performed for data analysis. Findings Four themes were generated from the data: “insufficient psychological healthcare competency,” “having a willing heart but not adequate support,” “families playing an essential role in residents’ mood” and “physical‐oriented care model.” Conclusions Long‐term care facilitie nurses felt that they were not adequately prepared for taking care of older adults' psychological problems before their nursing career or during their practice. Unreasonable nurse‐to‐resident ratios and an absence of care consensus among healthcare providers can make nurses feel that they have a willing heart but not adequate support. Family members are essential in older residents' emotional status within the Taiwanese cultural context. Physical care evaluation indicators emphasised by LTCF accreditation resulted in the current care practice model. Implications for practice This study provides valuable information for LTCF nurses, managers and directors to develop appropriate strategies to assist nurses in providing better psychological health care for older residents. Evaluation indicators required by LTCF accreditation in Taiwan must be re‐examined at the earliest stage.

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Long term care nursing competence and related factors among Taiwanese nurses: A national survey for those who completed the LTC training course

Cited by 18 publications

References 20 publications

Emergency Department Visits and Disease Burden Attributable to Ambulatory Care Sensitive Conditions in Elderly Adults

Emergency Department Visits and Disease Burden Attributable to Ambulatory Care Sensitive Conditions in Elderly Adults

Factors Related to the Clinical Competence of Registered Nurses: Systematic Review and Meta‐Analysis

Nurses’ perceptions regarding providing psychological care for older residents in long‐term care facilities: A qualitative study

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