Scoping review of medical assessment units and older people with complex health needs

Rushton, Carole; Crilly, Julia; Adeleye, Adeniyi O; Grealish, Laurie; Beylacq, Mandy; Forbes, Mark

doi:10.1111/ajag.12353

Cited by 5 publications

(4 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The delivery of care on in our study was similar to other MAPUs and patient discharges occurred within 48‐72 hours . The regulated timeline to provide patient care in this setting highlights the need for nurses to maximise each opportunity to connect and develop a relationship with patients and their family .…”

Section: Discussionsupporting

confidence: 52%

Patient and family members’ perceptions of family participation in care on acute care wards

Mackie

Mitchell

Marshall

2018

Scandinavian Caring Sciences

View full text Add to dashboard Cite

Background Hospital leaders, policymakers and healthcare professionals are realising the benefits of delivering care that promotes family participation because it is known to enhance the quality of care, and improve patient satisfaction. Aim The aim of this study was to explore, from the perspective of patients and family members within an adult acute care ward: (a) their beliefs and attitudes towards family participation in patient care and (b) staff behaviours that support or hinder family participation in patient care. Design and methods A naturalistic approach with an exploratory sequential design was used in a medical assessment and planning unit of a regional referral hospital in Australia. Purposeful maximum variation sampling was used to recruit patients and family members who differed in age, ethnicity, relationship to patient and gender. Observer‐as‐participant observation data and semi‐structured interviews were undertaken. Following separate inductive content analysis, data were triangulated. Results Thirty‐two patients and 26 family members were recruited. Thirty hours of observational data were gathered. Eighteen patients and 15 family members were interviewed. Analysis uncovered two contrasting categories: (a) disconnected communication and (b) family influence quality. Conclusion The findings of our study demonstrated that most patients and families perceived staff communication as disconnected and inadequate, which constrained them from engaging in care processes or decision‐making. However, when family felt empowered and participated in patient care, the quality of health care was enhanced. Healthcare professionals can use these findings to make informed evidence‐based changes to the way they practice and communicate to ensure family participation in patient care is optimised in the acute care setting.

show abstract

Section: Discussionsupporting

confidence: 52%

Patient and family members’ perceptions of family participation in care on acute care wards

Mackie

Mitchell

Marshall

2018

Scandinavian Caring Sciences

View full text Add to dashboard Cite

show abstract

“…The traditional model of acute medical care often involves hospital admission. To address the high level of bed occupancy, different entries for acute patients have emerged facilitating more flexible and dynamic bed management [6] with a proliferation of observation and assessment units [7, 8]. These entries comprise a wide variety of forms and allow patients to be observed on a short-term basis without using inpatient facilities [9, 10].…”

Section: Introductionmentioning

confidence: 99%

Converting acute inpatient take to outpatient take with fast-track assessment in internal medicine wards – a before-after study

Bell

Fredberg

Schlünsen

et al. 2019

BMC Health Serv Res

View full text Add to dashboard Cite

Background With an extensive rise in the number of acute patients and increases in both admissions and readmissions, hospitals are at times overcrowded and under immense pressure and this may challenge patient safety. This study evaluated an innovative strategy converting acute internal medicine inpatient take to an outpatient take. Here, acute patients, following referral, underwent fast-track assessment to the needed level of medical care as outpatients, directly in internal medicine wards. Method The two internal medicine wards at Diagnostic Centre, Silkeborg, Denmark, changed their take of acute patients 1st of March 2017. The intervention consisted of acute medical patients being received in medical examination chairs, going through accelerated evaluation as outpatients with assessment within one hour for either admission or another form of treatment. A before-and-after study design was used to evaluate changes in activity. All referred patients for 10 months following implementation of the intervention were compared with patients referred in corresponding months the previous year. Results A total of 5339 contacts (3632 patients) who underwent acute medical assessment (2633 contacts before and 2706 after) were included. Median hospital length-of-stay decreased from 32.6 h to 22.3 h, and the proportion of referred acute patients admitted decreased with 36.3% points from 94.5 to 58.2%. The median length-of-admission time for the admitted patients increased as expected after the intervention. The risk of being admitted, being readmitted as well as having a hospital length-of-time longer than 24 h, 72 h or 7 days, respectively, were significantly lower during the after-period in comparison to the before-period. Adverse effects, unplanned re-contacts, total contacts to general practice and mortality did not change after the intervention. Conclusion Assessing referred acute patients in medical examination chairs as outpatients directly in internal medicine wards and promoting an accelerated trajectory, reduced inpatient admissions and total length-of-stay considerably. This strategy seems effective in everyday acute medical patients and has the potential to ease the increasing pressure on the acute take for wards receiving acute medical patients.

show abstract

“…This integrative review identified 42 papers reporting 41 studies that examined technology in relation to the quality of nursing work in acute hospital settings. The focus of this review was to describe the research methods used in these studies, thereby addressing a current gap often “neglected” in integrative literature reviews (Rushton et al, ). Understanding how nursing work is defined and measured and how its outcomes are evaluated is essential to recognise and measure how emerging technologies contribute to, or hinder, quality nursing care in complex acute settings.…”

Section: Discussionmentioning

confidence: 99%

Methods used to examine technology in relation to the quality of nursing work in acute care: A systematic integrative review

Redley

Douglas

Botti

2020

Journal of Clinical Nursing

View full text Add to dashboard Cite

Aims and objectives:To systematically locate, assess and synthesise research to describe methods used to examine technology in relation to the quality of nursing work in acute care. Specific objectives were to (a) describe the types of nursing work examined; (b) describe methods used to examine technology in nursing work; (c) identify outcomes used to evaluate technology in relation to the quality of nursing work; and (d) make recommendations for future research.Background: New technologies can offer numerous benefits to nurses; however, it is challenging to evaluate health information technologies in relation to the quality of nurses' complex day-to-day work.Design: A systematic integrative review using a five-step process.Methods: Five databases were searched using search terms "nurs*," "workload," "task," "time." Data screening, extraction and interpretation were conducted independently by at least two authors and agreement verified by discussion. Data extraction followed PRISMA guidelines. Results:Of the 41 studies included, most (87.8%, n = 36) examined physical dimensions of nursing work; 31.7% (n = 13) organisational dimensions; 17.1% (n = 8) cognitive dimensions; and only 12.2% (n = 5) emotional dimensions. More than half (58.5%, n = 24) examined only one dimension; one captured all four dimensions. Most frequently examined technologies were electronic medical/health records (36.5%) and electronic medication management (19.5%). Direct observation (58.8%, n = 28) and multiple methods (19.5%, n = 8) were the most common methods; nurse tasks, frequency, duration and time distribution were variables most often measured. Conclusions: Examinations of technology in nursing work often failed to capture the multiple dimensions of this work nor did they recognise the complexity of day-to-day nursing work in acute care. There is a paucity of literature to inform how and what technology should be measured in relation to the quality of nursing care. Relevance to clinical practice: The outcomes inform useful research methods to comprehensively examine technology to enhance the quality of complex nursing work. K E Y W O R D S integrative review, methods, nursing, quality of care, technology S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section. How to cite this article: Redley B, Douglas T, Botti M. Methods used to examine technology in relation to the quality of nursing work in acute care: A systematic integrative review. J

show abstract

Scoping review of medical assessment units and older people with complex health needs

Abstract: Findings from this review indicate that future policy, research and practice relating to MAUs should focus on older people with complex needs, patient-centred metrics and those MAU characteristics most likely to deliver positive health outcomes to this particular cohort of patients.

Cited by 5 publications

References 48 publications

Patient and family members’ perceptions of family participation in care on acute care wards

Patient and family members’ perceptions of family participation in care on acute care wards

Converting acute inpatient take to outpatient take with fast-track assessment in internal medicine wards – a before-after study

Methods used to examine technology in relation to the quality of nursing work in acute care: A systematic integrative review

Contact Info

Product

Resources

About