Eat Walk Engage: Enabling acute care teams to deliver consistent fundamentals of care for older people.
complexity
fundamentals of care
hospitalization
leadership
multidisciplinary care
older adults
Journal
Journal of advanced nursing
ISSN: 1365-2648
Titre abrégé: J Adv Nurs
Pays: England
ID NLM: 7609811
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
revised:
29
05
2022
received:
29
09
2021
accepted:
05
07
2022
pubmed:
22
7
2022
medline:
14
3
2023
entrez:
21
7
2022
Statut:
ppublish
Résumé
Fundamentals of care are particularly important for older people in acute inpatient settings, who are at increased risk of serious hospital-associated complications like delirium and functional decline. These complications occur due to interactions between clinical complexity and the complex processes and context of hospital care and can be reduced by consistent attention to the fundamentals of care. This paper aims to illustrate of how multi-level nursing leadership of fundamentals of care can be supported to emerge within complex multidisciplinary delivery systems in acute care. Discussion paper informed by clinical and organizational experience of a multidisciplinary leadership team and complexity leadership theory. We provide a series of vignettes as practical illustrations of a successful multidisciplinary improvement program called Eat Walk Engage which supports the delivery of better care for older inpatients, significantly reducing delirium. We argue that taking a broader complexity-based approach including collaborative multidisciplinary engagement, iterative and integrated interventions and appropriate knowledge translation frameworks can enable emergent leadership by nurses at all levels. This promising approach to improving care for older patients requires organizational support for facilitation and reflective practice, and for meaningful data to support change. Our discussion challenges nursing leaders to support the time, agency and connections their nursing staff need in order to emerge as local leaders in fundamental care. The debate around scope and responsibilities for fundamentals of care in hospital care has important practical implications for conceptualizing leadership and accountability for improvement. Our discussion illustrates how a structured multidisciplinary approach that acknowledges and navigates complexity can empower nurses to lead and improve outcomes of older patients in acute care.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
961-969Subventions
Organisme : Metro North Health
ID : Clinician Researcher Fellowship
Informations de copyright
© 2022 John Wiley & Sons Ltd.
Références
Bail, K., & Grealish, L. (2016). 'Failure to maintain': A theoretical proposition for a new quality indicator of nurse care rationing for complex older people in hospital. International Journal of Nursing Studies, 63, 146-161. https://doi.org/10.1016/j.ijnurstu.2016.08.001
Ball, J. E. (2020). Care left undone: Untold damage. Journal of Clinical Nursing, 29(19-20), 3595-3596. https://doi.org/10.1111/jocn.15242
Braithwaite, J., Mannion, R., Matsuyama, Y., Shekelle, P., Whittaker, S., & Al-Adawi, S. (2016). Health systems improvement across the globe: Success stories from 60 countries. Taylor and Francis.
Burton, J., Craig, L., Yong, S., Siddiqi, N., Teale, E., Woodhouse, R., Barugh, A., Shepherd, A., Brunton, A., Freeman, S., Sutton, A., & Quinn, T. (2021). Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database of Systematic Reviews, 2021(7), CD013307. https://doi.org/10.1002/14651858.CD013307.pub2
Cahill, M., Lee-Steere, K., McRae, P., & Mudge, A. (2018). Eat Walk Engage: Delirium prevention for acute care. Australian Journal of Dementia Care, 7(3), 13-15.
de Foubert, M., Cummins, H., McCullagh, R., Brueton, V., & Naughton, C. (2021). Systematic review of interventions targeting fundamental care to reduce hospital-associated decline in older patients. Journal of Advanced Nursing, 77, 4661-4678. https://doi.org/10.1111/jan.14954
Feo, R., & Kitson, A. (2016). Promoting patient-centred fundamental care in acute healthcare systems. International Journal of Nursing Studies, 57, 1-11. https://doi.org/10.1016/j.ijnurstu.2016.01.006
Feo, R., Kitson, A., & Conroy, T. (2018). How fundamental aspects of nursing care are defined in the literature: A scoping review. Journal of Clinical Nursing, 27(11-12), 2189-2229. https://doi.org/10.1111/jocn.14313
Grealish, L., Ranse, K., Todd, J., Armit, L., Billett, S., Collier, L., Bail, K., & Moyle, W. (2022). Barriers and enablers to embedding fundamental nursing care for older patients-Implications of a mixed methods study for nursing leadership. Journal of Advanced Nursing. https://doi.org/10.1111/jan.15194
Harvey, G., & Kitson, A. (2015). Implementing evidence-based practice in healthcare: A facilitation guide. Routledge.
Harvey, G., & Lynch, E. (2017). Enabling continuous quality improvement in practice: The role and contribution of facilitation. Frontiers in Public Health, 5, 27. https://doi.org/10.3389/fpubh.2017.00027
Hoogendijk, E. O., Afilalo, J., Ensrud, K. E., Kowal, P., Onder, G., & Fried, L. P. (2019). Frailty: Implications for clinical practice and public health. Lancet, 394(10206), 1365-1375. https://doi.org/10.1016/S0140-6736(19)31786-6
Hubbard, R. E., Peel, N. M., Samanta, M., Gray, L. C., Mitnitski, A., & Rockwood, K. (2017). Frailty status at admission to hospital predicts multiple adverse outcomes. Age and Ageing, 46(5), 801-806. https://doi.org/10.1093/ageing/afx081
Hunter, S., Kim, B., Mudge, A., Hall, L., Young, A., McRae, P., & Kitson, A. (2020). Experiences of using the i-PARIHS framework: A co-designed case study of four multi-site implementation projects. BMC Health Services Research, 20, 573.
Kitson, A., Conroy, T., Kuluski, K., Locock, L., & Lyons, R. (2013). Reclaiming and redefining the fundamentals of care: Nursing's repsonse to meeting patients' basic human needs.
Lee-Steere, K., Liddle, J., Mudge, A., Bennett, S., McRae, P., & Barrimore, S. (2020). “You've got to keep moving, keep going”: Understanding older patients' experiences and perceptions of delirium and non-pharmacological delirium prevention strategies in the acute hospital setting. Journal of Clinical Nursing, 29(13-14), 2363-2377.
Mudge, A., McRae, P., Banks, M., Blackberry, I., Barrimore, S., Endacott, J., Graves, N., Green, T., Harvey, G., Hubbard, R. E., Kurrle, S., Lim, W., Lee-Steere, K., Masel, P., Pandy, S., Young, A., Barnett, A., & Inouye, S. K. (2022). Effect of a ward-based program on hospital-associated complications and length of stay for older inpatients. The cluster randomized CHERISH trial. JAMA Internal Medicine, 182(3), 274-282.
Mudge, A., McRae, P., & Cruickshank, M. (2015). Eat Walk Engage: An interdisciplinary collaborative model to improve care of hospitalized elders. American Journal of Medical Quality, 30(1), 5-13. https://doi.org/10.1177/1062860613510965
Mudge, A., McRae, P., Donovan, P., & Reade, M. (2020). Multidisciplinary quality improvement programme for older patients admitted to a vascular surgery ward. Internal Medicine Journal, 50(6), 741048, 741, 748.
Mudge, A. M., McRae, P., Hubbard, R. E., Peel, N. M., Lim, W. K., Barnett, A. G., & Inouye, S. K. (2019). Hospital-associated complications of older people: A proposed multicomponent outcome for acute care. Journal of the American Geriatrics Society, 67(2), 352-356. https://doi.org/10.1111/jgs.15662
Mudge, A. M., McRae, P., McHugh, K., Griffin, L., Hitchen, A., Walker, J., Cruickshank, M., Morris, N. R., & Kuys, S. (2016, Apr). Poor mobility in hospitalized adults of all ages. Journal of Hospital Medicine, 11(4), 289-291. https://doi.org/10.1002/jhm.2536
Naughton, C., Simon, R., White, T. J., de Foubert, M., Cummins, H., & Dahly, D. (2021). Mealtime and patient factors associated with meal completion in hospitalised older patients: An exploratory observation study. Journal of Clinical Nursing, 30(19-20), 2935-2947. https://doi.org/10.1111/jocn.15800
Parr, J. M., Bell, J., & Koziol-McLain, J. (2018). Evaluating fundamentals of care: The development of a unit-level quality measurement and improvement programme. Journal of Clinical Nursing, 27(11-12), 2360-2372. https://doi.org/10.1111/jocn.14250
Rechel, B., Grundy, E., Robine, J. M., Cylus, J., Mackenbach, J. P., Knai, C., & McKee, M. (2013). Ageing in the European Union. Lancet, 381(9874), 1312-1322. https://doi.org/10.1016/S0140-6736(12)62087-X
Richards, D. A., Hilli, A., Pentecost, C., Goodwin, V. A., & Frost, J. (2018). Fundamental nursing care: A systematic review of the evidence on the effect of nursing care interventions for nutrition, elimination, mobility and hygiene. Journal of Clinical Nursing, 27(11-12), 2179-2188. https://doi.org/10.1111/jocn.14150
Schubert, M., Ausserhofer, D., Bragadottir, H., Rochefort, C. M., Bruyneel, L., Stemmer, R., Andreou, P., Leppee, M., Palese, A., & CA, R. C. C. A. (2021). Interventions to prevent or reduce rationing or missed nursing care: A scoping review. Journal of Advanced Nursing, 77(2), 550-564. https://doi.org/10.1111/jan.14596
Uhl-Bien, M., Meyer, D., & Smith, J. (2020). Complexity leadership in the nursing context. Nursing Administration Quarterly, 44(2), 109-116. https://doi.org/10.1097/NAQ.0000000000000407
Young, A., Allia, A., Jolliffe, L., de Jersey, S., Mudge, A., McRae, P., & Banks, M. (2016). Assisted or protected mealtimes? Exploring the impact of hospital mealtime practices on meal intake. Journal of Advanced Nursing, 72(7), 1616-1625. https://doi.org/10.1111/jan.12940
Zisberg, A., Shadmi, E., Gur-Yaish, N., Tonkikh, O., & Sinoff, G. (2015). Hospital-associated functional decline: the role of hospitalization processes beyond individual risk factors. Journal of the American Geriatrics Society, 63(1), 55-62. https://doi.org/10.1111/jgs.13193