Success and failure in integrated models of nursing for long term conditions: Multiple case studies of whole systems.
Background: Current projections indicate that the UK faces a 252% increase in people aged over 65 with one or more long term conditions (LTC) by 2050. Nurses, managing their own caseloads and clinics, working across sectors and organisational boundaries and as part of a wider multi-disciplinary team...
| Publicado en: | International Journal of Nursing Studies Vol. 50; no. 5; pp. 632 - 644 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104264143&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104264143 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00207489 JHV jtl: International Journal of Nursing Studies issn: 00207489 maglogo: N pubinfo: dt: 2013 vid: 50 iid: 5 pid: 82545 pub: Elsevier B.V. place: Philadelphia, Pennsylvania artinfo: ui: 104264143 86698975 10.1016/j.ijnurstu.2012.10.007 NLM23131723 104264143 ppf: 632 ppct: 12 formats: fmt: @attributes: type: P tig: atl: Success and failure in integrated models of nursing for long term conditions: Multiple case studies of whole systems. aug: au: Procter, Susan Wilson, Patricia Mary Brooks, Fiona Kendall, Sally affil: Buckinghamshire New University, UK; Imperial College Healthcare NHS Trust, UK sug: subj: Office Nursing Community Health Nursing Nurse Consultants Registered Nursing Practice Disease Management Human Aged Exploratory Research Case Studies Qualitative Studies Purposive Sample England Wales Semi-Structured Interview Thematic Analysis National Health Programs Primary Health Care Epilepsy Pulmonary Disease, Chronic Obstructive Asthma Diabetes Mellitus Minority Groups Family Practice Professional Autonomy Funding Source Aged: 65+ years ab: Background: Current projections indicate that the UK faces a 252% increase in people aged over 65 with one or more long term conditions (LTC) by 2050. Nurses, managing their own caseloads and clinics, working across sectors and organisational boundaries and as part of a wider multi-disciplinary team, are frequently seen as key to managing this growing demand. However, the evidence base informing the nursing role in managing LTC, the most effective configuration of the multi-disciplinary team and the policy evidence relating to the infrastructure required to support cross organisational working, remains weak. Objectives: To explore, identify and characterise the origins, processes and outcomes of effective chronic disease management models and the nursing contributions to such models. Design: Case study whole systems analysis using qualitative interview methods. Settings: Two community matron services, two primary care (GP) practice nursing services, two hospital based specialist nursing services were purposefully sampled from across England and Wales. Participants: Selection criteria were derived using a consensus conference. The nurses in the service, all patients and carers on the caseload, members of the multi-disciplinary team and stakeholders were invited to participate. Methods: Semi-structured interviews with all participants, thematic analysis within a whole system framework. Results: The study found high levels of clinical nursing expertise which in the case of the community matrons was meeting the aim of reducing hospital admissions. Both the primary care and hospital nurse specialist indicate similar levels of clinical expertise which was highly valued by medical colleagues and patients. Patients continued to experience fragmented care determined by diagnostic categories rather than patient need and by the specific remit of the clinic or service the patient was using. Patient data systems are still organised around the impact on services and prevalence of disease at an individual level and not around the patient experience of disease. Conclusion: Nurses are making a major contribution to meeting the policy objectives for long term conditions. Primary care nurses and hospital nurse specialists do broadly similar roles. The scope of the nursing roles and services studied were idiosyncratic, opportunistic and reactive, rather than planned and commissioned on an analysis of local population need. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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