The role of unregulated care providers in managing heart failure patients in long‐term care facilities

Aims and objectives Heart failure is a complex syndrome in which abnormal heart function results in clinical symptoms and signs of low cardiac output and/or pulmonary or systemic congestion. Heart failure is common among long‐term care residents, and is associated with significant morbidity and acut...

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Veröffentlicht in:Journal of clinical nursing 2017-03, Vol.26 (5-6), p.849-861
Hauptverfasser: Heckman, George A, Boscart, Veronique M, D'Elia, Teresa, Kaasalainen, Sharon, McAiney, Carrie, Kelley, Mary Lou, Stolee, Paul, Strachan, Patricia, McKelvie, Robert S
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container_end_page 861
container_issue 5-6
container_start_page 849
container_title Journal of clinical nursing
container_volume 26
creator Heckman, George A
Boscart, Veronique M
D'Elia, Teresa
Kaasalainen, Sharon
McAiney, Carrie
Kelley, Mary Lou
Stolee, Paul
Strachan, Patricia
McKelvie, Robert S
description Aims and objectives Heart failure is a complex syndrome in which abnormal heart function results in clinical symptoms and signs of low cardiac output and/or pulmonary or systemic congestion. Heart failure is common among long‐term care residents, and is associated with significant morbidity and acute care utilisation. Heart failure guidelines endorse standard therapies, yet long‐term care residents are less likely to receive recommended treatments. The objective of this study is to understand the perceptions and potential role of unregulated care providers in contributing to better heart failure management among long‐term care residents. Design Focus group interviews. Methods This qualitative study employed focus groups to explore perceptions from 24 unregulated care providers in three Ontario, Canada long‐term care homes, about barriers to the optimal management of heart failure. Results Three overarching concepts emerged characterising unregulated care providers’ experiences in caring for residents with heart failure in long‐term care: (1) the complexity of providing heart failure care in a long‐term care setting, (2) striving for resident‐centred decision making and (3) unregulated care providers role enactment nested within an interprofessional team in long‐term care. These concepts reflect the complex interplay between individual unregulated care providers and residents, and heart failure‐related, socio‐cultural and organisational factors that influence heart failure care processes in the long‐term care system. Conclusions Optimising the management of heart failure in long‐term care is contingent on greater engagement of unregulated care providers as active partners in the interprofessional care team. Interventions to improve heart failure management in long‐term care must ensure that appropriate education is provided to all long‐term care staff, including unregulated care providers, and in a manner that fosters greater and more effective interprofessional collaboration. Relevance to clinical practice Active and collaborative engagement unregulated care providers has the potential to improve the management of heart failure in long‐term care residents.
doi_str_mv 10.1111/jocn.13413
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Heart failure is common among long‐term care residents, and is associated with significant morbidity and acute care utilisation. Heart failure guidelines endorse standard therapies, yet long‐term care residents are less likely to receive recommended treatments. The objective of this study is to understand the perceptions and potential role of unregulated care providers in contributing to better heart failure management among long‐term care residents. Design Focus group interviews. Methods This qualitative study employed focus groups to explore perceptions from 24 unregulated care providers in three Ontario, Canada long‐term care homes, about barriers to the optimal management of heart failure. Results Three overarching concepts emerged characterising unregulated care providers’ experiences in caring for residents with heart failure in long‐term care: (1) the complexity of providing heart failure care in a long‐term care setting, (2) striving for resident‐centred decision making and (3) unregulated care providers role enactment nested within an interprofessional team in long‐term care. These concepts reflect the complex interplay between individual unregulated care providers and residents, and heart failure‐related, socio‐cultural and organisational factors that influence heart failure care processes in the long‐term care system. Conclusions Optimising the management of heart failure in long‐term care is contingent on greater engagement of unregulated care providers as active partners in the interprofessional care team. Interventions to improve heart failure management in long‐term care must ensure that appropriate education is provided to all long‐term care staff, including unregulated care providers, and in a manner that fosters greater and more effective interprofessional collaboration. 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Heart failure is common among long‐term care residents, and is associated with significant morbidity and acute care utilisation. Heart failure guidelines endorse standard therapies, yet long‐term care residents are less likely to receive recommended treatments. The objective of this study is to understand the perceptions and potential role of unregulated care providers in contributing to better heart failure management among long‐term care residents. Design Focus group interviews. Methods This qualitative study employed focus groups to explore perceptions from 24 unregulated care providers in three Ontario, Canada long‐term care homes, about barriers to the optimal management of heart failure. Results Three overarching concepts emerged characterising unregulated care providers’ experiences in caring for residents with heart failure in long‐term care: (1) the complexity of providing heart failure care in a long‐term care setting, (2) striving for resident‐centred decision making and (3) unregulated care providers role enactment nested within an interprofessional team in long‐term care. These concepts reflect the complex interplay between individual unregulated care providers and residents, and heart failure‐related, socio‐cultural and organisational factors that influence heart failure care processes in the long‐term care system. Conclusions Optimising the management of heart failure in long‐term care is contingent on greater engagement of unregulated care providers as active partners in the interprofessional care team. Interventions to improve heart failure management in long‐term care must ensure that appropriate education is provided to all long‐term care staff, including unregulated care providers, and in a manner that fosters greater and more effective interprofessional collaboration. 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Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical nursing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Heckman, George A</au><au>Boscart, Veronique M</au><au>D'Elia, Teresa</au><au>Kaasalainen, Sharon</au><au>McAiney, Carrie</au><au>Kelley, Mary Lou</au><au>Stolee, Paul</au><au>Strachan, Patricia</au><au>McKelvie, Robert S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of unregulated care providers in managing heart failure patients in long‐term care facilities</atitle><jtitle>Journal of clinical nursing</jtitle><addtitle>J Clin Nurs</addtitle><date>2017-03</date><risdate>2017</risdate><volume>26</volume><issue>5-6</issue><spage>849</spage><epage>861</epage><pages>849-861</pages><issn>0962-1067</issn><eissn>1365-2702</eissn><abstract>Aims and objectives Heart failure is a complex syndrome in which abnormal heart function results in clinical symptoms and signs of low cardiac output and/or pulmonary or systemic congestion. Heart failure is common among long‐term care residents, and is associated with significant morbidity and acute care utilisation. Heart failure guidelines endorse standard therapies, yet long‐term care residents are less likely to receive recommended treatments. The objective of this study is to understand the perceptions and potential role of unregulated care providers in contributing to better heart failure management among long‐term care residents. Design Focus group interviews. Methods This qualitative study employed focus groups to explore perceptions from 24 unregulated care providers in three Ontario, Canada long‐term care homes, about barriers to the optimal management of heart failure. Results Three overarching concepts emerged characterising unregulated care providers’ experiences in caring for residents with heart failure in long‐term care: (1) the complexity of providing heart failure care in a long‐term care setting, (2) striving for resident‐centred decision making and (3) unregulated care providers role enactment nested within an interprofessional team in long‐term care. These concepts reflect the complex interplay between individual unregulated care providers and residents, and heart failure‐related, socio‐cultural and organisational factors that influence heart failure care processes in the long‐term care system. Conclusions Optimising the management of heart failure in long‐term care is contingent on greater engagement of unregulated care providers as active partners in the interprofessional care team. Interventions to improve heart failure management in long‐term care must ensure that appropriate education is provided to all long‐term care staff, including unregulated care providers, and in a manner that fosters greater and more effective interprofessional collaboration. Relevance to clinical practice Active and collaborative engagement unregulated care providers has the potential to improve the management of heart failure in long‐term care residents.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>27240117</pmid><doi>10.1111/jocn.13413</doi><tpages>13</tpages></addata></record>
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subjects Aged
Aged, 80 and over
Cardiovascular disease
Certification - standards
Clinical Competence - standards
Collaboration
Disease Management
evidence‐based practice
Female
Focus Groups
Health Personnel - standards
healthcare assistants
heart disease
Heart failure
Heart Failure - therapy
Humans
Insurance policies
Long term care insurance
Long term health care
Long-Term Care - standards
long‐term care
Male
Middle Aged
Nursing
nursing homes
Nursing Homes - standards
Older people
Ontario
Physicians
Practice Guidelines as Topic - standards
Professional Role
Qualitative Research
Skilled Nursing Facilities
title The role of unregulated care providers in managing heart failure patients in long‐term care facilities
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