Frailty in the clinical practice of nursing care

A number of aspects will be discussed with regard to frailty in hospitalised elderly patients and the role played by nurses. With regard to frailty, several definitions and operationalisations are used that may have an influence when frailty is used for case-finding. Frailty is related to disability and comorbidity and may occur more or less often in specific groups of patients. It is not clear whether information obtained from significant others is useful for assessing a patient's frailty and determining whether nurses of non-geriatric wards have sufficient experience to determine the specific problems of frail elderly people. Geriatric interventions have shown positive results with regard to frail elderly people. It can be studied whether an intervention with a central role for the Geriatric Nurse Specialist will also have a positive effect in frail elderly people and whether the RE-AIM model is useful in evaluating the intervention study undertaken.

Nursing leadership in hospital practice: A research program into perceptions, experiences, and self-assessment of leadership competencies of nurses in a top-clinical hospital in the Netherlands

Nursing Leadership is an important competence to develop in order to provide quality of care and prevent attrition of nurses. This research program looked into the perceptions and experiences of nurses on practising leadership. Next to that supporting the development of nursing leadership was addressed. The program has a mixed-method, action research design in which 75 in-depth interviews and 24 focus group interviews and quantitative data of 435 nurses form the backbone. According to hospital nurses, nursing leadership is related to proactiveness and voicing expertise in order to deliver good nursing care. Nevertheless, they do not feel fully competent and knowledge deficits were detected on aspects of the bachelor nursing profile, such as evidence based practice. Working-culture factors can either inhibit or encourage nursing leadership. The further awareness of unconsciously using expertise and knowledge deficits as well as team development towards a continuous safe learning environment are necessary steps for the enhancement of nursing leadership. A Nursing Leadership model was developed in which generic personal leadership competencies combined with expertise of the nurses' level of education and degrees form the essence of shared leadership in teams focussed on the realisation of good nursing care

Health Related Quality of Life and Care Dependency among Elderly Hospital Patients: An International Comparison

Many countries in Europe and the world have to cope with an aging population. Although health policy in many countries aims at increasing disability-free life expectancy, elderly patients represent a significant proportion of all patients admitted to different hospital departments. The aim of the research was to investigate the relationship between health-related quality of life (HRQOL) and the care dependency status among elderly hospital patients. In 2012, a descriptive survey was administered to a convenience sample of 325 elderly hospital patients (> 60 years) from The Netherlands (N = 125), from Poland (N = 100), and from Turkey (N = 100). We employed the Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System and the Care Dependency Scale. FACIT is a collection of HRQOL questionnaires that assess multidimensional health status in people with various chronic illnesses. From demographic variables, gender (female) (r = −0.13, p < 0.05), age and informal care given by family members (r = −0.27 to 0.27, p < 0.01) were significantly correlated with the care dependency status for the whole samples. All HRQOL variables, hearing aid and duration of illness correlated with care dependency status (r = −0.20 to 0.50, p < 0.01). Moreover, the FACIT sum score (Poland and Turkey) and functional wellbeing (The Netherlands) are significantly associated with the decrease in care dependency status. Thus, the FACIT variables are the most powerful indicators for care dependency. The study provides healthcare professionals insight into improvement of quality of care in all three countries