Factors influencing nurses' readiness to care for hospitalised older people

Abstract

Aims and objectives: To gain a better understanding of nurses' perspectives on factors that influence their readiness to provide appropriate care for hospitalised older people. Background: Hospitals have consistently been criticised for failing to address the unique, complex needs of older people. Research suggests that multiple issues have led to this situation, including a lack of educational preparation for nurses, limited attention to environmental factors, and an absence of organisational preparedness that ensures hospitals are adapted to meet the needs of older people. Design: An exploratory, qualitative approach was used. Methods: Forty-one Registered Nurses participated (24 point-of-care nurses; 17 organisational leaders). Six focus groups and one individual interview were conducted. Thematic data analysis was employed to generate the main study findings. Results: An overarching theme of 'Poor Fit' emerged. While participants identified the shifting needs of patients towards more complex and relational care, the broader organisational and societal contexts were, largely, unchanging. This resulted in nurses recognising the factors needed to be ready to care for older patients and their families, but working in hospitals that were not suited to these needs. Conclusions: The findings identify factors at the point-of-care, the organisational level, and in broader societal attitudes that shape nurses' readiness to care for hospitalised older people. However, many of these factors are modifiable and care for older people could be improved through quality improvement initiatives and nursing leadership. This study offers insight into ways to re-imagine nursing care that can be responsive to older people's complex needs in hospitals. Implications for practice: With a growing contingent of hospitalised older people, it is imperative that nurses, who comprise the largest workforce in this setting, be included in the planning and delivery of healthcare services to ensure readiness to meet the needs of this population.