Health professionals' perspectives of providing care to people with dementia in the acute setting: Toward better practice.
This article reports an interpretative research project about the care of patients with dementia admitted to the acute setting with a non-dementia-related illness. Open-ended interviews were conducted with 25 medical, nursing, and other health care professionals drawn from 3 metropolitan teaching hospitals in Australia. Qualitative data analysis generated 5 major themes relating to the built environment and organizational "system" as determinants of practice, the influence of key players, current dementia care management, and ideal dementia care management. Results showed acute care hospitals are not the best place for people with dementia and can negatively influence health outcomes such as functional independence and quality of life. Participants reported attempts to provide best practice but experienced major constraints stemming largely from environmental, sociocultural, and economic issues. Recommendations include the delivery of acute services in tandem with dementia services and a whole organization shift in thinking away from what conveniently suits the institution to thinking that is person-centered and dementia-friendly. With support from executive-level management, nurses can play a leading role in the implementation of practice change.
Borbasi
Sally
S
Griffith University, School of Nursing and Midwifery, Queensland, Autralia.
Jones
Jacqueline
J
Lockwood
Craig
C
Emden
Carolyn
C
D000203:Activities of Daily Living; D000208:Acute Disease; D001291:Attitude of Health Personnel; D019985:Benchmarking / Q000458:organization & administration*; D003704:Dementia / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D005190:Family / Q000523:psychology; D005851:Geriatric Nursing; D006272:Health Facility Environment / Q000458:organization & administration; D006293:Health Promotion; D006301:Health Services Needs and Demand; D006779:Hospitals, Public; D006784:Hospitals, Teaching; D006801:Humans; D015404:Nursing Methodology Research; D009936:Organizational Innovation; D010358:Patient Participation / Q000523:psychology; D018802:Patient-Centered Care / Q000458:organization & administration; D010564:Personnel, Hospital / Q000523:psychology*; D036301:Qualitative Research; D011787:Quality of Health Care / Q000458:organization & administration*; D011788:Quality of Life; D013021:South Australia; D011795:Surveys and Questionnaires; D017748:Time Management