Feasibility of a new transmural care pathway for advance care planning for older persons: A qualitative study into community care registered nurses' perspectives.

Autor:	Jepma P; Department of Medicine for Older People, Amsterdam UMC, Amsterdam, the Netherlands.; Amsterdam Public Health, Aging & Later Life, Amsterdam, the Netherlands., Eijk R; Department of Medicine for Older People, Amsterdam UMC, Amsterdam, the Netherlands.; Amsterdam Public Health, Aging & Later Life, Amsterdam, the Netherlands.; Dutch Healthcare Authority (NZa), Utrecht, the Netherlands., Bos AAE; Amsterdam University of Applied Sciences, Research Group Integrated Complex Care, Faculty of Health, Center of Expertise Urban Vitality, Amsterdam, the Netherlands., Toet N; Regioplatform, the Netherlands., Latour CHM; Amsterdam University of Applied Sciences, Research Group Integrated Complex Care, Faculty of Health, Center of Expertise Urban Vitality, Amsterdam, the Netherlands., Buurman BM; Department of Medicine for Older People, Amsterdam UMC, Amsterdam, the Netherlands.; Amsterdam Public Health, Aging & Later Life, Amsterdam, the Netherlands.; Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam UMC, Amsterdam, the Netherlands., van Rijn M; Department of Medicine for Older People, Amsterdam UMC, Amsterdam, the Netherlands.; Amsterdam Public Health, Aging & Later Life, Amsterdam, the Netherlands.; Amsterdam University of Applied Sciences, Research Group Integrated Complex Care, Faculty of Health, Center of Expertise Urban Vitality, Amsterdam, the Netherlands.
Jazyk:	angličtina
Zdroj:	International journal of nursing studies advances [Int J Nurs Stud Adv] 2024 Nov 08; Vol. 7, pp. 100264. Date of Electronic Publication: 2024 Nov 08 (Print Publication: 2024).
DOI:	10.1016/j.ijnsa.2024.100264
Abstrakt:	Background: Transmural palliative care interventions aim to identify older persons with palliative care needs and timely provide advance care planning, symptom management, and coordination of care. Nurses can have an important role in these interventions; however, their expertise is currently underused. A new transmural care pathway with a central role for the community care registered nurse in advance care planning aims to contribute to the quality of palliative care for older persons. Objective: To examine the perspectives of community nurses on the feasibility of a new transmural care pathway for advance care planning for older persons. Design: A qualitative study design using semi-structured interviews. Settings: Interviews were performed with community nurses of three participating homecare organizations in the Netherlands between March and May 2023. Participants: 19 community nurses. Methods: A topic guide was based on (1) challenges in advance care planning identified from the literature and (2) concepts that are important in assessing the feasibility of complex healthcare interventions provided by the Normalisation Process Theory framework. A combined inductive and deductive thematic analysis was performed. Results: Four themes were identified: views on the transmural care pathway, community nurses' needs to fulfil their role, key points regarding implementation, and evaluation of the new practice. In general, community nurses were positive about the feasibility of the new practice as it provided a more structured work process that could facilitate interprofessional collaboration and improve the quality of palliative care. Overall, the feasibility of the new practice, from community nurses perspective, was determined by (1) clear roles and responsibilities in the transmural care pathway, (2) standardized registration of advance care planning, and (3) close involvement of community nurses in the whole implementation process. Conclusions: We highlighted important factors, from the perspectives of community nurses, that need to be considered in the implementation of a new transmural care pathway for advance care planning. A clear division of roles and responsibilities, standardized registration of advance care planning, and involvement of community nurses during the whole implementation process were mentioned as important enabling factors. This knowledge might contribute to successful implementation of a transmural care pathway that aims to enhance the quality of palliative care for older persons. Tweetable Abstract: Community nurses' perspectives on the feasibility of a transmural care pathway for advance care planning for older persons. Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Marjon van Rijn reports financial support was provided by Netherlands Organisation for Health Research and Development. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2024 The Author(s).)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu