The Created Environment for Physical Assessment by Case Managers

Abstract

Goals of gerontological nursing include maximizing health and confronting functional impairments. The health of older adults is often fragile because of age-related change, complicated by chronic illnesses. Identification of changes in health status permits responsive care and consultation but requires proficiency in physical assessment. In 1995, research was conducted in Alberta, Canada, on registered nurse case managers’ reported use of assessment skills. Nineteen continuing-care facilities in 1 of 17 provincial health regions participated (N = 189). After expert review and pilot testing, questionnaires were distributed to two independent groups: nurse administrators/staff development coordinators and case managers (response rate = 73%). Qualitative data were subjected to descriptive, interpretive, and pattern coding. Reported are factors constraining or facilitating physical assessment in continuing care. Neuman’s concept of the created environment provided a factor-organizing framework. A holistic view of environment and data source triangulation increased confidence in the comprehensiveness and credibility of results.

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References

Alberta Health . (1991). Residents of Alberta’s long term care facilities: A descriptive profile. Edmonton, Alberta, Canada: Long Term Care Branch.

Anderson, M. C. , Skillen, D. L. , & Knight, C. L. (in press). Continuing care nurses’ perceptions of need for physical assessment skills. Journal of Gerontological Nursing.

Anderson, M. C. , Skillen, D. L. , Knight, C. L. , & Wales, M. (1996, October). Physical assessment skills in continuing care: Reporting the need. Paper presented at the 25th annual scientific educational meeting of the Canadian Association on Gerontology, Quebec City, Quebec.

Bell, D. F. , Chelf, J. H. , & Geerdes, P. (2000). An outcomes model prototype: Integrating continuing education learning into practice. Journal of Continuing Education in Nursing, 31(3), 111-115.

Crenshaw, R. S. , McLin, P. A. , & Lewis, D. J. (1990). Continuing education in gerontological nursing. Journal of Gerontological Nursing, 16(3), 6-10.

Culley, J. M. , Courtney, J. A. , Diamond, L. M. , & Bates, E. (1996). A continuing education program to retain registered nurses for careers in client-focused community health care. Journal of Continuing Education in Nursing, 27(6), 267-273.

Daft, R. L. (1995). Organization theory and design (5th ed.). New York: West.

Daley, B. J. , & Wilson, S. A. (1999). Needs assessment in long-term care facilities: Linking research and continuing education. Journal of Continuing Education in the Health Professions, 19(2), 111-121.

DiJerome, L. (1992). The nursing case management computerized system: Meeting the challenge of health care delivery through technology. Computers in Nursing, 10(6), 250-258.

10.

Fralic, M. F. (1992). The nurse case manager: Focus, selection, preparation, and measurement. Journal of Nursing Administration, 22(11), 13-14.

11.

Hekelman, F. P. , Niles, S. A. , & Brennan, P. F. (1994). Gerontologic home care: A prescription for distance continuing education. Computers in Nursing, 12(2), 106-109.

12.

Knowles, M. (1984). The adult learner: A neglected species (3rd ed.). Houston, TX: Gulf.

13.

LeFrancois, G. R. (1994). Psychology for teaching. Belmont, CA: Wadsworth.

14.

Matteson, M. A. , McConnell, E. S. , & Linton, A. D. (1997). Gerontological nursing: Concepts and practice (2nd ed.). Toronto, Canada: W. B. Saunders.

15.

Miles, M. B. , & Huberman, A. M. (1994). Qualitative data analysis (2nd ed.). London: Sage.

16.

Morgan, D. G. , Semchuk, K. M. , Stewart, N. J. , & D’Arcy, C. (1999). Dementia care in rural long-term care facilities: Barriers to a supportive social environment. In Proceedings of the International Conference on Nursing Research, “Research to Practice.” Edmonton Alberta Canada [Abstract].

17.

Nazarko, L. (1996). Nursing home nurses need support to update skills. Nursing Times, 92(42), 38-40.

18.

Neuman, B. (1995). The Neuman systems model (3rd ed.). Norwalk, CT: Appleton & Lange.

19.

Pearson, J. L. , & Small, J. M. (1994). Inservice education needs in gerontological nursing. AARN Newsletter, 50(9), 20-22.

20.

Putney, K. A. , Hauner, L. , Hall, T. , & Kobb, R. (1990). Case management in long-term care: New directions for professional nursing. Journal of Gerontological Nursing, 16(12), 30-33.

21.

Schroer, K. (1991). Case management: Clinical nurse specialist and nurse practitioner, converging roles. Clinical Nurse Specialist, 5(4), 189-194.

22.

Strauss, A. , & Corbin, J. (1990). Basics of qualitative research. London: Sage.

23.

Thomas, W. I. , & Thomas, D. S. (1928). The child in America: Behavior problems and programs. New York: Knopf.

24.

Timms, J. , & Ford, P. (1995). Registered nurses’ perceptions of gerontological continuing education needs in United Kingdom and in the US. Journal of Advanced Nursing, 22, 300-307.

25.

Travis, S. S. , & Duer, B. (1999). Preparing staff to deliver age-appropriate nursing care to elderly patients. Journal of Continuing Education in Nursing, 30(3), 105-107.

26.

Wyble, S. J. , Hanafin, L. F. , Brugge-Wiger, D. A. , & Kuskowski, M. A. (1990). A plan for staff development in gerontologic nursing. Journal of Nursing Staff Development, 6(6), 291-295.