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Fundamental care for people with cognitive impairment in the hospital setting: A study combining positive organisational scholarship and video‐reflexive ethnography
Author(s) -
Collier Aileen,
De Bellis Anita,
Hosie Annmarie,
Dadich Ann,
Symonds Tamsin,
Prendergast Justin,
Rodrigues Jade,
Bevan Alan
Publication year - 2020
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.15056
Subject(s) - reflexivity , scholarship , ethnography , psychology , cognition , nursing , cognitive impairment , qualitative research , medicine , sociology , psychiatry , anthropology , political science , law
Aims and objectives To clarify how high‐quality fundamentals of care for people with dementia and/or delirium were practised in a specialist geriatric evaluation and management unit. Background Older people with cognitive impairment represent a significant number of people who are admitted to hospital. They are at increased risk of dying, readmission and long hospital stays, relative to those without cognitive impairment. There is an urgent need to elucidate the conditions that underpin safe and high‐quality fundamental care for these patients and their families. Methods Using the innovative methodologies of positive organisational scholarship in healthcare and video‐reflexive ethnography, this 18‐month study was conducted within an inpatient geriatric evaluation and management unit for people with dementia and/or delirium in South Australia. Patients, family members and staff members (managerial, clinical and nonclinical) participated by allowing researchers to document ethnographic fieldwork notes and film their practices and/or accounts thereof; and/or interpreting digital recordings with researchers in order to make sense of data in a process of co‐analysis. This study is reported using Standards for Reporting Qualitative Research reporting guidelines. Results High‐quality fundamental care for people with dementia and/or delirium in hospital and their families was associated with the special space of the hospital unit; an aptitude for people with dementia; a capacity to translate person‐centred fundamentals of care from rhetoric to reality; and an appreciation for teamwork. Conclusion This study clarified how teams working in hospital can practise high‐quality fundamentals of care for older people with dementia and/or delirium. Delivery of high‐quality fundamental care in this setting was dependent, not only on nurses, but the entire ward team working cohesively in a “weave of commitment.” Relevance to clinical practice Efforts to improve fundamental care for people with cognitive impairment need to encompass values and philosophy of person‐centred care, including the contributions by all staff to care delivery.