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A competence improvement programme for the systematic observation of frail older patients in homecare: qualitative outcome analysis

BACKGROUND: The growth of frail older patients with extensive care needs in homecare creates a need for competence development. Improvement programmes are essential to fill this knowledge gap. However, the outcomes of such programmes remain unknown. Therefore, the aim of this study is to describe th...

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Autores principales: Strømme, Torunn, Tjoflåt, Ingrid, Aase, Karina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303045/
https://www.ncbi.nlm.nih.gov/pubmed/35864484
http://dx.doi.org/10.1186/s12913-022-08328-0
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author Strømme, Torunn
Tjoflåt, Ingrid
Aase, Karina
author_facet Strømme, Torunn
Tjoflåt, Ingrid
Aase, Karina
author_sort Strømme, Torunn
collection PubMed
description BACKGROUND: The growth of frail older patients with extensive care needs in homecare creates a need for competence development. Improvement programmes are essential to fill this knowledge gap. However, the outcomes of such programmes remain unknown. Therefore, the aim of this study is to describe the outcomes of a competence improvement programme for the systematic observation of frail older patients in homecare. METHODS: This study applied a qualitative mixed-method design. Data were collected in two homecare districts using participant observation, focus group interviews, and individual interviews. RESULTS: The analysis revealed five concepts characterising the outcomes of the competence improvement programme: 1) frequency of vital sign measurements, 2) situational awareness, 3) expectations and coping level, 4) activities for sustained improvement, and 5) organisational issues affecting CIP focus. Substantial differences were revealed across the two homecare districts in how homecare professionals enacted new knowledge and routines resulting from the competence improvement programme. The differences were related to the frequency of vital sign measurements, coping levels, and situational awareness, in which successful outcomes were shaped by implementation issues and contextual setting. This involved whether routines and planned activities were set to follow up the improvement programme, or whether organisational issues such as leadership focus, resources, and workforce stability supported the programme. CONCLUSIONS: This study documents the differences entailed in creating sustainable outcomes of an improvement programme for homecare professionals’ competence in recognising and responding to deteriorating frail older patients. Depending on the implementation process and the homecare context, professionals enact the activities of the improvement programme differently. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08328-0.
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spelling pubmed-93030452022-07-22 A competence improvement programme for the systematic observation of frail older patients in homecare: qualitative outcome analysis Strømme, Torunn Tjoflåt, Ingrid Aase, Karina BMC Health Serv Res Research BACKGROUND: The growth of frail older patients with extensive care needs in homecare creates a need for competence development. Improvement programmes are essential to fill this knowledge gap. However, the outcomes of such programmes remain unknown. Therefore, the aim of this study is to describe the outcomes of a competence improvement programme for the systematic observation of frail older patients in homecare. METHODS: This study applied a qualitative mixed-method design. Data were collected in two homecare districts using participant observation, focus group interviews, and individual interviews. RESULTS: The analysis revealed five concepts characterising the outcomes of the competence improvement programme: 1) frequency of vital sign measurements, 2) situational awareness, 3) expectations and coping level, 4) activities for sustained improvement, and 5) organisational issues affecting CIP focus. Substantial differences were revealed across the two homecare districts in how homecare professionals enacted new knowledge and routines resulting from the competence improvement programme. The differences were related to the frequency of vital sign measurements, coping levels, and situational awareness, in which successful outcomes were shaped by implementation issues and contextual setting. This involved whether routines and planned activities were set to follow up the improvement programme, or whether organisational issues such as leadership focus, resources, and workforce stability supported the programme. CONCLUSIONS: This study documents the differences entailed in creating sustainable outcomes of an improvement programme for homecare professionals’ competence in recognising and responding to deteriorating frail older patients. Depending on the implementation process and the homecare context, professionals enact the activities of the improvement programme differently. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08328-0. BioMed Central 2022-07-22 /pmc/articles/PMC9303045/ /pubmed/35864484 http://dx.doi.org/10.1186/s12913-022-08328-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Strømme, Torunn
Tjoflåt, Ingrid
Aase, Karina
A competence improvement programme for the systematic observation of frail older patients in homecare: qualitative outcome analysis
title A competence improvement programme for the systematic observation of frail older patients in homecare: qualitative outcome analysis
title_full A competence improvement programme for the systematic observation of frail older patients in homecare: qualitative outcome analysis
title_fullStr A competence improvement programme for the systematic observation of frail older patients in homecare: qualitative outcome analysis
title_full_unstemmed A competence improvement programme for the systematic observation of frail older patients in homecare: qualitative outcome analysis
title_short A competence improvement programme for the systematic observation of frail older patients in homecare: qualitative outcome analysis
title_sort competence improvement programme for the systematic observation of frail older patients in homecare: qualitative outcome analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303045/
https://www.ncbi.nlm.nih.gov/pubmed/35864484
http://dx.doi.org/10.1186/s12913-022-08328-0
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