NURS3008 Community Health Nursing

Question:

Discuss the nursing procedures used when admitting patients to a nursing home that follows the ACFI guidelines.

The last section will discuss whether nurses are following ACFI’s nursing responsibilities for patients.

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Answer:

Aged Care Funding Instrument is the funding system that is available for residents of aged care facilities in Australia.

The Australian Government grants care subsidy to those care recipients who have met the accreditation requirements of the relevant aged care services authority, as set out in the Aged Care Act of 1977.

These aged care facilities must adhere to the accreditation standards used by the quality agency in assessing their eligibility.

These four standards are essential.

Standard Two includes health and personal care

Standard Three is the standard for care recipient’s lifestyle

As well as being responsible for providing the best care possible to aged patients, nurses working in aged care facilities have distinct responsibilities.

Referring to the following questions from ACFI domains allows for the assessment of residents’ needs:

Activities of Daly Living are questions that ACFI asks about nutrition, personal hygiene (ADL), mobility, continence, and toileting

Cognition and Behavior includes ACFI questions related cognitive skills, verbal behavior and wandering.

Complex Health Care (CHC), constituting ACFI Questions relevant to medication or complex health care procedures

A number of assessments are done by nurses to assess the needs and care requirements of elderly patients.

Research has shown that the appropriate staffing is required to address the needs and requirements of residents in residential aged care facilities. Non-compliance with accepted procedures could result in negative outcomes (Willis, et al. 2016).

A second study was done to examine the suitability of the Cornell Scale for Depression In Dementia in Nursing Homes (CSDD) for ACFI assessment.

The CSDD scale can be used to detect depression. But, it is complex and takes too much time to get the information you need. This, along with the lack of staff skills and knowledge to evaluate depression, has led to some disagreements (Jeon et.al., 2015).

The frontline workers in the healthcare sector, nurses, remain in close contact with their clients. They are responsible for fulfilling their duties to ensure positive outcomes for the patients.

As it relates to the creation and maintenance of desirable outcomes, the safety and quality care they offer is vital.

Recent research on the current situation in nursing focused on registered nurses’ perceptions and experiences in working in aged care.

It was revealed that nurses have great difficulties meeting the needs of their consumers, employers, professions and policy.

Unemployment and resources constraints are two major barriers to professional output.

The sustainability of nursing in the aged care setting is also at risk from structural and policy barriers (Davis, et al. 2016).

A study focused on the perceptions and impacts of aged care reform and nursing staff in relation to residential aged care facilities.

There are many factors that could hinder optimal care for patients, including funding and resource constraints.

Nursing staff were also limited in their ability to acquire specialist knowledge about aged care. This made it difficult to provide the best care service.

Complex care, including those that involved medication review, pain management, wound care, was associated with care worker dependence (Henderson and al., 2016,).

A critical part of the ACFI nursing assessment regarding quality care for the elderly patient is continence care.

An investigation was done to examine the provision of continence services in aged care facilities.

Study results revealed that residents experience unprecedented consequences from the lack of continence care in aged care facilities due to staff’s perceptions and their experiences with the funding model and quality framework.

The incentivisation of continence management dependence was also included. This is in addition to the equating effective continence care with effective pad usage.

So, it was proposed to reevaluate the quality and safety of continence care in Australian aged care facilities (Ostaszkiewicz O’connell & Dunning 2016,).

The federal government’s regulatory activities have been shown to greatly affect the quality of care in aged-care facilities. This has led to nurses being required to follow the proposed guidelines (Johnson 2017,).

ACFI nursing responsibilities include the care of patients and their families. This includes documentation of continence records PAS-cognitive and behavior records that include wandering, verbal and physical behavior, as well as Cornell scales of depression.

Relevant research has been done on nursing care for dementia patients and residents in facilities with wander.

According to Cope (2016), a social order of care is recommended to produce maximum outcomes that protect the patient’s interests and take the necessary steps to attain optimal results.

Another study examined the needs and preferences of people with dementia in long-term residential aged care facilities.

In the case of dementia patients who were demarcated, it was found that they required more care than their non-dementia patients.

Dementia patients have a higher degree of complex care, which has led to an increased need for nursing intervention. (Joenpera 2017).

However, relevant literature has indicated that it is sometimes difficult for nurses to meet their ACFI-assigned responsibilities for patients.

The main reasons for missed nursing care are the increased workload, rationing of material and human resources in service delivery, and the increase in workload.

As part of staffing problems, work intensification was linked to patient acuity as well cost containment. It also undermined proposed staffing ratios. The workloads were changed across shifts and skill mix, in addition insufficient support from fellow colleagues, were all identified.

In this situation, resource issues are key obstacles that prevent the provision and quality of nursing care (Henderson, et al. 2016).

The report on the environment at work and the well-being of nurses showed some interesting findings. These may have been related to non-conformance with standard practice for elderly patients while they were in residential aged care facilities.

One of the respondents, a Registered Nurse, has stated that the ACFI is rotting and the reason they are not enthusiastic about their work. She also highlighted other factors like poor skill mix and increased reliance more on bureaucracy-based than knowledge-based healthcare.

Tham & Gill (2016) state that nurses’ performance in fulfilling their duties was affected by the lack of clarity in legislation and other factors.

Even with all the best efforts of nurses, it can often prove tedious to comply with the ACFI directives while caring for geriatric patients.

References

Standards for Ageing and Agedcare

The performance of care: The construction of nursing services for those with dementia who live in residential settings and wander (Doctoral dissertation at Queensland University of Technology).

From the inside, nursing in age care: reality and rhetoric.

Contemporary nurse, 52(2-3): 191-203.

The causes of missed nursing care: qualitative responses from an Australian nurse survey.

Labour & Industry, 26(4): 281-297.

The perceptions of nurses about the effect of aged care reform on residential aged care facilities and multipurpose services in rural Australia.

Australasian Journal on Ageing, 35(4).

Clinical utility of the Cornell Scale for Depression and Dementia for routine assessment in nursing homes.

American Journal of Geriatric Psychiatry. 23(8), 784-793.

Tales of the ACFI: Dementia and residential aged care.

Australasian journal on ageing, 36(1). 10-13.

AMA sends submission to government review on aged care facilities.

Australian Medicine, 29(15), 10.

Fear and overprotection among Australian residential aged?care homes: The unintended impact regulation has on quality continence care.

Australasian Journal on Ageing, 35(2) 119-126

What nurses and midwives want: Findings from National Survey on Workplace Culture and Well-being.

Study of the requirements for nursing and personal caregivers in meeting residents’ care needs.

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