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Gerontological Nursing Research in a Time of Change

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Keynote presentation given by Dr Catriona Murphy, School of Nursing and Human Sciences, Dublin City University at the 5th Annual Nursing Showcase at St Mary's Hospital, Phoenix Park, Dublin. September 6th 2017.

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Gerontological Nursing Research in a Time of Change

  1. 1. Gerontological Nursing Research in a Time of Change St. Mary’s Hospital, Phoenix Park, Nursing Showcase 6/9/17 Dr. Catriona Murphy School of Nursing and Human Sciences, DCU
  2. 2. Diversity in this room Transitional care Management
  3. 3. • Population change • Crossing boundaries • Opportunities to engage in research at individual, local, health system and population level
  4. 4. Population change
  5. 5. Source: http://www.cso.ie/en/releasesandpublications/ep/p-cp3oy/cp3/assr/ Male
  6. 6. Changes in population >65 years since 2006 0 50 100 150 200 250 2006 2011 2016 85+ 80-84 75-79 70-74 65-69 Data extracted from CSO interactive tables 1000’s Census Year
  7. 7. Changes in population >65 years since 2006 0 50 100 150 200 250 2006 2011 2016 85+ 80-84 75-79 70-74 65-69 211,236 47.3% Data extracted from CSO interactive tables 1000’s 143,336
  8. 8. Changes in population >65 years since 2006 0 50 100 150 200 250 2006 2011 2016 85+ 80-84 75-79 70-74 65-69 48,028 67,555 40.6% Data extracted from CSO interactive tables 1000’s
  9. 9. Impact • 33.7% of those aged 85 years and older utilised PHN services in the previous year (Murphy 2015) • Equates to approx. 16,200 in 2006 22,800 in 2017 Murphy C. Demographic and health profile of older adults using public health nursing services in Ireland: Findings from The Irish Longitudinal Study on Ageing (TILDA). Trinity College, Dublin: The Institute of Community Health Nursing and The Irish Longitudinal Study on Ageing; 2015.
  10. 10. Impact • The main area of missed care was in health promotion particularly in relation to older people and chronic disease management • There was a high degree of missed care where caseloads included disadvantaged groups (asylum seekers, homeless, migrants, travellers) PHELAN, A., MCCARTHY, S., 2016. Missed Care: Community Nursing in Ireland. Dublin: University College Dublin and The Irish Nurses and Midwives Organisation.
  11. 11. Average age by electoral division 2016 http://census.cso.ie/p3map21/
  12. 12. A Changing Landscape • Diversity as we age • Diverse needs/ personal preferences • Multicultural • Marginalised groups • Complex care needs • Chronic disease and Multimorbidity • Person centred care • Context: two tier health system, socioeconomic status, social support, housing, transport • Information/technology deficit • Learning from countries further along the ageing trajectory • Change in service delivery is slow to respond to the demographic changes
  13. 13. Crossing boundaries
  14. 14. Health Service Executive Workforce 2017 (n=106,000) 9% 33% 14% 16% 9% 19% Staff Categories Medical/Dental Nursing Health & Social Care Management/Admin General Support Staff Patient and Client Care HEALTH SERVICE EXECUTIVE 2016. National Service Plan 2017. Dublin: Health Service Executive.
  15. 15. Developing a network • Strength in our diverse roles • Exposure to a range of practitioners with similar interests or overlapping interests • Seek opportunities to engage in research (E.g. quality care metric indicators for older person services) • Provide evidence for improved nursing service provision in your local area • Examine research translation in your area of practice • Develop research skills and infrastructure within gerontological nursing • Engage with practice, policy and strategy development at local and national level
  16. 16. Opportunities to engage in research at individual, local, health system and population level
  17. 17. The Individual Patient Journey
  18. 18. Public patient involvement • Engaging patients/service users/clients/carers as co- researchers from the outset • Supports available in each third level institution
  19. 19. Population perspective Focus on the individual Focus on the whole population
  20. 20. The Irish Longitudinal Study on Ageing (TILDA) • Trinity College • Economic, social and health information on over 50s in Ireland • Funded by Atlantic Philanthropies, Irish Life and Department of Health https://tilda.tcd.ie/
  21. 21. International longitudinal studies of ageing
  22. 22. The Irish Longitudinal Study on Ageing • Nationally representative sample of community living adults over 50 years • Brief overview of research project on hypertension prevalence and knowledge translation
  23. 23. Blood pressure ≥ 140/90 mmHg
  24. 24. Blood pressure and medications recorded
  25. 25. Hypertension definition:SBP≥140 mmHg or DBP ≥90 mmHg and/or on antihypertensive medication This is equivalent to 797,000 in the population aged 50 years and older in Ireland Hypertension prevalence
  26. 26. • Grant from the Health Research Board • Challenge in shifting from a population perspective to impacting on patient care • Community nurses/Practice nurses • 17 Locations • 12 Counties • 386 nurses attended • Lessons from dissemination phase Knowledge Exchange and Dissemination
  27. 27. • Awareness raising: Public and professionals • Media: radio interviews, newspaper • Irish Heart Foundation’s blood pressure council • British and Irish Hypertension Society member • Undergraduate summer studentship • Hypertension education day (November 30th) • Lots done, more to do…… Further knowledge translation
  28. 28. TILDA resource https://tilda.tcd.ie/
  29. 29. Exciting time to be involved in gerontological nursing research • Constantly changing environment • Improve our knowledge to improve patient care • Develop research skills • Support nurses engaged in research • Develop networks: other nurses, other disciplines, patients/families/carers • Demonstrate the complexity of nursing older adults and the impact of research on quality of care and client satisfaction with care received • Enable visibility of the dynamism of gerontological nursing work • Today is about all of the above
  30. 30. Don’t hide the light
  31. 31. Thankyou Catriona.murphy@dcu.ie

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