Improving quality of care through detection of complexity amongst older people in the community: Impact study

56^th World Congers on Nursing and Health Care & 3^rd World Congress on Pediatric and Neonatal Nursing

May 02-03, 2022 | Joint Webinar

Jennifer Boak

Bendigo Health, Australia

Keynote: J Nurs Care

Abstract :

Background Older people are living longer with more chronic diseases, consequently their care is more complex. Their need for support and nursing care in their home is more common. Detection of complexity is lacking which impacts how care and supports are allocated to remain in their home. Objective: The impact study is a two-phase study. Phase one was a randomised controlled trial (RCT) to implement the Patient Complexity Instrument (PCI) in addition to usual assessment to enhance clinical judgement regarding detection of complexity, supporting the time allocated to patient care. Phase two was exploring the nurses and allied health professional’s perceptions of complexity using focus groups and the development of a resource toolkit to support the detection of complexity. Methods: A scoping review was conducted to determine the availability of instruments to detect complexity in a community nursing setting. One instrument was identified (PCI). An RCT was conducted to determine the feasibility of the PCI for use in a regional Australian community nursing setting between 1st July 2019 and 30th September 2020. Patients were randomised into one of two groups (i) usual assessment and (ii) usual assessment plus PCI. In August 2021 focus groups were conducted in the Loddon Mallee Region. Results: The RCT results demonstrated that a comparison on the level of complexity showed that the PCI was a good fit (blinded) for detecting complexity and that the time added after assessment had a significant effect Jennifer Boak Bendigo Health, Australia Jennifer Boak, J Nurs Care 2022, Volume 11 on medium and high levels of complexity (blinded). Outcomes of phase 2 of the study included allied health and nursing have different perspectives of complexity, however how they came to the decision was similar. A complexity instrument such as the PCI could not only be used to determine level of complexity but also as a handover tool or to track decisions a client was making about care needs. Conclusion: The PCI was found to be a feasible and acceptable tool to detect complexity of older people and support the nurse’s clinical judgement. Through co-design a resource to support of the used of a complexity instrument has been developed.

Biography :

Jennifer is a registered Nurse with over 30 years’ experience. She is currently managing a community nursing service in a regional Victoria setting. Jennifer is aiming to complete her PhD in early 2022. She has published a number of papers related to the copic of client complexity in in reputed journals.