Journal article
What are we asking for when requesting "Specialling" for the confused hospitalised older person? A concept analysis
International journal of older people nursing, Vol.15(2), e12302
06/2020
PMID: 31885196
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Abstract
Background and/or rationale
“Specialling” is a common nursing practice in hospitals which entails the allocation of extra staff to be with an older person who is confused to maintain safety. Despite ongoing use, this practice has little evidence of effectiveness. To facilitate further investigation, a concept analysis of “specialling” was undertaken.
Aims
The aim of this paper was to report on a concept analysis on the practice of “specialling” pertaining to older people who have cognitive impairment when in hospital.
Methods
This study used Rodgers evolutionary approach to concept analysis to clarify the attributes, antecedents and consequences of the concept to determine a definition of “specialling.” Web of Science (Core Collection and Web of Science Medline), CINAHL and SCOPUS databases were searched to identify relevant literature. Due to the scarcity of papers, the search was broadened to include all sources that could add understanding.
Findings
A total of (n = 43) sources were identified. The attributes were themed to 5 categories: Labels and descriptions; the “Special” role; Patient safety; Patient care; and Communication. The antecedents to 2 themes: Patient characteristics; and Organisational risk. The consequences of “specialling” were diverse with 6 themes: the “Special” role; the Older persons experience; Costly; “Special” use and nursing beliefs; Safety outcomes; and Opportunities.
Discussion
The process of concept analysis provided a means to identify knowledge gaps and practice challenges. The definition determined from this analysis has provided a reflective opportunity for clinicians and researchers to consider when implementing care initiatives to support older people in hospital. Important is the lack of person-centred approaches and the opportunities in developing nurse leadership through empowerment. The findings from this analysis will inform a PhD study.
Implications for practice
Nurses have an opportunity to lead care improvements by ensuring person-centred approaches in the care of older people with cognitive impairment.
Details
- Title
- What are we asking for when requesting "Specialling" for the confused hospitalised older person? A concept analysis
- Creators
- Miriam Anne Coyle - Illawarra Shoalhaven Local Health DistrictValerie Wilson - Illawarra Shoalhaven Local Health DistrictSamuel Lapkin - University of WollongongVictoria Traynor - University of Wollongong
- Publication Details
- International journal of older people nursing, Vol.15(2), e12302
- Publisher
- Wiley
- Number of pages
- 40
- Grant note
- Australian Government Research Training Programme (RTP).
- Identifiers
- 991013092524302368
- Copyright
- © 2019 John Wiley & Sons Ltd.
- Academic Unit
- Faculty of Health
- Language
- English
- Resource Type
- Journal article