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An Enhanced Role in Comprehensive Geriatric Assessment for Community-Nurse Case Managers

Published online by Cambridge University Press:  31 March 2010

Paul Stolee ,
Mary Lynne Patterson ,
Donna Crinklaw Wiancko ,
Jacquelin Esbaugh ,
Zora A. Arcese ,
Anne Marie Vinke ,
Sally Waddell ,
Joanne Hatt ,
Karen Wells  and
Richard G. Crilly
Paul Stolee*
Affiliation:
Southwestern Ontario Regional Geriatric Program, St. Joseph's Health Care, London, ON Lawson Health Research Institute Department of Epidemiology and Biostatistics, University of Western Ontario
Mary Lynne Patterson
Affiliation:
London-Middlesex Community Care Access Centre
Donna Crinklaw Wiancko
Affiliation:
Southwestern Ontario Regional Geriatric Program, St. Joseph's Health Care, London, ON
Jacquelin Esbaugh
Affiliation:
Southwestern Ontario Regional Geriatric Program, St. Joseph's Health Care, London, ON
Zora A. Arcese
Affiliation:
Southwestern Ontario Regional Geriatric Program, St. Joseph's Health Care, London, ON
Anne Marie Vinke
Affiliation:
London-Middlesex Community Care Access Centre
Sally Waddell
Affiliation:
London-Middlesex Community Care Access Centre
Joanne Hatt
Affiliation:
London-Middlesex Community Care Access Centre
Karen Wells
Affiliation:
Southwestern Ontario Regional Geriatric Program, St. Joseph's Health Care, London, ON
Richard G. Crilly
Affiliation:
Southwestern Ontario Regional Geriatric Program, St. Joseph's Health Care, London, ON Lawson Health Research Institute Division of Geriatric Medicine, University of Western Ontario
*
Requests for offprints should be sent to: / Les demandes de tirés-a-part doivent être adressé e s à: Dr. Paul Stolee, Southwestern Ontario Regional Geriatric Program, St. Joseph's Health Care London – Parkwood Site, 801 Commissioners Road East, London, ONN6C 5J1. (paul.stolee@sjhc.london.on.ca)
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Abstract

We evaluated an enhanced role in comprehensive geriatric assessment for community-nurse case managers. Following practicum education in geriatric assessment, two community-nurse case managers conducted assessments of frail older clients and served as a resource for their case-manager teams. Impacts on their colleagues' assessment skills were investigated in a non-randomized, controlled trial. Intervention-group case managers had higher confidence in assessing and managing the health and social concerns of older persons, greater use of standard assessment tools, and higher case-study assessment scores, than did control-group case managers. Case managers reported that interaction with the enhanced-role case managers had enhanced their skills and benefited clients; family physicians reported that improved patient outcomes had resulted from the assessment information received. Community case managers with enhanced training in geriatric assessment can have a valuable clinical and educational role. Issues include resource implications and integrating the enhanced role into home care operations.

Résumé

Nous avons évalué le rehaussement du rôle des gestionnaires responsables des cas pour les infirmiers de soins communautaires en matière de diagnostiques gériatriques compréhensifs. Suivant un stage pratique en diagnostique gériatrique, deux gestionnaires responsables des cas pour les infirmiers de soins communautaires ont réalisé des évaluations de clients âgés et frêles. Ils ont été indispensables à titre de personnes-ressource au sein de leur équipe de gestion de cas. Les répercussions sur les compétences diagnostiques de leurs collègues ont été examinées sous forme d'essai comparatif non randomisé. Les gestionnaires d'intervention de cas de groupe détenaient un plus haut niveau de confiance lors de la gestion et de l'évaluation des préoccupations sociales et des questions de santé des personnes âgées ; de plus, ces derniers utilisent davantage des outils normatifs d'évaluation et des résultats d'évaluation d'étude de cas que les gestionnaires du groupe témoin. Les gestionnaires de cas ont signalé que leurs compétences avaient été enrichies suivant leur interaction avec ces gestionnaires de cas et par conséquent, le client en tirerait profit. Suivant la réception des renseignements des évaluations, les médecins de famille ont signalé une amélioration dans les résultats des patients. Les gestionnaires de cas communautaires recevant une formation accrue en diagnostiques gériatriques peuvent avoir un rôle clinique et éducatif important à jouer. Les questions à examiner portent sur l'impact de cette formation sur les ressources et l'intégration du rôle accru au fonctionnement des soins à domicile.

Keywords

aginggeriatric assessmentcommunity carenursingvieillissementdiagnostique gériatriquesoins communautairessciences infirmières
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 22 , Issue 2 , Summer/L'été 2003 , pp. 177 - 184
Copyright
Copyright © Canadian Association on Gerontology 2003

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