Wiltjer, Hanneke, Seers, Kate and Tutton, Elizabeth (2019) Understanding assessment on a ward for older people : a qualitative study. Journal of Advanced Nursing, 75 (4). pp. 850-861. doi:10.1111/jan.13930 ISSN 0309-2402.

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Abstract

Aim: To explore assessment on a hospital ward for older people from the perspectives of patients and healthcare professionals.
Design: A qualitative study drawing on grounded theory was undertaken between February 2015 and January 2016.
Methods: Interviews with 15 patients and 22 healthcare professionals, a focus group with six healthcare professionals, 45 hours of observation, and review of 18 sets of patient notes. Analysis was conducted using initial and focused coding, continuously comparing data, emerging codes and themes.
Findings: The core category was navigating, constructed through three themes: containing complexity, networking, and situating the process. Navigating assessment was a complex, flexible, context dependent and social process in which healthcare professionals used a combination of formal, informal, visible and invisible ways of working. Registered nurses were at the centre of networking and focused on gathering and sharing information within the multi-disciplinary team, whilst patients had a passive role despite a variety of preferences about their involvement.
Conclusions: Navigating the assessment of older people is contextually situated, includes networking and a professional focus on containing complexity. This process may be enhanced by: 1) making informal assessment visible to others; 2) developing the nurses’ role beyond chasing information towards coordinating care; 3) asking patients and acting on how they would like to be involved in decision making.
Impact: Acknowledging that navigating assessment is a social, flexible and complex process, including different ways of working to meet patient needs, may enhance the usability of current assessment guidelines and their development.

Item Type:	Journal Article
Subjects:	H Social Sciences > HV Social pathology. Social and public welfare R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Older people -- Medical care , Geriatric nursing , Geriatrics -- Diagnosis
Journal or Publication Title:	Journal of Advanced Nursing
Publisher:	Wiley-Blackwell Publishing Ltd.
ISSN:	0309-2402
Official Date:	April 2019
Dates:	Date Event April 2019 Published 14 December 2018 Available 27 November 2018 Accepted
Volume:	75
Number:	4
Page Range:	pp. 850-861
DOI:	10.1111/jan.13930
Status:	Peer Reviewed
Publication Status:	Published
Reuse Statement (publisher, data, author rights):	This is the peer reviewed version of the following article: Wiltjer, H. , Seers, K. and Tutton, E. (2018), Understanding assessment on a hospital ward for older people: a qualitative study. J Adv Nurs. Accepted Author Manuscript. doi:10.1111/jan.13930, which has been published in final form at https://doi.org/10.1111/jan.13930. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Access rights to Published version:	Restricted or Subscription Access
Date of first compliant deposit:	30 November 2018
Date of first compliant Open Access:	14 December 2019
Related URLs:	Publisher

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