Case study of home care for isolated and frail elderly patients by general practice nurses: A controlled 17-month study, to May 2016
ISSN: 1476-9018
Article publication date: 29 May 2018
Issue publication date: 2 July 2018
Abstract
Purpose
In a novel approach, two part-time “Link Nurses” within an NE Hampshire practice of 16,500 patients were funded by a local charity, to assess and manage unmet needs of isolated frail elderly patients at home. The paper aims to discuss these issues.
Design/methodology/approach
Patients in this vulnerable group with no recorded healthcare contact for a prolonged period were identified from practice computer records. One group was to be assessed at home, and appropriate interventions effected. Follow-up visits or telephone contacts also offered support to carers as well as isolated individuals. A matching quasi control group was identified but not visited, to assess the overall impact on the patients, GP and other healthcare contacts. Difficulties with the control group were encountered and addressed.
Findings
Important unmet healthcare needs were found amongst the visited patients, which the nurses were able to address themselves, or refer to the GPs or appropriate agencies. The control group demonstrated greater demand for out-of-hours, GP and district nurse contacts, and more unplanned hospital admissions.
Practical implications
Besides dealing with unmet needs at home, ongoing support by local GP nurses may reduce bed-blocking by moving away from “crisis management” of patients in this vulnerable group.
Originality/value
Few other trials have employed practice nurses to see and manage frail elderly patients in their homes.
Keywords
Acknowledgements
The link nurses wish to express their thanks to the Odiham Cottage Hospital Combined Trusts (OCHCT), Charity No. 1068721, for their generous support; and to Dr Sarah Longstaff and Daphne Jamieson RGN who designed the study and approached the charity. Elizabeth Good prepared the table and bar charts of results. The authors also thank June White of Basingstoke Health Library and Dr William Hudson for assistance and advice with the text. Dr Hudson is a retired GP (ex-partner of the Whitewater Health Practice). He joined the OCHCT as a Trustee after the link nurses were appointed. As the new service appears to be an effective new component of community medicine, the practice doctors and OCHCT felt justified in their decision to extend it for a further two years (to September 2018), and to share the ongoing cost.
Citation
Longstaff, S., Rees, J., Good, E. and Kirby, E. (2018), "Case study of home care for isolated and frail elderly patients by general practice nurses: A controlled 17-month study, to May 2016", Journal of Integrated Care, Vol. 26 No. 3, pp. 211-218. https://doi.org/10.1108/JICA-02-2018-0008
Publisher
:Emerald Publishing Limited
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