Abstract
The goal of the nursing sector is to ensure that patients’ healthcare demands are met, regardless of whether their conditions are acute or chronic. Contemporary nursing homes are struggling to establish mechanisms that can help to manage various conditions of patients who present with long-term and persistent diseases. These ailing individuals, especially the aged, are unable to get adequate services to facilitate recovery processes or even their delayed stay in hospital settings.
Scholarly materials gathered indicate that nursing homes have put in place interventions that aim at helping patients with acute and worsening conditions with a view to lowering their chances of being hospitalized. This paper examines an article whose authors sought to find out whether such interventions deployed in various nursing homes are effective in reducing hospital admission rates among people in need of acute care.
Purpose
The purpose of the article by Graverholt, Forsetlund, and Jamtvedt (2014) entails providing a synopsis of impacts associated with interventions that are meant to minimize instances of acute hospitalizations in convalescent centers. This rationale is founded on the awareness that present-day medical facilities and nursing homes are facing challenges related to handling patients whose conditions require close and sophisticated attention (Sherlaw-Johnson, Smith, & Bardsley, 2016). Particularly, the article being examined reveals a case whereby people in need of acute care often require advanced medical procedures, for instance, transition strategies for individuals seeking end-of-life attention or even technical diagnostic services, which may not be accessible in their respective nursing homes.
The above challenge facing many nursing homes informs the purpose of the article under investigation. This scholarly work bases its claims on the understanding that no effective mechanisms have been found to address the issue of hospitalization rates among elderly patients (Jackson, 2017; Webster et al., 2016). Hence, this category of ailing people ends up spending huge financial resources in search of specialist attention during their continued stay in various nursing centers. This situation has compromised nursing homes’ primary objective of providing quality and affordable services to elderly patients who require end-of-life care.
Methods
Scholars deploy diverse research methods to help them to give reliable and evidence-based conclusions regarding their studies (Van der Walt, Brink, & Van Rensburg, 2017). The choice of such methods depends on the nature of the subject being examined. For instance, some researchers may find the use of interviews or questionnaires efficient for studies that require a mixture of quantitative and qualitative data.
Others will find the use of participant observation adequate for topics that revolve around fields such as human characteristics, communication studies, and social psychology among others. However, the current article uses a literature review as its data collection method. This choice is sufficient because the topic of hospital admissions has been extensively researched and hence the reason Graverholt et al. (2014) wish to rely on the available literature to substantiate their claims.
These authors conducted a literature review from several online libraries, including PubMed, PubMed, and CINAHL among others. To come up with suitable journals and books, they established specific search tactics and eligibility approaches. This plan helped to eliminate articles that could not contribute constructively to the subject being investigated. For instance, they considered articles that addressed matters related to geriatric nursing homes, particularly any interventions deployed to minimize instances of hospitalization among patients. Their concern was to get studies that mentioned the issue of acute care hospitalization (Graverholt et al., 2014).
Although language was not a factor to consider when selecting eligible articles, these authors ensured that the materials gathered were either methodical assessments or randomized controlled trials (RCT).
Graverholt et al. (2014) also assessed abstracts and titles that appeared during their search process. Based on this criterion, they selected materials that featured high-value abstracts, which passed the GRADE quality assessment framework. The procedure for identifying journal articles, appraising them, retrieving information, and rating the overall data was allocated to two autonomous scholars. A third person was hired to address any variations regarding the findings of the previous two individuals. Sources gathered were divided into two groups, which depended on the nature of the interventions examined therein.
Results
The results section presents the authors’ findings based on the data obtained using selected research methodologies. In the current article, the literature review search explained in the previous segment culminated in five methodical reviews and another equal number of primary sources.
These two categories of articles featured 11 dissimilar interventions. As earlier mentioned, the goal of the article being investigated is to find out different effects related to interventions, which aim at eliminating or reducing levels of acute hospitalizations in nursing homes (Rau, 2018). To determine these impacts, Graverholt et al. (2014) carried out seven assessments of structuring and normalizing medical practices. According to their findings, minimal cases of acute hospitalizations were observed in four of the above evaluations.
When examining the impact of advanced medical attention on individuals presenting with cognitive problems, three articles were found to contain the appropriate information. Interventions deployed in two of these publications revealed fewer cases of acute hospitalizations in convalescent zones as opposed to controlled centers. The connection between the strategy used in the remaining study and the extent of hospitalizations was not comprehensible. The implication is that its contribution to the anticipated goal of minimizing hospitalization levels could not be established.
Other studies focused on the efficacy of service provision mechanisms for availing sedative care. Results following this intervention indicated reduced hospitalization rates when compared to what was observed in the controlled group. Nonetheless, the GRADE framework rated the quality of this evidence as low (Graverholt et al., 2014). In addition, the impact of influenza immunization among nurses and other medical practitioners on acute hospital admissions among residents was not detectable. However, regarding this intervention, some articles had indicated a reduction in the number of reported hospitalizations among vaccinated individuals.
Overall, none of the studies included in this article passed this quality assessment procedure. Nonetheless, this finding does not imply that interventions mentioned therein are less effective in reducing hospital admission levels in nursing centers (Graverholt et al., 2014). Instead, regarding these scholarly materials as low in terms of quality suggests the need for advanced explorations into the topic of acute hospitalizations among not only elderly patients but also other individuals who are accommodated in various convalescent homes.
Conclusion
The study by Graverholt and colleagues sought to investigate the impact associated with interventions that are deployed in nursing centers to help in minimizing instances of hospital admissions. This article focused on patients who present with acute and worsening conditions that are associated with their old age, persistent ailments, and increased dependency rates. From the scholarly materials examined, 11 strategies for minimizing hospital admission levels in convalescent centers were singled out. It was established that these interventions had not been experimented with across diverse nursing homes to assess their effects on hospital admission rates.
As a result, the quality of substantiation provided, especially when comparing the effectiveness of these interventions, was below average. Nevertheless, some of the interventions observed had successfully helped to lower admission rates in specific nursing homes. This realization points to the need for further explorations regarding strategies that may have positive outcomes when deployed to address the high rate of hospital admissions in nursing homes.
References
Graverholt, B., Forsetlund, L., & Jamtvedt, G. (2014). Reducing hospital admissions from nursing homes: A systematic review. BMC Health Services Research, 14(36), 1-8. Web.
Jackson, B. L. (2017). Bereavement in the pediatric emergency department: Caring for those who care for others. Pediatric Nursing, 43(3), 113-119.
Rau, J. (2018). ‘It’s almost like a ghost town.’ Most nursing homes have overstated staffing for years. New York Times. Web.
Sherlaw-Johnson, C., Smith, S., & Bardsley, M. (2016). Continuous monitoring of emergency admissions of older care home residents to hospital. Age and Ageing, 45(1), 71–77. Web.
Van der Walt, C., Brink, H. I., & Van Rensburg, G. (2017). Fundamentals of research methodology for health care professionals (4th ed.). Pretoria, South Africa: Juta Legal and Academic Publishers.
Webster, T. N., Yorgason, J. B., Maag-Winter, A., Clifford, C., Baxter, K., & Thompson, D. (2016). Mental health concerns of older adults living in long-term care facilities: An area of expansion for MFTs. American Journal of Family Therapy, 44(5), 272-284. Web.