Nurses' clinical decision-making for preserving nursing home residents' remaining abilities

Abstract

Aims and objectivesThis study was conducted to clarify and conceptualise nurses' clinical decision-making for preserving the remaining abilities of nursing home residents suffering from physical-cognitive functional decline. BackgroundOlder adults experience physical, psychological and social changes, but their remaining abilities differ across individuals. DesignThis study used a qualitative research to gain a deeper understanding of nursing homes nurses' clinical decision-making. MethodsIn-depth interviews with 32 experienced nurses were undertaken. The data were analysed using conventional content analysis. ResultsSix categories and 58 subcategories of nursing practice related to managing the remaining abilities of residents with physical-cognitive functional decline were generated. The results of this study revealed five themes: (1) seeing residents' potential, (2) physical, emotional and psychosocial care in daily routines, (3) keeping personalised charts, (4) encouraging, promoting and physical and emotional support and (5) preparing residents for more independent living. The results were categorised into nurses' personal strategies based on their experience, practical nursing knowledge, nursing interventions and nursing evaluation criteria. ConclusionsThe themes reflected positive views on the residents' functional abilities and the nursing homes nurses' perception that their goal was to help residents achieve their highest level of independence. Relevance to clinical practicePreserving nursing home residents' remaining abilities represents nurses' optimistic view of residents' functional status. Routine care tailored for preserving the remaining abilities of individual nursing home residents with physical-cognitive functional decline is needed. Preserving the remaining abilities of nursing home resident is supported by therapeutic interactions including close contact as well as physical and emotional support. Nurses' main goal in working with residents with remaining abilities is improving their independence.