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Australas J Ageing ; 37(2): E61-E67, 2018 Jun.
Article in English | MEDLINE | ID: mdl-29476607

ABSTRACT

OBJECTIVE: To investigate decision-making around hospital transfer and/or referral of residents to a Residential InReach (RiR) service in north-eastern metropolitan Melbourne, Australia, from the perspectives of residential aged care facility (RACF) staff, general practitioners (GPs) and RiR registered nurses (RNs). METHODS: Thirty-one staff from eight RACFs, five GPs and four RiR RNs participated in individual or group interviews. RESULTS: Residential aged care facility staff and GPs valued and relied upon RiR to manage unwell residents. Thematic analysis identified RiR utilisation was driven by the following: (i) complexity of decision-making processes in RACFs; (ii) variability in facility-based medical and nursing care; and (iii) impact of RiR service outcomes on patients and referrers. CONCLUSION: Availability of timely and appropriate medical and nursing care in RACFs was reported to influence transfers to the hospital and/or referrals to RiR. RiR was used to complement or substitute usual care available to residents. Further research and improvements in RACF and RiR resources are required.


Subject(s)
Clinical Decision-Making , Geriatric Assessment/methods , Health Services for the Aged , Homes for the Aged , Nursing Homes , Patient Care Team , Patient Transfer , Referral and Consultation , Aged , Aged, 80 and over , Female , General Practitioners , Humans , Interviews as Topic , Male , Nurses , Victoria
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