Kristiina Kariniemi-Örmälä’s PhD study concerns important topics which are seldom studied in nursing sciences; older people's emergency nursing and care left undone.
The aim of the study was to investigate self-medication management, mental status such as symptoms of depression and memory disorders, the ability to self-manage activities of daily living (ADLs) at home and continuity of care among older people aged 70 years and above who had lived at home before an emergency department visit and returned home immediately after the emergency department visit. The purpose was to identify and examine factors in nursing carried out in emergency department, primary emergency duty or primary care, which lead to omission of certain aspects of required patient care in the care of older people.
The data were collected in two phases: At first data were collected (2004-2005) through structured interviews of older people (n=141) and by reviewing their medical records. Secondly, data were collected by questionnaire (2019) from nursing managers (n=5) working in Emergency departments and by structured questionnaire (2020) from nursing staff (n=59) working in primary emergency duty and primary care. In the structured interviews of older people, many measurements were used (GDS-15, IADL, MMSE). The questionnaires for nursing managers and for nursing staff were drawn up specially for this study and based on Kalischs´s model of missed nursing.
A significant number of home dwelling older people encountered challenges in self-medication management, mental health and ADLs and care. The earlier such a challenge is recognized and found, the earlier the care and rehabilitation can be provided. The main influencing factors contributing to missed nursing care were related to resources (busyness, lack of systematic assessing protocols and lack of measurements) and in the lack of communication between the emergency team and other caregivers of the older people and their relatives. It is very important to prevent missed care in older peoples´ emergency nursing. Unnoticed or overlooked assessment of self-medication management, signs of memory disorders and signs of depression, functional assessment and obscurity in continuity of care might be critical issues and barriers to continue living at home for older people. There is a need to develop intervention programmes to improve emergency nursing for older people before their discharge and to provide continuity of care after they are discharged home.
The doctoral dissertation of Kristiina Kariniemi-Örmälä, Master of Health Sciences, entitled Older people in emergency department, will be examined at the Faculty of Health Sciences. The Opponent in the public examination will be Docent Satu Elo of Lapland UAS, and the Custos will be Professor Katri Vehviläinen-Julkunen of the University of Eastern Finland. The public examination will be held in Finnish and it will be streamed online on 15 December 2020 starting at 12 noon.
Photo available for download: https://mediabank.uef.fi/A/UEF+Media+Bank/38552?encoding=UTF-8
Dissertation online: http://urn.fi/URN:ISBN:978-952-61-3639-4
