Optimizing nurses knowledge and competences on how to provide geriatric essential care to increase older persons autonomy; geriAtriC Care EsseNTials (ACCENT)

“Get inside the patient’s skin and supplement his strength, will or knowledge according to his needs.” Henderson 1964. The unique proposition of this proposal is to get not only inside the client’s skin but to get inside the nurses’ skin. By doing so we determine what nurses and clients really need to improve autonomy and autonomy supported behavior during the provision of essential geriatric ADL care. This project brings nurses back to the meaning and values of essential nursing care as stated by Henderson as; “helping the dependent person to gain independ and support the clients autonomy”. Nurses in all care settings are in an ideal position to facilitate geriatric clients in their autonomy and enable older people in what their value and need. The main objective of the current proposal is therefore to empower nurses in their behavior, competences, and professionalism and enable them to support the older client’s autonomy during ADL nursing care. We focus on geriatric nursing, as we know from other studies that their autonomy is most jeopardized of all client populations. Due to vulnerability and impairments older clients and they relatives are often highly dependent of nursing care and the supportive or restricting behavior of the nursing staff. Maintaining autonomy in geriatric essential care activities like activities of daily living (ADL), such as washing, grooming, dressing is of great importance in the frail older population since it positively influences early prevention and the persons physical fitness, independence, self-esteem wellbeing, and quality of life. It is also therefor that the current proposal focuses on the essential care activity that is most performed in older clients namely Activities of Daily Life. ADL care is one of the essentials of care that relevant for all clients’ irrespective of setting, age or age. ADL is extremely high valued by clients but highly undervalued and underestimated in complexity and importance by nurses. We propose a theoretically informed pragmatic bottom-up approach using participatory action research in a strong collaborative nursing research environment embedded with in the Living Lab in Ageing and Long-Term Care. To encourage nurses and lecturers working in geriatrics to combine nursing and practice, dual career tracks will be developed. These will be available for nurses with different educational backgrounds (all levels of RN’s) working in various geriatric care settings (home, nursing home and hospital). Throughout this career track they will be offered additional education to enhance career options in geriatrics. Dual tracks are tailor made and supported by our educational and care partners in the field of (geriatric) nursing. Within their dual appointment they contribute to the central theme addressed in the current proposal namely autonomy support in essential ADL nursing care. In this nursing practice- research infrastructure, together with a large team of nursing researchers, nurses, lecturers, clients and experts actively collaborate to expand our knowledge on what Henderson once mentioned as the heart of nursing care: autonomy. In 3 work packages we focus on 1) understanding and supporting nurses behavioural change towards supporting clients’ autonomy in essential care activities; 2) the development of outcome measures to assess nurses’ autonomy supported behavior, and autonomy in clients; 3) supporting current and nurses and current nursing by educational approaches and learning material towards supporting clients’ autonomy in essential care activities. This result in a course of action called geriAtriC Care EsseNTials (ACCENT). ACCENT stands for autonomy-supportive essential nursing care. It is a course of action for (geriatric) nursing teams to provide essential care in function of the client’s autonomy, values and needs. ACCENT includes a course of action of educational methods and materials, behavioural insights and nurse sensitive outcomes. The project evaluates the various elements of ACCENT. In addition, the experiences with the dual nursing career paths that were established in the geriatric care chain for all nursing levels will be evaluated. Revenues of the project include: - CareEsseNTials (ACCENT) that supports nurses in providing ADL care taking into account clients’ needs and abilities to optimize autonomy. ACCENT includes learning and reflection materials for future and current nurses; - Nurse sensitive outcomes to assess autonomy (client level) and autonomy supported behavior (nurse level); - Professional nurses who understand the real value of essential geriatric nursing care - A strong infrastructure including expanded nursing practice-research capacity