Parke et al 2013 CanadaFacilitators and barriers tosafe emergencydepartment transitionsfor community-dwellingolder people withdementia and theircaregivers: a socialecological studyInterpretive,qualitative exploratorydesignPurposive samplingParticipants were: PWDplus familymember/carer (6)Carers (4) ED nurses(10) Nurse practitioners(4)To identify factors thatimpede/facilitate safetransitional care forPWD in the ED. Toidentify potentialsolutions that wouldsupport nurses toprovide sensitive careThree phases:interviews; creation ofa photographicnarrative journal;photo-elicitation focusgroups. Verbatimtranscription. NvivoConstant comparativeanalysisBeing under-triaged;time pressures; lack ofattention to basicneeds; feeling ignored,forgotten andunimportant. Triagesystem in the ED doesnot recognise atypicalpresentations—sets inmotion a cascade ofvulnerability of olderPWD. Family membersvalue the relationalaspects of care—recognition ofvulnerability,communication,interactions withnursesNurses should beadvocates forrelationship-centredcareNurses need supportto carry out bestpracticeDifficult to recruitolder people withdementia to the studybecause of effects ofdiseaseNeed for researchabout contextNeed for research thatfocuses on what workswell and wh

Hunter et al, 2017 CanadaBalancing safety andharm for older adults withdementia in ruralemergency departments:health professionals'perspectivesInterpretative,descriptive exploratorydesign: social ecologicalperspectivePurposive/snowballingsamplingTo understand safetyand harm in rural EDtransitional care forcommunity-dwellingolder adults withdementia fromperspectives of HPs.HPs asked to describetheir experiences ofworking with olderpeople with dementiaand their caregivers inED2 small rural EDs (95inpatient beds/76inpatient beds)12 healthprofessionals: nurses,social worker,occupational therapist,physiotherapist,medicsSemi-structuredinterviewsHP perspectives: ED ischallenging for olderpeople with dementia.Chaotic andovercrowded. Thisgroup not a prioritydue to priorities ofemergency care. HPsometimes too busy togive proper care to thisgroup. Competingpressures in triage.HPs experience moraldistress when theycannot provide carethat they should beable to give. Negativeconsequences: no safespace, no quietenvironment. HPssensitive to familymember situation.Need to look at olderpeople with dementiaand family member asa complete package—obligations to bothSmall ED can be ofbenefit: potential toget older person withdementia out of EDfaster due to goodcommunity links.Disadvantages: makingassumptions orbecoming complacentabout patients whoare well known to HPsMaking things better:more resources,valuing contribution offamily members whocould provide care inED. Changing triageapproach to olderpeople with dementia,getting to know theperson beyond thesuperficial, betterdischarge planning

Fry et al 2015(b) AustraliaTitle Emergency nurses'perceptions of the role offamily/carers in caring forcognitively impaired olderpersons in pain: adescriptive qualitativestudyQualitative descriptivestudyPurposive samplingSee above (Fry et al,2015a)To understand EDnurses' perceptions ofthe role offamily/carers for oldercognitively impairedpersons experiencingpain as a result of along bone fractureFocus groups (4)Nvivo 9.2Thematic analysis(Gibbs, 2007)ED nurses perceivethat family members:were valuable inassisting staff to buildthe clinical picture onarrival in the ED; canprovide criticalinformation thatwould otherwise beunknown; reducenegative impact of theED environment onpatientIf family memberswere not present, thisadded to the workloadof nurses who couldnot deliver the carethe person with CIrequiredWorry and stress forfamily members. EDnurses expect familymembers to provideFamily members arethe hidden workforce.Collaboration betweenfamily members andnurses needs furtherexploration. Role offamily members in EDis sometimes unclearMore research neededto determine familymembers' perceptionsof emergency care

Critically explore the role of the nurse regarding changing contexts of care and the promotion of health and well-being, considering existing partnerships with community, national, and international agencies working to support individuals with RA

Help to get you out and about to appointments and community activitiesQuestion 9Select one:a.Nursing care servicesb.Transport servicesc.Domestic assistance

What groups of people are in need of care?1 pointAdultsElderlyChildrenIndividuals with special needsAdolescentsAll of the above