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Vari Drennan

Publications and source records attributed to Vari Drennan.

11 recordsLinked to original sources
PubMed2006

Assessing the needs of older burglary victims: a link nurse scheme.

Distraction burglary is a type of burglary where the method of entry is by a trick rather than the typical forced entry. Research suggests this type of event can contribute to a decline in health amongst victims aged over 65 years. This article describes a scheme that employed a district nurse to work in partnership with the police to address the health and social care needs of older victims of distraction burglary living in the London Borough of Islington.

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PubMed2006

Attracting and retaining nurses in primary care.

There is increasing demand for nurses to work in primary care. This is driven in part by the need to retain current levels but also by the modernisation plans for primary care services, which require new roles for nurses, new ways of working and more nurses in primary care settings. While campaigns for increased recruitment of hospital nurses and doctors has been largely successful in recent years, primary care has still to see the impact. This article reports on a Department of Health (England) funded project that aimed to identify strategies and exemplars to assist primary care trusts (PCTs) and the workforce development confederations (WDCs) in strategic health authorities in attracting and retaining nurses to primary care at registered nurse level. It reports on the range of initiatives identified, the perceived benefits and challenges. It concludes by proposing a strategic model for planning for the recruitment and retention of primary care nurses.

Community Health Nursing↗
PubMed2005

The feasibility and acceptability of a specialist health and social care team for the promotion of health and independence in 'at risk' older adults.

Population ageing, escalating costs in pensions, health-care and long-term care have prompted a new policy agenda for active ageing and quality of life in old age across the European Union and other developed countries. In England, the National Service Framework for Older People (NSF OP) explicitly demands for the first time that the NHS and local authorities, in partnership, agree programmes to promote health ageing and to prevent disease in older people. These programmes are expected to improve access for older people to mainstream health promotion services and also to develop multiagency initiatives to promote health, independence and well-being in old age. This paper describes the evaluation of one interagency project team established to test out mechanisms for addressing health promotion for older people through primary care. A mixed methodology was used to understand the processes of service development, the impact of the team's intervention, and the primary and secondary outcomes for older people. The project demonstrated that multi-agency partnerships have the potential to improve the quality of the lives of older people deemed 'at risk' by their general practitioners, particularly through income generation but also in the identification of medical problems such as unrecognised hypertension, hearing loss and visual loss. It also offered some key learning points for other multi-agency groups developing similar services.

Activities of Daily Living↗
PubMed2005

Partnership working by default: district nurses and care home staff providing care for older people.

Older people residents in care homes that only offer residential care rely on primary health care services for medical and nursing needs. Research has investigated the demands that care homes staff and residents make on general practice, but not the involvement of other members of the primary health care team. This paper describes two consecutive studies completed in 2001 and 2003 that involved focus groups and survey methods of enquiry conducted in two settings: an England shire and inner London. The research questions that both studies had in common were (1) What is the contribution of district nursing and other primary care services to care homes that do not have on-site nursing provision? (2) What strategies promote participation and collaboration between residents, care home staff and NHS primary care nursing staff? and (3) What are the current obstacles and aids to effective partnership working and learning? A total of 74 community-based nurses and care home managers and staff took part in 10 focus groups, while 124 care home managers (73% of the 171 surveyed) and 113 district nurse team leaders (80% of the 142 surveyed) participated in the surveys. Findings from both studies demonstrated that nurses were the most frequent NHS professional visiting care homes. Although care home managers and district nurses believed that they had a good working relationship, they had differing expectations of what the nursing contribution should be and how personal and nursing care were defined. This influenced the range of services that older people had access to and the amount of training and support care home staff received from district nurses and the extent to which they were able to develop collaborative and reciprocal patterns of working. Findings indicate that there is a need for community-based nursing services to adopt a more strategic approach that ensures older people in care homes can access the services they are entitled to and receive equivalent health care to older people who live in their own homes.

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PubMed2005

Practice nurses and older people: a case management approach to care.

AIM: This paper reports on aspects of a study designed to answer the research questions: (i) To what extent do practice nurses use the five cyclical elements of a case management approach when caring for people aged over 75 years? (ii) What determines or deters practice nurses' use of the cyclical elements of a case management approach in caring for older people? BACKGROUND: Case management is an approach that uses a cyclical process of assessment, planning, implementation, monitoring and evaluation to provide systematic proactive care to people with complex health and social care needs. In England, specialist practice nurse case managers for older people have been piloted in ten primary care trusts and the posts are to be implemented nationally by 2008. No baseline work has, however, considered the applicability of developing the existing generalist practice nurse workforce. METHOD: A 26-item structured postal questionnaire was used to explore both practice nurses' use of a case management approach when working with older people, and what factors influenced the care provided. A random sample of 500 practice nurses was selected from the Royal College of Nursing Practice Nurse Association member database. RESULTS: A 45% response rate was achieved. Practice nurses assessed, planned and implemented care, but reviewing medication opportunistically and evaluating the care were uncommon. A case management approach was significantly (P = 0.005) more likely to be used in on-going management activities than in one-off treatment room care. Practice nurses with postregistration education in district nursing were significantly (P = 0.016) more likely to refer patients to social care services. Lack of time and the central role of the general practitioner were the main reasons for not incorporating case management into practice. CONCLUSIONS. The extent to which practice nurses used elements of a case management approach was highly variable and influenced by individual professional expertise, the nature of the consultation and the practice nurse's position in the general practice.

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PubMed2004

The workforce in health and social care services to older people: developing an education and training strategy.

Planning workforce development across the health and social care services for older people presents a formidable challenge. In England, Workforce Development Confederations are responsible for commissioning the education and training of the current and future health and social care workforce. This article reports on an analysis of local issues in planning the workforce for older people's services undertaken in one Confederation. It reports on the perceived priorities for developing the workforce in older peoples services in a policy environment where multiple initiatives were competing for attention. It highlights the key challenges in planning a strategy that embraces numerous service and education providers and offers practical solutions. Although this analysis was in one Confederation, the issues raised have relevance for other Confederations and their education and service partner organisations.

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PubMed2004

Nurse-led case management for older people with long-term conditions.

People in the UK are successfully living longer but demonstrating an increased incidence of long-term conditions. In response to this, there has been a growth of service models that draw on the principles of case management, particularly for those older people with multiple and complex needs. Nurses working in primary care, and district nurses in particular, have always made a significant contribution to the care of older people with long-term, chronic conditions using case management techniques. However, the recent emphasis on case management has created new and expanded roles for nurse in primary care as the providers and coordinators of care. The aim of this article is to provide an overview of service models that use a case management approach and the current evidence for their effectiveness. We will then describe current examples of nurse-led case management in the UK and discuss some key issues for nurses in primary care and their patients.

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PubMed2004

The development of a short instrument to identify common unmet needs in older people in general practice.

BACKGROUND: No structured needs assessment tool exists that is appropriate for older people and also suitable for use in routine consultations in general practice. AIMS: To engage older people in the development of a brief, valid, practical, and acceptable instrument to help identify common unmet needs suitable for use in routine clinical practice in primary care. DESIGN OF STUDY: User involvement in a multi-stages approach to heuristic development. SETTING: General practices, voluntary groups, and community organisations in north and central London. METHOD: Subjects included patients aged 65 years and over in purposively selected practices, voluntary organisations for older people in the same localities, community organisations involving older people, general practitioners and community nurses. Data were collected through mixed methodology interviews using a structured assessment tool (Camberwell Assessment of Need for the Elderly), a postal questionnaire, and focus groups. Synthesis and interpretation of results was done through a consensus conference followed by a Delphi process involving primary care professionals. RESULTS: Five domains of unmet need were identified as priority areas by all three data collection methods, the consensus conference, and the Delphi process: senses (vision and hearing), physical ability (mobility and falls), incontinence, cognition, and emotional distress (depression and anxiety) (SPICE). CONCLUSIONS: Public involvement in the design of clinical tools allowed the development of a brief assessment instrument that could potentially identify common, important, and tractable unmet needs in older people.

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PubMed2003

Older people's services. A picture of health.

A scheme offering joint health and social care assessments to people aged over 75 in inner London identified more than a quarter in need of services. The older people were accessed via general practice, but this proved an inefficient way of identifying the target population. In some practices, almost half of those contacted were no longer at the same address. The assessments, conducted by a community nurse and social welfare officer, often involved two visits. The mobility of the elderly population needs to be taken into account when planning joint assessments. Organisations involved had different aspirations for the scheme and management proved problematic.

Activities of Daily Living↗
PubMed2002

Applying community-oriented primary care methods in British general practice: a case study.

BACKGROUND: The '75 and over' assessments built into the 1990 contract for general practice have failed to enthuse primary care teams or make a significant impact on the health of older people. Alternative methods for improving the health of older people living at home are being sought. AIM: To test the feasibility of applying community-oriented primary care methodology to a relatively deprived sub-population of older people in a relatively deprived area. DESIGN OF STUDY: A combination of developmental and triangulation approaches to data analysis. SETTING: Four general practices in an inner London borough. METHOD: A community-oriented primary care approach was used to initiate innovative care for older people, supported financially by the health authority and practically by primary care academics. RESULTS: All four practices identified problems needing attention in the older population, developed different projects focused on particular needs among older people, and tested them in practice. Patient and public involvement were central to the design and implementation processes in only one practice. Innovations were sustained in only one practice, but some were adopted by a primary care group and others extended to a wider group of practices by the health authority. CONCLUSION: A modified community-oriented primary care approach can be used in British general practice, and changes can be promoted that are perceived as valuable by planning bodies. However, this methodology may have more impact at primary care trust level than at practice level.

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