Question:
Discuss the ACFI standards and the nursing practices used in admitting patients to nursing homes.
Last, talk about whether nurses comply with ACFI nursing responsibilities.
Answer to Question: NURS3008 Community Health Nursing
Aged Care Funding Instrument, also known as the Aged Care Funding Instrument, refers the funding system available to residents living in aged care facilities. It is also operational in Australia.
The Australian Government offers care subsidy to recipients of care who comply with the accreditation requirements of the concerned aged services authority. This is as per the Aged Care Act of 1987.
These aged care facilities are required to adhere to the accreditation standards which are considered by the quality agent for determining their eligibility.
These four standards must be followed:Standard One encompasses management systems, organizational development alongside staffing
Standard Two includes personal care and health.
Standard Three describes the life style of the care receiverStandard Four refers to physical environment and safe systems (Agedcare.health.gov.au, 2017).
A nurse appointed to an aged care facility is also responsible for providing optimal care to patients according to accepted conventions.
It is possible to assess the needs and preferences of residents by using the questions belonging to three ACFI domains:
Activities of Daly Living, also known as ADL, are ACFI questions regarding nutrition, personal hygiene mobility, continence, toileting and mobility.
The ACFI questions in Cognition and Behavior (BEH), are related to cognitive skills and verbal behavior. They also cover depression and physical behavior.
Complex Health Care, (CHC), is ACFI question relevant to complex medical procedures and medications
Nursing professionals usually conduct a variety of assessments in order to address the varied needs of the elderly and determine the appropriate level of care.
Relevant research has suggested that adequate staffing should be used to adequately address the needs of residents living in residential aged care facilities. Any deviation from these accepted practices can lead to adverse outcomes (Willis et. al., 2016).
Another ACFI assessment has examined the question of whether the Cornell Scale for Depression in Dementia is appropriate for use in nursing homes.
Findings support the use of the CSDD to detect depression. The complexity of the scale and time it takes to collect pertinent information, as well as the knowledge and skills of staff in evaluating depression, have been criticized (Jeon et.al. 2015).
Because nurses are the frontline workers in healthcare, they remain close to clients and are responsible for ensuring that patients receive positive outcomes.
In this regard, it is critical that nurses provide safe and high quality care.
However, a new study has been done to examine the perceptions and experiences registered nurses have about working in aged-care.
The findings show that nurses have great difficulties meeting the needs of their consumers, employers, professions and policy.
Resource constraints and workforce instability are other major hurdles to generating professional output.
Supporting nursing in older care is also possible due to structural barriers or aged care policy environments (Davis et. al., 2016,).
The study examined the issues surrounding residential aged care facilities as well as multipurpose services. It also looked at nurses’ perceptions about aged care reform.
The potential barriers to providing optimal care to patients include funding and resource shortages.
In order to provide the best aged care service, there were limitations in the ability of nurses to acquire specialist knowledge.
Henderson et.al. (2016) found that care deficiencies in complex care such a medication review, pain management or wound care were related to the dependence on care workers.
A vital part of the ACFI nursing assessment pertaining to quality care for the geriatric population is continence care.
A study was conducted to determine how continence care is provided in aged care facilities.
The results of the study showed that the perceptions and experiences of staff regarding funding model, quality framework, and the environment of care led to fearful and dangerous environments that can have unimaginable impacts on the residents’ continence.
It was encouraged to depend on continence management, as well as ensuring effective continence and pad use.
In 2016, O’connell, Dunning and O’connell proposed a reassessment of the quality of continence management in Australian aged care facilities.
The federal government’s regulatory activities have been shown to greatly affect the quality of aged care. Accordingly, it is imperative that nurses follow the proposed guidelines. Johnson, 2017.
ACFI’s nursing responsibilities to patients includes the handling and execution of duties related to documentation of continence, behavioral, and cognitive records. Behavior records include wandering and verbal behavior.
This study examined the nursing care of people with dementia, who are able to access residential facilities with wandering.
A social order for practice was suggested to enable maximum outcomes. This would ensure that the interests of patients are protected and that appropriate measures are taken in order to obtain optimal results. (Cope, 2016,
Another study looked at the differing needs and demands of dementia care in permanent residential aged facilities.
The complexity of care requirements regarding nutrition, cognition, continence and other aspects was higher in dementia patients than in their non-dementia-affected counterparts.
In the case of dementia patients, there has been an accentuated assessment of care in permanent residential aged homes due to increased complexity. This emphasizes the need for nurses to use appropriate nursing interventions in order attain desired results.
The relevant literature supports the fact that nurses may not always be able to follow their ACFI-assigned responsibilities.
Missed nursing care can be attributed to an increased workload due to the rationing and misallocation of resources.
Insufficient support from colleagues and work intensification have been identified as part of staffing challenges. They include the altering of workloads across shifts, changing skill mix, and aligning work with patient acuity.
Henderson et. al. (2016) identified that resource issues are the main obstacles to providing adequate nursing care.
An important report on the wellbeing and workplace climate of the nurses has revealed some key findings. These could be connected to the reasons for non-conformance with usual care for aged patients at residential aged care facilities.
One Respondent Registered Nurse has quoted that ACFI was the root cause of nurses’ lack of enthusiasm and lower work output. Other confounding factors include poor skill mix and increased reliance more on bureaucracy-based than knowledge-based care.
Tham & Gill (2016) claim that poor performance by nurses in the discharge of their duties is due to legislative vagueness, among other factors.
Despite the best efforts of the nurses, it is often tedious for them align with ACFI’s dictums for caring for geriatric patients.
ReferencesAgedcare.health.gov.au. (2017).
Standards
The performance of Caring: The construction of nursing care facilities for people with dementia who live at home or wander (Doctoral dissertation by Queensland University of Technology).Davis, J., Morgans, A., Birks, M., & Browning, C. (2016).
The reality and the rhetoric of nursing in elderly care: perspectives from the inside.
Contemporary nurse 52(2-3), 191-203.Henderson, J., Willis, E., Blackman, I., Toffoli, L., & Verrall, C. (2016).
Qualitative responses to an Australian survey on nursing care.
Labour & Industry. A journal of economic and social relations at work. 26(4), 281-297.Henderson, J., Willis, E., Xiao, L., Toffoli, L., & Verrall, C. (2016).
Perceptions of nurses regarding the effects of aged care reform upon services for rural residents of multi-purpose services and residential aged homes in rural Australia.
Australasian journal about ageing, 35(4).Jeon, Y. H., Li, Z., Low, L. F., Chenoweth, L., O’Connor, D., Beattie, E., … & Brodaty, H. (2015).
The clinical utility of Cornell Scale for Depression in Dementia for routine assessment at nursing homes.
American Journal of Geriatric Psychiatry. 23(8), 784-793.Joenpera, J. (2017).
Tales from ACFI: Dementias in residential aged care.
Australasian Review on Ageing 36(1), 10-13Johnson, C. (2017).
AMA provides submission for government review regarding aged care facilities.
Australian Medicine 29(15), 10.Ostaszkiewicz, J., O’connell, B., & Dunning, T. (2016).
Fear and overprotection at Australian residential aged care facilities. The inadvertent effect of regulation on quality continence treatment.
Australasian journal about ageing, 35(2). 119-126Tham, M. T. L., & Gill, F. (2016).
What Nurses and Midwives Want: Findings From the National Survey on Well-being and Workplace Climate.Willis, E., Price, K., Bonner, R., Henderson, J., Gibson, T., Hurley, J., … & Currie, T. (2016).
The need to meet residents’ care demands: A study of the nursing and personal care staff requirements.