An exploration of the experiences of registered nurses working in aged residential care facilities regarding interRAI: A qualitative research design
AbstractTitleAn exploration of the experiences of registered nurses’ working in aged residential care facilities regarding interRAI: A qualitative research design.Aim To assess the experiences of RNs’ working in aged residential care facilities in Christchurch, about performing interRAI assessments using interRAI MOMENTUM software.Objectives • To explore the positive and negative experiences of registered nurses regarding using interRAI for their clients’ assessments.• To explore the factors affecting the registered nurses in performing interRAI based comprehensive health assessments.• To identify the aids and barriers faced by registered nurses in interRAI application or use.Review of LiteratureThe interRAI assessment system first introduced in New Zealand in the year 2004 is a standardized tool for performing client assessments in aged residential care (ARC) facilities in NZ since 2015. The word ‘interRAI’ stands for ‘international resident assessment instrument’ which has replaced the paper assessments used in planning and implementing evidence based care for clients. The interRAI suite of instruments is used in acute, residential and community care settings. At present, registered nurses (RNs) who are interRAI competent and working in aged care are required to complete these assessments nationwide. Aged residential care (ARC) is one of the most rewarding and at the same time a complex area of nursing practice which requires techniques that are advanced and practical. With a growing older population and increasing RN turnover in aged care, it is a difficult time for private aged care providers in terms of sustaining the nursing workforce and ensuring the quality of nursing care being provided. Furthermore, the implementation and maintenance of interRAI services is managed by Technical Advisory Services (TAS) across both North and South islands of NZ. Since Ministry of Health, New Zealand has made the interRAI assessments mandatory for the aged care sector, it is important to understand the RNs’ experiences and perceptions around interRAI and the factors associated with its completion within the scheduled time period, once an assessment is undertaken. MethodsA qualitative design was utilized to assess the experiences of RNs about interRAI. Focus group interview technique was implemented to collect data. Seven RN participants who gave consent for participation from various ARC facilities were interviewed in a focus group. Focus group methodology was conducive for the participants in terms of spontaneously discussing the issues and aids they believe could potentially improve their approach towards interRAI assessments. Thematic analysis was used to analyze the findings from the data collected that reflected in four themes. The data was audio taped and later transcribed for maintaining accuracy.FindingsFour themes identified were RN’s positive experiences and engagement with interRAI tool; challenges with using interRAI tool; professional and system barriers faced by RNs; and need for a unified standard assessment system.ConclusionThemes and subthemes represented the various factors affecting interRAI use and its perception by RNs in aged care sector. Theme one includes positive understanding of the interRAI tool, and RNs’ acknowledgement for its comprehensive and multidisciplinary feature. Theme two reflects on the challenges faced by RNs namely the mandatory and time consuming nature of these assessments, increased workload on RNs and the limited implementation of the tool in NZ. Theme three discusses various obstacles faced by RNs ranging from a preference for paper-based assessments, organisational and technical barriers to miss-constructed perception of the nursing profession among the team of health care assistants. And, theme four states the need for a universal assessment system at all levels of health care. However, the focus group acknowledged that interRAI assessments are valuable in informing nursing practice and with required improvements in its current implementation strategy, interRAI assessment system might become instrumental in changing the current health care practice for better in the future.
Advisor: Burrell, Beverley; Ritchie, Lorraine
Degree Name: Master of Health Sciences
Degree Discipline: Centre for postgraduate nursing studies
Publisher: University of Otago
Keywords: interRAI; Aged; residential; care; facilities; christchurch; New; Zealand
Research Type: Thesis