Improving the Quality of Life for Patients With Co-morbidities requiring Acute Care Allison Williams PhD Student School of Nursing Deakin University Supervisor: Assoc. Prof. Mari Botti

SPECIFIC AIMS how episodic care is integrated into the on-going care of patients with chronic illnesses [CM] focussing on altered functional health status and comfort how the episodic event is utilised to review the overall management of these patients what extent nursing staff met the expectations of this group of patients

Defining Key Terms Chronic [long term] illness 'an altered health state that will not be cured by a simple surgical procedure or a short course of medical therapy' [Miller, 1992, p. 4] CM- > one chronic illness Quality of life ‘a person’s sense of well- being that stems from satisfaction or dissatisfaction with the areas of life that are important to him/her’ [Ferrans, 1985]

The research problem Reduced mortality rates Most require episodic care Focus- primary diagnosis Rapid throughput Lack of research Nursing - key role Acute health care

Acute care- government funding increase of 8.4% of total health care costs- $47b hospital room - 86% of total health care costs reduction in length of stay Casemix DRGs Clinical pathways Personal costs

ACUTE CARE- the medical perspective Increased quantity of life Curing underpinning Medical treatment limited Health care system does not facilitate supportive care Consultation- focus not on CM Under-recording of CM

ACUTE CARE- the chronically ill Conflict of interest Patients with CM more resource intensive Patient satisfaction Nurse-patient relationship Home quicker & sicker CM require long term continuity of care Discharge concerns Models of care single chronic illnesses ICIDH-2

The research process Methodology Sample Procedure Data analysis

FINDINGS Demographics Number of CM unclear Living from day to day Murphy’s Law Too hard basket Too much trouble Coping mechanisms

Findings cont.

Conclusion Fatalistic expectations An absence of evidence to suggest that these patients have continuity & co-ordinated care of CM New layer of care that has not been factored in Nursing role- responsibility to ensure these patients and their co-existing illnesses receive continuity, co-ordinated and seamless delivery of care to improve the quality of life for this group

Next steps Secondary diagnoses Survey Increase sample size Thank you