Nursing Practice for Early Detection of Long-Term Care Resident Deterioration: A Qualitative Study

In long-term care (LTC) facilities, nurses play a key role in detecting changes in residents' health conditions and preventing avoidable emergency transfers and hospitalisations through multidisciplinary collaboration. This study aimed to explore how nurses detect changes that indicate the deterioration in LTC residents' conditions.

Semi-structured interviews were conducted with 23 nurses from 14 LTC facilities. Data from these interviews were qualitatively analysed using coding and constant comparison methods.

The three main categories were 'preparing', 'assessing' and 'judging'. Nurses worked closely with care workers who spent a considerable amount of time with the residents, and by sharing information, the nurses could rapidly respond to changes in the residents' conditions. They also evaluated the risk of residents experiencing changes by leveraging their clinical experience.

This study found that LTC nurses should collaborate with care workers to enhance their health assessment skills, enabling them to detect changes in residents' conditions. Findings from this study can be used to promote collaboration between nurses and care workers and to develop effective educational interventions to improve nursing practice in LTC facilities.

This study underscores the necessity of nurses' ability to identify early deterioration in LTC residents. The findings reveal key symptoms and warning signs that nurses should prioritize in their assessments. By leveraging clinical experience and close observation, nurses can make timely and effective decisions to address residents' health changes, preventing further deterioration and enhancing their quality of life.