2020 Volume 24 Issue 1 Pages 220-231
Objective: This study describes nursing practices for older adults when clinical pathways are adopted in gastroenterological surgery wards.
Method: Semi-structured interviews were conducted with nine nurses with a clinical experience of five years or more. Data were examined using qualitative content analysis.
Results: Nurses were aware of the advantages and difficulties of adapting clinical pathways for older adults. Nursing practices were grouped into four categories. Of these, two categories pertained to nursing practices considering the characteristics of older adults when using clinical pathways, i.e.,: (1) providing older adults with nursing care by emphasizing on clinical judgment based on clinical experience, regardless of clinical pathways, and (2) recognizing the need for executing appropriate discharge planning for older adults. The other two categories pertained to difficulties experienced during nursing practice with older adults, i.e.,: (3) lack of confidence in caring for older adults, and (4) not considering the characteristics of older adults.
Discussion: Some nurses experienced difficulties in adapting the clinical pathway to needs for older, frail adults. These results suggest that clinical pathways for adults are ineffective for older, frail adults. Some nurses provided geriatric nursing practices regardless of clinical pathways; these practices should be disseminated to other nurses.
Conclusion: It is necessary to develop clinical pathways considering older adults' characteristics and to educate nurses to improve their geriatric nursing practice abilities in acute care hospitals.
