Care planning in long-stay settings for older people in Ireland: Practitioner perspectives

Nursing and care planning have shared such long and intimate histories that it would appear only a slight exaggeration to suggest the two are now almost synonymous. In light of such shared histories, there may be little... [ view full abstract ]

Nursing and care planning have shared such long and intimate histories that it would appear only a slight exaggeration to suggest the two are now almost synonymous. In light of such shared histories, there may be little surprise that research around more novel areas of care planning, such as the contribution of information technology, often enjoys the limelight. While more taken-for-granted considerations, such as how care planning is perceived or operationalised in practice, tend to languish in the shadows. The introduction of new regulatory frameworks therefore provides an ideal opportunity to re-examine potentially taken-for-granted considerations and it is against such a backdrop that this study was conducted.

In Ireland in mid-2009, National Quality Standards for Residential Care Settings for Older People were introduced by the Health Information and Quality Authority. As part of a study into this development, in late 2010, Directors of Nursing/Care Managers were surveyed using an online/postal questionnaire. The sample was comprised of 250 long-stay residential centres (42.5% response rate). This survey sought to examine the tools, processes and practices that surrounded care planning. In addition, this survey included open-ended questions that sought practitioner perspectives on the benefits (n=90), drawbacks (n=89) and obstacles (n=88) to care planning. Data analysis was conducted using a variation of conventional content analysis and this presentation details the findings of this qualitative section of the larger survey.

The key findings were that care planning was viewed very much in a Janus-faced manner. On the one hand, respondents’ viewed care planning positively, valuing it for its contribution to facilitating continuity of care and for promoting person-centred care. On the other hand, care planning was seen as incurring significant burdens, particular in relation to ‘time’, with time demands viewed both as a significant drawback of care plans and a substantial obstacle to their completion.