AN INVESTIGATION INTO THE COMPETENCE OF GERIATRIC NURSES AS A  CLINICAL NURSING STAFF ACROSS GENERAL HOSPITALS IN NIGERIA

CHAPTER ONE

INTRODUCTION

Background of the study

According to the WHO figures [2022], the world’s population is living longer. Globally, the population of elderly people is growing and is predicted to double by 2050. Nigeria, the second-biggest economy in the world, has one of the highest ageing populations in the world, and as such, it presents substantial healthcare concerns [Fang et al, 2020]. By 2050, there is expected to be a significant increase in the number of elderly people, with over 400 million persons over 65 [WHO, 2021]. The senior population is expected to grow significantly over the next several decades, marking a substantial shift in the global demographic picture. The World Health Organisation (WHO, 2021) projects that there will be twice as many persons 60 years of age and older by 2050—1 billion in 2020 and 2 billion by 2050. Healthcare systems have both possibilities and problems as a result of this demographic transition, especially in the area of geriatrics. A professional workforce that can provide this vulnerable population with high-quality care is required due to the rising frequency of age-related health concerns, including chronic illnesses, cognitive decline, and frailty (Huntley et al., 2019). Geriatric nursing is a specialist discipline focused on fulfilling the particular health requirements of older persons. The physical, mental, and social facets of ageing are all complicated, and geriatric nurses are taught to recognise this. They are essential in overseeing the care of senior citizens, which frequently entails managing several comorbidities, organising multidisciplinary treatment, and offering assistance to families (Woods et al., 2020). The competency of geriatric nurses is a problem for many healthcare systems, despite the critical role they play. According to reports, a sizable portion of nurses are not sufficiently trained or experienced in providing geriatric care, which may result in worse than ideal patient outcomes (Davis et al., 2020). The difficulties geriatric nurses encounter are caused by a number of causes.First, there is a geriatrics shortage of nurses, which is made worse by an ageing nursing staff. Younger nurses entering the industry will lack knowledge and skills as a result of the retirement of many experienced nurses (Baldwin et al., 2019). Furthermore, many new nurses are unprepared for the challenges of working with older patients since traditional nursing education frequently places more emphasis on acute care than the complexity of geriatric care (Gonzalez et al., 2021). Furthermore, geriatric nurses must possess a variety of competences due to the changing nature of healthcare, which includes a move towards community-based care and a focus on patient-centered methods. These include the capacity to involve patients and their families in the decision-making process about their treatment, as well as communication and cultural competency (Heath et al., 2021). But inconsistent care delivery might result from inadequate attention to these abilities in current training programs (Fitzgerald et al., 2020). The ability of geriatric nurses to provide efficient, superior care is critical. Research has indicated that superior patient outcomes, such as fewer hospital admissions, enhanced functional status, and more patient satisfaction, are linked to enhanced competency among nursing personnel (Tzeng & Yin, 2019). On the other hand, insufficient proficiency may result in unfavourable consequences such prescription mistakes, disregard for critical medical requirements, and a decline in the standard of living for senior citizens (Burr et al., 2020). Research assessing elderly nurses' competency is crucial given their vital role in the healthcare system and the difficulties they encounter. Therefore, the researcher sought to investigate the competence of Geriatric nurses as a  clinical nursing staff across general hospitals in Nigeria.

Statement of the problem

Globally, the number of aged people is growing, which has increased demand for healthcare services, especially in the geriatrics field. The need for skilled geriatric nurses grows as the senior population faces a variety of complicated health conditions, including chronic illnesses, mobility issues, and cognitive loss. Many healthcare systems, particularly those in developing nations, claim a shortfall of appropriately qualified and professional geriatric nurses, despite the rising need (World Health Organisation [WHO], 2021). This lack of expertise might result in older people receiving subpar treatment, recovering slowly, and experiencing a deterioration in their quality of life.According to a number of studies, the lack of geriatric nursing programs in clinical settings, inadequate specialised training, and lack of experience managing conditions unique to the elderly all contribute to geriatric nurses' lack of competence (Chan et al., 2020; Eglseer et al., 2019). The issue is made more apparent by the fact that nurses may find it difficult to evaluate the complex requirements of senior patients, especially when it comes to palliative care, mental health, and fall prevention. Hence, the study investigate the competence of Geriatric nurses as a  clinical nursing staff across general hospitals in Nigeria.

1.3 Objective of the study

The broad objective of the study is to investigate  the competence of Geriatric nurses as a  clinical nursing staff across general hospitals in Nigeria. The specific objectives is as follows

To assess the level of clinical competence among geriatric nurses in providing care to patients.

To examine the impact of specialized training on the clinical skills of geriatric nurses.

To identify the challenges faced by geriatric nurses in delivering quality care in clinical settings

1.4 Research questions

The following questions have been prepared to guide the study

What is the level of clinical competence among geriatric nurses in providing care to patients?

What is the impact of specialized training on the clinical skills of geriatric nurses?

What are the challenges faced by geriatric nurses in delivering quality care in clinical settings?

1.5 Significance of the study

Findings of the study can provide evidence-based recommendations for health policy makers aimed at improving geriatric care practices. Policies that support adequate staffing, training, and resources can ultimately lead to better care for the elderly population. Findings of the study will also be significant to the academic community as it will contribute to the existing literature, add to library resources and serve as a guide to future academic researchers.

1.6 Scope of the study

The study focus on the competence of Geriatric nurses as a  clinical nursing staff across general hospitals in Nigeria. Empirically, the study will assess the level of clinical competence among geriatric nurses in providing care to patients, examine the impact of specialized training on the clinical skills of geriatric nurses and identify the challenges faced by geriatric nurses in delivering quality care in clinical settings.

Geographically, the study will be delimited to federal medical center Owo, Ondo State.

1.7 Limitation of the study

Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. The significant constraint are: 

Time: The researcher encountered time constraint as the researcher had to carry out this research along side other academic activities such as attending lectures and other educational activities required of her.

Finance: The researcher incurred more financial expenses in carrying out this study such as typesetting, printing, sourcing for relevant materials, literature, or information and in the data collection process.

Availability of Materials: The researcher encountered challenges in sourcing for literature in this study. The scarcity of literature on the subject due to the nature of the discourse was a limitation to this study.

1.8 Definition of terms

Geriatric Nursing: A specialized field of nursing focused on the care of elderly patients, addressing their unique health needs and challenges related to aging, chronic illnesses, and end-of-life issues.

Competence: The ability of nurses to effectively perform their duties, demonstrating the necessary knowledge, skills, and attitudes to provide high-quality care to patients, particularly the elderly.

Clinical Nursing Staff: Healthcare professionals, including registered nurses and licensed practical nurses, who provide direct patient care in clinical settings such as hospitals, nursing homes, and outpatient facilities.

Elderly Patients: Individuals typically aged 65 and older who may experience complex health issues associated with aging, including physical disabilities, cognitive impairments, and chronic diseases.

Specialized Training: Education and skill development focused on specific areas of practice, such as geriatric care, which enhances nurses' competencies and prepares them for the unique challenges associated with caring for elderly patients.