How training could improve the way HCAs relate to older people

This is the first in a series of six articles that aim to encourage nurse leaders to explore how to use research findings to improve practice and services where they work. The series focuses on research that has been funded by the National Institute for Health Research (NIHR) and included in NIHR Dissemination Centre publications. The authors seek to relate the content directly to the Nursing and Midwifery Council’s code of professional standards of practice and behaviour, specifically the themes of practising safely and promoting professionalism and trust.

Introduction to the first article by Elaine Maxwell, clinical adviser at the National Institute for Health Research Dissemination Centre:

The NIHR Dissemination Centre provides good research evidence for decision-making in health and social care. Our review of research into hospital care of older people living with frailty, published recently, identified the importance of good relationships for clinical outcomes as well as for patient satisfaction.

The review also describes the challenges of doing this in busy hospital settings. You can read more about the research findings on this and other aspects of managing frailty by downloading the report Comprehensive Care.

‘Caring’ can be seen as less skilled than task-based work, and is often perceived to be based on personal attributes, hence the focus on values-based recruitment. Caring involves developing meaningful relationships that lead to dignity, empathy and emotional support, although Benner and Wrubel (1989) assert that caring for strangers is significantly different from caring for friends and family members.

Caring for family happens in the context of long-term relationships, but caring for strangers requires staff to develop therapeutic relationships quickly and in atypical circumstances. Despite this, few resources are devoted to teaching these skills, particularly to healthcare assistants (HCAs), who provide much of the direct care of older people in hospital.

One of the studies featured in Comprehensive Care looked at the feasibility of developing a relational care training programme for HCAs. In this article, lead researcher Tony Arthur describes the study and a chief nurse, Cheryl Lenney, discusses the implications for nurse managers.

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