Editorial: Call to action: greater investment in the registered nurse role is required to improve care outcomes for dementia patients living in residential aged care and their families.

Taylor and Francis
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Journal Article
Contemporary nurse, 2016, 52 (2-3), pp. 137 - 139
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The number of people living with dementia will triple by 2050 (World Health Organization, 2012). Dementia is a complex terminal illness and international global public health priority (World Health Organization, 2012). Whilst enormous efforts focus on dementia treatments, there is an equally urgent need to address workforce issues and invest in increasing the registered nurse role and ratios in residential aged care to meet the projections. In most high-income countries residential aged care facilities have evolved over the past two to three decades from homes for the aged into slow-stream hospices, caring for our most vulnerable community members (Allen, Chapman, O’Connor, & Francis, 2008). This population has complex care needs requiring the input of a range of health professionals, such as geriatricians, general practitioners, registered nurses and care assistants (Hickman, Rolley, & Davidson, 2010; Phillips, Heneka, Hickman, Lam, & Shaw, 2014). Over this same time period the number of registered or enrolled nurses working in residential aged care facilities has fallen and those that remain have been largely relegated to managerial responsibilities. As a result the bulk of nursing care in residential aged care is now provided by a largely unskilled and unregulated workforce. Without the prerequisite dementia knowledge, skills or training, these staff are supervised by a small number of registered nurses (Hullick et al., 2016). This is in contrast to emerging evidence from long-term care and acute care setting, that nurse qualifications impact outcome. It also differs significantly from standards in countries like Germany, where a minimum RN ratio of 50% is mandatory (Aiken et al., 2010)
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