Keynote presentation given by Dr Catriona Murphy, School of Nursing and Human Sciences, Dublin City University at the 5th Annual Nursing Showcase at St Mary's Hospital, Phoenix Park, Dublin. September 6th 2017.

1. Gerontological Nursing Research
in a Time of Change
St. Mary’s Hospital, Phoenix Park, Nursing Showcase 6/9/17
Dr. Catriona Murphy
School of Nursing and Human Sciences, DCU

2. Diversity in this room
Transitional care
Management

3. • Population change
• Crossing boundaries
• Opportunities to engage in research at individual, local, health system
and population level

4. Population change

5. Source: http://www.cso.ie/en/releasesandpublications/ep/p-cp3oy/cp3/assr/
Male

6. Changes in population >65 years since 2006
0 50 100 150 200 250
2006
2011
2016
85+ 80-84 75-79 70-74 65-69
Data extracted from CSO interactive tables
1000’s
Census
Year

7. Changes in population >65 years since 2006
0 50 100 150 200 250
2006
2011
2016
85+ 80-84 75-79 70-74 65-69
211,236 47.3%
Data extracted from CSO interactive tables
1000’s
143,336

8. Changes in population >65 years since 2006
0 50 100 150 200 250
2006
2011
2016
85+ 80-84 75-79 70-74 65-69
48,028
67,555 40.6%
Data extracted from CSO interactive tables
1000’s

9. Impact
• 33.7% of those aged 85
years and older utilised
PHN services in the
previous year (Murphy 2015)
• Equates to approx.
16,200 in 2006
22,800 in 2017
Murphy C. Demographic and health profile of older adults using public health nursing services in Ireland: Findings from The Irish Longitudinal
Study on Ageing (TILDA). Trinity College, Dublin: The Institute of Community Health Nursing and The Irish Longitudinal Study on Ageing; 2015.

10. Impact
• The main area of missed care was in
health promotion particularly in
relation to older people and chronic
disease management
• There was a high degree of missed
care where caseloads included
disadvantaged groups (asylum
seekers, homeless, migrants,
travellers)
PHELAN, A., MCCARTHY, S., 2016. Missed Care: Community Nursing in Ireland. Dublin: University College Dublin and The Irish Nurses and
Midwives Organisation.

11. Average age by electoral division 2016
http://census.cso.ie/p3map21/

13. A Changing Landscape
• Diversity as we age
• Diverse needs/ personal preferences
• Multicultural
• Marginalised groups
• Complex care needs
• Chronic disease and Multimorbidity
• Person centred care
• Context: two tier health system, socioeconomic status, social support, housing, transport
• Information/technology deficit
• Learning from countries further along the ageing trajectory
• Change in service delivery is slow to respond to the demographic changes

15. Crossing boundaries

16. Health Service Executive Workforce 2017 (n=106,000)
9%
33%
14%
16%
9%
19%
Staff Categories
Medical/Dental
Nursing
Health & Social Care
Management/Admin
General Support Staff
Patient and Client Care
HEALTH SERVICE EXECUTIVE 2016. National Service Plan 2017. Dublin: Health Service Executive.

18. Developing a network
• Strength in our diverse roles
• Exposure to a range of practitioners with
similar interests or overlapping interests
• Seek opportunities to engage in research
(E.g. quality care metric indicators for
older person services)
• Provide evidence for improved nursing
service provision in your local area
• Examine research translation in your area
of practice
• Develop research skills and infrastructure
within gerontological nursing
• Engage with practice, policy and strategy
development at local and national level

19. Opportunities to engage in research
at individual, local, health system
and population level

20. The Individual Patient Journey

21. Public patient involvement
• Engaging patients/service
users/clients/carers as co-
researchers from the outset
• Supports available in each third
level institution

22. Population perspective
Focus on the individual Focus on the whole population

23. The Irish Longitudinal Study on Ageing (TILDA)
• Trinity College
• Economic, social and health
information on over 50s in
Ireland
• Funded by Atlantic
Philanthropies, Irish Life and
Department of Health
https://tilda.tcd.ie/

24. International longitudinal studies of ageing

25. The Irish Longitudinal Study on Ageing
• Nationally representative sample
of community living adults over 50
years
• Brief overview of research project
on hypertension prevalence and
knowledge translation

26. Blood pressure ≥ 140/90 mmHg

27. Blood pressure and medications recorded

28. Hypertension definition:SBP≥140 mmHg or DBP ≥90 mmHg and/or on antihypertensive medication
This is equivalent to 797,000 in the population aged 50 years and older in Ireland
Hypertension prevalence

30. • Grant from the Health Research
Board
• Challenge in shifting from a
population perspective to
impacting on patient care
• Community nurses/Practice nurses
• 17 Locations
• 12 Counties
• 386 nurses attended
• Lessons from dissemination phase
Knowledge Exchange and Dissemination

32. • Awareness raising: Public and professionals
• Media: radio interviews, newspaper
• Irish Heart Foundation’s blood pressure council
• British and Irish Hypertension Society member
• Undergraduate summer studentship
• Hypertension education day (November 30th)
• Lots done, more to do……
Further knowledge translation

33. TILDA resource
https://tilda.tcd.ie/

34. Exciting time to be involved in gerontological
nursing research
• Constantly changing environment
• Improve our knowledge to improve patient care
• Develop research skills
• Support nurses engaged in research
• Develop networks: other nurses, other disciplines, patients/families/carers
• Demonstrate the complexity of nursing older adults and the impact of
research on quality of care and client satisfaction with care received
• Enable visibility of the dynamism of gerontological nursing work
• Today is about all of the above

35. Don’t hide the light

36. Thankyou
Catriona.murphy@dcu.ie