AN EXAMINATION OF THE CLINICAL COMPETENCY OF GERIATRIC NURSES WORKING IN GENERAL HOSPITALS ACROSS NIGERIA

CHAPTER ONE INTRODUCTION 1.1 Background of the Study According to data from the World Health Organization (WHO, 2022), people worldwide are living longer than ever before. This global increase in life expectancy means that the elderly population is expanding rapidly and is expected to double by the year 2050. Nigeria, ranked as the second-largest economy in Africa, is experiencing one of the fastest-growing ageing populations, which poses significant challenges for its healthcare system (Fang et al., 2020). Projections estimate that by 2050, more than 400 million people worldwide will be aged 65 and above (WHO, 2021). This anticipated growth represents a major demographic shift, with the number of people aged 60 and older expected to rise from 1 billion in 2020 to 2 billion by 2050. This demographic transition presents both opportunities and challenges for healthcare systems, particularly in the field of geriatrics. There is an increasing need for a skilled healthcare workforce capable of delivering quality care to this vulnerable group, which faces a higher prevalence of age-related conditions such as chronic diseases, cognitive decline, and frailty (Huntley et al., 2019). Geriatric nursing is a specialized branch of nursing focused on addressing the unique health needs of older adults. Because ageing affects physical, mental, and social aspects of health in complex ways, geriatric nurses are trained to understand and manage these multifaceted challenges. They play a crucial role in the care of elderly patients, often coordinating treatment for multiple coexisting conditions, collaborating with multidisciplinary teams, and providing support to patients’ families (Woods et al., 2020). Despite their importance, many healthcare systems struggle with the competency levels of geriatric nurses. Studies have shown that a significant number of nurses lack adequate training and experience in geriatric care, which can lead to poorer patient outcomes (Davis et al., 2020). Several factors contribute to these challenges. First, there is a shortage of nurses specializing in geriatrics, compounded by an ageing nursing workforce. As experienced nurses retire, younger nurses enter the profession without sufficient expertise in geriatric care (Baldwin et al., 2019). Additionally, traditional nursing education often prioritizes acute care over the complexities involved in caring for elderly patients, leaving many new nurses unprepared for geriatric challenges (Gonzalez et al., 2021). Moreover, the evolving healthcare environment—with its emphasis on community-based care and patient-centered approaches—demands a broader skill set from geriatric nurses. These include the ability to engage patients and their families in care decisions, along with strong communication and cultural competence (Heath et al., 2021). Unfortunately, current training programs do not always adequately emphasize these critical skills, potentially leading to inconsistent care (Fitzgerald et al., 2020). The competence of geriatric nurses directly impacts patient outcomes. Research indicates that higher levels of nursing competency are associated with reduced hospital admissions, improved functional abilities, and increased patient satisfaction (Tzeng & Yin, 2019). Conversely, insufficient competence can lead to medication errors, neglect of essential care needs, and diminished quality of life for older adults (Burr et al., 2020). Given the vital role geriatric nurses play and the challenges they face, it is essential to assess their competency. This study therefore aims to investigate the clinical competence of geriatric nurses working across general hospitals in Nigeria. 1.2 Statement of the Problem The global rise in the elderly population has intensified the demand for healthcare services tailored to older adults, particularly in geriatrics. As the senior population encounters various complex health issues—ranging from chronic diseases and mobility limitations to cognitive impairments—the need for qualified geriatric nurses becomes even more pressing. However, many healthcare systems, especially in developing countries, report a shortage of adequately trained and professional geriatric nursing staff despite this growing need (WHO, 2021). This lack of competence among nurses can result in substandard care, slower recovery times, and a decline in the overall quality of life for elderly patients. Several studies suggest that this competence gap stems from a lack of geriatric-specific training programs, insufficient practical experience in managing elderly patients’ unique conditions, and a general deficit in clinical exposure to geriatric care (Chan et al., 2020; Eglseer et al., 2019). This problem is particularly evident when nurses face the challenge of addressing the complex needs of elderly patients in areas like palliative care, mental health, and fall prevention. Therefore, this research focuses on investigating the competence of geriatric nurses as clinical nursing staff within general hospitals in Nigeria. 1.3 Objectives of the Study The main aim of this study is to explore the competence of geriatric nurses working as clinical staff in general hospitals across Nigeria. The specific objectives include: i. Assessing the level of clinical competence among geriatric nurses in patient care. ii. Examining how specialized training influences the clinical skills of geriatric nurses. iii. Identifying the challenges geriatric nurses face in delivering quality care in clinical settings. 1.4 Research Questions This study will be guided by the following questions: i. What is the level of clinical competence among geriatric nurses in providing care to elderly patients? ii. How does specialized training affect the clinical skills of geriatric nurses? iii. What challenges do geriatric nurses encounter in delivering quality care in clinical environments? 1.5 Significance of the Study The findings of this study are expected to offer valuable evidence-based recommendations for policymakers aimed at enhancing geriatric care practices. By influencing policies that promote adequate staffing, targeted training, and provision of necessary resources, the study could contribute to improved healthcare services for the elderly population. Additionally, the research will be important to the academic community, as it will add to existing literature, enrich library resources, and serve as a foundation for future studies. 1.6 Scope of the Study This study focuses on assessing the competence of geriatric nurses serving as clinical nursing staff in general hospitals throughout Nigeria. Empirically, it will evaluate the nurses’ clinical competence in patient care, investigate the impact of specialized training on their clinical skills, and identify the challenges they face in delivering high-quality care. Geographically, the study is limited to the Federal Medical Center in Owerri, Imo State. 1.7 Limitations of the Study As with any research, this study faced some constraints. These include: Time: The researcher had limited time due to concurrent academic responsibilities such as attending lectures and other educational activities. Financial Resources: The study required expenses related to printing, typesetting, sourcing relevant materials, and data collection, which posed financial challenges. Availability of Materials: There was difficulty sourcing adequate literature on this specific topic, which limited the depth of the review. 1.8 Definition of Terms Geriatric Nursing: A specialized nursing field focused on caring for elderly patients, addressing their unique health issues related to aging, chronic illnesses, and end-of-life care. Competence: The ability of nurses to effectively perform their duties, demonstrating the knowledge, skills, and attitudes necessary to provide high-quality care, especially to older adults. Clinical Nursing Staff: Healthcare professionals, including registered and licensed practical nurses, who provide direct patient care in settings like hospitals, nursing homes, and outpatient facilities. Elderly Patients: Individuals generally aged 65 years and above who often face complex health problems associated with aging, such as physical disabilities, cognitive decline, and chronic diseases. Specialized Training: Education and skill development targeted at specific areas of practice, such as geriatric care, aimed at enhancing nurses’ competencies and preparing them for the challenges of caring for older patients.