Programme d'intervention visant à réduire l'utilisation des contentions physiques dans des unités de soins de longue durée — mise en oeuvre et effets sur le personnel soignant

2002 ◽  
Vol 21 (4) ◽  
pp. 559-576 ◽  
Author(s):  
Pierre J. Durand ◽  
Jean-Paul Ouellet ◽  
Line Beauchesne ◽  
André Tourigny ◽  
René Verreault ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Care Staff ◽  
Controlled Clinical Trial ◽  
Staff Perceptions ◽  
Term Care ◽  
Restraint Reduction ◽  
Post Test ◽  
Personnel Soignant

ABSTRACTThis study aimed at (a) developing a restraint reduction program, (b) describing its implementation in long-term care units, and (c) examining its effects on care staff's perceptions of and knowledge about the use of restraints. The program was composed of three parts: consciousness-raising meetings, staff education, and clinical follow-up. The study was a randomized, controlled clinical trial with eight intervention care units (five nursing homes) and 11 controls (five additional nursing homes). Care staff was surveyed at two time intervals over a 7-month period (pre- and post-test intervention; intervention care units: N = 171 [T0] and N = 158 [T1]; controls: N = 181 [T0] and N = 166 [T1]). The implementation of the program was successful and results showed significant changes in care staff perceptions of and knowledge about the use of restraints.

scholarly journals Development and Mixed-Methods Evaluation of a Pain Assessment Video Training Program for Long-Term Care Staff

2013 ◽  
Vol 18 (6) ◽  
pp. 307-312 ◽  
Author(s):  
Michelle M Gagnon ◽  
Thomas Hadjistavropoulos ◽  
Jaime Williams
Keyword(s):  
Focus Groups ◽  
Pain Assessment ◽  
Long Term Care ◽  
Care Staff ◽  
Term Care ◽  
Pain Education ◽  
Video Training ◽  
Training Video

INTRODUCTION: Inadequacies in pain assessment and management in long-term care have been well documented. Insufficient pain education and inaccurate beliefs about the nature of pain and aging have been identified as possible contributors. The present study addresses the need for improved, efficient and feasible continuing pain education through the use of an assessment training video.METHODS: A total of 148 long-term care staff viewed and evaluated the training video. Knowledge changes and pain beliefs were assessed postvideo and at a four-week follow-up. Beliefs about pain, as well as pain and aging, were also examined using multivariate procedures to determine whether these variables influenced participants’ evaluation of the video. Focus groups were also conducted, and transcripts were analyzed using thematic content analysis.RESULTS: Pain assessment knowledge improved postvideo and at the four-week follow-up. Participants positively evaluated the content and quality of the video. Individuals who held stronger beliefs (at baseline) about the organic nature of pain provided more positive evaluations. Barriers to implementation of practices in the video identified by the focus groups (and qualitative analysis) included time, workload and resistance to change. Facilitators to implementation included continued management support and observing the benefits to implementation.DISCUSSION: The present study provides support for the use of video training. However, based on the focus group results, top-down implementation approaches with ongoing management involvement throughout the implementation process may be needed to achieve sustained changes in pain assessment practices. A model useful for sustained implementation was proposed and discussed, and is hoped to facilitate future research.

scholarly journals INTEREST GROUP SESSION—RESEARCH IN QUALITY OF CARE: LIVING IN AND LEAVING NURSING HOMES: THE FACTORS THAT CONTRIBUTE TO QUALITY OF LIFE, HEALTH, AND SAFETY OUTCOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S359-S359
Author(s):  
Nancy Kusmaul ◽  
Mercedes Bern-Klug
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Community Dwelling ◽  
Care Staff ◽  
Term Care ◽  
The Impact

Abstract Nursing homes house some of the most vulnerable older adults. They often have complex medical conditions and/or cognitive impairments that put them at risk for negative outcomes and poor quality of life. These outcomes can be altered through incorporating evidence-based practices aimed to improve care and residents’ life experiences. In this symposium we will explore factors that are shown to influence outcomes and quality of life for people that live in and are discharged from, long term care settings. Amy Roberts and colleagues will explore the influences of nursing home social service staff qualifications on residents’ discharge outcomes. Colleen Galambos and colleagues will present findings on advance directives and their impact on reducing potentially avoidable hospitalizations. Kelsey Simons and colleagues will discuss the potential for unmet needs for mental health services as part of nursing home care transitions, and will discuss a model of quality improvement that addresses this gap in care. Vivian Miller will present findings on the impact transportation access has on the ability of community-dwelling family members to visit and provide social support to their family member residents in long-term care. Finally, Nancy Kusmaul and Gretchen Tucker report the findings of their study comparing perceptions of nursing home residents, direct care staff, management, and families on the care practices that influence resident health and quality of life while they live in a long term care setting.

scholarly journals Condition-Specific Pamphlets to Improve End-of-life Communication in Long-term Care: Staff Perceptions on Usability and Use

2019 ◽  
Vol 20 (3) ◽  
pp. 262-267 ◽  
Author(s):  
Tamara Sussman ◽  
Sharon Kaasalainen ◽  
Eunyoung Lee ◽  
Noori Akhtar-Danesh ◽  
Patricia H. Strachan ◽  
...  
Keyword(s):  
End Of Life ◽  
Long Term Care ◽  
Care Staff ◽  
Staff Perceptions ◽  
Term Care ◽  
End Of Life Communication

Preventing Suicide and Depression: A Training Program for Long-Term Care Staff

2001 ◽  
Vol 42 (1) ◽  
pp. 55-69 ◽  
Author(s):  
Bonnie L. Walker ◽  
Nancy J. Osgood
Keyword(s):  
Training Program ◽  
Test Scores ◽  
Long Term Care ◽  
The Elderly ◽  
Care Staff ◽  
Term Care ◽  
Attitudes And Practices ◽  
Care Facilities ◽  
Post Test

Approximately 5 percent of those sixty-five and older live in long-term care facilities (1.5 million). Neither suicide and depression among the elderly who reside in long-term care facilities nor prevention techniques are well-understood by staff. This article discusses the development of a curriculum designed to train long-term care staff in preventing suicide among the elderly and the results of a pilot test of a training program based on that curriculum. The participants ( N=43) significantly improved their scores from pre- to post-test on the knowledge, attitudes, and practices subtests. The knowledge areas in which staff performed the most poorly at pre-test were related to identifying appropriate primary and secondary interventions, the relationship between dementia and suicide, methods of self-destruction used by the elderly, and understanding of depression in the elderly. There was a significant relationship between pre-test and post-test scores on all subtests. Staff with higher levels of education had significantly higher pre- and post-test scores on the knowledge and attitudes subtests. More experienced staff had significantly higher post-test scores on the practices subtest. A large majority of the participants had highly positive attitudes toward the program and thought the program had been very useful or useful to them as caregivers. The study demonstrated the need for staff training related to suicide prevention in long-term care as well as the usefulness of even a brief training.

The Differential Influence of Culture Change Models on Long-Term Care Staff Empowerment and Provision of Individualized Care

2009 ◽  
Vol 28 (2) ◽  
pp. 165-175 ◽  
Author(s):  
Sienna Caspar ◽  
Norm O’Rourke ◽  
Gloria M. Gutman
Keyword(s):  
Nous Avons ◽  
Long Term Care ◽  
Care Staff ◽  
Term Care ◽  
Change Models ◽  
Eden Alternative ◽  
Individualized Care ◽  
Conditions De Travail ◽  
Personnel Soignant

RÉSUMÉLa présente étude vise à déterminer si des différences existent entre les divers modèles de changement de culture (MCC) relativement à la perception du personnel soignant agréé à l’égard de l’accès aux structures d’habilitation et des prestations connues de soins individualisés. Nous avons embauché des employés qui travaillent dans des établissements ayant mis en œuvre les modèles sociaux de soins Eden Alternative, GentleCare ou Facility Specific ou n’ayant pas implanté de MCC. Nous avons effectué des analyses de variance multidimensionnelles de chacun des trois groupes de personnel soignant (infirmières autorisées, infirmières auxiliaires autorisées et aides-soignants) en fonction de chaque CCM. Les résultats indiquent qu’il existe des différences considérables entre le personnel soignant agréé et entre chacun des MCC. Plus le personnel soignant côtoie quotidiennement les patients, plus l’influence des MCC semble affecter l’autonomisation perçue et les prestations connues de soins individualisés. Des recherches suggèrent que les employés travaillant dans des établissements ayant mis en œuvre un des modèles sociaux de soins mentionnés ci-dessus profitent des meilleures conditions de travail. Inversement, parmi les établissements ayant implanté un de ces modèles, seul le personnel d’un établissement a fourni des réponses différentes de celles des employés travaillant dans des établissements sans MCC.

scholarly journals “We are Scapegoats”: Front-Line Nursing Home Staff Experiences During the COVID-19 Pandemic

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 965-966
Author(s):  
Elizabeth White ◽  
Terrie Wetle ◽  
Ann Reddy ◽  
Rosa Baier
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Organizational Communication ◽  
Media Coverage ◽  
Direct Care ◽  
Care Staff ◽  
Term Care ◽  
Convenience Sample ◽  
Nursing Home Staff

Abstract The COVID-19 pandemic is an unprecedented challenge for nursing homes, where staff have faced rapidly evolving circumstances to care for a vulnerable resident population. To document these healthcare professionals’ experiences during the pandemic, we used social media and professional networks to disseminate an electronic survey with closed- and open-ended questions to a convenience sample of long-term care staff from May 11 through June 4, 2020. Four investigators identified themes from qualitative responses for 152 nursing home staff respondents from 32 states. Key themes included: constraints on personal protective equipment (PPE) and testing; burdensome regulations and guidance; concern for self, family, and residents; workforce burnout; organizational communication and teamwork; and public lack of recognition. Respondents described ongoing constraints on testing, and reliance on crisis standards for extended use and reuse of PPE. Administrators discussed implementing sometimes confusing or contradictory guidance from numerous agencies. Direct-care staff expressed fears of infecting themselves and their families, and expressed empathy and concern for their residents. They described burnout due to increased workloads and the emotional burden of caring for residents facing isolation, illness, and death. Respondents cited the presence or lack of organizational communication and teamwork as factors influencing their ability to work under challenging circumstances. They also described the demoralizing impact of negative media coverage of nursing homes, contrasting this with the heroic public recognition given to hospital staff. These challenges added significant burden to an already strained workforce and are likely to contribute to increased burnout, turnover, and staff shortages in the long-term.

scholarly journals Factors associated with mortality and sequelae in patients living in long-term facilities hospitalized for COVID-19: a longitudinal 6-month follow-up study

2021 ◽  
Vol 106 (106(812)) ◽  
pp. 121-133
Author(s):  
M. Rivera-Izquierdo ◽  
A. Romero-Duarte ◽  
A. Cárdenas-Cruz
Keyword(s):  
Nursing Homes ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Long Term Care Facility ◽  
Factors Associated ◽  
Causes Of Mortality ◽  
Main Factors

Objectives: To evaluate the main factors associated with prognosis (mortality, sequelae at 6 months and readmissions) of patients admitted for COVID-19 at the Hospital Clínico San Cecilio who live in a long-term care facility. Methods: Longitudinal observational study carried out on the cohort of 441 patients admitted for COVID-19 confirmed by PCR at the Hospital Clínico San Cecilio between 01/03/20 and 15/04/20. These patients were followed up, through their medical records, for 6 months after discharge. Sociodemographic, admission, clinical, therapeutic and sequelae variables were collected. Descriptive and bivariate analyses and multivariate logistic regression models were performed with R statistical software, through its R Commander tool. Results: The mean age of the cohort was 66.4 years (s=15.3), with 55.1% male. In-hospital mortality was 18.1%. Patients living in nursing homes had higher mean age and higher frequencies of comorbidities, mortality and hospital readmissions. During the 6 months after discharge, they had a high frequency of sequelae (59%), and a higher frequency of confusion, hematologic and nephrological problems, and superinfections. The main factors associated with mortality were advanced age, male sex, admission to the ICU and vulnerability at admission measured with clinical prognostic scales. Conclusions: Living in a long-term care facility was not an independent factor of mortality, but it did bring together a group of special vulnerability to COVID-19. The causes of mortality analysed in this study could be similar to the causes of mortality of elderly people in nursing homes during the first months of the pandemic. These data should serve to optimize strategies for in-hospital management and follow-up of the elderly during the months following hospital discharge, and to try to reduce the unrecorded mortality due to COVID-19 in this population.

Development of the Care Environment Scale–Long-Term Care

2018 ◽  
Vol 29 (3) ◽  
pp. 169-176
Author(s):  
Marie Boltz ◽  
Kyung Hee Lee ◽  
Joseph Shuluk ◽  
Michelle Secic
Keyword(s):  
Nursing Homes ◽  
Performance Improvement ◽  
Content Validity ◽  
Long Term Care ◽  
Care Staff ◽  
Term Care ◽  
Care Environment ◽  
Environment Scale ◽  
K 12

A critical dimension of Quality Assurance and Performance Improvement (QAPI) activity in long-term care is an analysis of the care environment, that is, the way care and services are organized. The purpose of this study was to develop and pilot test a psychometrically sound tool that long-term care staff could use to assess the care environment and guide performance improvement activity. Focus groups with 57 interdisciplinary participants in five nursing homes developed initial items, with excellent content validity (item content validity index = 1.0) evaluated by an expert panel. Pilot testing of internal consistency of the Care Environment Scale–Long-Term Care (CES-LTC) was conducted in a web-based administration of the items by 425 interdisciplinary staff members in 30 nursing homes and four assisted living facilities. The CES-LTC is internally consistent (Cronbach’s alpha = .90) and accounts for approximately 71.6% of the total variance. The three factors extracted from the exploratory factor analysis are Institutional Values ( k = 6), Access to Resources ( k = 10), and Person-Centered Approaches ( k = 12). Intrarater reliability in a subsample of 66 registered nurses revealed good test-retest results (overall intraclass correlation coefficients [ICC] = 0.78). The CES-LTC appears to be a valid and reliable measure of staff perceptions of the care environment and may be used to actively engage staff in QAPI endeavors including root cause analyses and improvement activity.

Communication Disordered: Program Implementation in Long-Term Care

2016 ◽  
Vol 1 (15) ◽  
pp. 64-67
Author(s):  
George Barnes ◽  
Joseph Salemi
Keyword(s):  
Program Implementation ◽  
Long Term Care ◽  
Family Satisfaction ◽  
Regulatory Compliance ◽  
Care Staff ◽  
Term Care ◽  
Staff Members ◽  
Change Policy

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.

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