Relocation experiences with unplanned admission to a nursing home: a qualitative study

2016 ◽  
Vol 29 (3) ◽  
pp. 517-527 ◽  
Author(s):  
Andrea Luise Koppitz ◽  
Jutta Dreizler ◽  
Jeanine Altherr ◽  
Georg Bosshard ◽  
Rahel Naef ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Hospital Discharge ◽  
Qualitative Content Analysis ◽  
Secondary Data ◽  
Unplanned Admission ◽  
Convenience Sample ◽  
Face To Face ◽  
The Usa ◽  
Unplanned Admissions

ABSTRACTBackground:In many countries, people over 85 years of age are relocated involuntarily or unplanned to a nursing home. In Switzerland, 43% of elderly over 85 years are admitted to nursing homes after hospital discharge. This percentage is higher than in the USA with 32.5% or in Germany with only 19%. Despite those more frequent Swiss admissions, no research has been conducted exploring how unplanned admissions to nursing homes affect the adaptation. Therefore, the aim of this study was to gain an in-depth understanding into unplanned admissions to nursing homes and to explore its impact on adaptation.Methods:The study used a qualitative interview design based on Meleis’ transition model. Secondary data analysis was guided by Mayring's qualitative content analysis. Face-to-face interviews with elderly over 77 years (n= 31) were conducted from a convenience sample in Switzerland between January and March 2013.Results:The following four patterns of adaptation emerged from the analysis: “being cut-off,” “being restricted,” “being cared for,” and “moving on.” The patterns evaluate the relocation into nursing homes and provide an opportunity to appraise the stages of adaption.Conclusions:This study presents a model of analysis to evaluate patterns of adaptation following an unplanned admission to a nursing home after hospital discharge.

scholarly journals Facilitators and barriers to implement nurse-led interventions in long-term dementia care: a qualitative interview study with Swiss nursing experts and managers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julian Hirt ◽  
Melanie Karrer ◽  
Laura Adlbrecht ◽  
Susi Saxer ◽  
Adelheid Zeller
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Public Perception ◽  
Dementia Care ◽  
Term Care ◽  
Face To Face ◽  
People With Dementia ◽  
Qualitative Interview Study ◽  
Facilitators And Barriers

Abstract Background To support the implementation of nurse-led interventions in long-term dementia care, in-depth knowledge of specific supporting factors and barriers is required. Conditions and structures of caring for people with dementia differ widely, depending on the country and the care context. Our study aimed to describe the experiences and opinions of nursing experts and managers with regard to facilitators and barriers to the implementation of nurse-led interventions in long-term dementia care. Methods We conducted a qualitative descriptive study using individual interviews based on qualitative vignettes as a useful stimulus to generate narrations allowing to study peoples’ perceptions and beliefs. The study took place in nursing homes in the German-speaking part of Switzerland and in the Principality of Liechtenstein using purposive sampling. We intended to conduct the interviews face-to-face in a quiet room according to the participant’s choice. However, due to the lockdown of nursing homes during the COVID-19 pandemic in spring 2020, we performed interviews face-to-face and by video. We analysed data thematically following Braun and Clarke to achieve a detailed, nuanced description. To verify our interpretation and to ensure congruence with participants’ perspectives, we conducted member checks. The Standards for Reporting Qualitative Research (SRQR) served to structure our manuscript. Results Six dyads of nursing home managers and nursing experts from six nursing homes took part in our study (n = 12). Our thematic analysis yielded seven themes reflecting facilitators and barriers to implementing nurse-led interventions in long-term dementia care: «A common attitude and cohesion within the organization», «Commitment on several levels», «A needs-oriented implementation», «The effect and the public perception of the intervention», «A structured and guided implementation process», «Supporting knowledge and competencies», as well as «Resources for implementing the intervention». Conclusions To support the implementation of nurse-led interventions in long-term dementia care, active commitment-building seems essential. It is necessary that the value of the intervention is perceptible.Commitment-building is the precondition to reach the persons involved, such as nursing home managers, nursing staff, residents and relatives. Furthermore, nurses should precisely inform about the intervention. It is necessary that the value of the intervention is perceptible. In addition, nurses should adjust the interventions to the situational needs of people with dementia, thus. Therefore, it is important to support dementia-specific competencies in long-term care. Findings indicate that the barrier is determined by the intervention and its implementation – and not by the behaviour of the person with dementia.

scholarly journals How implementation of a national strategy for nursing homes is experienced by the healthcare personnel: A qualitative study with content analysis of interviews.

2020 ◽  
Author(s):  
Beate Andre ◽  
RN. Kjersti Grønning ◽  
Frode F. Jacobsen ◽  
Gørill Haugan
Keyword(s):  
Content Analysis ◽  
Nursing Home ◽  
Nursing Homes ◽  
Qualitative Content Analysis ◽  
Implementation Process ◽  
Care Quality ◽  
Healthcare Personnel ◽  
Health Promoting ◽  
Positive Experiences

Abstract Background: Nursing homes are under strong pressure to provide good care to the residents. In Norway, municipalities have applied the ‘Joy-of-Life-Nursing-Home’ strategy to increase a health-promoting perception that focuses on the older persons` resources. Implementations represent introducing changes to the healthcare personnel; however, changing one’s working approaches, routines and working culture may be demanding. On this background, we explored how the ‘Joy-of-Life-Nursing-Home’ strategy is perceived by the employees in retrospective, over a period after the implementation and which challenges the employees experience with this implementation.Method: We used a qualitative approach and interviewed 14 healthcare personnel working in nursing homes in one Norwegian municipality, which had implemented the ‘Joy-of-Life-Nursing-Home’ strategy. The analysis was conducted following Kvale’s approach to qualitative content analysis.Results: The main categories were: (a) the characteristics of care activities before implementations of ‘Joy-of-Life-Nursing-Home’, (b) how ‘Joy-of-Life-Nursing-Home’ influenced the care activities, and (c) challenges with the implementation of ‘Joy-of-Life-Nursing-Home’. Some of the informants spoke well about the implementation concerning the care quality stating “to see the joy in the eyes of the resident then I feel we have succeeded”. For informants who experienced resistance toward the implementation, they felt it was too much to document, it was too complicated, and the requirements were too many. Conclusions: Quality of care seems to have increased after the implementation, as perceived by the informants. Nevertheless, the fact that the informants seemed to be divided into two different groups related to their main perspective of the implementation is concerning. One group has positive experiences with the implementations process and the benefits of it, while the other group focuses on lack of benefits and problems with the implementation process. In order to understand what facilitates and hinders the implementation, research on contextual factors like work environment and leadership is recommended.

scholarly journals Motivators for Physical Activity among Ambulatory Nursing Home Older Residents

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Yuh-Min Chen ◽  
Yueh-Ping Li
Keyword(s):  
Physical Activity ◽  
Content Analysis ◽  
Nursing Home ◽  
Nursing Homes ◽  
Mood State ◽  
Qualitative Content Analysis ◽  
Regular Physical Activity ◽  
Purposive Sampling ◽  
State Filling ◽  
Empty Time

The purpose of this study was to explore self-identified motivators for regular physical activity among ambulatory nursing home older residents. A qualitative exploratory design was adopted. Purposive sampling was performed to recruit 18 older residents from two nursing homes in Taiwan. The interview transcripts were analyzed by qualitative content analysis. Five motivators of physical activity emerged from the result of analysis: eagerness for returning home, fear of becoming totally dependent, improving mood state, filling empty time, and previously cultivated habit. Research on physical activity from the perspectives of nursing home older residents has been limited. An empirically grounded understanding from this study could provide clues for promoting and supporting lifelong engagement in physical activity among older residents. The motivators reported in this study should be considered when designing physical activity programs. These motivators can be used to encourage, guide, and provide feedback to support older residents in maintaining physical activity.

scholarly journals Hospital and nursing home patients’ experiences with delirium assessments: A qualitative content analysis

2019 ◽  
Vol 40 (1) ◽  
pp. 52-58
Author(s):  
Helle Svenningsen ◽  
Dorthe Sørensen
Keyword(s):  
Content Analysis ◽  
Nursing Home ◽  
Qualitative Method ◽  
Healthcare Professionals ◽  
Qualitative Content Analysis ◽  
Well Being ◽  
Relevant Information ◽  
Delirium Assessment ◽  
Face To Face ◽  
Nursing Home Patients

To explore hospital and nursing home patients’ experiences with delirium assessments and better understand their attitudes, we used a qualitative method to summarise, in everyday terms, specific events observed by researchers and experienced by patients. We performed participant observations of delirium assessments of eight patients and conducted individual semi-structured face-to-face interviews with seven other patients. We carried out content analysis using an inductive approach. Our findings indicate that patients approached delirium assessment with initial scepticism due to a lack of knowledge. Their scepticism changed to complete acceptance after the assessment’s purpose was explained. However, some patients gave up on the assessment due to cognitive challenges, lack of energy, fatigue, or language barriers. Patients appreciated that professionals were interested in their mental and physical well-being. Despite initial scepticism, the patients found the delirium assessment valuable when they better understood its purpose. Thus, healthcare professionals should provide patients with relevant information about delirium assessments.

scholarly journals Challenges in Current Nursing Home Care in Rural Germany and How They Can Be Reduced by Telehealth - an Exploratory Pre-post Study

2021 ◽  
Author(s):  
Susann May ◽  
Kai Jonas ◽  
Thomas Zahn ◽  
Martin Heinze ◽  
Felix Mühlensiepen
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Rural Areas ◽  
Qualitative Content Analysis ◽  
Nursing Home Residents ◽  
Nursing Home Care ◽  
Alternative Form ◽  
Supporting Evidence ◽  
Existing Structures

Abstract BackgroundTelemedical care of nursing home residents in Germany, especially in rural areas, is limited to a few pilot projects and is rarely implemented as part of standard care. The possible merits of implementing video consultations in longer-term nursing care currently lack supporting evidence. In particular, there is little documentation of experiences and knowledge about the effects and potential benefits of the implementation in presently existing structures. ObjectiveThe goal was to assess the effect of implement medical video consultations into nursing home care addressing the following research questions:- How is medical care currently provided to nursing home residents, and where do problems in its implementation arise? - How can video consultations be used to reduce difficulties arising in everyday care? - How does implementation of video consultations impact day-to-day nursing home care delivery?MethodsTwenty-one guided interviews (pre-implementation n=13; post-implementation n=8) were conducted with a total of 13 participants (physicians, nurses and medical technical assistants). Narratives were analysed using qualitative content analysis. The results were contrasted in a pre-post analysis.ResultsChallenges described by the participants before implementation included a requirement for additional organisational and administrative efforts, interruptions in the daily care routine or delayed treatments, and risk for loss of patient-relevant information due to process diversity. After implementation, communication was facilitated upon introduction of assigned time slots for video consultations. Clinical information was less likely to be lost, additional work was spared, and medication and therapeutic and assistive devices were provided more quickly.ConclusionsTelehealth cannot replace physical, in-person visits, but does offer an alternative form of service delivery when properly integrated into existing structures. Our results suggest that the use of video consultations in nursing homes can reduce the burden and additional workload, and increase the efficiency of care provision for nursing home residents. Video consultations can complement in-person visits to nursing homes, especially to address the shortage of medical specialists in rural areas in Germany. To promote implementation and acceptance of video consultation in nursing homes, we need to increase awareness of its benefits and undertake further evaluation of video consultations in nursing home care.

scholarly journals De-implementing and sustaining an intervention to eliminate nursing home resident bed and chair alarms: interviews on leadership and staff perspectives

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Christine W. Hartmann ◽  
Christopher Gillespie ◽  
George G. Sayre ◽  
A. Lynn Snow
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Community Living ◽  
Position Change ◽  
Improvement Program ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Local Leadership ◽  
Positive Effects ◽  
Community Living Centers

Abstract Background Improving nursing home quality of care relies partly on reducing or stopping ineffective or harmful practices, a process known as de-implementation. We know little about de-implementation in this setting. Relatively recent policy changes reclassified resident position-change (bed and chair) alarms, which monitor resident movement, as restraints. This created an optimal environment in which to study impressions of an alarm de-implementation and sustainment intervention. Methods This cross-sectional interview study focused on understanding participants’ experience of a quality improvement program in the Department of Veterans Affairs Community Living Centers (nursing homes). The program’s goal was to improve resident outcomes and staff communication and teamwork through, among other foci, eliminating resident position-change alarms. The Community Living Centers were located in geographically dispersed areas of the continental United States. Interview participants were leadership and staff members from seven Community Living Centers. We conducted in-depth, semi-structured qualitative interviews using a convenience sample and used a thematic analytic approach. Results We conducted seventeen interviews. We identified five main themes: Initiating De-implementation (compelling participants with evidence, engaging local leadership, and site-level education and training), Changing Expectations (educating staff and family members), Using Contrasting Approaches (gradual or abrupt elimination of alarms), Witnessing Positive Effects of De-implementation (reduction in resident falls, improved resident sleep, reduction in distressing behaviors, and increased resident engagement), and Staying the Course (sustainment of the initiative). Conclusions Findings highlight how participants overcame barriers and successfully eliminated resident position-change alarms and sustained the de-implementation through using convincing evidence for the initiative, local leadership involvement and support, and staff and family member education and engagement. These findings and the resulting three-phase process to support nursing homes' de-implementation efforts expand the de-implementation science knowledge base and provide a promising framework for other nursing home-based de-implementation initiatives.

Factors Associated With Care Workers’ Intention to Leave Employment in Nursing Homes: A Secondary Data Analysis of the Swiss Nursing Homes Human Resources Project

2017 ◽  
Vol 38 (11) ◽  
pp. 1537-1563 ◽  
Author(s):  
Clergia Gaudenz ◽  
Sabina De Geest ◽  
René Schwendimann ◽  
Franziska Zúñiga
Keyword(s):  
Nursing Home ◽  
Data Analysis ◽  
Nursing Homes ◽  
Secondary Data ◽  
Intention To Leave ◽  
Nursing Home Care ◽  
Affective Organizational Commitment ◽  
Care Workers ◽  
Home Care Workers ◽  
Care Worker

The emerging care personnel shortage in Swiss nursing homes is aggravated by high turnover rates. As intention to leave is a predictor of turnover, awareness of its associated factors is essential. This study applied a secondary data analysis to evaluate the prevalence and variability of 3,984 nursing home care workers’ intention to leave. Work environment factors and care worker outcomes were tested via multiple regression analysis. Although 56% of care workers reported intention to leave, prevalences varied widely between facilities. Overall, intention to leave showed strong inverse relationships with supportive leadership and affective organizational commitment and weaker positive relationships with stress due to workload, emotional exhaustion, and care worker health problems. The strong direct relationship of nursing home care workers’ intention to leave with affective organizational commitment and perceptions of leadership quality suggest that multilevel interventions to improve these factors might reduce intention to leave.

Family members' narrated experiences of communicating via video-phone with patients with dementia staying at a nursing home

2003 ◽  
Vol 9 (4) ◽  
pp. 216-220 ◽  
Author(s):  
Stefan Sävenstedt ◽  
Christine Brulin ◽  
P-O Sandman
Keyword(s):  
Content Analysis ◽  
Nursing Home ◽  
Nursing Homes ◽  
Qualitative Data ◽  
Family Members ◽  
Respite Care ◽  
Face To Face

We studied the experience of family members who communicated via video-phones with elderly demented patients who were either staying at a home for temporary respite care or living in a nursing home. The study was based on qualitative data from seven interviews. The interviewees each had three or more months' experience with a video-phone. The open interviews were transcribed. Content analysis showed that video-phone conversations made the relatives of patients at nursing homes more involved in the caring process and that conversation via the video-phone was a different way of communicating. Video-phone conversations with demented patients were in some cases more focused and of better quality than face-to-face conversations. In most cases the video-phone conversations required the assistance of staff at the home in order to be meaningful. Video-phones have the potential to become useful tools for family members caring for elderly relatives.

scholarly journals The Impact of Leadership Styles on Quality and Financial Performance in High Medicaid Nursing Homes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 679-679
Author(s):  
Justin Lord ◽  
Akbar Ghiasi ◽  
Ganisher Davlyatov ◽  
Robert Weech-Maldonado
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Financial Performance ◽  
Leadership Styles ◽  
Secondary Data ◽  
Trade Offs ◽  
Autocratic Leadership ◽  
Resource File ◽  
Composite Scores ◽  
The Impact

Abstract This study examined the association between leadership styles (autocrat, consultative autocrat, consensus manager, and shareholder manager) and resident quality and financial performance in under-resourced nursing homes. Survey data from 391 Directors of Nursing were merged with secondary data from LTCFocus, Area Health Resource File, Medicare Cost Reports, and Nursing Home Compare. Two multivariate regressions were used to model the relationship between leadership styles and the dependent variables: nursing home star ratings (1-5) and operating margin. The independent variables were composite scores for leadership styles, while control variables included organizational and county-level factors. Results show that compared to autocratic leadership, the consultative autocrat (solicits feedback but has total authority) was associated with lower quality (p < 0.05), while the consensus manager (delegates authority to the group) was associated with lower profit margin (p < 0.05). Under-resourced facilities need to recognize trade-offs of different decision making styles for performance.

scholarly journals “Joy of life” in nursing homes. Healthcare personnel experiences of the implementation of the national strategy. A qualitative study with content analysis of interviews

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Beate André ◽  
Kjersti Grønning ◽  
Frode F. Jacobsen ◽  
Gørill Haugan
Keyword(s):  
Content Analysis ◽  
Nursing Home ◽  
Nursing Homes ◽  
Qualitative Content Analysis ◽  
Implementation Process ◽  
Care Quality ◽  
Healthcare Personnel ◽  
Health Promoting ◽  
Positive Experiences

Abstract Background Nursing homes are under strong pressure to provide good care to the residents. In Norway, municipalities have applied the ‘Joy-of-Life-Nursing-Home’ strategy to increase a health-promoting perception that focuses on the older persons` resources. Implementations represent introducing changes to the healthcare personnel; however, changing one’s working approaches, routines and working culture may be demanding. On this background, we explored how the ‘Joy-of-Life-Nursing-Home’ strategy is perceived by the employees in retrospective, over a period after the implementation and which challenges the employees experience with this implementation. Method We used a qualitative approach and interviewed 14 healthcare personnel working in nursing homes in one Norwegian municipality, which had implemented the ‘Joy-of-Life-Nursing-Home’ strategy. The analysis was conducted following Kvale’s approach to qualitative content analysis. Results The main categories were: (a) the characteristics of care activities before implementations of ‘Joy-of-Life-Nursing-Home’, (b) how ‘Joy-of-Life-Nursing-Home’ influenced the care activities, and (c) challenges with the implementation of ‘Joy-of-Life-Nursing-Home’. Some of the informants spoke well about the implementation concerning the care quality stating “to see the joy in the eyes of the resident then I feel we have succeeded”. For informants who experienced resistance toward the implementation, they felt it was too much to document, it was too complicated, and the requirements were too many. Conclusions Quality of care seems to have increased after the implementation, as perceived by the informants. Nevertheless, the fact that the informants seemed to be divided into two different groups related to their main perspective of the implementation is concerning. One group has positive experiences with the implementations process and the benefits of it, while the other group focuses on lack of benefits and problems with the implementation process. To understand what facilitates and hinders the implementation, research on contextual factors like work environment and leadership is recommended.

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