Correlates of nursing care burden among institutionalized patients with dementia

2018 ◽  
Vol 30 (10) ◽  
pp. 1549-1555 ◽  
Author(s):  
Meng Sun ◽  
Brian J. Mainland ◽  
Tisha J. Ornstein ◽  
Gwen Li Sin ◽  
Nathan Herrmann
Keyword(s):  
Aggressive Behavior ◽  
Nursing Care ◽  
Nursing Staff ◽  
Attitude Score ◽  
Linear Regression Models ◽  
Term Care ◽  
Care Burden ◽  
Dementia Patients ◽  
Care Assessment ◽  
Institutionalized Patients

ABSTRACTBackground:The stress associated with care of patients with dementia has led to high nursing staff turnover. This study aims to explore patient factors that are related to nursing burden.Methods:The present study examined nursing care burden related to 55 institutionalized dementia patients using the Modified Nursing Care Assessment Scale (M-NCAS). Cognition was assessed with the Severe Impairment Battery (SIB), activities of daily living (ADLs) were measured with the Alzheimer's Disease Functional Assessment of Change Scale (ADFACS), aggression was measured with the Aggressive Behavior Scale (ABS), and the Charlson Comorbidity Index (CCI) was used to assess medical comorbidity. Finally, the Dementia Cognitive Fluctuation Scale (DCFS) was used to assess the presence and severity of cognitive fluctuations (CFs). Linear regression models were used to assess their relationships with nursing care burden.Results:The mean age of the patients was 90.41 years (SD=2.84) and 89.10% were males. ADFACS total score (B = 0.36, β = 0.42, p = 0.002) and ABS score (B = 2.933, β = 0.37, p = 0.002) significantly predicted the M-NCAS Attitude score. ABS score was the only significant predictor of M-NCAS Strain score (B = 2.57, β = 0.35, p = 0.009).Conclusions:In the long-term care setting, aggressive behavior plays an important role in both subjective and objective nursing burden, while impaired ADLs increase the objective burden for nursing staff.

OP48 Nursing Requirements In Long-Term Care: A Health Technology Assessment

2019 ◽  
Vol 35 (S1) ◽  
pp. 11-12
Author(s):  
Paula Corabian ◽  
Charles Yan ◽  
Susan Armijo-Olivo ◽  
Bing Guo
Keyword(s):  
Nursing Care ◽  
Nursing Staff ◽  
Real World ◽  
Research Evidence ◽  
Long Term Care ◽  
Staff Time ◽  
Term Care ◽  
Policy Makers ◽  
The Relationship

IntroductionThe objectives of this study were to systematically review published research on the relationship between nursing staff coverage, care hours, and quality of care (QoC) in long-term care (LTC) facilities; and to conduct a real world evidence (RWE) analysis using Alberta real world data (RWD) to inform policy makers on whether any amendments could be made to current regulations.MethodsA systematic review (SR) of research evidence published between January 2000 and May 2018 on the relationship between nursing staff coverage, care hours, and QoC in LTC facilities was conducted. Panel data regressions using available RWD from Alberta, Canada, were performed to assess associations between nursing care hours and LTC outcomes. Outcomes of interest included quality indicators related to resident outcomes, hospital admissions, emergency room visits and family satisfaction. Nursing care hours considered in SR and RWE analysis included those provided by registered nurses (RNs) and licensed practical nurses (LPNs).ResultsThe SR found inconsistent and poor quality evidence relevant to the questions of interest, indicating a great uncertainty about the association between nursing staff time and type of coverage and QoC. Although some positive indications were suggested, major weaknesses of reviewed studies limited interpretation of SR results. RWE analysis found that impact of care hours on LTC outcomes was heterogeneous, dependent on outcome measurements. There was evidence that total staff, RN, and LPN hours had positive effects on some resident outcomes and magnitude of effect differed for different nursing staff.ConclusionsNo definitive conclusion could be drawn on whether changing nursing staff time or nursing staff coverage models would affect residents’ outcomes based on the research evidence gathered in the SR. RWE analysis helped to fill a gap in the available published literature and allowed policy makers to better understand the impact of revising current regulations based on actual outcomes.

Withdrawal of Neuroleptic Medications from Institutionalized Dementia Patients: Results of a Double-Blind, Baseline-Treatment—Controlled Pilot Study

1997 ◽  
Vol 10 (3) ◽  
pp. 119-126 ◽  
Author(s):  
Sarah Bridges-Parlet ◽  
David Knopman ◽  
Susan Steffes
Keyword(s):  
Aggressive Behavior ◽  
Objective Assessment ◽  
Extended Period ◽  
Good Clinical Practice ◽  
Chi Square ◽  
Double Blind ◽  
Term Care ◽  
Dementia Patients ◽  
Significant Difference ◽  
The Difference

Among dementia patients in long-term care facilities, neuroleptics (NL) are frequently prescribed for the treatment of agitation. Although good clinical practice and federal law mandate attempts at withdrawal of these medications, empiric data regarding the cessation of NL treatment are limited in this population. The objective of the present study was to assess through direct observation the effects of short-term NL withdrawal on physically aggressive behavior and other aspects of agitation. We carried out a randomized, double-blind, baseline NL-controlled 4-week trial of the effects of NL withdrawal in 36 institutionalized patients with possible or probable Alzheimer's disease. Patients were directly observed for four 2-hour sessions during baseline, a prerandomization week, and during weeks 1, 2, and 4 of the double-blind portion of the study. Completion of the 4 weeks of double-blind medication and number of observed episodes of physically aggressive behavior (PAB) were the two primary outcome measures. Of the 22 patients who were withdrawn from NL, 20 (91%) completed the 4-week double-blinded withdrawal. Two patients were discontinued from the study due to unacceptable levels of agitation at the request of their nursing staff. Of the 14 patients not withdrawn, all completed the 4-week trial. The chi-square test for the difference between groups was not significant ( P > .05). Based on the observed instances of PAB, there was no significant difference ( P > .05) between withdrawn and not-withdrawn subjects. Half of the withdrawn patients remained off NLs for an extended period of time after the end of the study, even after the blind was broken. Withdrawing institutionalized dementia patients from NLs was successful in most but not all study patients. Generalization of these results is limited by the highly selected nature of the participants. Unmasking of unmanageable agitation and physical aggressiveness in a small minority must be weighed against the benefits of removing unnecessary medication in the majority of dementia patients in whom NL withdrawal is attempted. PAB itself should not drive continuing NL use without regard to objective assessment of efficacy of the NL treatment.

scholarly journals Nursing care missed in patients at risk of or having pressure ulcers

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Jonathan Hermayn Hernández Valles ◽  
María Guadalupe Moreno Monsiváis ◽  
Ma. Guadalupe Interial Guzmán ◽  
Leticia Vázquez Arreola
Keyword(s):  
At Risk ◽  
Nursing Care ◽  
Nursing Staff ◽  
Public Hospital ◽  
Pressure Ulcers ◽  
Correlation Study ◽  
Position Change ◽  
Care Assessment ◽  
Patients At Risk ◽  
Patient Assessments

ABSTRACT Objective: to determine the nursing care missed as perceived by the nursing staff and its relation with the nursing care missed identified in the assessment of patients at risk of or having pressur ulcers. Method: descriptive correlation study. The participants were 161 nurses and 483 patients from a public hospital. The MISSCARE survey was used in combination with a Nursing Care Assessment Form for Patients at Risk of or having pressure ulcers. For the analysis, descriptive and inferential statistics were used. Results: the nursing staff indicated greater omission in skin care (38.5%), position change (31.1%) and the registration of risk factors for the development of pressure ulcers (33.5%). The nursing care missed identified in the assessment related to the use of pressure relief on bony prominences and drainage tubes interfering in the patient's movements (both with 58.6%) and the use of pneumatic mattresses (57.6%). Conclusion: a high percentage of nursing care missed was found according to the staff's perception. Nevertheless, the assessment of the nursing care missed was much higher. No significant relation was found between both. Therefore, it is a priority to reflect on the importance of objective patient assessments.

Infections caused by medical products at longterm nursing care

2020 ◽  
pp. 7-10
Author(s):  
Hardy Thorsten Panknin
Keyword(s):  
Nursing Care ◽  
Nursing Staff ◽  
Nosocomial Infections ◽  
The Elderly ◽  
Relevant Information ◽  
Medical Products ◽  
The Disabled ◽  
The Usa ◽  
Therapeutic Measures

Nosocomial infections in the elderly, often suffering from many ailments, patients in homes for the disabled and the old are among the problematic diseases that specialized nursing staff and doctors have to deal with more often in such institutions. Review work from the USA introduces relevant information about infectious risks, as well as possible preventive and therapeutic measures.

scholarly journals Nursing care time and quality indicators for adult intensive care: correlation analysis

2012 ◽  
Vol 20 (4) ◽  
pp. 651-658 ◽  
Author(s):  
Paulo Carlos Garcia ◽  
Fernanda Maria Togeiro Fugulin
Keyword(s):  
Intensive Care ◽  
Correlation Analysis ◽  
Intensive Care Units ◽  
Quality Indicators ◽  
Nursing Care ◽  
Nursing Staff ◽  
Care Delivery ◽  
Average Length ◽  
Quality Care ◽  
Descriptive Study

The objective of this quantitative, correlational and descriptive study was to analyze the time the nursing staff spends to assist patients in Adult Intensive Care Units, as well as to verify its correlation with quality care indicators. The average length of time spent on care and the quality care indicators were identified by consulting management instruments the nursing head of the Unit employs. The average hours of nursing care delivered to patients remained stable, but lower than official Brazilian agencies' indications. The correlation between time of nursing care and the incidence of accidental extubation indicator indicated that it decreases with increasing nursing care delivered by nurses. The results of this investigation showed the influence of nursing care time, provided by nurses, in the outcome of care delivery.

scholarly journals Experiences of nursing professionals involved in the care of COVID-19 patients

2022 ◽  
Vol 6 ◽  
Author(s):  
Gitumoni Konwar ◽  
Sweetimani Kakati ◽  
Nabanita Sarma
Keyword(s):  
Nursing Care ◽  
Nursing Staff ◽  
Final Stage ◽  
Professional Growth ◽  
Limited Resources ◽  
Front Line ◽  
North Eastern ◽  
Changing Patterns ◽  
Nursing Professionals ◽  
Phenomenological Design

The outbreak of SARS-COV-2 has become an opportunity for nursing professionals of North Eastern states of India to experience handling patients during pandemics with limited resources. To explore the experiences of nursing staff in the care of COVID-19 patients. Descriptive phenomenological design was adopted to describe the experiences of nursing professionals involved in the care of COVID-19 patients in selected hospitals/COVID centers of Assam, India. The experiences of nurses caring for COVID-19 patients were summarized into 4 themes and various sub-themes. The themes include: Perspectives about COVID-19 duty, Experience on PPE kit, Conflicts & disagreements and Swab test & the final stage of isolation. Nurses reported changing patterns of nursing care, anxiety regarding COVID-19 duty, professional growth amidst risks and pressure. The nurses had to work under certain conflicts and disagreements in relation to patient care, their personal and career related decisions and interprofessional role distribution. At the final stage of isolation, most nurses were prepared to handle the situation even if they test COVID-19 positive. During this COVID-19 outbreak, positive and negative emotions of the front-line nurses interweaved and coexisted. The experience was new and challenging, the nurses had contributed in the management of COVID-19.

scholarly journals Meanings attributed by nursing staff about permanent education in cardiovascular institution

Rev Rene ◽  
2016 ◽  
Vol 17 (1) ◽  
pp. 93 ◽  
Author(s):  
Cintia Koerich ◽  
Alacoque Lorenzini Erdmann
Keyword(s):  
Qualitative Study ◽  
Health Services ◽  
Nursing Care ◽  
Nursing Staff ◽  
Management Practice ◽  
Staff Education ◽  
Professional Qualification ◽  
Daily Work ◽  
Managerial Training ◽  
Nursing Professionals

Objective: to understand the meanings attributed by the nursing staff to permanent educational practices in a reference cardiovascular hospital. Methods: this is a qualitative study, which used the Grounded Theory in Data for collecting and analyzing data. The sample consisted of 22 nursing professionals. Results: the study presents two categories that highlight the need for further clarification of the nursing staff about the concept of permanent education in health, as well as reinforce the permanent education of nurses as a management practice which needs to be incorporated into other assignments in daily work. Conclusion: it is admitted the need to work the concepts of permanent education in health even in professional qualification, as well as place greater emphasis on managerial training of nurses, so they acquire the power to take their assignment as a nursing care manager and the nursing staff education contribute to the necessary changes in the health services.

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