scholarly journals Race, Class, and the Nursing Home Workforce: Experiences of Staff of Color in High-Minority-Proportion Nursing Homes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 689-689
Author(s):  
Odichinma Akosionu ◽  
Janette Dill ◽  
Manka Nkimbeng ◽  
Tricia Skarphol ◽  
Tetyana Shippee
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Quality Care ◽  
Structured Interviews ◽  
Culturally Sensitive Care ◽  
Services And Supports ◽  
Staff Wellbeing ◽  
The Impact

Abstract The long-term services and supports workforce is an important part of delivering quality care for nursing home (NH) residents – and increasingly includes staff who are from diverse communities. Our study captured staff (n=61) perspectives on resident quality of care and quality of life through semi-structured interviews, using thematic analysis in six Minnesota high proportion minority NHs. Findings show that although staff of color are valued for the diversity they contribute to the workforce, and the culturally sensitive care they provide, they are also exposed to discriminatory events. In addition, tensions exist between U.S. and non-U.S. born staff of color in NHs. Overall, staff of color who are lower ranked may feel less empowered. Research is needed to explore the impact of negative and discriminatory exposures on staff wellbeing and related outcomes in addition to the direct and indirect impact on the quality of care delivered to NH residents.

scholarly journals Understanding contributors to quality of care in long-term care and changes under COVID-19

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Sara Luck ◽  
Katie Aubrecht
Keyword(s):  
Quality Of Care ◽  
Long Term Care ◽  
The United States ◽  
Control Measures ◽  
Qualitative Description ◽  
Care Staff ◽  
Term Care ◽  
The Impact

Abstract Nursing home facilities are responsible for providing care for some of the most vulnerable groups in society, including the elderly and those with chronic medical conditions. In times of crisis, such as COVID-19 or other pandemics, the delivery of ‘regular’ care can be significantly impacted. In relation to COVID-19, there is an insufficient supply of personal protective equipment (PPE) to care for residents, as PPE not only protects care staff but also residents. Nursing homes across the United States and Canada have also taken protective measures to maximize the safety of residents by banning visitors, stopping all group activities, and increasing infection control measures. This presentation shares a research protocol and early findings from a study investigating the impact of COVID-19 on quality of care in residential long-term care (LTC) in the Canadian province of New Brunswick. This study used a qualitative description design to explore what contributes to quality of care for residents living in long-term care, and how this could change in times of crisis from the perspective of long-term care staff. Interviews were conducted with a broad range of staff at one LTC home. A semi-structured interview guide and approach to thematic analysis was framed by a social ecological perspective, making it possible to include the individual and proximal social influences as well as community, organizations, and policy influencers. Insights gained will improve the understanding of quality of care, as well as potential barriers and facilitators to care during times of crisis.

scholarly journals A Qualitative Study Exploring the Impact and Effects Following Hospital Discharge of COVID-19

2021 ◽  
Vol 1 (3) ◽  
pp. 216-222
Author(s):  
Abigail Reay ◽  
Avinash Aujayeb ◽  
Catherine Dotchin ◽  
Ellen Tullo ◽  
John Steer ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Hospital Discharge ◽  
Psychological Effects ◽  
Functional Abilities ◽  
Long Term Effects ◽  
Structured Interviews ◽  
Discharge From Hospital ◽  
The Impact

Introduction: Research into the long-term effects of coronavirus disease 2019 (COVID-19) continues at an unprecedented pace. Many physical long-term symptoms of COVID-19 have been reported and include headache, fatigue, muscle pain and breathlessness, etc. Psychological effects are not dissimilar to survivors of SARS. There is limited qualitative research exploring the mental health impacts and experiences of hospitalized COVID-19 inpatients. Methods: A prospective qualitative study is planned to explore patient experiences post hospital discharge following a diagnosis of COVID-19. The research aims to gain an understanding of how COVID-19 affects quality of life (QoL) and functional abilities. Patients discharged from the hospital will be invited to take part in semi-structured interviews discussing their experiences of hospitalization and the impact of COVID-19 on their QoL. Interviews will be conducted at three and six months following discharge from hospital. This study will provide important qualitative insight and may inform clinical interventions and commissioning decisions. Trial registration: The study has Research Ethics Committee (REC) and Health Research Authority (HRA) approvals obtained from Health and Care Research Wales (HCRW) [IRAS project ID 293196].

Medical Staffing Organization and Quality of Care Outcomes in Post-acute Care Settings

2020 ◽  
Author(s):  
Laura M Wagner ◽  
Paul Katz ◽  
Jurgis Karuza ◽  
Connie Kwong ◽  
Lori Sharp ◽  
...  
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Acute Care ◽  
Quality Measures ◽  
Medical Providers ◽  
Medical Provider ◽  
Provider Characteristics ◽  
The Impact

Abstract Background and Objectives Medical providers are significant drivers of care in post-acute long-term care (PALTC) settings, yet little research has examined the medical provider workforce and its role in ensuring quality of care. Research Design and Methods This study examined the impact of nursing home medical staffing organization (NHMSO) dimensions on the quality of care in U.S. nursing homes. The principal data source was a survey specifically designed to study medical staff organization for post-acute care. Respondents were medical directors and attending physicians providing PALTC. We linked a number of medical provider and nursing home characteristics to the Centers for Medicaid and Medicare Services Nursing Home Compare quality measures hypothesized to be sensitive to input by medical providers. Results From the sample of nursing home medical providers surveyed (n = 1,511), 560 responses were received, yielding a 37% response rate; 425 medical provider responses contained sufficient data for analysis. The results of the impact of NHMSO dimensions were mixed, with many domains not having any significance or having negative relationships between provider characteristics and quality measures. Respondents who reported having a formal process for granting privileges and nursing homes with direct employment of physicians reported significantly fewer emergency visits. Discussion and Implications Further research is needed regarding what quality measures are sensitive to both medical provider characteristics and NHMSO characteristics.

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 Hospital Information Systems (HIS) in the Examination Rooms and Wards: Doctors Perceived Positive Impact on Quality of Care and Patient Safety

2018 ◽  
Vol 7 (2.29) ◽  
pp. 871 ◽  
Author(s):  
Lizawati Salahuddin ◽  
Zuraini Ismail ◽  
. .
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Information Systems ◽  
Positive Impact ◽  
Healthcare Services ◽  
Hospital Information Systems ◽  
Structured Interviews ◽  
Healthcare Organizations ◽  
The Impact

Hospital Information Systems [HIS] is developed to support healthcare organizations in providing efficient, quality, and safe healthcare services. The objective of this study is to identify and describe doctors’ perspective on the impact of HIS use in the examination rooms and wards on quality of care and patient safety. Semi-structured interviews were carried out with thirty one doctors from three Malaysian government hospitals. Thematic qualitative analysis was performed by using ATLAS.ti to deduce the relevant themes. HIS were commonly believed to improve quality of care and patient safety in terms of : [1] accessibility of patients’ record, [2] efficient patient-care, [3] well-structured report viewing, [4] less missing patients’ records, [5] legibility of patients’ records, and [6] safety features. In conclusion, the use of HIS in examination rooms and wards suggests to improve the quality of care and patient safety.  

Improving Quality of Care and Life in Nursing Homes

1988 ◽  
Vol 7 (3) ◽  
pp. 406-419 ◽  
Author(s):  
Anne P. Glass
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Quality Care ◽  
Nursing Home Residents ◽  
Institutional Quality ◽  
Care Policy ◽  
Regulatory Systems ◽  
Nursing Home Patients ◽  
Care Index

For nursing home residents, quality of life is largely determined by the quality of the care they receive. Unfortunately, that quality is all too often inadequate. Current regulatory systems have failed in their efforts to assure high-quality care. Policy could vitally improve institutional quality of care in three ways: (1) increase efforts to derive a valid and reliable quality of care index that incorporates resident outcomes; (2) change the emphasis of resident care inspections; and (3) expand outside involvement. These elements are all essential and interdependent. They offer a myriad of creative opportunities for researchers, practitioners, and volunteers to make major contributions toward improving the quality of care, and, ultimately of life, for nursing home patients.

scholarly journals Person-Centred Care Transformation in a Nursing Home for Residents with Dementia

2021 ◽  
pp. 1-9
Author(s):  
Peiyan Ho ◽  
Rachel Chin Yee Cheong ◽  
Siew Pei Ong ◽  
Carol Fusek ◽  
Shiou Liang Wee ◽  
...  
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Quality Care ◽  
Well Being ◽  
Care Quality ◽  
Care Recipient ◽  
Staff Retention ◽  
Term Care

<b><i>Background:</i></b> Conventional nursing homes in Singapore adopt an institutional and medical model of care with a focus on safety and risk management. As such, less regard is placed on upholding the dignity and autonomy of the resident, which compromises quality of care and the well-being of the resident. Today, person-centred care (PCC) has become synonymous with high-quality care that sustains the well-being and personhood of the care recipient. <b><i>Objectives:</i></b> To describe the model of PCC adopted by a nursing home, Apex Harmony Lodge (AHL), with a logic model and evaluate outcomes on residents’ well-being, care quality, and staff attrition by comparing pre-PCC initiation (2015) to post-implementation (2016). <b><i>Methods:</i></b> Male residents in a 30-bed assisted living facility for persons with dementia in AHL were assessed using Dementia Care Mapping. Residents’ well-being and staff attrition were measured before and after PCC implementation. <b><i>Results:</i></b> There were statistically significant improvements in resident well-being (Δ = 0.44, <i>p</i> = 0.029), Positive Engagement Potential (Δ = 0.17, <i>p</i> = 0.002), and Occupational Diversity (Δ = 0.12, <i>p</i> = 0.014) in 2016. Withdrawal and Passive Engagement in the residents were reduced significantly as were Care Detractors. There was also a 55% reduction in staff attrition rates post-PCC. <b><i>Conclusions:</i></b> Post-PCC implementation, the outcomes indicate a superior quality of care, enhanced resident well-being, and better staff retention. The AHL PCC model could serve as a roadmap for other nursing homes aspiring to raise the quality of care and influence long-term care standards and regulations for policy makers and legislators.

scholarly journals Age Matters: Building Blocks Needed to Inform Nurse Staffing Hours Requirements in Residential Care for Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 87-87
Author(s):  
Heng Wu ◽  
Christopher Kelly ◽  
Lyn Holley
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nurse Staffing ◽  
Building Blocks ◽  
Technical Note ◽  
Future Research ◽  
Additional Increase ◽  
Nurse Aide ◽  
The Impact

Abstract This study addresses the need for more complete information about the impact of nurse staffing hours (NSH) on nursing home quality of care. We used national data to examine the relationship between three types (Registered Nurse, Licensed Practical Nurse, and Nurse Aide) of hours, and long-stay quality of care measures over time, taking into account the possible confounding influence of regional differences. Data analyzed were from U.S. Nursing Home Compare datasets which reflect quarterly reports, July 1, 2018 - June 30, 2019 (14,768 facilities). The hours for each staff type in each facility were compared with the facility’s four-quarter quality average scores for each of the 12 measures. Results showed only one strong and statistically significant relationship (Beta= .548; p&lt; .001) between Nurse Aide hours and the quality measure used in data sets to exemplify facilities that serve “lower-risk” residents. Analyzes using multiple R (.517) indicate that the linear combination of the three NSH types strongly and significantly (p&lt; .001) predicted the four-quarter average scores and explained 27% of the variance in the scores. Holding the other two NSH types constant, the scores for that measure increased by 63 for each additional increase in the Nurse Aide nurse staffing hours per resident per day. There was no multicollinearity among the three types of staffing hours. This research adds information to the foundation needed for future research about process indicators to assess their efficacy as measures of actual quality of care, and will be submitted as a Technical Note to journals.

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