scholarly journals Exploring the Role of Contextual Factors in Medicaid Nursing Homes' Performance: A Qualitative Perspective

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 21-22
Author(s):  
Justin Lord ◽  
Midge Ray ◽  
Amy Landry ◽  
Heather Lee ◽  
Nataliya Ivankova ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Organizational Development ◽  
Contextual Factors ◽  
Quality Care ◽  
Community Support ◽  
Open Door Policy ◽  
Nursing Home Administrators ◽  
Performance Quality ◽  
Low Performance

Abstract This study explored the role of tested contextual factors (structural, market, and management) in high Medicaid (under resourced) nursing homes performance. Four nursing homes in geographically diverse states were purposefully selected for site visits based on high and low performance (quality/ profitability) indicators. Eight nursing home administrators and directors of nursing, and twenty-one nursing staff (RNs, LPNs, and CNAs) and providers of support services were interviewed. Data were analyzed using an inductive thematic approach with NVivo 12 Plus. Within and across case analysis was used to compare participants’ perspectives across nursing homes and across administrators and staff. Several themes provide insight into varied influences of contextual factors on these nursing homes’ performance: focus on quality care, team-based approach, community support and engagement, and staffing retention. Providing quality care to residents was strategic priority in all facilities, which was enhanced by an adopted team-based leadership approach, open-door policy and home-like atmosphere. Community reputation and availability of local training opportunities for CNAs affected nursing staffing which some facilities addressed using creative retention strategies. These research findings will facilitate interventions, such as leadership training and organizational development activities, aimed at improving the performance of low performing facilities in terms of lower costs and better quality.

Assuring Quality in Nursing Homes: The Black Box of Administrative and Clinical Leadership --a Scoping Review

2020 ◽  
Author(s):  
Elena O Siegel ◽  
Heather M Young
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Scoping Review ◽  
Research Policy ◽  
Quality Care ◽  
Black Box ◽  
Future Research ◽  
Nursing Home Administrators ◽  
Policy Practice ◽  
Role Structure

Abstract Background and Objectives Licensed nursing home administrators (NHA) and directors of nursing (DON) are responsible for nursing home quality and assuring optimal performance and job satisfaction/retention of their nursing home workforce. NHA/DON-focused studies have generated important foundational knowledge over the last three decades; yet, targeted research is needed to understand and apply the complexities of the black box of this top management team. This scoping review identifies, reviews, synthesizes and maps the topical areas of research in NHA/DON positions in US nursing homes. Research Design and Methods We conducted searches of five databases, yielding 3,479 records; screening/review yielded 88 unique records analyzed using Donabedian’s structure-process-outcome model (Donabedian, 2003) as an organizing framework. Results Most papers (n=40) focused on role characteristics, 23 examined approaches to management and leadership, 24 focused on perceptions about the role, and the remaining 12 examined role structure. The role-related themes linked to outcomes (n=42), processes (n=27) and structures (n=30). Discussion and Implications We highlight important gaps for future research and offer a call to action for research, policy, practice, and education collaborations to accelerate the rate of research and translate the findings into best practices for NHA/DON to lead and manage the nursing home workforce and build capacity to ensure person-centered, high quality care. Based on foundational descriptive studies, it is time to use what is known to design and implement interventions that enhance the capacity of NHA/DON to improve the structures, processes and outcomes of nursing homes.

Situational Breakdowns

2019 ◽  
Author(s):  
Anne Nassauer
Keyword(s):  
United States ◽  
Large Scale ◽  
Contextual Factors ◽  
The United States ◽  
Social Outcomes ◽  
Dynamic Processes ◽  
Collective Decisions ◽  
Different Types ◽  
The Impact

This book provides an account of how and why routine interactions break down and how such situational breakdowns lead to protest violence and other types of surprising social outcomes. It takes a close-up look at the dynamic processes of how situations unfold and compares their role to that of motivations, strategies, and other contextual factors. The book discusses factors that can draw us into violent situations and describes how and why we make uncommon individual and collective decisions. Covering different types of surprise outcomes from protest marches and uprisings turning violent to robbers failing to rob a store at gunpoint, it shows how unfolding situations can override our motivations and strategies and how emotions and culture, as well as rational thinking, still play a part in these events. The first chapters study protest violence in Germany and the United States from 1960 until 2010, taking a detailed look at what happens between the start of a protest and the eruption of violence or its peaceful conclusion. They compare the impact of such dynamics to the role of police strategies and culture, protesters’ claims and violent motivations, the black bloc and agents provocateurs. The analysis shows how violence is triggered, what determines its intensity, and which measures can avoid its outbreak. The book explores whether we find similar situational patterns leading to surprising outcomes in other types of small- and large-scale events: uprisings turning violent, such as Ferguson in 2014 and Baltimore in 2015, and failed armed store robberies.

Breastfeeding Experiences of Baccalaureate Nursing Students: A Qualitative Study

2020 ◽  
pp. 089033442097998
Author(s):  
Cheryl Langford ◽  
Marcella Gowan ◽  
Monica Haj
Keyword(s):  
Nursing Students ◽  
Health Care Providers ◽  
Baccalaureate Nursing ◽  
Community Support ◽  
Baccalaureate Nursing Students ◽  
Care Providers ◽  
Structured Interviews ◽  
Breastfeeding Support ◽  
Cross Sectional

Background Students returning to school who are breastfeeding face unique challenges. There is limited literature on breastfeeding university students. Several researchers have studied breastfeeding employees in the workplace. Institutions of higher education closely mimic the employment environment. Breastfeeding college students who express their milk while at school share similar challenges to employed mothers. A baccalaureate nursing program is rigorous and little is known about the challenges facing breastfeeding student nurses returning to classes. Research aim To explore the breastfeeding experience of baccalaureate nursing students. Methods Our study was a cross-sectional descriptive qualitative design. Purposive sampling was used to enroll participants ( N = 12). In depth, semi-structured interviews were conducted. Qualitative thematic analysis was used to analyze the data both manually and using Dedoose QDA software. Results An overarching theme of pervasive conflict between the role of the breastfeeding mother and the role of the student nurse surfaced. Three interrelated organizing themes also emerged; challenging, vulnerability, and resilience. Time constraints, self-care versus role demands, and structural accommodations contributed to the challenges. Only one participant indicated a knowledge of her breastfeeding rights. All of the participants expressed gratitude for faculty and community support, regardless of conflicts. Conclusion Breastfeeding participants were both vulnerable and resilient. Faculty may improve experiences through providing specific areas of support. A breastfeeding support policy outlining student rights and faculty responsibilities is needed to educate, guide, and enforce protections. Health care providers may enhance breastfeeding students’ experiences through anticipatory guidance, education, and continued support.

The Role of Dimensional Distinctiveness in Children's and Adults' Artifact Categorization

2005 ◽  
Vol 16 (2) ◽  
pp. 137-144 ◽  
Author(s):  
Rubi Hammer ◽  
Gil Diesendruck
Keyword(s):  
Preschool Children ◽  
Contextual Factors ◽  
A Priori ◽  
Functional Similarity ◽  
Second Stage ◽  
Functional Dimension

There are conflicting results as to whether preschool children categorize artifacts on the basis of physical or functional similarity. The present study investigated the effect of the relative distinctiveness of these dimensions in children's categorization. In a physical-distinctive condition, preschool children and adults were initially asked to categorize computer-animated artifacts whose physical appearances were more distinctive than their functions. In a function-distinctive condition, the functional dimension of objects was more distinctive than their physical appearances. Both conditions included a second stage of categorization in which both dimensions were equally distinctive. Participants in a control condition performed only this stage of categorization. Adults in all conditions and stages consistently categorized by functional similarity. In contrast, children's categorization was affected by the relative distinctiveness of the dimensions. Children may not have a priori specific beliefs about how to categorize novel artifacts, and thus may be more susceptible to contextual factors.

scholarly journals A critical review on the moderating role of contextual factors in the associations between video gaming and well-being

2021 ◽  
pp. 100135
Author(s):  
Andree Hartanto ◽  
Verity Y.Q. Lua ◽  
Frosch Y.X. Quek ◽  
Jose C. Yong ◽  
Matthew H.S. Ng
Keyword(s):  
Critical Review ◽  
Contextual Factors ◽  
Well Being ◽  
Video Gaming ◽  
Moderating Role
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