scholarly journals SAFETY CLIMATE IN NURSING HOMES: ARE SENIOR MANAGERS IN AGREEMENT WITH DIRECT CARE STAFF?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S62-S63
Author(s):  
Emma Quach ◽  
Lewis Kazis ◽  
Shibei Zhao ◽  
Sarah McDannold ◽  
Christine W Hartmann
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Safety Climate ◽  
Reference Group ◽  
Random Effect ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Senior Managers ◽  
Employee Survey

Abstract Nursing home safety climate in nursing homes reflects norms and attitudes about the safety of residents and is a key driver of safety. We investigated views of direct care staff and senior managers in 56 Department of Veterans Affairs nursing homes, because prior hospital studies reveal incongruent views of these two groups, which compromises quality of care. Each domain of the previously validated CLC Employee Survey of Attitudes about Resident Safety (CESARS) served as a dependent variable, with occupation as the major independent variable distinguishing senior managers (the reference group) from licensed nurses, nursing assistants, and clinicians/specialists. Mixed random effect models controlled for job tenure, work shift, ≤ 40 weekly work hours or more, as well as clustering effects (by VA hospitals, VA service networks, and geographic regions). We analyzed responses of 1316 direct care staff and senior managers, a 26% response rate. Senior managers were more favorable about their co-worker interactions regarding safety and their nursing home globally than each direct care staff group (small to moderate effects or ⅓ to ½ of a standard deviation) (p < 0.05). Direct care staff had comparable ratings on these two safety climate domains. We found incongruence between senior managers and direct care staff in their perceptions of their facility’s safety. Results imply that regular and open conversations between direct care staff and senior managers around safety may keep senior managers informed about frontline safety issues and direct care staff about high-level quality improvement initiatives, bringing them closer to a mutual understanding.

Nursing Home Senior Managers and Direct Care Staff

2019 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Emma D. Quach ◽  
Lewis E. Kazis ◽  
Shibei Zhao ◽  
Sarah McDannold ◽  
Valerie Clark ◽  
...  
Keyword(s):  
Nursing Home ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Senior Managers

Resilience and Challenges among Staff of Gulf Coast Nursing Homes Sheltering Frail Evacuees following Hurricane Katrina, 2005: Implications for Planning and Training

2009 ◽  
Vol 24 (1) ◽  
pp. 54-62 ◽  
Author(s):  
Sarah B. Laditka ◽  
James N. Laditka ◽  
Carol B. Cornman ◽  
Courtney B. Davis ◽  
Jane V.E. Richter
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Hurricane Katrina ◽  
Well Being ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Staff Members ◽  
And Training ◽  
Physical Care

AbstractPurpose:The purpose of this study was to: (1) explore experiences and responses of staff in caring for sheltered, frail, Hurricane Katrina evacuees; and (2) identify how planning and training can be enhanced for staff who may care for frail older populations during and after disasters.Methods:Individual, in-person, semi-structured interviews were conducted with 38 staff members in four nursing homes in Mississippi, sheltering 109 evacuees in November 2005, nine weeks after Hurricane Katrina.Twenty-four were direct care staff, including certified nursing assistants, licensed nurses, dietary aides, and social workers; 14 were support staff, including maintenance and business managers. The number interviewed in each nursing home averaged 9.5 (range 6–15). Using a discussion guide and focusing on their experiences caring for nursing home evacuees, staff were asked to describe: (1) experiences; (2) problems; (3) what helped; and (4) what was learned. Data were processed using grounded theory and thematic analysis. Responses of direct care staff differed in emphasis from those of support staff in several areas; responses from these groups were analyzed separately and together. Three of the researchers identified recurring themes; two organized themes conceptually.Results:Staff emphasized providing emotional reassurance to evacuees as well as physical care. Many described caring for evacuees as “a blessing,” saying the experience helped them bond with residents, evacuees, and other staff. However, caring for evacuees was difficult because staff members were extremely anxious and in poor physical condition after an arduous evacuation. Challenges included communicating with evacuees' families, preventing dehydration, lack of personal hygiene supplies, staff exhaustion, and emotional needs of residents, evacuees, and staff. Teamwork, community help, and having a well-organized disaster plan, extra supplies, and dependable staff helped personnel cope with the situation.Conclusions:Staff of nursing homes that sheltered Katrina evacuees demonstrated resilience in the disaster's aftermath. Many placed the well-being of residents as their first priority. Results underscore the importance of planning, teamwork, and adequate supplies and staffing. Training for long-term care staff should emphasize providing emotional support as well as physical care for residents and evacuees during and following disasters. Nurses, social workers, and other staff members responsible for promoting emotional well-being for nursing home residents should be prepared to respond to disasters.

scholarly journals Mealtime Care for People With Dementia: What Do Nursing Home Staff Think?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 182-183
Author(s):  
James Faraday ◽  
Clare Abley ◽  
Catherine Exley ◽  
Joanne Patterson
Keyword(s):  
Nursing Homes ◽  
Ethnographic Study ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Structured Interviews ◽  
Staff Members ◽  
People With Dementia ◽  
Comparison Approach ◽  
The Right

Abstract More and more people with dementia are living in nursing homes (NH). Often, they depend on NH staff for help with eating and drinking. It is important that staff have the skills and support they need to provide good care at mealtimes. This qualitative study explores mealtime care for people with dementia, from the perspective of NH staff. Semi-structured interviews with NH staff (n=16) were carried out in two nursing homes. The homes were chosen to have diverse characteristics: one home had a large number of beds and was part of a small local organization; the other had a small number of beds and was part of a large national organization. Various staff members were interviewed, including direct care staff, senior carers, nurses, managers, and kitchen staff. Interviews were audio-recorded and transcribed verbatim. A constant comparison approach was taken, so that data from early interviews were explored in more depth subsequently. From the analysis, five themes emerged as important in mealtime care for people with dementia living in nursing homes: Setting the right tone; Working well as a team; Knowing the residents; Promoting autonomy and independence; Gently persevering. This work forms part of a larger ethnographic study on the topic, which includes data from residents with dementia, and family carers. Results will inform the development of a staff training intervention to optimize mealtime care for this population.

scholarly journals Grief After Patient Death: Direct Care Staff in Nursing Homes and Homecare

2015 ◽  
Vol 49 (2) ◽  
pp. 214-222 ◽  
Author(s):  
Kathrin Boerner ◽  
Orah R. Burack ◽  
Daniela S. Jopp ◽  
Steven E. Mock
Keyword(s):  
Nursing Homes ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Patient Death

scholarly journals PERSON-CENTERED CARE: DEFINITIONS AND PERCEPTIONS OF VARIOUS STAKEHOLDERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S359-S359
Author(s):  
Nancy Kusmaul ◽  
Gretchen Tucker
Keyword(s):  
Nursing Homes ◽  
Well Being ◽  
Direct Care ◽  
Care Staff ◽  
Administrative Staff ◽  
Direct Care Staff ◽  
Potential Conflict ◽  
Person Centered Care ◽  
Centered Care

Abstract Implementation of culture change in nursing homes shifts the care model from a traditional, more medically focused approach to person-directed care. Person-directed care promotes resident autonomy and decision making and the empowerment of direct care staff. In this paper, we examine how different stakeholders in nursing homes (residents, family members, direct care staff, administrative staff) conceptualize and experience a selection of person-centered care concepts (consistent assignment, meal choice, waking/bedtime practices, and bathing). We describe the commonalities and differences in the ways different groups of stakeholders operationalize these core person centered care practices and describe areas of potential conflict of views. Lastly, we consider how the well-being and quality of life for residents is affected by the use of these practices.

scholarly journals DEMENTIA-FOCUSED PERSON-DIRECTED CARE TRAINING IN THE NURSING HOME: FIDELITY AND OUTCOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S380-S380
Author(s):  
Joann P Reinhardt ◽  
Orah Burack ◽  
Verena Cimarolli ◽  
Audrey Weiner
Keyword(s):  
Nursing Home ◽  
Clinical Symptoms ◽  
Intervention Group ◽  
Well Being ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Care Needs ◽  
Model Versus ◽  
The Impact

Abstract To address the behavioral health of nursing home (NH) residents living with dementia, training direct care staff (DCS) is essential, for the well-being of both residents and staff. We evaluated a training for DCS focused on providing care for persons with advanced dementia who are at-risk of not having care needs met, largely due to communication deficits. Staff were trained in promoting comfort and reducing distress through person-directed care (PDC), deeply knowing each resident, and anticipating needs. Subsequent fidelity interviews with staff showed a higher number of PDC practices utilized by staff in the intervention communities compared to usual care. We also compared the impact of the PDC model versus a traditional model of NH care on resident clinical outcomes, finding a significant interaction where those in the intervention group had fewer clinical symptoms over a 6-month period. Implications for training in the NH setting will be discussed.

scholarly journals Implementing Changing Talk Online Training: A Pragmatic Trial to Improve Dementia Care Communication in NHs

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 495-495
Author(s):  
Carissa Coleman ◽  
Kristine Williams ◽  
Yelena Perkhounkova ◽  
Maria Hein ◽  
Tim Beachy ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Culture Change ◽  
Pragmatic Trial ◽  
Implementation Strategies ◽  
Direct Care ◽  
Care Staff ◽  
Knowledge Gain ◽  
Staff Members ◽  
Post Test

Abstract The Changing Talk (CHAT) training effectively reduces elderspeak and subsequent behavioral challenges in residents with dementia in nursing homes. The Changing Talk: Online (CHATO) training was developed to increase staff access to education using a new online format. A pilot test was conducted to confirm the feasibility and effects of CHATO on training outcomes. In the initial nursing home, twenty-three direct care staff members in a small Midwestern nursing home enrolled in the course including 12 CNAs, 4 RNs, 2 LPNs, 2 CMAs, 1 Dietary Aide, 1 Social Worker, and 1 in Transportation. Two forms of a 13-item scenario-based test to measure knowledge gain were developed and tested. Of the 23 staff, 18 (78%) completed the post-test and 83% of completers achieved a post-test score of 70% or greater. Scores on the test improved from M=69% correct (SD=11.7) at pretest to 86% correct (SD=10.6) on posttest demonstrating knowledge gain (p=.024). Participants improved their recognition of elderspeak (21%) and person-centered communication (24%) in a video vignette and 86% self-reported improvement in their abilities to recognize ineffective communication and to apply more effective communication strategies in practice. A randomized control trial enrolled staff (N=187) in eight additional nursing homes. Preliminary results confirm improvements in test scores from M=70.6% correct (SD=15.8) at pretest to 77.2% correct (SD=14.1) on posttest and increased elderspeak recognition (p=.004). Relationships between nursing home characteristics, implementation strategies, and culture change measured by the Artifacts of Culture Change Tool and their relationship to communication outcomes will be presented.

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.

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