scholarly journals A CASE STUDY: THE INVISIBLE LABOR OF CULTURALLY SENSITIVE CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S699-S700
Author(s):  
Mai See Thao ◽  
Odichinma C Akosionu ◽  
Heather Davila ◽  
Tetyana P Shippee
Keyword(s):  
Care Delivery ◽  
Ethnically Diverse ◽  
Culturally Sensitive ◽  
Direct Care ◽  
Care Staff ◽  
Culturally Sensitive Care ◽  
Staff Members ◽  
Language Needs

Abstract Nursing homes are increasingly becoming more racially/ethnically diverse yet racial disparities in resident’s quality of life and quality of care continue to persist. One reason for these disparities is lack of culturally-sensitive care and racial/ethnic similarity between residents and staff. This study examines a case of a high proportion minority nursing home with racially/ethnically diverse staff to understand how shared culture among direct care staff and residents may influence care delivery. We used three months of participant observation, supplemented by in-depth qualitative interviews with 8 Hmong residents and 5 Hmong staff to explore the labor of culturally sensitive care in a large, urban NH. We discovered four themes: 1) Culturally sensitive care was often equated to fulfilling language needs for residents who didn’t speak English. 2) Hmong staff members had to take the initiative to inform non-Hmong staff members how to care for Hmong residents. 3) Hmong staff members also had to communicate the culture of NH care and its limitations to Hmong residents and their families. 4) Hmong staff members have to advocate for the culturally relevant needs of Hmong residents. The findings of this case study illuminate that having staff members from diverse cultural backgrounds and meeting language needs of residents does not reflect the everyday practices of culturally sensitive care. This type of emotional labor can also result in higher levels of burn-out for staff of color. Additional research into what constitutes culturally sensitive care to NH residents and staff is needed.

Predictors of Caring in the Context of Relationship-Based Care

2018 ◽  
Vol 24 (2) ◽  
pp. 74-87 ◽  
Author(s):  
John W. Nelson ◽  
Mary Ann Hozak
Keyword(s):  
Health Care ◽  
Care Delivery ◽  
Secondary Analysis ◽  
Direct Care ◽  
Care Staff ◽  
Health Care Staff ◽  
Staff Members ◽  
Primary Nursing ◽  
Care Delivery Model ◽  
Relationship Based Care

The caring connection between patients and health-care staff members is important to both patients and staff. This connection is amplified in organizations implementing Relationship-Based Care (RBC), a patient care delivery model that has relationships with self and others as its central concept. A secondary analysis of data from 542 health-care workers in a health-care system in the northeastern United States was performed to identify a profile of staff factors that predict a caring connection as perceived by staff. Specifically, staff self-care, clarity (of self, role, and system), dimensions of job satisfaction, and demographics were examined in relationship to caring for patients. The study demonstrated that constructs within RBC do relate to the creation of a caring connection between health-care staff members and patients, including caring for self, having a direct relationship with the patient using concepts of Primary Nursing, clarity of role, and being a direct care provider.

Communication Disordered: Program Implementation in Long-Term Care

2016 ◽  
Vol 1 (15) ◽  
pp. 64-67
Author(s):  
George Barnes ◽  
Joseph Salemi
Keyword(s):  
Program Implementation ◽  
Long Term Care ◽  
Family Satisfaction ◽  
Regulatory Compliance ◽  
Care Staff ◽  
Term Care ◽  
Staff Members ◽  
Change Policy

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.

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.

Best Practices in Dementia Care: A Review of the Grey Literature on Guidelines for Staffing and Physical Environment in Long-Term Care

2020 ◽  
pp. 1-16
Author(s):  
Kishore Seetharaman ◽  
Habib Chaudhury ◽  
Michael Kary ◽  
Jennifer Stewart ◽  
Barbara Lindsay ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Best Practices ◽  
Physical Environment ◽  
Care Delivery ◽  
Grey Literature ◽  
Care Staff ◽  
Care Homes ◽  
National Strategy ◽  
Term Care

ABSTRACT In its first national strategy on dementia, the Government of Canada has highlighted the need to improve quality of care for individuals living with dementia, with emphasis on following best practices and evidence in care delivery and providing care staff access to education and training. It is also known that the design of the physical environment of care homes is integral to the care experience of individuals living with dementia. Therefore, this study aims to identify the best national and international practices implemented in care homes for people living with dementia in: (1) education, training, staffing, and care practices; and (2) environmental design and physical infrastructure, through the review of relevant grey literature. This article highlights key recommendations for improving the quality of care for residents living with dementia in care homes, such as: (1) facilitating translation of training into practice, (2) maintaining consistent staffing levels, and (3) designing care homes to facilitate wayfinding, accessibility, safety, comfort, appropriate sensory stimulation, familiarity, and homelikeness. The findings from this review are expected to inform the development of guidelines for a provincial dementia-friendly care home designation program and various advocacy efforts to help achieve the objectives of the national strategy on dementia.

scholarly journals A Comparative Case Study of Prescribing and Non-Prescribing Physiotherapists and Podiatrists

2020 ◽  
Author(s):  
Nicola Carey ◽  
Judith Edwards ◽  
Simon Otter ◽  
Heather Gage ◽  
Peter Williams ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Health Professionals ◽  
Care Delivery ◽  
Comparative Case Study ◽  
Allied Health Professionals ◽  
Future Developments ◽  
The World

Abstract BackgroundIncreasing numbers of nurses, pharmacists and allied health professionals across the world have prescribing rights: over 90,000 of the eligible United Kingdom workforce are qualified as non-doctor prescribers. In order to inform future developments, it is important to understand the benefits and impact of prescribing by allied health professionals including physiotherapists and podiatrists.Aim: to compare outcomes of Physiotherapist and Podiatrist Independent Prescriber (PP- IP) patients with those of Physiotherapist and Podiatrist non-prescribers (PP-NPs). Outcome measures included patient satisfaction, ease of access to services, quality of life and cost implications.Design: a mixed method comparative case studyMethods: Using mixed methods of data collection, outcomes were compared between 7 sites where care was provided from a PP-IP (3 podiatrist and 4 physiotherapist IPs) and 7 sites from a PP-NP (3 podiatrist and 4 physiotherapist NPs). Patients were followed up for 2 months (2015-2016).Results: 488 patients were recruited: n=243 IP sites, and n=245 NP sites. Independent prescribing was found to be highly acceptable, and equivalent in terms of quality of life (p>0.05) and patient satisfaction (p≤0.05) compared to care provided by NPs. PP-IP care delivery was found to be more resource intensive than NP-PP, with longer consultation duration for IPs (around 6.5 mins), and a higher proportion of physiotherapy patients discussed with medical colleagues (around 9.5 minutes). ConclusionThis study provides new knowledge that PP-IPs provide high levels of care. PP-IP care delivery was found to be more resource intensive. Further research is required to explore cost effectiveness. A more focussed exploration within each profession using targeted outcome measures would enable a more robust comparison, inform future developments around the world and help ensure non-doctor prescribing is recognised as an effective way to alleviate shortfalls in the global workforce.

scholarly journals Evaluating an ESP textbook: a case study of English for banking purposes at EDBI

2020 ◽  
Vol 13 (32) ◽  
pp. 1-16
Author(s):  
Mohammad-reza Takrousta ◽  
Parviz Behrouzi ◽  
Sholeh Kolahi
Keyword(s):  
English Language ◽  
Language Skills ◽  
Physical Appearance ◽  
New Materials ◽  
Text Book ◽  
Positive Attitudes ◽  
Language Needs

An English language textbook for banking purposes had been designed based on the language needs of EDBI staffs. Consequently, an English course for banking purposes was held at EDBI using the designed book. To ensure about the validity and quality of the textbook, it was evaluated by 2 language experts through an interview before the course and 30 bank’s staffs as the learners through a set of questionnaire after the course. Based on the quantitative and qualitative findings of the study, both language experts and EDBI’s staffs had positive attitudes toward the materials, topics, activities and tasks, language skills and physical appearance of the text book and recognized it relevant to their language needs. However, they asked for some modifications such as edition of misspelling and ungrammatical use of some sentences and additions of new materials such as a glossary and business and banking correspondences to the existing ones. The results of the study became a basis to further improvement and correction until the draft would be finalized as a ready use material. Therefore, some modifications and alternations were conducted based on their evaluations to make the product more valid and more practical. The findings of the present research bear significant implications for materials developers and teachers especially in applying appropriate materials in ESP courses and evaluating the textbooks in the related studies.

scholarly journals A comparative case study of prescribing and non-prescribing physiotherapists and podiatrists

2020 ◽  
Author(s):  
Nicola Carey ◽  
Judith Edwards ◽  
Simon Otter ◽  
Heather Gage ◽  
Peter Williams ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Health Professionals ◽  
Care Delivery ◽  
Comparative Case Study ◽  
Allied Health Professionals ◽  
Future Developments ◽  
The World

Abstract BackgroundIncreasing numbers of nurses, pharmacists and allied health professionals across the world have prescribing rights for medicines: over 90,000 of the eligible United Kingdom workforce are qualified as non-doctor prescribers. In order to inform future developments, it is important to understand the benefits and impact of prescribing by allied health professionals including physiotherapists and podiatrists.Aim: to compare outcomes of physiotherapist and podiatrist Independent Prescriber (PP- IP) patients with those of physiotherapist and podiatrist non-prescribers (PP-NPs). Outcome measures included patient satisfaction, ease of access to services, quality of life and cost implications.Design: a mixed method comparative case study Methods: Using mixed methods of data collection, outcomes were compared between 7 sites where care was provided from a PP-IP (3 podiatrist and 4 physiotherapist IPs) and 7 sites from a PP-NP (3 podiatrist and 4 physiotherapist NPs). Patients were followed up for 2 months (2015-2016). Results: 489 patients were recruited: n=243 IP sites, and n=246 NP sites. Independent prescribing was found to be highly acceptable, and equivalent in terms of quality of life (p>0.05) and patient satisfaction (p≤0.05) compared to care provided by NPs. PP-IP care delivery was found to be more resource intensive than PP-NP, with longer consultation duration for IPs (around 6.5 mins), and a higher proportion of physiotherapy patients discussed with medical colleagues (around 9.5 minutes). ConclusionThis study provides new knowledge that PP-IPs provide high levels of care. PP-IP care delivery was found to be more resource intensive. Further research is required to explore cost effectiveness. A more focussed exploration within each profession using targeted outcome measures would enable a more robust comparison, inform future developments around the world and help ensure non-doctor prescribing is recognised as an effective way to alleviate shortfalls in the global workforce.

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 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.

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