Certified nursing assistants as agents of creative caregiving in long‐term care

Background: Certified nursing assistants (CNAs) provide 80% to 90% of direct care and are 23 times more likely to experience aggressive behavior from residents in long-term care (LTC) facilities than in other health care settings. The purpose of this study was to describe CNAs’ perceptions of workplace violence while working in LTC facilities. Methods: Ten CNAs were recruited from five LTC facilities through snowball sampling. A semi-structured interview was conducted with CNAs currently working in LTC facilities in Alabama. Question domains included (a) demographics, (b) residents’ behavior, (c) behavior of residents with dementia, (d) experiences of verbal or physical violence from residents, (e) quality of care delivered, (f) coping strategies, (g) administrative support, and (h) training for dementia-related care challenges. The resulting transcripts were thematically analyzed. Findings: CNAs described workplace violence as part of the job. They expressed a lack of administrative support as inadequate communication and a dismissal of violence against them. They regularly experienced racially charged abuse, but the perception of abuse was moderated by the presence or absence of dementia. They described a lack of training and direction to recognize and de-escalate workplace violence. Conclusions/Application to Practice: Workplace violence from residents residing in LTC facilities is an occupational health risk for CNAs. LTC facilities need a multisystem approach to reduce episodes of resident-on-CNA violence. This approach should include comprehensive training to recognize triggers of violent behavior, especially when working with individuals with dementia, as well as administrative support, and mental health resources to address the cumulative and negative consequences of racism.

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Comparison Between Quality of Care Provided by Trained Feeding Assistants and Certified Nursing Assistants During Between-Meal Supplementation in Long-Term Care Settings

Journal of Applied Gerontology ◽

10.1177/0733464816669806 ◽

2016 ◽

Vol 37 (11) ◽

pp. 1391-1410 ◽

Cited By ~ 2

Author(s):

Emily K. Hollingsworth ◽

Emily A. Long ◽

Sandra F. Simmons

Keyword(s):

Nursing Staff ◽

Long Term Care ◽

Nursing Assistants ◽

Certified Nursing Assistants ◽

Research Staff ◽

Term Care ◽

Trained Staff ◽

Feeding Assistance

The purpose of this study was to compare the quality of feeding assistance provided by trained non-nursing staff with care provided by certified nursing assistants (CNAs). Research staff provided an 8-hr training course that met federal and state requirements to non-nursing staff in five community long-term care facilities. Trained staff were assigned to between-meal supplement and/or snack delivery for 24 weeks. Using standardized observations, research staff measured feeding assistance care processes between meals across all study weeks. Trained staff, nurse aides, and upper level staff were interviewed at 24 weeks to assess staff perceptions of program impact. Trained staff performed significantly better than CNAs for 12 of 13 care process measures. Residents also consumed significantly more calories per snack offer from trained staff ( M = 130 ± 126 [ SD] kcal) compared with CNAs ( M = 77 ± 94 [ SD] kcal). The majority of staff reported a positive impact of the training program.

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Impact of serious mental illness online training for certified nursing assistants in long term care

Gerontology & Geriatrics Education ◽

10.1080/02701960.2016.1188811 ◽

2016 ◽

Vol 38 (4) ◽

pp. 359-374 ◽

Cited By ~ 5

Author(s):

Victor Molinari ◽

John V. Hobday ◽

Rosalyn Roker ◽

Mark E. Kunik ◽

Rosalie Kane ◽

...

Keyword(s):

Mental Illness ◽

Serious Mental Illness ◽

Long Term Care ◽

Online Training ◽

Nursing Assistants ◽

Certified Nursing Assistants ◽

Term Care

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Education and Training in End-of-Life Care for Certified Nursing Assistants in Long-Term Care

The Journal of Continuing Education in Nursing ◽

10.3928/00220124-20170119-09 ◽

2017 ◽

Vol 48 (2) ◽

pp. 81-85 ◽

Cited By ~ 4

Author(s):

Mansura Malik ◽

Wendy Chapman

Keyword(s):

End Of Life ◽

End Of Life Care ◽

Long Term Care ◽

Education And Training ◽

Nursing Assistants ◽

Certified Nursing Assistants ◽

Life Care ◽

Term Care ◽

And Training

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Organizational Factors Associated With Retention of Certified Nursing Assistants and Direct Care Workers

Innovation in Aging ◽

10.1093/geroni/igaa057.1238 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 384-385

Author(s):

Katherine Kennedy ◽

Robert Applebaum ◽

John Bowblis ◽

Jane Straker

Keyword(s):

Long Term Care ◽

Response Rate ◽

Nursing Assistants ◽

Direct Care ◽

Retention Rates ◽

Direct Care Workers ◽

Certified Nursing Assistants ◽

Term Care ◽

Care Workers

Abstract Low retention of certified nursing assistants (CNAs) and direct care workers (DCWs) continues to be an unresolved problem for nursing homes (NH) and assisted living (AL) settings. While numerous studies have examined predictors of CNA retention in NHs, little attention has been paid to differences between settings of long-term care. To inform practice and policy related to growth in the AL industry, this study compares the predictors of CNA and DCW retention rates. The 2017 Ohio Biennial Survey of Long-Term Care Facilities provides facility-level information from 968 NHs (91% response rate) and 708 ALs (88% response rate). Using regression analysis, we compare the factors that predict retention rates among providers with complete data on retention and controls. The same covariates relating to structural and financial characteristics, as well as staffing, management, and a number of retention best practices are used. Average DCW and CNA retention rates were 66% and 61% in ALs and NHs, respectively, with some settings reporting very low (and even 0%) retention over a year. AL and NH providers rated the problem’s severity highest (6 out of 10) compared to retaining other licensed nurses. Similar and different predictors were found across financial, environmental, and managerial practices supporting retention. CNA and DCW retention strategies may not be equivalently meaningful between settings, given differing working environments, resources, and regulations. Aging services managers should be attuned to practices supporting retention in their industry.

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Assessing apathy in long-term care residents with dementia: Who should be the rater?

Dementia ◽

10.1177/1471301217745104 ◽

2017 ◽

Vol 18 (6) ◽

pp. 2220-2229

Author(s):

Ying-Ling Jao ◽

Kristine Williams ◽

Jacqueline Mogle ◽

Liza Behrens ◽

Caroline McDermott

Keyword(s):

Long Term Care ◽

Pearson Correlation ◽

Statistical Significance ◽

Nursing Assistants ◽

Future Research ◽

Certified Nursing Assistants ◽

Term Care ◽

Licensed Practical Nurses ◽

Practical Nurses

Background Apathy is prominent in persons with dementia and apathy assessment is challenging. It remains unclear who should conduct apathy assessments in long-term care settings for residents with moderate to advanced dementia. The Apathy Evaluation Scale (AES) is a widely used instrument and its use for long-term care residents with dementia needs to be further established. This study explored the relationship among apathy assessments conducted by family and clinical caregivers using the original AES (AES-18) and the nursing home version (AES-10). Methods This study used a cross-sectional, descriptive design and enrolled 15 quartets of participants recruited from long-term care settings. Each quartet consisted of one resident with dementia, one family member, one certified nursing assistant, and one licensed practical nurse or activity staff. Family, certified nursing assistants, and licensed practical nurses/activity staff rated the resident’s apathy level on the AES independently. Bivariate Pearson correlation coefficients were used for analysis. Results The results revealed that ratings conducted by certified nursing assistants and licensed practical nurses/activity staff were moderately correlated for the AES-18 and the result approached statistical significance (r = 0.47, p = .08). None of the other AES ratings among family, certified nursing assistants, and licensed practical nurses/activity staff were significantly correlated. Discussion Family and clinical caregivers were incongruent on their AES ratings of apathy. It remains undetermined which rater provides the most valid AES rating for residents with dementia. Findings from this study further highlight challenges in rating apathy in this population. Future research is needed to determine best practices for accurate apathy assessment for residents with dementia in long-term care.

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