scholarly journals Themes Related to Experienced Quality of Care in Nursing Homes From the Resident’s Perspective: A Systematic Literature Review and Thematic Synthesis

2020 ◽  
Vol 6 ◽  
pp. 233372142093196
Author(s):  
Katya Y. J. Sion ◽  
Hilde Verbeek ◽  
Sandra M. G. Zwakhalen ◽  
Gaby Odekerken-Schröder ◽  
Jos M. G. A. Schols ◽  
...  
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Social Engagement ◽  
Centered Care ◽  
Meaningful Relationships ◽  
And Coping

Background: The culture change from task-centered care to person- and relationship-centered care has resulted in the resident’s voice gaining importance when assessing experienced quality of care in nursing homes. This review aimed to identify which factors contribute to experienced quality of care in nursing homes worldwide from the resident’s perspective. Method: A systematic literature review and thematic data synthesis were performed. The databases PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, and Business Source Complete were searched to identify qualitative studies aimed at retrieving factors related to residents’ experienced quality of care in nursing homes. Only studies in which residents themselves were interviewed were included. Results: This literature review included 27 publications covering 14 countries. Thematic analysis revealed three overarching themes related to residents’ care experiences: (a) The nursing home environment consisted of the physical environment and caring environment, (b) individual aspects of living in the nursing home consisted of personhood and coping with change, and (c) social engagement consisted of meaningful relationships and care provision. Discussion: To achieve high experienced quality of care in nursing homes, residents’ care experiences need to be assessed and used in quality management.

scholarly journals Nursing Home Implementation of Health Information Technology: Review of the Literature Finds Inadequate Investment in Preparation, Infrastructure, and Training

2018 ◽  
Vol 55 ◽  
pp. 004695801877890 ◽  
Author(s):  
Michelle Ko ◽  
Laura Wagner ◽  
Joanne Spetz
Keyword(s):  
Information Technology ◽  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Literature Review ◽  
Health Information Technology ◽  
Health Information ◽  
Nursing Home Staff ◽  
And Training

Health information technology (HIT) is increasingly adopted by nursing homes to improve safety, quality of care, and staff productivity. We examined processes of HIT implementation in nursing homes, impact on the nursing home workforce, and related evidence on quality of care. We conducted a literature review that yielded 46 research articles on nursing homes’ implementation of HIT. To provide additional contemporary context to our findings from the literature review, we also conducted semistructured interviews and small focus groups of nursing home staff (n = 15) in the United States. We found that nursing homes often do not employ a systematic process for HIT implementation, lack necessary technology support and infrastructure such as wireless connectivity, and underinvest in staff training, both for current and new hires. We found mixed evidence on whether HIT affects staff productivity and no evidence that HIT increases staff turnover. We found modest evidence that HIT may foster teamwork and communication. We found no evidence that the impact of HIT on staff or workflows improves quality of care or resident health outcomes. Without initial investment in implementation and training of their workforce, nursing homes are unlikely to realize potential HIT-related gains in productivity and quality of care. Policy makers should consider creating greater incentives for preparation, infrastructure, and training, with greater engagement of nursing home staff in design and implementation.

The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review

Dementia ◽  
2021 ◽  
pp. 147130122110126
Author(s):  
Alexandra E Harper ◽  
Lauren Terhorst ◽  
Marybeth Moscirella ◽  
Rose L Turner ◽  
Catherine V Piersol ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Scoping Review ◽  
Informal Caregivers ◽  
Nursing Home Care ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Background Person-centered care has been shown to increase desired outcomes for people with dementia, yet informal caregivers’ dissatisfaction with care is often reported. For those living in a nursing home, informal caregivers are uniquely situated to provide key insights into the individual’s care. However, little is known of the informal caregivers’ perspective, which hinders efforts to improve their satisfaction with person-centered nursing home care. Thus, we examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia. Methods In collaboration with stakeholders, a scoping review of Medline (Ovid), EMBASE.com , CINAHL (EBSCO), the Cochrane Library (Wiley), and PsycINFO (Ovid) databases from January 2000 to July 2020 was conducted. Data were extracted reflecting the experiences, priorities, and preferences of caregivers of people with dementia residing in nursing homes. Results We identified 114 articles that revealed nine themes: (1) communication, (2) transition to nursing home, (3) quality of care, (4) quality of life, (5) informal caregiver role, (6) knowledge of dementia, (7) end-of-life preferences, (8) medication use to manage neuropsychiatric behaviors, and (9) finances. Conclusion Informal caregivers described aspects of care that led to both positive and negative experiences with and perceptions of nursing home care. The shortcomings in communication were discussed most frequently, indicating a high priority area. While researchers define the identified themes individually, informal caregivers perceive them to be interwoven as they relate to person-centered care delivery. Although we did not assess the quality of included articles, by identifying themes relevant to caregivers’ perspectives of nursing home care, our findings may help to inform efforts to optimize caregivers’ satisfaction with nursing home care for residents with dementia.

scholarly journals Analyzing Nursing Home Complaints: From Substantiated Allegation to Deficiency Citations

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 82-83
Author(s):  
Kallol Kumar Bhattacharyya ◽  
Lindsay Peterson ◽  
John Bowblis ◽  
Kathryn Hyer
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Staff Training ◽  
Policy And Practice ◽  
Abuse And Neglect ◽  
The Relationship ◽  
Investigation Process

Abstract Complaints provide important information to consumers about nursing homes (NHs). Complaints that are substantiated often lead to an investigation and potentially a deficiency citation. The purpose of this study is to understand the relationship between substantiated complaints and deficiency citations. Because a complaint may contain multiple allegations, and the data do not identify which allegation(s) lead to a complaint’s substantiation, we identified all substantiated single allegation complaints for NHs in 2017. Our data were drawn from federally collected NH complaint and inspection records. Among the 369 substantiated single-allegation complaints, we found most were categorized as quality of care (31.7%), resident abuse (17.3%), or resident neglect (14.1%). Of the deficiency citations resulting from complaints in our sample, 27.9% were categorized as quality of care and 19.5% were in the category of resident behavior and facility practices, which includes abuse and neglect. While two-thirds (N=239) of the substantiated complaints generated from 1 to 19 deficiency citations, nearly one third had no citations. Surprisingly, 28% of substantiated abuse and neglect allegations resulted in no deficiency citations. More surprisingly, a fifth of complaints that were categorized as “immediate jeopardy” at intake did not result in any deficiency citations. We also found a number of asymmetries in the allegation categories suggesting different processes by Centers for Medicare and Medicaid Services (CMS) region. These results suggest that the compliant investigation process warrants further investigation. Other policy and practice implications, including the need for better and more uniform investigation processes and staff training, will be discussed.

scholarly journals Review: Relation Between Quality-of-Care Indicators for Diabetes and Patient Outcomes: A Systematic Literature Review

2011 ◽  
Vol 68 (3) ◽  
pp. 263-289 ◽  
Author(s):  
Grigory Sidorenkov ◽  
Flora M Haaijer-Ruskamp ◽  
Dick de Zeeuw ◽  
Henk Bilo ◽  
Petra Denig
Keyword(s):  
Quality Of Care ◽  
Literature Review ◽  
Patient Outcomes ◽  
Systematic Literature Review

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.

Two Decades of Nursing Home Compare: What Have We Learned?

2020 ◽  
pp. 107755872093165
Author(s):  
R. Tamara Konetzka ◽  
Kevin Yan ◽  
Rachel M. Werner
Keyword(s):  
Systematic Review ◽  
Quality Improvement ◽  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Risk Adjustment ◽  
Public Reporting ◽  
Review Of The Literature ◽  
Nursing Home Compare

Approximately two decades ago, federally mandated public reporting began for U.S. nursing homes through a system now known as Nursing Home Compare. The goals were to provide information to enable consumers to choose higher quality nursing homes and to incent providers to improve the quality of care delivered. We conduct a systematic review of the literature on responses to Nursing Home Compare and its effectiveness in meeting these goals. We find evidence of modest but meaningful response by both consumers and providers. However, we also find evidence that some improvement in scores does not reflect true quality improvement, that disparities by race and income have increased, that risk-adjustment of the measures is likely inadequate, and that several key domains of quality are not represented. Our results support moderate success of Nursing Home Compare in achieving intended goals but also reveal the need for continued refinement.

Effects of Nonparental Child Care on Child Development: An Update

1996 ◽  
Vol 41 (6) ◽  
pp. 330-342 ◽  
Author(s):  
Michael E Lamb
Keyword(s):  
Quality Of Care ◽  
Literature Review ◽  
Home Care ◽  
Poor Quality ◽  
Behaviour Problems ◽  
Out Of Home Care ◽  
Narrative Literature ◽  
Narrative Literature Review ◽  
Meaningful Relationships

Objective: To review the published literature on the effects of nonparental and out-of-home care on infants, toddlers, and preschoolers. Method: Narrative literature review. Results: Although substantial controversy persists, the accumulated evidence suggests that nonparental care does not necessarily have either beneficial or detrimental effects on infants and children, although it can have such effects. In some circumstances, careproviders establish relationships with children that have significant effects on development, and this increases the importance of ensuring that careproviders are well trained, behave sensitively, and are stable rather than ephemeral figures in children's lives. Nonparental care is associated with behaviour problems (including aggression and noncompliance) when the care is of poor quality and opportunities for meaningful relationships with stable careproviders are not available, however. Conclusion: The effects of out-of-home care vary depending on the quality of care as well as the characteristics of individual children, including their age, temperaments, and individual backgrounds.

Quality of dying of nursing home residents with dementia as judged by relatives

2013 ◽  
Vol 25 (10) ◽  
pp. 1697-1707 ◽  
Author(s):  
Nicole van Uden ◽  
Lieve Van den Block ◽  
Jenny T. van der Steen ◽  
Bregje D. Onwuteaka-Philipsen ◽  
An Vandervoort ◽  
...  
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Retrospective Study ◽  
Nursing Homes ◽  
The Netherlands ◽  
Nursing Home Residents ◽  
Quality Of Dying ◽  
People With Dementia ◽  
Number Of Patients

ABSTRACTBackground:Providing good quality care for the growing number of patients with dementia is a major challenge. There is little international comparative research on how people with dementia die in nursing homes. We compared the relative's judgment on quality of care at the end of life and quality of dying of nursing home residents with dementia in Belgium and the Netherlands.Methods:This was a Belgian cross-sectional retrospective study (2010) combined with a prospective and retrospective study from the Netherlands (January 2007–July 2011). Relatives of deceased residents of 69 Belgian and 34 Dutch nursing homes were asked to complete questionnaires. We included 190 and 337 deceased nursing home residents with dementia in Belgium and the Netherlands, respectively.Results:Of all identified deceased nursing home residents with dementia, respectively 53.2% and 74.8% of their relatives in Belgium and the Netherlands responded. Comfort while dying (CAD-EOLD, range 14–42) was rated better for Dutch nursing home residents than for Belgian nursing homes residents (26.1 vs. 31.1, OR 4.5, CI 1.8–11.2). We found no differences between countries regarding Satisfaction With Care (SWC-EOLD, range 10–40, means 32.5 (the Netherlands) and 32.0 (Belgium)) or symptom frequency in the last month of life (SM-EOLD, range 0–45, means 26.4 (the Netherlands) and 27.2 (Belgium)).Conclusion:Although nursing home structures differ between Belgium and the Netherlands, the quality of care in the last month of life for residents with dementia is similar according to their relatives. However, Dutch residents experience less discomfort while dying. The results suggest room for improved symptom management in both countries and particularly in the dying phase in Belgium.

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