To Turn or Not to Turn: Exploring Nurses’ Decision-Making Processes Concerning Regular Turning of Nursing Home Residents

Background: Nursing home (NH) residents are at high-risk for pressure injuries (PrIs), and those living with Alzheimer's Disease and Related Dementias (ADRD) are at even greater risk. Understanding how nursing staff approach repositioning remains critical. Methods: As part of an ongoing clinical trial, this mixed-method prospective, exploratory, descriptive study examined repositioning efforts for PrI prevention. An investigator-developed checklist guided researcher observations, and focus groups revealed staff perspective on resident behaviors and corresponding repositioning approaches. Focus group transcripts were analyzed using the constant comparative coding method. Results: Repositioning observations were conducted for 88 residents. Resident behaviors and nursing approaches were similar between the ADRD ( n = 62, 70%) and non-ADRD ( n = 26, 30%) groups. Thirty-six staff participated in one of six focus group sessions. A conceptual model was developed to depict the repositioning process. Staff revealed care is guided by clinical frameworks and guidelines, along with resident preferences and behaviors. Conclusions: Protocol-driven, standardized PrI prevention care may limit the capacity to honor repositioning preferences. Insights from the focus groups highlight the importance of being cognizant of competing factors that may interfere with successful repositioning. Approaches by staff may be protocol-driven or an integrated method of care.

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Grindagutar på sjukeheim: Tilsette sin erfaring med kulturprosjekt

Nordisk tidsskrift for helseforskning ◽

10.7557/14.2819 ◽

2014 ◽

Vol 9 (2) ◽

pp. 42

Author(s):

Aud Berit Fossøy ◽

Solveig Hauge ◽

Ellen Karine Grov

Keyword(s):

Nursing Home ◽

Focus Group ◽

Nursing Home Residents ◽

Holistic Care ◽

Focus Group Interviews ◽

Cultural Project ◽

Group Interviews ◽

Culture Activity

Grindagutar at nursing home: Employees experience with cultural project. Background: Culture activity contributes to holistic care for nursing home residents, and the employees are key personnel for success. Aim: Explore the employees’ experience putting culture projects into life in a nursing home. Methods: The material, based on four focus group interviews with employees in the nursing home, is categorized and analyzed through text condensation. Results: The culture projects created activity and were sources for thriving. However, not participating directly in the activity, the employees let the artists in, were available for them, and watched the patients during the performances. Their function as “door-openers/-keepers” resulted in hosting responsibility, leading to a position of confusion regarding the role as protectors for the patients. Main challenges were how to give feedback regarding whether the patients liked/disliked the performance, and the feeling of being trapped in a position as bystander rather than making the culture activity a common happening for the patients and the employees.

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Requirements Analysis on Emotional Preferences for Leisure Activities in Virtual Reality for Female Nursing Home Residents – A Mixed Method Approach

Advances in Neuroergonomics and Cognitive Engineering - Lecture Notes in Networks and Systems ◽

10.1007/978-3-030-80285-1_52 ◽

2021 ◽

pp. 453-460

Author(s):

Alfred Haeussl ◽

Sandra Schuessler ◽

Lucas Paletta ◽

Hermine Fuerli ◽

Beatrix Koch ◽

...

Keyword(s):

Virtual Reality ◽

Nursing Home ◽

Mixed Method ◽

Leisure Activities ◽

Nursing Home Residents ◽

Requirements Analysis ◽

Mixed Method Approach ◽

Method Approach

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The Focus Group Method in Practical Ecclesiology: Performative Effects and Ecclesiological Rationale

Ecclesial Practices ◽

10.1163/22144471-00202005 ◽

2015 ◽

Vol 2 (2) ◽

pp. 235-254 ◽

Cited By ~ 1

Author(s):

Henk de Roest

Keyword(s):

Focus Group ◽

Focus Groups ◽

Mixed Method ◽

Group Method ◽

Research Project ◽

Advantages And Disadvantages ◽

Focus Group Method

The author gives an analysis of the methodological advantages and disadvantages of using focus groups in practical ecclesiology. He makes a plea for including focus groups in a mixed method strategy in practical ecclesiological research, being attentive to their performative effects. He asks, if ecclesiology governs the methodological design of a practical-ecclesiological research project, should not methods that focus on conversational practices and how people build up a view out of the interaction that takes place within a group, be pulled into the heart of the research? In his reply to this question, the article gives a relational-constructionist, an ecclesiological and a theological rationale for using focus groups.

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Paramedics's perspectives on hospital transfers of nursing home residents - a qualitative focus group study

10.21203/rs.2.16936/v1 ◽

2019 ◽

Author(s):

Alexandra Pulst ◽

Alexander Maximilian Fassmer ◽

Falk Hoffmann ◽

Guido Schmiemann

Keyword(s):

Emergency Department ◽

Nursing Home ◽

Health Status ◽

Qualitative Study ◽

Focus Groups ◽

Emergency Medical Services ◽

Nursing Staff ◽

Transfer Process ◽

Nursing Home Residents ◽

Point Of View

Abstract Background: Emergency department (ED) visits and hospital admissions are common among nursing home residents (NHRs). These transfers are often considered avoidable and can have negative effects on residents’ health status. Emergency medical services (EMS) are an important linking profession between nursing homes (NHs) and hospitals and responsible for transports. So far, little is known about the perspectives of paramedics in this context. The aim of this qualitative study is to explore how paramedics experience hospital transfer process of NHRs and how hospitalizations could be avoided from their point of view. Methods: A qualitative study with three focus groups was conducted with paramedics. The focus groups followed a semi-structured question guide focusing on issues during transfer process, avoidable hospital transfers and potential interventions which might reduce transfers from NHs. Discussions were audio recorded and transcribed verbatim. Data were analyzed by content analysis using the software MAXQDA. Results: In total, 18 paramedics (mean age: 33 years, male n=14) participated in the focus groups. Paramedics mainly reported about perceived structural reasons (e.g. understaffing or lack of time) in NHs which led to initiation of an emergency call. Paramedics were often faced with poorly organized handovers because of lacking or incomplete information. In many cases, nursing staff was perceived as insufficiently qualified and not well-prepared regarding health status of NHRs. Throughout transfer process, the behavior of all involved professional groups (dispatcher/ambulance control center, nurses, physicians and paramedics) was influenced by legal uncertainties. Paramedics rated hospital transfers as avoidable in case of urinary catheter complications, exsiccosis/infections and partially in case of falls. Emergency standards in NHs, trainings for nursing staff, improvement of working conditions and legal conditions were discussed as potential interventions which could reduce hospital transfers of NHRs. Conclusion: Paramedics are faced with complex issues when transporting a NHR to hospital. According to their point of view staff shortage and legal uncertainties play a relevant role in transfer decisions. Interventions reducing (avoidable) hospital transfers of NHRs have to take these factors into account. Keywords: nursing home residents, hospitalization, hospital admission, patient transfer, referral, transition, emergency department, emergency medical services, decision making, advance care planning

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Inter-organisational collaboration in palliative care trajectories for nursing home residents: A nation-wide mixed methods study among key persons

International Journal of Care Coordination ◽

10.1177/2053434519857352 ◽

2019 ◽

Vol 22 (2) ◽

pp. 69-80 ◽

Cited By ~ 1

Author(s):

Sofie Hermans ◽

Aline Sevenants ◽

Anja Declercq ◽

Nady V Broeck ◽

Luc Deliens ◽

...

Keyword(s):

Palliative Care ◽

Nursing Home ◽

Mixed Methods ◽

Focus Group ◽

Home Care ◽

Residential Care ◽

Nursing Home Residents ◽

Mixed Methods Study ◽

Focus Group Interviews ◽

Group Interviews

Introduction Multiple care organisations, such as home care services, nursing homes and hospitals, are responsible for providing an appropriate response to the palliative care needs of older people admitted into long-term care facilities. Integrated palliative care aims to provide seamless and continuous care. A possible organisational strategy to help realise integrated palliative care for this population is to create a network in which these organisations collaborate. The aim is to analyse the collaboration processes of the various organisations involved in providing palliative care to nursing home residents. Method A sequential mixed-methods study, including a survey sent to 502 participants to evaluate the collaboration between home and residential care, and between hospital and residential care, and additionally three focus group interviews involving a purposive selection among the survey participants. Participants are key persons from the nursing homes, hospitals and home care organisations that are part of the 15 Flemish palliative care networks dispersed throughout the region of Flanders, Belgium. Results Survey data were gathered from 308 key persons (response rate: 61%), and 16 people participated in three focus group interviews. Interpersonal dimensions of collaboration are rated higher than structural dimensions. This effect is statistically significant. Qualitative analyses identified guidelines, education, and information-transfer as structural challenges. Additionally, for further development, members should become acquainted and the network should prioritise the establishment of a communication infrastructure, shared leadership support and formalisation. Discussion The insights of key persons suggest the need for further structuration and can serve as a guideline for interventions directed at improving inter-organisational collaboration in palliative care trajectories for nursing home residents.

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Resident-to-Resident Aggression in Long-Term Care Facilities: Insights from Focus Groups of Nursing Home Residents and Staff

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.2008.01808.x ◽

2008 ◽

Vol 56 (8) ◽

pp. 1398-1408 ◽

Cited By ~ 63

Author(s):

Tony Rosen ◽

Mark S. Lachs ◽

Ashok J. Bharucha ◽

Scott M. Stevens ◽

Jeanne A. Teresi ◽

...

Keyword(s):

Nursing Home ◽

Focus Groups ◽

Long Term Care ◽

Nursing Home Residents ◽

Term Care ◽

Care Facilities

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Nurses' Perception and Experiences at Nursing Home Residents with Dysphagia: Focus Group Interviews

The Korean Journal of Rehabilitation Nursing ◽

10.7587/kjrehn.2013.112 ◽

2013 ◽

Vol 16 (2) ◽

pp. 112-121

Author(s):

Yeon-Hwan Park ◽

Hee Kyung Chang ◽

Hwal Lan Bang ◽

Jin-Yi Lee

Keyword(s):

Nursing Home ◽

Focus Group ◽

Nursing Home Residents ◽

Focus Group Interviews ◽

Group Interviews

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The concept of restraint in nursing home practice: a mixed-method study in nursing homes for people with dementia

International Psychogeriatrics ◽

10.1017/s1041610210002267 ◽

2011 ◽

Vol 23 (5) ◽

pp. 826-834 ◽

Cited By ~ 10

Author(s):

Sandra A. Zwijsen ◽

Marja F. I. A. Depla ◽

Alistair R. Niemeijer ◽

Anneke L. Francke ◽

Cees M. P. M. Hertogh

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Focus Group ◽

Nursing Home Residents ◽

Developed Countries ◽

Nursing Home Care ◽

Care Practice ◽

Focus Group Discussions ◽

Group Discussions ◽

People With Dementia

ABSTRACTIntroduction: Although in most developed countries the use of restraints is regulated and restricted by law, the concept of restraint in nursing home care remains ambiguous. This study aims to explore how care professionals and family members of nursing home residents with dementia in the Netherlands experience and define the concept of restraint.Methods: Individual interviews were held with relatives (n = 7) and key persons (n = 9) in seven nursing homes. We also conducted eight focus group discussions with nursing home staff. In addition, a structured questionnaire was administered to the nurses of participating nursing homes.Results: In the questionnaire, over 80% of the respondents indicated considering “fixation” (e.g. use of belts) as a restraint and 50 to 70% of the respondents regarded other physical interventions, such as geriatric chairs and bedrails, as restraints. The interviews and focus group discussions show that the residents' perception of the intervention, the staff's intention behind the intervention and concerns of privacy are the criteria used by the respondents in defining an intervention as a restraint.Conclusions: When trying to diminish restraint use, it is important to be aware of the “local logic” of care practice and to take into account the fact that, for staff and relatives, an intervention is only regarded as a restraint when it is bothering a resident or when an intervention is used for the sole purpose of restricting freedom and/or when interventions invade the privacy of a resident.

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ORGANIZATIONAL AND POLICY FACTORS INFLUENCING FEEDING IN RESIDENTS WITH DEMENTIA: NURSING ASSISTANTS’ EXPERIENCES

Innovation in Aging ◽

10.1093/geroni/igz038.2584 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S702-S703

Author(s):

Joy W Douglas ◽

Seung Eun Jung ◽

Hyunjin Noh ◽

Amy Ellis ◽

Christine Ferguson

Keyword(s):

Nursing Home ◽

Focus Groups ◽

Ecological Model ◽

Interdisciplinary Collaboration ◽

Nursing Home Residents ◽

The United States ◽

State Inspection ◽

Nursing Assistants ◽

Direct Care ◽

Staffing Ratios

Abstract In the United States, Certified Nursing Assistants (CNAs) are critical in providing direct care to nursing home residents with dementia, which includes the challenging task of feeding residents. Guided by the Social Ecological Model (SEM), this qualitative study aimed to gain an in-depth understanding of organizational and policy constructs that CNAs encounter when feeding residents with dementia. Using purposive sampling, nine semi-structured focus groups were conducted with 53 CNAs. Each participant had at least one year of experience working as a CNA with older adults. Focus groups were audio recorded and transcribed verbatim. Data were analyzed using the directed content analysis. Factors that emerged were organized into organizational and policy categories within the SEM levels. CNAs identified organizational barriers such as exclusion from the interdisciplinary team, inability to meet resident needs and wants due to budgetary constraints, and inadequate staffing to function efficiently. Organizational facilitators included teamwork, interdisciplinary assistance, and varying dining styles and meal times to accommodate resident needs. Policy-related barriers included funding concerns, staffing ratios, and frustration with unrealistic regulations and state inspections. These results suggest that organizational and policy factors have a large influence on the ease of feeding nursing home residents with dementia. Involving CNAs in interdisciplinary collaboration, resident-centered accommodations, and subtler state inspection behaviors could improve the mealtime experience for both residents and CNAs. Careful attention to these factors may enhance facilitators and minimize barriers to improve the feeding experience of CNAs and residents with dementia.

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