The association between nurses’ burnout and objective care quality indicators: a cross-sectional survey in long-term care wards

Abstract Background Worldwide, rather few studies have examined the association between burnout and care quality using objectively measured quality indicators, with most of the studies have relied on perceived quality outcomes. This study aimed to examine the association between staff nurses’ burnout and selected objective quality metrics in long-term care wards in Japan. Methods This is a secondary analysis of a cross-sectional survey. Nurse managers and staff nurses working at randomly selected hospitals with long-term care wards—the equivalent of skilled nursing homes in Western countries— completed self-administered, anonymous questionnaires. The questionnaires collected data regarding care quality indicators, staff nurses’ burnout, and other confounders (e.g., ward size, participants’ years of experience, and patients’ conditions). All statistical analyses were conducted at the ward level. A multivariate regression analysis was used to examine associations between burnout and outcome indicators. Results Data from 196 wards in 196 hospitals (196 nurse managers and 2473 staff nurses) across Japan were analyzed. Multivariate regression analysis showed that higher emotional exhaustion was associated with higher rates of pneumonia and pressure ulcers (p-value = .036 and .032, respectively), and that reduced personal accomplishment was associated with higher rates of tube feeding (p-value = .018). A larger ward size was also associated with low rates of pneumonia (regression coefficient = −.001, p-value = .019). Conclusions Staff nurses’ burnout is a significant determinant of care quality in long-term care wards, implying that organizations that implement burnout reducing strategies may see greater benefits in patient outcomes. A large ward size was significantly associated with better care outcomes—specifically, low rates of pneumonia. Future research needs to determine feasible quality improvement measures in small-scale long-term care facilities, and to provide more comprehensive insights on ward-level variables that influence care quality in long-term care settings.

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Correlates of perceived caring behaviour of formal caregivers in long‐term care facilities: A cross‐sectional survey

Scandinavian Journal of Caring Sciences ◽

10.1111/scs.12981 ◽

2021 ◽

Author(s):

Huei‐Lih Hwang ◽

Chin‐Tang Tu ◽

Tian‐Yuan Kuo

Keyword(s):

Long Term Care ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Term Care ◽

Formal Caregivers ◽

Care Facilities

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Factors associated with SARS-CoV-2 infection and outbreaks in long-term care facilities in England: a national cross-sectional survey

The Lancet Healthy Longevity ◽

10.1016/s2666-7568(20)30065-9 ◽

2021 ◽

Vol 2 (3) ◽

pp. e129-e142 ◽

Cited By ~ 3

Author(s):

Laura Shallcross ◽

Danielle Burke ◽

Owen Abbott ◽

Alasdair Donaldson ◽

Gemma Hallatt ◽

...

Keyword(s):

Long Term Care ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Term Care ◽

Factors Associated ◽

Care Facilities

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A cross-sectional survey assessing the preparedness of the long-term care sector to respond to the COVID-19 pandemic in Ontario, Canada

10.21203/rs.3.rs-57368/v3 ◽

2020 ◽

Author(s):

Henry Yu-Hin Siu ◽

Lorand Kristof ◽

Dawn Elston ◽

Abe Hafid ◽

Fred Mather

Keyword(s):

Public Health ◽

Long Term Care ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Term Care ◽

Wide Range ◽

Significant Public Health ◽

Public Health Officials ◽

The Government

Abstract Background: The COVID-19 pandemic is a significant public health emergency that impacts all sectors of healthcare. The negative health outcomes for the COVID-19 infection have been most severe in the frail elderly dwelling in Canadian long-term care (LTC) homes.Methods: An online cross-sectional survey of Ontario LTC Clinicians working in LTC homes in Ontario Canada was conducted to provide the LTC clinician perspective on the preparedness and engagement of the LTC sector during the COVID-19 pandemic. The survey questionnaire was developed in collaboration with the Ontario Long-Term Care Clinicians organization (OLTCC) and was distributed between March 30, 2020 to May 25, 2020. All registered members of the OLTCC and Nurse-led LTC Outreach Teams were invited to participate. The primary outcomes were: 1) the descriptive report of the screening measures implemented, communication and information received, and the preparation of the respondent’s LTC home to a potential COVID-19 outbreak; and 2) the level of agreement, as reported using a five-point Likert scale), to COVID-19 preparedness statements for the respondent’s LTC home was also assessed.Results: The overall response rate was 54% (160/294). LTC homes implemented a wide range of important interventions (e.g. instituting established respiratory isolation protocols, active screening of new LTC admissions, increasing education on infection control processes, encouraging sick staff to take time off, etc). Ample communications pertinent to the pandemic were received from provincial LTC organizations, the government and public health officials. However, the feasibility of implementing public health recommendations, as well as the engagement of the LTC sector in pandemic planning were identified as areas of concern. Medical director status was associated with an increased knowledge of local implementation of interventions to mitigate COVID-19, as well as endorsing increased access to reliable COVID-19 information and resources to manage a potential COVID-19 outbreak in their LTC home.Conclusions: This study highlights the communication to and implementation of recommendations in the Ontario LTC sector, despite some concerns regarding feasibility. Importantly, LTC clinician respondents clearly indicated that better engagement with LTC leaders is needed to plan a coordinated pandemic response.

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Long‐term care services and care workers in Hangzhou City, China: A cross‐sectional survey

Journal of Nursing Management ◽

10.1111/jonm.12842 ◽

2019 ◽

Vol 27 (7) ◽

pp. 1546-1553 ◽

Cited By ~ 1

Author(s):

Shaohua Hong ◽

Ping Yu ◽

Xueping Chen ◽

Shiyu Qian

Keyword(s):

Long Term Care ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Term Care ◽

Care Services ◽

Care Workers

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Health IT acceptance factors in long-term care facilities: A cross-sectional survey

International Journal of Medical Informatics ◽

10.1016/j.ijmedinf.2008.07.006 ◽

2009 ◽

Vol 78 (4) ◽

pp. 219-229 ◽

Cited By ~ 131

Author(s):

Ping Yu ◽

Haocheng Li ◽

Marie-Pierre Gagnon

Keyword(s):

Long Term Care ◽

Health It ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Term Care ◽

Care Facilities ◽

It Acceptance ◽

Acceptance Factors

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Unregulated provider perceptions of audit and feedback reports in long-term care: cross-sectional survey findings from a quality improvement intervention

BMC Geriatrics ◽

10.1186/1471-2318-13-15 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 1

Author(s):

Kimberly D Fraser ◽

Hannah M O’Rourke ◽

Melba Andrea B Baylon ◽

Anne-Marie Boström ◽

Anne E Sales

Keyword(s):

Quality Improvement ◽

Long Term Care ◽

Audit And Feedback ◽

Quality Improvement Intervention ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Term Care ◽

Provider Perceptions ◽

Improvement Intervention

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Management of Constipation in Long-term Care Hospitals and its Ward Manager and Organization Factors

10.21203/rs.2.18003/v2 ◽

2020 ◽

Author(s):

Manami Takaoka ◽

Ayumi Igarashi ◽

Asako Futami ◽

Noriko Yamamoto-Mitani

Keyword(s):

Organizational Climate ◽

Long Term Care ◽

Organizational Factors ◽

Staff Nurses ◽

Cross Sectional ◽

Term Care ◽

Pharmacological Management ◽

Bowel Movement Frequency ◽

Hospital Study

Abstract Background Studies examining organizational factors that may influence constipation management in long-term care (LTC) hospitals are lacking. This study aimed to clarify the practice of constipation management in LTC hospitals and to explore its factors, including ward manager’s perception, organizational climate, and constipation assessment.Methods In this cross-sectional questionnaire survey of ward managers and staff nurses working in LTC wards, we determined daily assessment and practices regarding constipation management. We also conducted multivariate analyses to examine factors related to constipation management.Results There was a 20% response rate to the questionnaire. Nearly all LTC wards routinely assessed bowel movement frequency; other assessments were infrequent. Laxatives were used, but the use of dietary fiber and probiotic products was implemented in only 20%–30% of wards. The implementation of non-pharmacological management and adequate use of stimulant laxatives were positively associated with the ward manager’s belief and knowledge, organizational climate, the existence of nursing records for constipation assessment, planned nursing care for constipation, and organized conferences and in-hospital study sessions on constipation management.Conclusion Areas to improve constipation management in LTC hospitals include altering the ward manager’s perception, improving hospital’s organizational climate, and introducing standardized assessment/care planning systems.

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A cross-sectional survey assessing the preparedness of the long-term care sector to respond to the COVID-19 pandemic in Ontario, Canada

10.21203/rs.3.rs-57368/v2 ◽

2020 ◽

Author(s):

Henry Yu-Hin Siu ◽

Lorand Kristof ◽

Dawn Elston ◽

Abe Hafid ◽

Fred Mather

Keyword(s):

Public Health ◽

Long Term Care ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Term Care ◽

Wide Range ◽

Significant Public Health ◽

Public Health Officials ◽

The Government

Abstract Background: The COVID-19 pandemic is a significant public health emergency that impacts all sectors of healthcare. The negative health outcomes for the COVID-19 infection have been most severe in the frail elderly dwelling in Canadian long-term care (LTC) homes. Methods: An online cross-sectional survey of Ontario LTC Clinicians working in LTC homes in Ontario Canada was conducted to provide the LTC clinician perspective on the preparedness and engagement of the LTC sector during the COVID-19 pandemic. The survey questionnaire was developed in collaboration with the Ontario Long-Term Care Clinicians organization (OLTCC) and was distributed between March 30, 2020 to May 25, 2020. All registered members of the OLTCC and Nurse-led LTC Outreach Teams were invited to participate. The primary outcomes were: 1) the descriptive report of the screening measures implemented, communication and information received, and the preparation of the respondent’s LTC home to a potential COVID-19 outbreak; and 2) the level of agreement, as reported using a five-point Likert scale), to COVID-19 preparedness statements for the respondent’s LTC home was also assessed.Results: The overall response rate was 54% (160/294). LTC homes implemented a wide range of important interventions (e.g. instituting established respiratory isolation protocols, active screening of new LTC admissions, increasing education on infection control processes, encouraging sick staff to take time off, etc). Ample communications pertinent to the pandemic were received from provincial LTC organizations, the government and public health officials. However, the feasibility of implementing public health recommendations, as well as the engagement of the LTC sector in pandemic planning were identified as areas of concern. Medical director status was associated with an increased knowledge of local implementation of interventions to mitigate COVID-19, as well as endorsing increased access to reliable COVID-19 information and resources to manage a potential COVID-19 outbreak in their LTC home. Conclusions: This study highlights the communication to and implementation of recommendations in the Ontario LTC sector, despite some concerns regarding feasibility. Importantly, LTC clinician respondents clearly indicated that better engagement with LTC leaders is needed to plan a coordinated pandemic response.

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The relationship between caregivers’ perceptions of end-of-life care in long-term care and a good resident death

Palliative & Supportive Care ◽

10.1017/s1478951520000292 ◽

2020 ◽

Vol 18 (6) ◽

pp. 683-690

Author(s):

Eunyoung Lee ◽

Tamara Sussman ◽

Sharon Kaasalainen ◽

Pamela Durepos ◽

Lynn McCleary ◽

...

Keyword(s):

End Of Life ◽

Long Term Care ◽

Critical Role ◽

Good Death ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Term Care ◽

Spiritual Issues ◽

Eol Care

AbstractObjectiveQuality end-of-life (EOL) care is critical for dying residents and their family/friend caregivers. While best practices to support resident comfort at EOL in long-term care (LTC) homes are emerging, research rarely explores if and how the type of care received at EOL may contribute to caregivers’ perceptions of a good death. To address this gap, this study explored how care practices at EOL contributed to caregivers’ perceptions of a good resident death.MethodThis study used a retrospective cross-sectional survey design. Seventy-eight participants whose relative or friend died in one of five LTC homes in Canada completed self-administered questionnaires on their perceptions of EOL care and perceptions of a good resident death.ResultsOverall, caregivers reported positive experiences with EOL care and perceived residents to have died a good death. However, communication regarding what to expect in the final days of life and attention to spiritual issues were often missing components of care. Further, when explored alongside direct resident care, family support, and rooming conditions, staff communication was the only aspect of EOL care significantly associated with caregivers’ perceptions of a good resident death.Significance of resultsThe findings of this study suggest that the critical role staff in LTC play in supporting caregivers’ perceptions of a good resident death. By keeping caregivers informed about expectations at the very end of life, staff can enhance caregivers’ perceptions of a good resident death. Further, by addressing spiritual issues staff may improve caregivers’ perceptions that residents were at peace when they died.

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