IDENTIFYING BEST-PRACTICE STRATEGIES FOR MANAGING RESIDENTIAL CAREGIVERS WORKING WITH CHILDREN AT RISK

Residential caregivers are the central figures responsible for the children in their charge. Their work is physically and emotionally taxing, and carried out under pressure: they are prone to burnout. In addition, their status is lower than that of other staff. This study aimed to identify the strategies to improve caregiver functioning that have been adopted in Israel’s residential social-service facilities, and to examine the extent of their implementation. A two-stage, mixed-methods study design was employed. In the qualitative stage, six successful care facilities were identified; their directors were interviewed in depth using the Learning from Success method. In the quantitative stage, a survey was administered to 95 directors, using open and closed questions. Six best-practice strategies for working with caregivers were identified: careful screening, training, ongoing supervision, personal and professional support mechanisms, flexible schedules, and a clear work plan and procedures. While these strategies were applied to some extent in most facilities, they varied in scope and implementation. Using a regression model, we found a connection between the implementation of these strategies and the directors’ satisfaction with the caregivers’ work. We discuss recommendations that can help directors incorporate the six strategies in residential homes and meet the challenges directors face in their work with caregivers.

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Current Developments and Best Practice in Open and Distance Learning

The International Review of Research in Open and Distributed Learning ◽

10.19173/irrodl.v1i1.7 ◽

2000 ◽

Vol 1 (1) ◽

Cited By ~ 1

Author(s):

Armando Rocha Trinidade ◽

Hermano Carmo ◽

José Bidarra

Keyword(s):

Learning Strategies ◽

Best Practice ◽

Intrinsic Value ◽

Good Practice ◽

Poor Quality ◽

Technical Content ◽

Support Mechanisms ◽

The Many ◽

Absolute Concept ◽

Near Future

Through the many documents regularly emitted by those dedicated to this activity, it is comparatively easy to describe factual developments in the field of open and distance education in different places in the world. However, it is much more difficult to produce judgements of value about their quality. Quality is a subjective rather than an absolute concept and may be examined from different analytical perspectives: consumers' satisfaction level, intrinsic value of scientific and technical content of learning materials, soundness of learning strategies, efficiency of organisation and procedures, adequate use of advanced technologies, reliability of student support mechanisms, etc. These parameters should be put into the context of specific objectives, nature of target populations and availability of different kinds of resources. In a specific geographic, social, economic and cultural situation a given set of solutions might be judged as adequate and deserving the qualification of "good practice", while in a different context it could be considered of rather poor quality. The selection of examples in this article is the sole responsibility of the authors: neither should the chosen cases be considered as clearly better than any other one, nor missing cases be interpreted as lack of appreciation or a negative judgement. Finally, the authors are aware of the risks of interpreting trends and trying to extrapolate them into the near future: readers should use their own judgement in accepting (or forcefully rejecting) these projections.

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Conflict Behaviours of Administrators in Long Term Care Facilities Influence Facility Ratings: SOS-Semantics of Self in Conflict™

Journal of Mediation & Applied Conflict Analysis ◽

10.33232/jmaca.5.1.9870 ◽

2018 ◽

Vol 5 (1) ◽

pp. 711-724

Keyword(s):

Best Practice ◽

Long Term Care ◽

Care Facility ◽

Harris County ◽

Nursing Facility ◽

Term Care ◽

Care Facilities ◽

Us Government ◽

Nursing Care Facility

Long term care (LTC) facilities, also called nursing homes, are often ripe for conflicts which cause stress for residents, their families and staff. This article presents the results of a survey showing how nursing facility administrators in Harris County, Texas, managed conflict within their facilities and how a more positive approach was consistently reflected in how their facilities were rated in US government quality consumer ratings. The concept at the centre of this study, SOS-Semantics of Self in Conflict™, recognises that the degradation of standards due to conflict is not just an event in a nursing care facility. It is a process that is heavily influenced, and in some cases exacerbated, by the way in which facility administrators react to conflict. These reactions have important broader implications for the facility’s best practice retrospectively.

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1236. Infection Control Risk Mitigation and Implementation of Best Practice Recommendations in Long-Term Care Facilities

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.1069 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S375-S376

Author(s):

Teresa Fitzgerald ◽

Regina Nailon ◽

Kate Tyner ◽

Sue Beach ◽

Margaret Drake ◽

...

Keyword(s):

Infection Control ◽

Best Practice ◽

Long Term Care ◽

Audit And Feedback ◽

Risk Assessments ◽

Term Care ◽

Practice Recommendations ◽

Care Facilities

Abstract Background Nebraska (NE) Infection Control Assessment and Promotion Program (ICAP) is a quality improvement initiative supported by the NE Department of Health and Human Services. This initiative utilizes subject matter experts (SMEs) including infectious diseases physicians and certified infection preventionists (IP) to assess and improve infection prevention and control programs (IPCP) in various healthcare settings. NE ICAP conducted on-site surveys and observations of IPCP in many volunteer facilities to include long-term care facilities (LTCF) between November 2015 and July 2017. SMEs provided on-site coaching and made best practice recommendations (BPR) for priority implementation. Impact of this intervention on LTCF IPCP was examined. Methods Using a standardized questionnaire, follow-up phone calls were made with LTCF to evaluate implementation of the BPR one-year post-assessment. Descriptive analyses were performed to examine BPR implementation in LTCF that had follow-up between 4/4/17 to 4/17/18 and to identify factors that promoted or impeded BPR implementation. Results Overall, 45 LTCF were assessed. The top 5 IC categories requiring improvement were audit and feedback practices (28 of 45, 62%), PPE supplies at point of use (62%), IC risk assessments (58%), TB risk assessments (56%), and supply and linen storage practices (56%). Follow-up assessments were completed for 270 recommendations in 25 LTCF. Recommendations reviewed ranged from three to 26 per LTCF (median = 15). The majority of the 270 recommendations (n = 162, 60%) had been either completely (35%) or partially (25%) implemented by the time of the follow-up calls. The ICAP visit itself was reported as the most helpful resource for BPR implementation (77 of 162). Lack of staffing was the most commonly mentioned barrier to implementation when LTCF implemented BPR partially or implementation was not planned (37 of 85). BPR Implementation most frequently involved additional staff training (64 of 162), review of policies and procedures (38 of 162), and implementing audit (34 of 162) and/or feedback (23 of 162) programs. Conclusion Numerous IC gaps exist in LTCF. Peer-to-peer feedback and coaching by SMEs facilitated implementation of many BPR directed toward mitigating identified IC gaps. Disclosures All authors: No reported disclosures.

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Increasing the uptake of vitamin D supplement use in Australian residential aged care facilities: results from the vitamin D implementation (ViDAus) study

BMC Geriatrics ◽

10.1186/s12877-020-01784-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Pippy Walker ◽

Annette Kifley ◽

Susan Kurrle ◽

Ian D. Cameron

Keyword(s):

Vitamin D ◽

Best Practice ◽

Aged Care ◽

Residential Aged Care ◽

Supplement Use ◽

Care Facilities ◽

Aged Care Facilities ◽

Residential Aged Care Facilities ◽

Facility Level ◽

Vitamin D Supplement

Abstract Background Adequate (≥800 IU/day) vitamin D supplement use in Australian residential aged care facilities (RACFs) is variable and non-optimal. The vitamin D implementation (ViDAus) study aimed to employ a range of strategies to support the uptake of this best practice in participating facilities. The aim of this paper is to report on facility level prevalence outcomes and factors associated with vitamin D supplement use. Methods This trial followed a stepped wedge cluster, non-randomised design with 41 individual facilities serving as clusters pragmatically allocated into two wedges that commenced the intervention six months apart. This multifaceted, interdisciplinary knowledge translation intervention was led by a project officer, who worked with nominated champions at participating facilities to provide education and undertake quality improvement (QI) planning. Local barriers and responsive strategies were identified to engage stakeholders and promote widespread uptake of vitamin D supplement use. Results This study found no significant difference in the change of vitamin D supplement use between the intervention (17 facilities with approx. 1500 residents) and control group (24 facilities with approx. 1900 residents) at six months (difference in prevalence change between groups was 1.10, 95% CI − 3.8 to 6.0, p = 0.6). The average overall facility change in adequate (≥800 IU/day) vitamin D supplement use over 12 months was 3.86% (95% CI 0.6 to 7.2, p = 0.02), which achieved a facility level average prevalence of 59.6%. The variation in uptake at 12 months ranged from 25 to 88% of residents at each facility. In terms of the types of strategies employed for implementation, there were no statistical differences between facilities that achieved a clinically meaningful improvement (≥10%) or a desired prevalence of vitamin D supplement use (80% of residents) compared to those that did not. Conclusions This work confirms the complex nature of implementation of best practice in the RACF setting and indicates that more needs to be done to ensure best practice is translated into action. Whilst some strategies appeared to be associated with better outcomes, the statistical insignificance of these findings and the overall limited impact of the intervention suggests that the role of broader organisational and governmental support for implementation should be investigated further. Trial registration Retrospectively registered (ANZCTR ID: ACTRN12616000782437).

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