Expressions of Caring as Lived by Nursing Home Staff, Residents, and Families

2005 ◽  
Vol 9 (3) ◽  
pp. 31-37 ◽  
Author(s):  
Theris A. Touhy, ◽  
Wendy Strews ◽  
Cynthia Brown
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Qualitative Analysis ◽  
Family Member ◽  
Culture Change ◽  
Healthcare Delivery ◽  
Interview Data ◽  
Nursing Home Staff

Nursing as caring (Boykin & Schoenhofer, 1993, 2001) was utilized as the framework for design of a model of healthcare delivery in a nursing home that is intentionally grounded in caring. The article presents themes emerging from a qualitative analysis of interview data in which participants were asked what was most important when caring for a resident or family member and to share an experience that best represented caring. Suggestions are offered for creating a model of culture change in nursing homes that honors and values expressions of caring as lived by staff, families, and residents.

scholarly journals Culture Change Initiatives in High Medicaid Nursing Homes: Does Time of Adoption Make a Difference?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 22-23
Author(s):  
Latarsha Chisholm ◽  
Akbar Ghiasi ◽  
Justin Lord ◽  
Robert Weech-Maldonado
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Culture Change ◽  
Fixed Effects ◽  
Ethnic Disparities ◽  
State Level ◽  
Change Initiatives ◽  
Term Care ◽  
Star Rating ◽  
Racial Ethnic

Abstract Racial/ethnic disparities have been well documented in long-term care literature. As the population ages and becomes more diverse over time, it is essential to identify mechanisms that may eliminate or mitigate racial/ethnic disparities. Culture change is a movement to transition nursing homes to more home-like environments. The literature on culture change initiatives and quality has been mixed, with little to no literature on the use of culture change initiatives in high Medicaid nursing homes and quality. The purpose of this study was to examine how the involvement of culture change initiatives among high Medicaid facilities was associated with nursing home quality. The study relied on both survey and secondary nursing home data for the years 2017-2018. The sample included high Medicaid (85% or higher) nursing homes. The outcome of interest was the overall nursing home star rating obtained from the Nursing Home Compare Five-Star Quality Rating System. The primary independent variable of interest was the years of involvement in culture change initiatives among nursing homes, which was obtained from the nursing home administrator survey. The final model consisted of an ordinal logistic regression with state-level fixed effects. High-Medicaid nursing homes with six or more years in culture change initiatives had higher odds of having a higher star rating, while facilities with one year or less had significantly lower odds of having a higher star rating. Culture change initiatives may require some time to effectively implement, but these initiatives are potential mechanisms to improve quality in high Medicaid nursing homes.

scholarly journals A Proof of Concept of a Mobile Health Application to Support Professionals in a Portuguese Nursing Home

Sensors ◽  
2019 ◽  
Vol 19 (18) ◽  
pp. 3951
Author(s):  
Márcia Esteves ◽  
Marisa Esteves ◽  
António Abelha ◽  
José Machado
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Mobile Health ◽  
Health Professionals ◽  
Point Of Care ◽  
Healthcare Delivery ◽  
Proof Of Concept ◽  
Mobile Health Application ◽  
And Performance

Over the past few years, the rapidly aging population has been posing several challenges to healthcare systems worldwide. Consequently, in Portugal, nursing homes have been getting a higher demand, and health professionals working in these facilities are overloaded with work. Moreover, the lack of health information and communication technology (HICT) and the use of unsophisticated methods, such as paper, in nursing homes to clinically manage residents lead to more errors and are time-consuming. Thus, this article proposes a proof of concept of a mobile health (mHealth) application developed for the health professionals working in a Portuguese nursing home to support them at the point-of-care, namely to manage and have access to information and to help them schedule, perform, and digitally record their tasks. Additionally, clinical and performance business intelligence (BI) indicators to assist the decision-making process are also defined. Thereby, this solution aims to introduce technological improvements into the facility to improve healthcare delivery and, by taking advantage of the benefits provided by these improvements, lessen some of the workload experienced by health professionals, reduce time-waste and errors, and, ultimately, enhance elders’ quality of life and improve the quality of the services provided.

scholarly journals Staff exchange within and between nursing homes in The Netherlands and potential implications for MRSA transmission

2016 ◽  
Vol 145 (4) ◽  
pp. 739-745 ◽  
Author(s):  
R. D. VAN GAALEN ◽  
H. A. HOPMAN ◽  
A. HAENEN ◽  
C. VAN DEN DOOL
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
The Netherlands ◽  
Exploratory Study ◽  
Large Network ◽  
Nursing Home Staff ◽  
Staff Members ◽  
Study Participants ◽  
Staff Exchange ◽  
National Prevalence

SUMMARYA recent countrywide MRSA spa-type 1081 outbreak in The Netherlands predominantly affected nursing homes, generating questions on how infection spreads within and between nursing homes despite a low national prevalence. Since the transfer of residents between nursing homes is uncommon in The Netherlands, we hypothesized that staff exchange plays an important role in transmission. This exploratory study investigated the extent of former (last 2 years) and current staff exchange within and between nursing homes in The Netherlands. We relied on a questionnaire that was targeted towards nursing-home staff members who had contact with residents. We found that 17·9% and 12·4% of the nursing-home staff formerly (last 2 years) or currently worked in other healthcare institutes besides their job in the nursing home through which they were selected to participate in this study. Moreover, 39·7% of study participants worked on more than one ward. Our study shows that, in The Netherlands, nursing-home staff form a substantial number of links between wards within nursing homes and nursing homes are linked to a large network of healthcare institutes through their staff members potentially providing a pathway for MRSA transmission between nursing homes and throughout the country.

Physical Abuse of Older Adults in Nursing Homes: A Random Sample Survey of Adults With an Elderly Family Member in a Nursing Home

2012 ◽  
Vol 24 (1) ◽  
pp. 65-83 ◽  
Author(s):  
Lawrence B. Schiamberg ◽  
James Oehmke ◽  
Zhenmei Zhang ◽  
Gia E. Barboza ◽  
Robert J. Griffore ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Family Member ◽  
Physical Abuse ◽  
Random Sample ◽  
Sample Survey ◽  
Elderly Family

scholarly journals A qualitative assessment of factors affecting nursing home caregiving staff experiences during the COVID-19 pandemic

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260055
Author(s):  
Rachel L. Snyder ◽  
Laura E. Anderson ◽  
Katelyn A. White ◽  
Stephanie Tavitian ◽  
Lucy V. Fike ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Focus Groups ◽  
Financial Incentives ◽  
Well Being ◽  
The United States ◽  
Qualitative Assessment ◽  
Simple Random Sample ◽  
Nursing Home Staff ◽  
The Impact

Background A large portion of COVID-19 cases and deaths in the United States have occurred in nursing homes; however, current literature including the frontline perspective of staff working in nursing homes is limited. The objective of this qualitative assessment was to better understand what individual and facility level factors may have contributed to the impact of COVID-19 on Certified Nursing Assistants (CNAs) and Environmental Services (EVS) staff working in nursing homes. Methods Based on a simple random sample from the National Healthcare Safety Network (NHSN), 7,520 facilities were emailed invitations requesting one CNA and/or one EVS staff member for participation in a voluntary focus group over Zoom. Facility characteristics were obtained via NHSN and publicly available sources; participant demographics were collected via SurveyMonkey during registration and polling during focus groups. Qualitative information was coded using NVIVO and Excel. Results Throughout April 2021, 23 focus groups including 110 participants from 84 facilities were conducted homogenous by participant role. Staffing problems were a recurring theme reported. Participants often cited the toll the pandemic took on their emotional well-being, describing increased stress, responsibilities, and time needed to complete their jobs. The lack of consistent and systematic guidance resulting in frequently changing infection prevention protocols was also reported across focus groups. Conclusions Addressing concerns of low wages and lack of financial incentives may have the potential to attract and retain employees to help alleviate nursing home staff shortages. Additionally, access to mental health resources could help nursing home staff cope with the emotional burden of the COVID-19 pandemic. These frontline staff members provided invaluable insight and should be included in improvement efforts to support nursing homes recovering from the impact of COVID-19 as well as future pandemic planning.

scholarly journals Notification and Communication Technology: An Observational Study of Call Light Systems in Nursing Homes

2019 ◽  
Author(s):  
Haneen Ali ◽  
Huiyang Li
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Observational Study ◽  
Standard Procedure ◽  
The Elderly ◽  
Nursing Home Staff ◽  
Before And After ◽  
Long Time ◽  
To Come

Abstract Background and Objectives: The call light system is one of the major communication technologies that links the nursing home staff to the needs of the residents. By providing residents with the ability to request assistance, the system becomes an indispensable resource for patient-focused healthcare. However, there is little known about how the call light systems are being used in nursing homes and how the system contributes to the safety and the quality of care for seniors. Therefore, the aims of this study are to understand the nursing home staff experience while using the call light systems and to uncover the usability issues associated with the implemented systems. Method: A mix of 150 hours of hypothetic-deductive (unstructured) and 90 hours of standard-procedure (structured) observational study were conducted in four different nursing homes. The data collected includes insights into the nursing homes work system and the process of locating and responding to call lights. Results: The data shows that the highest alarm rate is before and after meal times. The nursing staff exceeded the allotted time set by administration 50% of the time. Additionally, the staff canceled 10% of the call lights and did not immediately assist residents due to high workloads. Further, the staff forgot to come back to assist residents over 3% of the time. Usability issues such as broken parts, lack of feedback, lack of prioritization, and low/no discriminability are contributing to the long response time. More than 8% of the time, residents notified the staff about call lights after they waited for a long time, as these residents were left unattended. Conclusion: Nursing homes that are still using old call light systems risk the continuation of usability issues that can affect performance of the staff and contribute to a decline in staff and resident outcomes. While the healthcare industry has been at the forefront of technological advancements and implementation, it is important to recognize the influence of technology in the quality of service delivery for the elderly population in nursing homes and to the nursing homes staff working conditions.

scholarly journals Reducing Antibiotic Prescriptions for Urinary Tract Infection in Nursing Homes Using a Complex Tailored Intervention Targeting Nursing Home Staff: Protocol for a Cluster Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Sif Helene Arnold ◽  
Jette Nygaard Jensen ◽  
Marius Brostrøm Kousgaard ◽  
Volkert Siersma ◽  
Lars Bjerrum ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Nursing Home ◽  
Nursing Homes ◽  
Antibiotic Prescription ◽  
Controlled Trial ◽  
Nursing Home Residents ◽  
Cluster Randomized Controlled Trial ◽  
Nursing Home Staff ◽  
Randomized Controlled ◽  
Cluster Randomized

BACKGROUND Urinary tract infection (UTI) is the most common reason for antibiotic prescription in nursing homes. Overprescription causes antibiotic-related harms in those who are treated and others residing within the nursing home. The diagnostic process in nursing homes is complicated with both challenging issues related to the elderly population and the nursing home setting. A physician rarely visits a nursing home for suspected UTI. Consequently, the knowledge of UTI and communication skills of staff influence the diagnosis. OBJECTIVE The objective of this study is to describe a cluster randomized controlled trial with a tailored complex intervention for improving the knowledge of UTI and communication skills of nursing home staff in order to decrease the number of antibiotic prescriptions for UTI in nursing home residents, without changing hospitalization and mortality. METHODS The study describes an open-label cluster randomized controlled trial with two parallel groups and a 1:1 allocation ratio. Twenty-two eligible nursing homes are sampled from the Capital Region of Denmark, corresponding to 1274 nursing home residents. The intervention group receives a dialogue tool, and all nursing home staff attend a workshop on UTI. The main outcomes of the study are the antibiotic prescription rate for UTI, all-cause hospitalization, all-cause mortality, and suspected UTI during the trial period. RESULTS The trial ended in April 2019. Data have been collected and are being analyzed. We expect the results of the trial to be published in a peer-reviewed journal in the fall of 2020. CONCLUSIONS The greatest strengths of this study are the randomized design, tailored development of the intervention, and access to medical records. The potential limitations are the hierarchy in the prescription process, Hawthorne effect, and biased access to data on signs and symptoms through a UTI diary. The results of this trial could offer a strategy to overcome some of the challenges of increased antibiotic resistance and could have implications in terms of how to handle cases of suspected UTI. CLINICALTRIAL ClinicalTrials.gov NCT03715062; https://clinicaltrials.gov/ct2/show/NCT03715062 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17710

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