scholarly journals Use and alternatives to coercive measures in inpatient residential care facilities for adults with disabilities: study protocol of a mixed-methods study

2022 ◽  
Author(s):  
Malte Klemmt ◽  
Peter Brieger ◽  
Thomas Schmitt-Schäfer ◽  
Annika Mörtz ◽  
Tanja Henking
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
Residential Care ◽  
Fundamental Rights ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Residential Care Facilities ◽  
Coercive Measures ◽  
Adults With Disabilities ◽  
Care Facilities

Abstract BackgroundIn Germany, the use of coercive measures such as physical or chemical restraints in certain settings has been the focus of high court decisions, political debates, and scientific research in areas like psychiatric care. Such encroachments on fundamental rights could easily be overlooked in the case of residents in inpatient residential care facilities for adults with disabilities. However, little data are available on this issue. This study aims to investigate the types, frequencies, and characteristics of the use of coercive measures as well as the reasons and justifications of their use. Possible alternatives to these measures and contextual conditions will also be identified.MethodsThe study is based on an explorative, multi-phase, cross-sectional design, which consists of a mixed-methods approach including several forms of data collection and analysis bringing together forensic, sociological, pedagogical and medical perspectives and expertise. First, the entirety of the approximately n = 880 residential care facilities for adults with disabilities in the study area will be surveyed by an online questionnaire. Participating passive observations will be carried out in n = 5 selected residential care facilities (24 hours per facility), with an approximate total of n = 150 residents. In these facilities, organizational documents such as house rules and residential documents such as medication plans will also be collected and analysed. Focus groups will be conducted in each of the five facilities including residents, staff, and legal guardians of the residents.DiscussionThis study will address important gaps in the current research by providing different forms of empirical data on the use or avoidance, causes, contexts, and alternatives to coercive measures in inpatient residential care facilities for adults with disabilities. This study is the first in Germany to combine a general overview (survey) and detailed insight (observations, document analysis, focus groups) approach to this issue. These findings will provide a basis for further research in the field as well as for the management of coercive measures in practical settings.

scholarly journals Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa: a cross-sectional prevalence study

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Jason September ◽  
Leon Geffen ◽  
Kathryn Manning ◽  
Preneshni Naicker ◽  
Cheryl Faro ◽  
...  
Keyword(s):  
Risk Factors ◽  
South Africa ◽  
Residential Care ◽  
Cape Town ◽  
Resistant Bacteria ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Residential Care Facilities ◽  
Care Facilities ◽  
Stool Samples

Abstract Background Residential care facilities (RCFs) act as reservoirs for multidrug-resistant organisms (MDRO). There are scarce data on colonisation with MDROs in Africa. We aimed to determine the prevalence of MDROs and C. difficile and risk factors for carriage amongst residents of RCFs in Cape Town, South Africa. Methods We performed a cross-sectional surveillance study at three RCFs. Chromogenic agar was used to screen skin swabs for methicillin-resistant S. aureus (MRSA) and stool samples for extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E). Antigen testing and PCR was used to detect Clostridiodes difficile. Risk factors for colonisation were determined with logistic regression. Results One hundred fifty-four residents were enrolled, providing 119 stool samples and 152 sets of skin swabs. Twenty-seven (22.7%) stool samples were positive for ESBL-E, and 13 (8.6%) residents had at least one skin swab positive for MRSA. Two (1.6%) stool samples tested positive for C. difficile. Poor functional status (OR 1.3 (95% CI, 1.0–1.6)) and incontinence (OR 2.9 (95% CI, 1.2–6.9)) were significant predictors for ESBL-E colonisation. MRSA colonization appeared higher in frail care areas (8/58 v 5/94, p = 0.07). Conclusions There was a relatively high prevalence of colonisation with MDROs, particularly ESBL-E, but low C. difficile carriage, with implications for antibiotic prescribing and infection control practice.

scholarly journals Nursing staff´s evaluation of facilitators and barriers during implementation of wireless nurse call systems in residential care facilities. A cross-sectional study.

2019 ◽  
Author(s):  
Janne Dugstad ◽  
Vibeke Sundling ◽  
Etty R. Nilsen ◽  
Hilde Eide
Keyword(s):  
Residential Care ◽  
Nursing Staff ◽  
Response Times ◽  
Measurement Instrument ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Residential Care Facilities ◽  
Care Facilities ◽  
Facilitators And Barriers

Abstract Background Nurse call systems (NCS) encompass all patients and nursing staff in healthcare facilities. Wireless NCSs offer increased mobility for all users and new affordances to patients unable to actively interact with such systems. Integrated technology potentially decrease response times and prevent alarm-fatigue, and thus increase patient safety and enhance nursing workflow. This study aimed to explore facilitators and barriers for implementation of wireless NCSs in residential care facilities. Methods The study had a cross-sectional descriptive design. Using a questionnaire, we collected data from care providers (n=98) based on the Measurement Instrument for Determinants of Innovations (MIDI) in five Norwegian residential care facilities during the first year of implementation of wireless NCSs. Descriptive statistics were used to explore participant characteristics and MIDI scores. MIDI items to which ≥20% of participants disagreed/totally disagreed were regarded as barriers and items to which ≥80% of participants agreed/totally agreed were regarded as facilitators for implementation. Results More facilitators (n=23) than barriers (n=6) were identified. No features of the technology itself were found to impede the implementation. The most salient barriers, reported by 37% of the care providers, were their lack of prior knowledge and that they found the wireless NCS difficult to learn. However, 87% became familiar with the systems during implementation. Respectively, 86% and 90% regarded themselves and their colleagues as competent users after the implementation. The greatest facilitators, reported by 98%, were firstly the normative belief of unit managers and secondly the expected outcomes of the NCSs: the importance and probability of achieving prompt call responses and increased safety. Conclusions The wireless NCSs were well received and the implementations were satisfactory executed. The barriers to implementation were addressed by training and practicing technological skills, facilitated by the influence and support by the manager and the colleagues within the residential care unit. Wireless NCSs offer a range of advanced applications and services, and further research is needed as more wireless NCS functionalities are implemented into residential care services.

scholarly journals Factors Associated with Older Peoples′ Perceptions of Dignity and Well-being at Residential Care Facilities

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 976-976
Author(s):  
Charlotte Roos ◽  
Moudud Alam ◽  
Anna Swall ◽  
Anne-Marie Boström ◽  
Lena Hammar
Keyword(s):  
Older People ◽  
Residential Care ◽  
Well Being ◽  
Cross Sectional ◽  
Care Environment ◽  
Residential Care Facilities ◽  
Self Rated Health ◽  
Care Facilities ◽  
Being There ◽  
Mealtime Environment

Abstract Dignity and well-being should be promoted in care of older people living at residential care facilities (RCFs). In addition, care should be person-centred. Dignity and well-being can be interpreted as person-centred outcomes. Older people living at RCFs experience a lack of dignity and well-being. To promote this, it is important to understand the associated factors to target. The aim of this study was to examine the associations between perceived dignity and well-being and factors related to attitudes of staff, the care environment and individual issues (age, gender, self-rated health and dementia) among older people living at RCFs. A national cross-sectional study was conducted retrospectively. All older people 65 years and older (n=71,696) living at RCFs in 2018 were invited to respond to the survey. The survey included the areas: self-rated health, indoor-outdoor-mealtime environment, performance of care, treatment from staff, safety, social activities, availability of staff and care in its entirety. Age, gender and diagnosed dementia were collected from two national databases. Data was analysed using ordinal logistic regression models. The result indicated that respondents who had experienced disrespectful treatment, who did not thrive in the indoor-outdoor-mealtime environment, who rated their health as poor and respondents with dementia had higher odds of being dissatisfied with dignity and well-being. There is a need to improve the prerequisites of staff regarding respectful attitudes and to improve the care environment. The Person-centred Practice framework, targeting the prerequisites of staff and the care environment, can be used as a theoretical framework for designing future improvements.

scholarly journals Nursing staff’s evaluation of facilitators and barriers during implementation of wireless nurse call systems in residential care facilities. A cross-sectional study.

2020 ◽  
Author(s):  
Janne Dugstad ◽  
Vibeke Sundling ◽  
Etty R. Nilsen ◽  
Hilde Eide
Keyword(s):  
Residential Care ◽  
Measurement Instrument ◽  
Implementation Process ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Residential Care Facilities ◽  
Care Facilities ◽  
Facilitators And Barriers ◽  
Expected Outcomes

Abstract Background: Traditional nurse call systems used in residential care facilities rely on patients to summon assistance for routine or emergency needs. Wireless nurse call systems (WNCS) offer new affordances for persons unable to actively or consciously engage with the system, allowing detection of hazardous situations, prevention and timely treatment, as well as enhanced nurse workflows. This study aimed to explore facilitators and barriers of implementation of WNCSs in residential care facilities. Methods: The study had a cross-sectional descriptive design. We collected data from care providers (n=98) based on the Measurement Instrument for Determinants of Innovation (MIDI) framework in five Norwegian residential care facilities during the first year of WNCS implementation. The self-reporting MIDI questionnaire was adapted to the contexts. Descriptive statistics were used to explore participant characteristics and MIDI item and determinant scores (D1-29). MIDI items to which ≥20% of participants disagreed/totally disagreed were regarded as barriers and items to which ≥80% of participants agreed/totally agreed were regarded as facilitators for implementation. Results: More facilitators (n=22) than barriers (n=6) were identified. The greatest facilitators, reported by 98% of the care providers, were the expected outcomes: the importance and probability of achieving prompt call responses and increased safety (D9 expected outcomes), and the normative belief of unit managers (D15 subjective norm). During the implementation process, 87% became familiar with the systems (D18 awareness of content), and 86% and 90%, respectively regarded themselves (D17 knowledge) and their colleagues (D14 descriptive norm) as competent users of the WNCS. The most salient barriers, reported by 37%, were their lack of prior knowledge (D17 knowledge) and that they found the WNCS difficult to learn (D8 personal drawback). No features of the technology were identified as barriers. Conclusions: Overall, the care providers gave a positive evaluation of the WNCS implementation. The barriers to implementation were addressed by training and practicing technological skills, facilitated by the influence and support by the manager and the colleagues within the residential care unit. WNCSs offer a range of advanced applications and services, and further research is needed as more WNCS functionalities are implemented into residential care services.

scholarly journals Predictors of fracture from falls reported in hospital and residential care facilities: a cross-sectional study

BMJ Open ◽  
2013 ◽  
Vol 3 (8) ◽  
pp. e002948 ◽  
Author(s):  
Satyan Chari ◽  
Prue McRae ◽  
Paul Varghese ◽  
Kaye Ferrar ◽  
Terry P Haines
Keyword(s):  
Residential Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Residential Care Facilities ◽  
Care Facilities

scholarly journals Nursing staff’s evaluation of facilitators and barriers during implementation of wireless nurse call systems in residential care facilities. A cross-sectional study.

2019 ◽  
Author(s):  
Janne Dugstad ◽  
Vibeke Sundling ◽  
Etty R. Nilsen ◽  
Hilde Eide
Keyword(s):  
Residential Care ◽  
Measurement Instrument ◽  
Implementation Process ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Residential Care Facilities ◽  
Care Facilities ◽  
Facilitators And Barriers ◽  
Expected Outcomes

Abstract Background: Traditional nurse call systems used in residential care facilities rely on patients to summon assistance for routine or emergency needs. Wireless nurse call systems (WNCS) offer new affordances for persons unable to actively or consciously engage with the system, allowing detection of hazardous situations, prevention and timely treatment, as well as enhanced nurse workflows. This study aimed to explore facilitators and barriers of implementation of WNCSs in residential care facilities. Methods: The study had a cross-sectional descriptive design. We collected data from care providers (n=98) based on the Measurement Instrument for Determinants of Innovation (MIDI) framework in five Norwegian residential care facilities during the first year of WNCS implementation. The self-reporting MIDI questionnaire was adapted to the contexts. Descriptive statistics were used to explore participant characteristics and MIDI item and determinant scores (D1-29). MIDI items to which ≥20% of participants disagreed/totally disagreed were regarded as barriers and items to which ≥80% of participants agreed/totally agreed were regarded as facilitators for implementation. Results: More facilitators (n=22) than barriers (n=6) were identified. The greatest facilitators, reported by 98% of the care providers, were the expected outcomes: the importance and probability of achieving prompt call responses and increased safety (D9 expected outcomes), and the normative belief of unit managers (D15 subjective norm). During the implementation process, 87% became familiar with the systems (D18 awareness of content), and 86% and 90%, respectively regarded themselves (D17 knowledge) and their colleagues (D14 descriptive norm) as competent users of the WNCS. The most salient barriers, reported by 37%, were their lack of prior knowledge (D17 knowledge) and that they found the WNCS difficult to learn (D8 personal drawback). No features of the technology were identified as barriers. Conclusions: Overall, the care providers gave a positive evaluation of the WNCS implementation. The barriers to implementation were addressed by training and practicing technological skills, facilitated by the influence and support by the manager and the colleagues within the residential care unit. WNCSs offer a range of advanced applications and services, and further research is needed as more WNCS functionalities are implemented into residential care services.

scholarly journals Nursing staff’s evaluation of facilitators and barriers during implementation of wireless nurse call systems in residential care facilities. A cross-sectional study.

2020 ◽  
Author(s):  
Janne Dugstad ◽  
Vibeke Sundling ◽  
Etty R. Nilsen ◽  
Hilde Eide
Keyword(s):  
Residential Care ◽  
Measurement Instrument ◽  
Implementation Process ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Residential Care Facilities ◽  
Care Services ◽  
Care Facilities ◽  
Facilitators And Barriers

Abstract Background: Traditional nurse call systems used in residential care facilities rely on patients to summon assistance for routine or emergency needs. Wireless nurse call systems (WNCS) offer new affordances for persons unable to actively or consciously engage with the system, allowing detection of hazardous situations, prevention and timely treatment, as well as enhanced nurse workflows. This study aimed to explore facilitators and barriers of implementation of WNCSs in residential care facilities. Methods: The study had a cross-sectional descriptive design. We collected data from care providers (n=98) based on the Measurement Instrument for Determinants of Innovation (MIDI) framework in five Norwegian residential care facilities during the first year of WNCS implementation. The self-reporting MIDI questionnaire was adapted to the contexts. Descriptive statistics were used to explore participant characteristics and MIDI item and determinant scores. MIDI items to which ≥20% of participants disagreed/totally disagreed were regarded as barriers and items to which ≥80% of participants agreed/totally agreed were regarded as facilitators for implementation. Results: More facilitators (n=22) than barriers (n=6) were identified. The greatest facilitators, reported by 98% of the care providers, were the expected outcomes: the importance and probability of achieving prompt call responses and increased safety, and the normative belief of unit managers. During the implementation process, 87% became familiar with the systems, and 86% and 90%, respectively regarded themselves and their colleagues as competent users of the WNCS. The most salient barriers, reported by 37%, were their lack of prior knowledge and that they found the WNCS difficult to learn. No features of the technology were identified as barriers. Conclusions: Overall, the care providers gave a positive evaluation of the WNCS implementation. The barriers to implementation were addressed by training and practicing technological skills, facilitated by the influence and support by the manager and the colleagues within the residential care unit. WNCSs offer a range of advanced applications and services, and further research is needed as more WNCS functionalities are implemented into residential care services.

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