scholarly journals A Scoping Review of Health Promotion in the Nursing Home Setting

2021 ◽  
Vol 11 (1) ◽  
pp. 16-36
Author(s):  
Tannys Helfer ◽  
Kathrin Sommerhalder ◽  
Jos M.G.A. Schols ◽  
Sabine Hahn
Keyword(s):  
Health Promotion ◽  
Nursing Home ◽  
Nursing Homes ◽  
Medical Model ◽  
Well Being ◽  
Inclusion Criteria ◽  
Model Of Care ◽  
Home Setting ◽  
Nursing Home Setting ◽  
Traditional Medical Model

Background Nursing homes in many countries continue to follow a traditional medical model of care. This study explored health promotion approaches in the nursing home setting, partly in order to move away from a medical model and to improve the well-being of residents and staff. Methods A scoping study was conducted to review the scientific literature. The Integrated Model of Population Health and Health Promotion was adapted for utilization with the literature analysis. Result A total of 64 publications met the inclusion criteria and were analysed. Five main approaches were shown to have applied health promotion in nursing homes, although gaps were present in the usage of systematically applied health promotion. Conclusion A variety of approaches do exist for the nursing home setting which apply health promotion; however, their usage is fragmented. This study revealed that a framework designed to support nursing homes in the systematic usage of health promotion, could improve the well-being for both residents and staff.

scholarly journals The Impact of Isolation on Healthcare Worker Contact and Compliance With Infection Control Practices in Nursing Homes

2018 ◽  
Vol 39 (6) ◽  
pp. 683-687 ◽  
Author(s):  
Lisa Pineles ◽  
Chris Petruccelli ◽  
Eli N. Perencevich ◽  
Mary-Claire Roghmann ◽  
Kalpana Gupta ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Hand Hygiene ◽  
Healthcare Worker ◽  
Healthcare Workers ◽  
Home Setting ◽  
Prevention Behavior ◽  
Nursing Home Setting ◽  
Hygiene Compliance ◽  
The Impact

OBJECTIVETo directly observe healthcare workers in a nursing home setting to measure frequency and duration of resident contact and infection prevention behavior as a factor of isolation practiceDESIGNObservational studySETTING AND PARTICIPANTSHealthcare workers in 8 VA nursing homes in Florida, Maryland, Massachusetts, Michigan, Washington, and TexasMETHODSOver a 15-month period, trained research staff without clinical responsibilities on the units observed nursing home resident room activity for 15–30-minute intervals. Observers recorded time of entry and exit, isolation status, visitor type (staff, visitor, etc), hand hygiene, use of gloves and gowns, and activities performed in the room when visible.RESULTSA total of 999 hours of observation were conducted across 8 VA nursing homes during which 4,325 visits were observed. Residents in isolation received an average of 4.73 visits per hour of observation compared with 4.21 for nonisolation residents (P<.01), a 12.4% increase in visits for residents in isolation. Residents in isolation received an average of 3.53 resident care activities per hour of observation, compared with 2.46 for residents not in isolation (P<.01). For residents in isolation, compliance was 34% for gowns and 58% for gloves. Healthcare worker hand hygiene compliance was 45% versus 44% (P=.79) on entry and 66% versus 55% (P<.01) on exit for isolation and nonisolation rooms, respectively.CONCLUSIONSHealthcare workers visited residents in isolation more frequently, likely because they required greater assistance. Compliance with gowns and gloves for isolation was limited in the nursing home setting. Adherence to hand hygiene also was less than optimal, regardless of isolation status of residents.Infect Control Hosp Epidemiol 2018;39:683–687

scholarly journals The Preservation of Spousal and Partner Relationships Among Nursing Home Residents

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 852-852
Author(s):  
Shanae Shaw ◽  
Ellen Csikai
Keyword(s):  
Nursing Home ◽  
Social Workers ◽  
Online Survey ◽  
Nursing Home Residents ◽  
Well Being ◽  
Home Setting ◽  
Formal Program ◽  
Nursing Home Setting ◽  
Partner Relationships ◽  
Strong Attachment

Abstract The decision to seek placement in a nursing home may be especially difficult for spouses or partners of the potential nursing home residents. Disruption of the attachment relationship following placement may influence the psychosocial well-being of nursing home residents. Although the responsibility of nursing home staff is to ensure psychosocial well-being, including awareness of the influence that separation can have on a spousal or partner relationship, little is known about services offered for the maintenance of spousal and partner relationships. This study was conducted to identify nursing home practices that had preservation of spouse/partner relationships as the goal. A mixed methods approach utilized both an online survey (81 respondents) with nursing home social workers in four Southern states and ten telephone interviews (from among the respondents). Survey results revealed that 49% of respondents’ facilities had a written policy to preserve these relationships, however, only 22% reported having a specific formal program to carry this out. In the interviews, participants expanded on survey topics and shared that facilitating outings and encouraging participation in routine facility activities were commonly used to preserve relationships. Privacy was discussed as being important in maintaining relationships and also found to be a barrier to doing so. Nursing home social workers can utilize the results in the design and implementation of specific services to preserve relationships and maintain strong attachment between residents and their spouses/partners. These will be best carried out in a coordinated, collaborative manner among multiple disciplines within the nursing home setting.

scholarly journals DESCRIBING A CONCEPT OF NURSE INTUITION AND IMPLICATIONS FOR DEMENTIA CARE IN NURSING HOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S838-S838 ◽  
Author(s):  
Rebekah Perkins ◽  
Katherine Supiano’katherine supiano@hsc utah edu’ kather
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Psychological Symptoms ◽  
Empirical Studies ◽  
Dementia Care ◽  
Limited Information ◽  
Mentor Programs ◽  
Home Setting ◽  
Nurse Residency ◽  
Nursing Home Setting

Abstract The purpose of this concept analysis was to explore nurse intuition historically and in current literature, appraise the value of nurse intuition to research and practice, and discuss implications for practice in caring for residents with behavioral and psychological symptoms of Dementia (BPSD) in nursing homes. To date, no research has examined the presence or utility of nurse intuition in the nursing home setting. A conceptual analysis using pragmatic utility was chosen and based on the work of Walker and Avant (2005). In the literature, nurse intuition is characterized by attributes of knowledge not preceded by inference, knowledge that is holistic in nature, independent of linear thinking, and drawn from synthesis instead of analysis. Nurse intuition is based on preconditions of experience, empathy, limited information, and limited time to make vital decisions about patient care. Studies on nurse intuition have been criticized for their lack of rigor and empirical evidence of the effect of nurse intuition on positive patient outcomes. The attributes of intuitive nursing practice have important implications in nursing applied to residents with BPSD. The nursing home nurse with extensive educational and experiential knowledge is well-situated to understand the complex, changing needs of residents exhibiting various forms of BPSD in an effort to communicate their needs. Future studies on nurse intuition should focus on early education in dementia care, nurse residency-mentor programs to enhance intuitive thinking in the management of BPSD, and more empirical studies on the use of intuition in the context of dementia care.

Validity of the geriatric depression scale and the collateral source version of the geriatric depression scale in nursing homes

2015 ◽  
Vol 27 (9) ◽  
pp. 1495-1504 ◽  
Author(s):  
Zhicheng Li ◽  
Yun-Hee Jeon ◽  
Lee-Fay Low ◽  
Lynn Chenoweth ◽  
Daniel W. O’Connor ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Roc Curves ◽  
Diagnostic Interview ◽  
Geriatric Depression ◽  
Home Setting ◽  
Nursing Home Setting ◽  
Axis I

ABSTRACTBackground:Depression is a common psychiatric disorder in older people. The study aimed to examine the screening accuracy of the Geriatric Depression Scale (GDS) and the Collateral Source version of the Geriatric Depression Scale (CS-GDS) in the nursing home setting.Methods:Eighty-eight residents from 14 nursing homes were assessed for depression using the GDS and the CS-GDS, and validated against clinician diagnosed depression using the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders (SCID) for residents without dementia and the Provisional Diagnostic Criteria for Depression in Alzheimer Disease (PDCdAD) for those with dementia. The screening performances of five versions of the GDS (30-, 15-, 10-, 8-, and 4-item) and two versions of the CS-GDS (30- and 15-item) were analyzed using receiver operating characteristic (ROC) curves.Results:Among residents without dementia, both the self-rated (AUC = 0.75–0.79) and proxy-rated (AUC = 0.67) GDS variations performed significantly better than chance in screening for depression. However, neither instrument adequately identified depression among residents with dementia (AUC between 0.57 and 0.70). Among the GDS variations, the 4- and 8-item scales had the highest AUC and the optimal cut-offs were >0 and >3, respectively.Conclusions:The validity of the GDS in detecting depression requires a certain level of cognitive functioning. While the CS-GDS is designed to remedy this issue by using an informant, it did not have adequate validity in detecting depression among residents with dementia. Further research is needed on informant selection and other factors that can potentially influence the validity of proxy-based measures in the nursing home setting.

scholarly journals A Scoping Study of Health Promotion in the Nursing Home Setting

2015 ◽  
Vol 25 (suppl_3) ◽  
Author(s):  
T Helfer ◽  
K Sommerhalder ◽  
J Schols ◽  
S Hahn
Keyword(s):  
Health Promotion ◽  
Nursing Home ◽  
Home Setting ◽  
Scoping Study ◽  
Nursing Home Setting

scholarly journals Transmission of Methicillin-Resistant Staphylococcus aureus (MRSA) to Healthcare Worker Gowns and Gloves During Care of Nursing Home Residents

2015 ◽  
Vol 36 (9) ◽  
pp. 1050-1057 ◽  
Author(s):  
Mary-Claire Roghmann ◽  
J. Kristie Johnson ◽  
John D. Sorkin ◽  
Patricia Langenberg ◽  
Alison Lydecker ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Nursing Home ◽  
Nursing Homes ◽  
Glucose Monitoring ◽  
Nursing Home Residents ◽  
Standards Of Care ◽  
Home Setting ◽  
Methicillin Resistant ◽  
Skin Breakdown ◽  
Nursing Home Setting

OBJECTIVETo estimate the frequency of methicillin-resistant Staphylococcus aureus (MRSA) transmission to gowns and gloves worn by healthcare workers (HCWs) interacting with nursing home residents to better inform infection prevention policies in this settingDESIGNObservational studySETTINGParticipants were recruited from 13 community-based nursing homes in Maryland and MichiganPARTICIPANTSResidents and HCWs from these nursing homesMETHODSResidents were cultured for MRSA at the anterior nares and perianal or perineal skin. HCWs wore gowns and gloves during usual care activities. At the end of each activity, a research coordinator swabbed the HCW’s gown and gloves.RESULTSA total of 403 residents were enrolled; 113 were MRSA colonized. Glove contamination was higher than gown contamination (24% vs 14% of 954 interactions; P<.01). Transmission varied greatly by type of care from 0% to 24% for gowns and from 8% to 37% for gloves. We identified high-risk care activities: dressing, transferring, providing hygiene, changing linens, and toileting the resident (OR >1.0; P<.05). We also identified low-risk care activities: giving medications and performing glucose monitoring (OR<1.0; P<.05). Residents with chronic skin breakdown had significantly higher rates of gown and glove contamination.CONCLUSIONSMRSA transmission from MRSA-positive residents to HCW gown and gloves is substantial; high-contact activities of daily living confer the highest risk. These activities do not involve overt contact with body fluids, skin breakdown, or mucous membranes, which suggests the need to modify current standards of care involving the use of gowns and gloves in the nursing home setting.Infect. Control Hosp. Epidemiol. 2015;36(9):1050–1057

scholarly journals Between Social Inclusion and Exclusion: Integration of Daycare Guests in the Nursing Home Setting

2020 ◽  
Author(s):  
Kerstin Hämel ◽  
Gundula Röhnsch
Keyword(s):  
Nursing Home ◽  
Social Inclusion ◽  
Nursing Home Residents ◽  
Community Dwelling ◽  
Cognitive Capacity ◽  
Home Setting ◽  
Residential Care Facilities ◽  
Care Approach ◽  
Nursing Home Setting ◽  
Close Relatives

Abstract Background and Objectives In integrated daycare, community-dwelling older people in need of care join existing groups in residential care facilities during the day. This study focuses on how nursing home residents experience the integrative care approach, exploring opportunities for social inclusion and mechanisms of exclusion. Research Design and Methods A purposive sample of residents differing in cognitive capacity and level of (non)conflictual interaction with daycare guests was selected. Episodic interviews with residents (N = 10) and close relatives (N = 2) were conducted in 3 pilot facilities in Germany and analyzed using thematic coding. Results The analysis revealed different orientation patterns towards the presence of daycare guests: respondents (a) demonstrated indifference to the daycare guests, (b) saw bonding with guests as a means to connect to the outside world, and (c) perceived incompatibility between in-group and out-group. Criticisms included disruption of daily routines and loss of privacy. Most interviewees came to terms with the care situation using rational and moral arguments. Discussion and Implications The study reveals the importance of residents’ participation when integrating daycare guests. Institutional procedures are required to prevent exclusion of daycare guests and avoid overtaxing residents.

scholarly journals PRagmatic trial Of Video Education in Nursing homes: The design and rationale for a pragmatic cluster randomized trial in the nursing home setting

2017 ◽  
Vol 14 (2) ◽  
pp. 140-151 ◽  
Author(s):  
Vincent Mor ◽  
Angelo E Volandes ◽  
Roee Gutman ◽  
Constantine Gatsonis ◽  
Susan L Mitchell
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Advance Care Planning ◽  
Pragmatic Trial ◽  
Healthcare Systems ◽  
Care Planning ◽  
Home Setting ◽  
Randomized Controlled ◽  
Advance Care ◽  
Video Education

Background/Aims Nursing homes are complex healthcare systems serving an increasingly sick population. Nursing homes must engage patients in advance care planning, but do so inconsistently. Video decision support tools improved advance care planning in small randomized controlled trials. Pragmatic trials are increasingly employed in health services research, although not commonly in the nursing home setting to which they are well-suited. This report presents the design and rationale for a pragmatic cluster randomized controlled trial that evaluated the “real world” application of an Advance Care Planning Video Program in two large US nursing home healthcare systems. Methods PRagmatic trial Of Video Education in Nursing homes was conducted in 360 nursing homes (N = 119 intervention/N = 241 control) owned by two healthcare systems. Over an 18-month implementation period, intervention facilities were instructed to offer the Advance Care Planning Video Program to all patients. Control facilities employed usual advance care planning practices. Patient characteristics and outcomes were ascertained from Medicare Claims, Minimum Data Set assessments, and facility electronic medical record data. Intervention adherence was measured using a Video Status Report embedded into electronic medical record systems. The primary outcome was the number of hospitalizations/person-day alive among long-stay patients with advanced dementia or cardiopulmonary disease. The rationale for the approaches to facility randomization and recruitment, intervention implementation, population selection, data acquisition, regulatory issues, and statistical analyses are discussed. Results The large number of well-characterized candidate facilities enabled several unique design features including stratification on historical hospitalization rates, randomization prior to recruitment, and 2:1 control to intervention facilities ratio. Strong endorsement from corporate leadership made randomization prior to recruitment feasible with 100% participation of facilities randomized to the intervention arm. Critical regulatory issues included minimal risk determination, waiver of informed consent, and determination that nursing home providers were not engaged in human subjects research. Intervention training and implementation were initiated on 5 January 2016 using corporate infrastructures for new program roll-out guided by standardized training elements designed by the research team. Video Status Reports in facilities’ electronic medical records permitted “real-time” adherence monitoring and corrective actions. The Centers for Medicare and Medicaid Services Virtual Research Data Center allowed for rapid outcomes ascertainment. Conclusion We must rigorously evaluate interventions to deliver more patient-focused care to an increasingly frail nursing home population. Video decision support is a practical approach to improve advance care planning. PRagmatic trial Of Video Education in Nursing homes has the potential to promote goal-directed care among millions of older Americans in nursing homes and establish a methodology for future pragmatic randomized controlled trials in this complex healthcare setting.

The Herth Hope Index—A Psychometric Study Among Cognitively Intact Nursing Home Patients

2013 ◽  
Vol 21 (3) ◽  
pp. 378-400 ◽  
Author(s):  
Gørill Haugan ◽  
Britt Karin Støen Utvær ◽  
Unni Karin Moksnes
Keyword(s):  
Factor Analysis ◽  
Nursing Home ◽  
Home Care ◽  
Well Being ◽  
Nursing Home Care ◽  
Cross Sectional ◽  
Home Setting ◽  
Nursing Home Patients ◽  
Herth Hope Index ◽  
Cognitively Intact

Background and Purpose: Hope is seen as the act by which the temptation of despair is actively overcome and has thus been interpreted as an inner strength and an available resource for living in the present. An understanding of hope and its meaning in the lives of institutionalized older adults may aid in developing interventions to enhance hope and well-being in the nursing home setting. This study aimed to investigate the psychometric properties of the Norwegian version of the Herth Hope Index among cognitively intact nursing home patients. Methods: Cross-sectional data was obtained in 2008 and 2009 from 202 of 250 patients who met the inclusion criteria in 44 different nursing homes. Results: Exploratory factor analysis revealed 3 internal consistent dimensions of hope, explaining 51.2% of the variance. The 1-factor, 2-factor, and the originally 3-factor solutions of the Herth Hope Index were tested by means of confirmatory factor analysis. A 2-factor construct comprising 11 items came out with the best model fit. Conclusions: The Herth Hope Index was found to be a reliable and valid instrument for assessing hope in nursing home patients. The 2-factor structure was psychometrically superior the original 3-factor construct of hope in this particular sample. The Herth Hope Index might be used to assess hope and changes in the hope process during long-term nursing home care. An enhanced understanding of hope in this population might contribute to increased quality of nursing home care.

Sign in / Sign up

Export Citation Format

Share Document