scholarly journals Hourly Rounding and Fall Prevention among the elderly in long term care: A change process.

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Joice Anu
Keyword(s):  
Fall Prevention ◽  
Long Term Care ◽  
Care Facility ◽  
The Elderly ◽  
Daily Routine ◽  
Term Care ◽  
Staff Members ◽  
Hourly Rounding ◽  
Evidenced Based

AbstractLong term care facilities have a rising rate of falls and fall related injuries with increasing cost and more hospitalization. Hourly rounding® is an evidenced based intervention that is proactive for nursing staff to be able to identify patient’s needs. This helps with positive fall prevention outcome. This project focused on process improvement efforts for 10 weeks and examining the education and implementation of an evidenced-based hourly rounding program that assisted in reducing the number of falls in the pilot unit. The implementation of the intervention took place in a long-term care facility located in Dallas, Georgia. The hourly rounding tools used in this project were the Studer Group hourly rounding log and competency checklist with permission. Twenty staff members were included in the sample, age 18 years and 60 years. The unit has 41 residents who were included in the pilot case study design. Staff members were first educated regarding hourly rounding and documentation on the hourly rounding log was done two days before implementation and the pre and post fall rate was retrieved from the facilities fall database. Competency checklist was completed prior to implementation and post implementation to evaluate staff understanding of the main tenets of the 4 P’s (potty, pain, possession, and position). For this project, descriptive statistics was used to help determine fall rates. Minitab was used to analyzed data and to determine if it was clinically significant. In the ten weeks following the hourly rounding implementation, participants performed hourly rounding by incorporating it to each resident’s daily routine and documented their rounds on the log sheet. The results indicated that it is statistically significant and with a P-values = -<0.0001 and t-value = -5.81.Keywords: Rounding and education; fall risk; fall reduction; older adult patients; quality improvement; fall prevention; fall and fall related injury.

“They don't just disappear”: Acknowledging death in the long-term care setting

2012 ◽  
Vol 10 (4) ◽  
pp. 241-247 ◽  
Author(s):  
Janine Maitland ◽  
Kevin Brazil ◽  
Bill James-Abra
Keyword(s):  
Long Term Care ◽  
Emotional Health ◽  
Family Members ◽  
Care Facility ◽  
Term Care ◽  
Long Term Care Facility ◽  
Qualitative Research Study ◽  
Staff Members

AbstractObjective:The purpose of this study was to describe the value of a formal room blessing ritual held within a long-term care facility, from the perspectives of staff, residents, and family members.Method:A qualitative research study involving interviews with staff, residents, and family members was conducted to examine the perceived value of a room blessing ritual.Results:Twenty-four room blessing attendees participated in the study (nine staff, eight residents, and seven family members). Attendees felt that the room blessing provided an opportunity to formally acknowledge the death of the resident and their grief; the majority felt that this was a positive experience and that it provided an element of closure. Staff members and residents expressed their appreciation for the opportunity to connect with family members of the deceased to express their condolences during the ritual. Participants also identified the inclusivity of the ritual (i.e., an open invitation to all staff, residents, and family members) as a positive aspect that served as a reminder that others shared in their grief. Staff members felt that blessing the room for the new resident was an important component of the ritual, helping to bridge the gap between mourning and welcoming a new person. Staff, residents, and family members felt that the room blessing positively reflected the mission and values of the facility. The most highly valued aspect of the ritual for all attendees was the sharing of stories about the deceased to celebrate that person's life.Significance of results:Long-term care facilities need to recognize that formal supports to manage the bereavement needs of staff and residents, such as a room blessing ritual, should be incorporated into their model for managing end-of-life care, given the relationship between the emotional health of staff and the quality of care provided for residents.

scholarly journals Silencing and Silence: Language and Specialized Listening in a Long-Term Institution for the Elderly

2020 ◽  
pp. 1-9
Author(s):  
Simone Maximo Pelis ◽  
Nirvana Ferraz Santos Sampaio
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
The Elderly ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Methodological Perspective ◽  
Alternative System

This article presents the result of research developed with the language of elderly residents at the Long Term Care Facility for the Elderly - ILPI, in Vitória da Conquista, Bahia, Brazil. In response to the initial questions as to whether institutionalization affects the language of the elderly, whether the re-signification of verbal by non-verbal speech occurs, and whether silence, as language is part of an alternative system of possible meaning for the elderly, it was perceived that language in institutionalized long-lived individuals it reveals that in response to diversified processes of silencing, they have instituted silence as a possibility of reframing, and structuring of meaning. We collected data through the filming and recording of the elderly in enunciative-discursive situations, considering the uniqueness of each subject's history and their respective crossings as well as the condition of production of the narratives based on the concept of data-finding by Maria HadlerCoudry (1), aligned with notions relevant to Linguistics in the theoretical-methodological perspective of Discursive Neurolinguistics.

Changing the Culture of Long-Term Care: Combating Heterosexism

2015 ◽  
Vol 20 (2) ◽  
Author(s):  
Susan Schwinn ◽  
Shirley Dinkel
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Holistic Care ◽  
Culturally Competent ◽  
Sexual Diversity ◽  
Term Care ◽  
Culturally Competent Care ◽  
Staff Members ◽  
Unique Position

The purpose of this article is to describe how heterosexism impedes the provision of culturally competent care for lesbian, gay, bisexual, transgender, and queer (LGBTQ) residents in long-term care (LTC) facilities. LTC facilities continue to employ staff members who lack an understanding of sexuality and sexual diversity in the elderly. In this article, we identify the heterosexual assumption, namely heterosexism, as the primary issue surrounding the holistic care of the LGBTQ elder in LTC. We first review the literature related to LGBTQ elders in LTC facilities, identifying the themes that emerged from the review, specifically the definitions of homophobia and heterosexism; perceptions of LGBTQ elders as they consider placement in LTC facilities; and staff knowledge of and biases toward sexuality and sexual diversity in LTC settings. Then, we suggest approaches for changing the culture of LTC to one in which LGBTQ elders feel safe and valued, and conclude by considering how facility leaders are in a unique position to enable LGBTQ elders to flourish in what may be their last home.

FoodNet Survey of Food Use and Practices in Long-Term Care Facilities

2008 ◽  
Vol 71 (2) ◽  
pp. 365-372 ◽  
Author(s):  
JENNIFER M. NELSON ◽  
ROBERT BEDNARCZYK ◽  
JOELLE NADLE ◽  
PAULA CLOGHER ◽  
JENNIFER GILLESPIE ◽  
...  
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
The Elderly ◽  
Foodborne Illness ◽  
Elderly Persons ◽  
Surveillance Network ◽  
Term Care ◽  
Shell Eggs ◽  
Safe Food

Foodborne illness is an important problem among the elderly. One risk factor for foodborne illness and diarrhea-associated mortality among the elderly is residence in a long-term care facility (LTCF); thus, these facilities must implement measures to ensure safe food. To assess safe food practices, knowledge, and policies, we used a mailed, self-administered questionnaire to survey food service directors at LTCFs that were certified to receive Medicare or Medicaid at eight Foodborne Diseases Active Surveillance Network (FoodNet) sites. Surveys were distributed to 1,630 LTCFs; 55% (865 of 1,568) of eligible facilities returned a completed questionnaire. Only three LTCFs completely followed national recommendations for prevention of Listeria monocytogenes contamination. Nine percent of LTCFs reported serving soft cheeses made from unpasteurized milk. Most LTCFs reported routinely serving ready-to-eat deli meats; however, few reported always heating deli meats until steaming hot before serving (only 19% of the LTCFs that served roast beef, 13% of those that served turkey, and 11% of those that served ham). Most LTCFs (92%) used pasteurized liquid egg products, but only 36% used pasteurized whole shell eggs. Regular whole shell eggs were used by 62% of facilities. Few LTCFs used irradiated ground beef (7%) or irradiated poultry products (6%). The results of this survey allowed us to identify several opportunities for prevention of foodborne illnesses in LTCFs. Some safety measures, such as the use of pasteurized and irradiated foods, were underutilized, and many facilities were not adhering to national recommendations on the avoidance of certain foods considered high risk for elderly persons. Enhanced educational efforts focusing on food safety practices and aimed at LTCFs are needed.

Geriatric Teams in the Long-term Care Facility

1988 ◽  
Vol 1 (3) ◽  
pp. 195-201
Author(s):  
Ruthanne R. Ramsey
Keyword(s):  
Health Care ◽  
Long Term Care ◽  
Care Delivery ◽  
Care Facility ◽  
The Elderly ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Inpatient Settings

Geriatric teams have emerged as an accepted method of health care delivery to the elderly patient in ambulatory and acute inpatient settings. As one model of specialized health care teams, geriatric teams vary in structure, membership, and type. The purposes may be diverse, ranging from providing primary care to multidimensional functional and diagnostic assessment. Geriatric teams have convincingly demonstrated benefit to the care of the elderly. Overcoming significant barriers to their formation, geriatric teams are beginning to develop in long-term care facilities as a result of economic and educational pressures. However, the unique environment and needs of the long-term care facility have resulted in differences in leadership, membership, and structure of long-term care teams. Pharmacist involvement in the long-term care geriatric team could benefit the facility, patient care, and the profession. The key to future involvement by pharmacists in teams appears to depend on their interest, ability to acquire necessary skills, and demonstration of unique professional contributions.

An Outbreak of Norovirus Infection in a Long-Term-Care Unit in Spain

2005 ◽  
Vol 26 (3) ◽  
pp. 259-262 ◽  
Author(s):  
Gemma Navarro ◽  
Rosa M. Sala ◽  
Ferran Segura ◽  
César Arias ◽  
Pilar Varela ◽  
...  
Keyword(s):  
Long Term Care ◽  
Clinical Symptoms ◽  
Care Facility ◽  
Care Hospital ◽  
Term Care ◽  
Long Term Care Facility ◽  
Staff Members ◽  
Genotype 2 ◽  
Stool Cultures

AbstractBackground:Norovirus belongs to the Caliciviridae family and causes outbreaks of infectious enteritis by fecal-oral transmission. In Spain, there have been few outbreaks reported due to this virus. We describe an outbreak on a long-term-care hospital ward.Methods:Cases were classified as probable, confirmed, and secondary. Stool cultures were performed. Polymerase chain reaction detection of norovirus was also performed.Results:The outbreak occurred from December 7 to 28, 2001, involving 60 cases (32 patients, 19 staff members, 8 patients' relatives, and 1 relative of a staff member). Most (82%) of the cases were female. The most frequently involved ages were 20 to 39 years for staff members and 70 to 89 years for patients. The incubation period of secondary cases in patients' families had a median of 48 hours (range, 1 to 7 days). Clinical symptoms included diarrhea (85%), vomiting (75%), fever (37%), nausea (23%), and abdominal pain (12%). Median duration of the disease was 48 hours (range, 1 to 7 days). All cases resolved and the outbreak halted with additional hygienic measures. Stool cultures were all negative for enteropathogenic bacteria and rotaviruses. In 16 of 23 cases, the norovirus genotype 2 antigen was detected.Conclusion:This outbreak of gastroenteritis due to norovirus genotype 2 affected patients, staff members, and their relatives in a long-term-care facility and was controlled in 21 days.

Prevalence and Nosocomial Spread of Methicillin-ResistantStaphylococcus aureusin a Long-Term-Care Facility in Slovenia

2005 ◽  
Vol 26 (2) ◽  
pp. 184-190 ◽  
Author(s):  
Tjasa Zohar Cretnik ◽  
Petra Vovko ◽  
Matjaz Retelj ◽  
Borut Jutersek ◽  
Tatjana Harlander ◽  
...  
Keyword(s):  
Potential Role ◽  
Long Term Care ◽  
Genetic Relatedness ◽  
Care Facility ◽  
The Elderly ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Mrsa Colonization

AbstractObjectives:To determine the prevalence and incidence of methicillin-resistantStaphylococcus aureus(MRSA) colonization among residents and healthcare workers (HCWs) of a long-term-care facility (LTCF), to assess possible routes of nosocomial spread, and to determine genetic relatedness of the isolates.Setting:A 351-bed community LTCF for the elderly.Design and Participants:Study investigators made two visits, approximately 3 months apart, to the facility. Samples for cultures were obtained from 107 residents during the first visit, 91 residents during the second visit, and 38 HCWs.Results:The prevalence of MRSA colonization among residents was 9.3% during the first visit and 8.8% during the second visit. During the first visit, two HCWs were colonized. During the second visit, no HCWs were colonized. The colonization of HCWs suggested a potential role in the transmission of MRSA. Molecular typing showed that two of three roommates in one room had the same strain, whereas two in another room differed from one another. All isolates, except one, belonged to two related clonal groups. It seems that the clonal group to which most isolates belonged had the greatest potential for spreading among both residents and HCWs.Conclusions:Similar prevalence rates of MRSA colonization have been found in other European countries, but such studies have usually involved residents with better functional status than that of the participants in this study. Nosocomial spread of MRSA occurred in the facility examined, but not frequently. More attention should be focused on the hand hygiene of HCWs.

scholarly journals Institutional routines and interpersonal conflicts among elderly in a Long-Term Care Facility

2021 ◽  
Vol 55 ◽  
Author(s):  
Jamile Lais Bruinsma ◽  
Margrid Beuter ◽  
Zulmira Newlands Borges ◽  
Caren da Silva Jacobi ◽  
Eliane Raquel Rieth Benetti ◽  
...  
Keyword(s):  
Long Term Care ◽  
Elderly Women ◽  
Participant Observation ◽  
Care Facility ◽  
The Elderly ◽  
Term Care ◽  
Interpersonal Conflicts ◽  
Term Care Facility ◽  
Long Term Care Facility

ABSTRACT Objective: To describe the influence of institutional routines on interpersonal conflicts among institutionalized elderly women. Method: A qualitative study, with an ethnographic framework, performed with 17 elderly women in a Long-Term Care Facility. The field immersion occurred from August 2017 to May 2018. The data were produced by participant observation and fieldnotes and analyzed through the sociocultural perspective with theoretical tools related to the total institutions described by Erving Goffman. Results: External bonds outside the institution and the routines were trigger factors of conflicts in the Long-Term Care Facility. The dissatisfaction with the lack of external bonds was noticed in the impossibility of leaving with family members, receiving visits, objects, money, foods, or attention. The standardization and collectivization of internal routines of basic activities generated dissatisfaction and challenged the elderly women’s tolerance towards the norms. Such situations facilitated interpersonal conflicts in the institutional environment. Conclusion: The conflicts occurred among elderly women and professionals, and among them, from the insubordination of the elderly, based on the idea of reaffirming their individualities.

scholarly journals Relocation experiences of the elderly to a long-term care facility in Taiwan: a qualitative study

2019 ◽  
Author(s):  
Chia-Shan Wu ◽  
Jiin-Ru Rong
Keyword(s):  
Qualitative Study ◽  
Elderly People ◽  
Long Term Care ◽  
Care Facility ◽  
The Elderly ◽  
Living Environment ◽  
Theory Approach ◽  
Major Life ◽  
Term Care

Abstract Background Relocation to a long-term care (LTC) facility is a major life change for most elderly people. Following relocation, many elderly experience difficulties in adapting to changes in the living environment. Taiwan is increasingly becoming an "aging society” and the numbers of those who relocate from family residences to long-term residential care facilities have increased over years. However, in-depth evidence on the experiences of the elderly of their stay in LTC facilities in Taiwan is relatively sparse. This study aimed to explore the relocation experiences of the elderly to a LTC facility to inform policy and practice to address their needs effectively. Methods A qualitative study, using semi-structured in-depth interviews, was conducted to explore the experiences of 16 elderly people who have relocated to and lived in a LTC facility in Taiwan for up to a period of 12 months. All interviews were recorded, transcribed, and analyzed using grounded theory approach. Results Participants’ accounts reflected four interrelated key themes: wish to minimize the burden, but stay connected with the family; perceived barriers to adaptation; valuing tailored care; and acceptance and engagement. Each theme included interrelated subthemes that influenced one another and represented the different stages in the relocation journey. Most participants viewed relocation as a way of minimizing the burden of their care from family members, but desired to keep a close connection with family and friends. Participants recounted experiences of psychological resistance while making the decision to relocate. Fear of losing autonomy and the ability to perform self-care was a major reason for resistance to adapt. Provision of tailored care was accorded much value by the participants. The decision to accept the relocation and to adapt themselves to the new environment due to their needs for constant care was explicit in some accounts. Conclusions Relocation to LTC facility is a dynamic process in the first year of moving into the facility, and involves a range of emotions, feelings and experiences. Adaptation of the elderly into the LTC facility can be maximized if the relocation is well planned with provisions for individually tailored care and family involvement.

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