scholarly journals Resident and family perceptions of the nurse practitioner role in long term care settings: a qualitative descriptive study

2021 ◽  
Author(s):  
Jenny Ploeg ◽  
Sharon Kaasalainen ◽  
Carrie McAiney ◽  
Ruth Martin-Misener ◽  
Faith Donald ◽  
...  

Background Research evidence supports the positive impact on resident outcomes of nurse practitioners (NPs) working in long term care (LTC) homes. There are few studies that report the perceptions of residents and family members about the role of the NP in these settings. The purpose of this study was to explore the perceptions of residents and family members regarding the role of the NP in LTC homes. Methods The study applied a qualitative descriptive approach. In-depth individual and focus group interviews were conducted with 35 residents and family members from four LTC settings that employed a NP. Conventional content analysis was used to identify themes and sub-themes. Results Two major themes were identified: NPs were seen as providing resident and family-centred care and as providing enhanced quality of care. NPs established caring relationships with residents and families, providing both informational and emotional support, as well as facilitating their participation in decision making. Residents and families perceived the NP as improving availability and timeliness of care and helping to prevent unnecessary hospitalization. Conclusions The perceptions of residents and family members of the NP role in LTC are consistent with the concepts of person-centred and relationship-centred care. The relationships NPs develop with residents and families are a central means through which enhanced quality of care occurs. Given the limited use of NPs in LTC settings, there is an opportunity for health care policy and decision makers to address service inadequacies through strategic deployment of NPs in LTC settings. NPs can use their expert knowledge and skill to assist residents and families to make informed choices regarding their health care and maintain a positive care experience

2021 ◽  
Author(s):  
Jenny Ploeg ◽  
Sharon Kaasalainen ◽  
Carrie McAiney ◽  
Ruth Martin-Misener ◽  
Faith Donald ◽  
...  

Background Research evidence supports the positive impact on resident outcomes of nurse practitioners (NPs) working in long term care (LTC) homes. There are few studies that report the perceptions of residents and family members about the role of the NP in these settings. The purpose of this study was to explore the perceptions of residents and family members regarding the role of the NP in LTC homes. Methods The study applied a qualitative descriptive approach. In-depth individual and focus group interviews were conducted with 35 residents and family members from four LTC settings that employed a NP. Conventional content analysis was used to identify themes and sub-themes. Results Two major themes were identified: NPs were seen as providing resident and family-centred care and as providing enhanced quality of care. NPs established caring relationships with residents and families, providing both informational and emotional support, as well as facilitating their participation in decision making. Residents and families perceived the NP as improving availability and timeliness of care and helping to prevent unnecessary hospitalization. Conclusions The perceptions of residents and family members of the NP role in LTC are consistent with the concepts of person-centred and relationship-centred care. The relationships NPs develop with residents and families are a central means through which enhanced quality of care occurs. Given the limited use of NPs in LTC settings, there is an opportunity for health care policy and decision makers to address service inadequacies through strategic deployment of NPs in LTC settings. NPs can use their expert knowledge and skill to assist residents and families to make informed choices regarding their health care and maintain a positive care experience


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 517-517
Author(s):  
Sil Aarts ◽  
Coen Hacking ◽  
Hilde Verbeek ◽  
Jan Hamers ◽  
Katya Sion

Abstract In nursing homes, narrative data are collected to evaluate quality of care as perceived by residents or their family members. This results in a large amount of textual data which exceeds the capability of humans to analyse it. This study aims to explore the usefulness of text-mining approaches regarding narrative data gathered in a nursing home setting. Data has been collected as part of the project ‘Connecting Conversations’: assessing experienced quality of care by conducting individual interviews (n=125) with residents of nursing homes, family members and care professionals. Several pre-processing steps were applied to the textual data. Finally, a variety of text-mining analyses were conducted: individual and bigram word frequencies, correlation analysis and sentiment analysis. A survey was conducted to establish a sentiment analysis model tailored to text collected in long-term care for older adults. Residents, family members and care professionals uttered respectively 285, 362 and 549 words per interview. Word frequency analysis showed that words that occurred most frequently in the interviews are often positive. Although there are some differences in wording such as the use of ‘mother’ and ‘breakfast’, correlation analysis displayed that similar words are used by all three groups to describe quality of care. The majority of interviews displayed a neutral sentiment. Care professionals are more diverse in their sentiment than residents and family members: while some express a more positive sentiment, others express more negativity. This study demonstrates the usefulness of text-mining to extend our knowledge regarding quality of care in a nursing home setting.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Letasha Kalideen ◽  
Pragashnie Govender ◽  
Jacqueline Marina van Wyk ◽  
Desmond Kuupiel

Abstract Background Ageing is a global and universal process that results in physiological, psychological and behavioural changes. Due to the changing needs of the individual and the circumstances of the family, long-term care of older persons in facilities has become essential. The standard and quality of health care for older persons in long-term care facilities is critical to maintain functional ability in keeping with international goals of healthy ageing. This study, therefore, will aim to systematically map literature and describe the evidence on standards and the quality of health care for older persons living in long-term care facilities (LTCFs). Methods A scoping review will be conducted using Arksey and O’Malley’s framework and recommendations set out by Levac and colleagues. PubMed, CINAHL, Health Sources, PsycInfo, Web of Science, Scopus, and Google Scholar will be searched for relevant published studies/sources of evidence up to the last search date. The search will be conducted using keywords, and Boolean terms, and Medical Subject Headings/Subject Headings. EndNote X9 will be used to compile all relevant sources of evidence. This study will include studies involving participants ≥ 65 years old, living in LTCFs for older persons. English language publications, with no time limitations, and primary studies, guidelines, and quality of care specific to LTCFs for older persons will be sourced. Two reviewers will independently screen all sources of evidence at the title, abstract, and full-text screening stages as well as perform the data charting. The Preferred Reporting Items for Systematic Review and Meta-Analysis flow diagram will be used to account for all relevant sources of evidence during the screening. Thematic content analysis will be used to describe the themes aligned with this study’s research question based on initial coding and categorisation and a summary of the findings reported narratively for each theme. Discussion We anticipate that this scoping review will highlight the standards of care and assessment tools available worldwide, in addition to gaps that exist in the evidence base for older persons in LTCFs. These may include an exposition of the standards and quality of care documented, monitoring and evaluation processes, instruments used for reviewing standards of care. This would contribute towards identifying the need for practical and universally acceptable tools for LTCFs for older persons.


2020 ◽  
Vol 32 (S1) ◽  
pp. 15-16
Author(s):  
William E. Reichman ◽  
L. Bradford Perkins ◽  
Hilde Verbeek

This symposium will review the latest data on the influence of environmental design and its attributes on the cognitive and psychological wellbeing of older adults living with dementia. The presenters will cover the myriad ways in which the physical environment of care can adapt to the changing demands of older adults with sensory, motor and cognitive deficits and foster optimal functioning and quality of life. The role of emerging technologies will also be reviewed as they complement the contribution of the design of the physical environment to the wellbeing of older adults with cognitive impairment. Information will be offered through a review of the existing research literature as well as case studies that illustrate the impact of environmental modification on fostering wellbeing and minimizing the emergence of the behavioral and psychological symptoms of dementia. The presenters will represent and integrate sensibilities that have emerged from the fields of architecture, cognitive neuroscience and psychology.How the Principles of the Culture Change Movement Inform Environmental Design and the Application of Technology in the Care of Older Adults Living with DementiaWilliam E. ReichmanThe culture change movement informs a number of principles that have been applied to more contemporary design concepts for the congregate care of older adults living with dementia. This talk will review the core tenets of the Culture Change Movement as exemplified by the Greenhouse, Dementia Village and other innovative models of congregate long-term care. Specific reference will be made to how these tenets have been operationalized around the world into the design of programming and the creation of residential care environments that foster a better quality of life for older adults and an enhanced work environment for care providers. This talk will also include the emerging role of technologies that complement innovative design of the environment and which foster optimized social and recreational functioning of older adults living with dementia.A Better Life Through a Better Nursing Home DesignL. Bradford PerkinsOver the last 20 years there has been extensive experimentation related to the role of the environment in the housing, care and treatment of persons with Alzheimer’s and other age related dementias. Prior to that time the typical housing and care environment was a locked unit in a skilled nursing or other restrictive senior living facility. In 1991 the Presbyterian Association on Aging in Western Pennsylvania opened Woodside Place on its Oakmont campus. This small 36 bed facility was designed to incorporate the latest research and care experience with persons suffering from these issues. This one small project, as well as the long post occupancy research led by Carnegie Mellon University, clearly demonstrated that individuals with Alzheimer’s and related forms of dementia could lead a healthier, happier, higher quality of life in a more residential, less restrictive environment. Not everything in this pioneering project worked, and five generations of living and care models have followed that have refined the ideas first demonstrated by Woodside Place. Bradford Perkins, whose firm designed Woodside Place and over 100 other related projects, will discuss what was learned from Woodside Place as well as the five generations of projects (and post occupancy research) that followed.Innovative dementia care environments as alternatives for traditional nursing homes: evidence and experiences from the NetherlandsHilde VerbeekKey goals of the dementia care environment focus on increasing autonomy, supporting independence and trying to enable one’s own lifestyle for as long as possible. To meet these goals, innovative, small-scale and homelike care environments have been developed that have radically changed the physical, social and organizational aspects of long-term care in the Netherlands. This presentation discusses various Dutch models that have implemented small-scale and homelike care environments, including green care farms, dementia village and citizen initiatives. The models reflect a common care concept, focusing on residents’ remaining strengths, providing opportunity for choice and aiming to sustain a sense of self and control. A small number of residents (usually 6 to 8) live together in a homelike environment and nursing staff are part of the household. Residents are encouraged to participate in daily household activities, emphasizing normalization of daily life with person-centred care. The physical environment resembles an archetypal home. This talk presents the scientific evidence on the impact and effects of these small-scale, homelike models on residents, their family caregivers and staff. Furthermore, the presentation will highlight working approaches and how these initiatives have positively influenced routine care across the long-term care spectrum.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Sara Luck ◽  
Katie Aubrecht

Abstract Nursing home facilities are responsible for providing care for some of the most vulnerable groups in society, including the elderly and those with chronic medical conditions. In times of crisis, such as COVID-19 or other pandemics, the delivery of ‘regular’ care can be significantly impacted. In relation to COVID-19, there is an insufficient supply of personal protective equipment (PPE) to care for residents, as PPE not only protects care staff but also residents. Nursing homes across the United States and Canada have also taken protective measures to maximize the safety of residents by banning visitors, stopping all group activities, and increasing infection control measures. This presentation shares a research protocol and early findings from a study investigating the impact of COVID-19 on quality of care in residential long-term care (LTC) in the Canadian province of New Brunswick. This study used a qualitative description design to explore what contributes to quality of care for residents living in long-term care, and how this could change in times of crisis from the perspective of long-term care staff. Interviews were conducted with a broad range of staff at one LTC home. A semi-structured interview guide and approach to thematic analysis was framed by a social ecological perspective, making it possible to include the individual and proximal social influences as well as community, organizations, and policy influencers. Insights gained will improve the understanding of quality of care, as well as potential barriers and facilitators to care during times of crisis.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 602-603
Author(s):  
Rachael Spalding ◽  
Emma Katz ◽  
Barry Edelstein

Abstract Most older adults living in long-term care settings (LTCs) indicate that expressing their sexuality is important to them (Doll, 2013). Little is known about the general public’s attitudes towards sexual behaviors in LTCs. Attitudes of LTC residents’ family members are particularly important, as family members are most likely to visit residents and to care about their quality of life. Family members’ attitudes could in turn inform facility policies and management. We will present preliminary data from a series of qualitative interviews with community-dwelling adults regarding their attitudes. We will discuss how these data are being used to inform current work on a measure of attitudes toward sexual behavior in LTCs.


2012 ◽  
Vol 10 (4) ◽  
pp. 241-247 ◽  
Author(s):  
Janine Maitland ◽  
Kevin Brazil ◽  
Bill James-Abra

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.


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