Nursing homes’ preparedness plans and capabilities

2012 ◽  
Vol 7 (2) ◽  
pp. 127-135 ◽  
Author(s):  
Hilary Eiring, MPH ◽  
Sarah C. Blake, MA, PhD Candidate ◽  
David H. Howard, PhD
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Disaster Preparedness ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Probit Regression ◽  
Nursing Home Administrators ◽  
Local Officials ◽  
Almost All ◽  
Question Survey

Objectives: To assess nursing homes’ capabilities to evacuate or shelter-in-place during a disaster and to determine their actual preparedness-related capacity.Design: A 27-question survey assessing disaster preparedness plans and capabilities in nursing homes. Respondents and nonresponders were compared based on characteristics from the Nursing Home Compare Web site using t tests for continuous variables and χ2 test for categorical variables. Probit regression was used to estimate the relationships between nursing home characteristics and dichotomous measures of preparedness.Setting: Web and paper surveys of nursing home administrators.Participants: Nursing home administrators in California, Florida, and Georgia.Main outcome measures: Number of disaster drills, days supply of emergency food and water, evacuation transportation and destination.Results: All facilities reported conducting at least one disaster drill per year. Only 55 percent of facilities used a template to develop their disaster plans and 74 percent of facilities reported that they discuss their disaster plans with local or state emergency management officials. Most facilities (81 percent) have generators. All but 19 (7 percent) of nursing homes are able to shelterin- place for 2 days or longer. Ambulance services are the most common form of transportation (76 percent). Most facilities (73 percent) plan to evacuate residents to nursing homes affiliated with their corporate group.Discussion: Almost all respondents conducted disaster drills, discussed preparedness with local officials, and were able to shelter-in-place for at least 2 days. However, many facilities rely on resources that may not be available during a large disaster.

San Diego's Area Coordinator System: A Disaster Preparedness Model for US Nursing Homes

2012 ◽  
Vol 6 (4) ◽  
pp. 424-427 ◽  
Author(s):  
Sarah C. Blake ◽  
David H. Howard ◽  
Hilary Eiring ◽  
Scott Tarde
Keyword(s):  
Health Care ◽  
Nursing Home ◽  
Nursing Homes ◽  
Emergency Management ◽  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
San Diego County ◽  
Nursing Home Administrators ◽  
System A ◽  
Daily Contact

ABSTRACTAlmost 2 million Americans rely on nursing homes for care, and many require daily or near daily contact with the health care system to remain alive and functional. In October 2007, Southern California experienced a series of wildfires that burned over 500 000 acres and caused 14 nursing homes to evacuate more than 1200 residents. In response to this event, nursing home administrators and officials from various health care and emergency management agencies in San Diego County collaborated to form a model for nursing home emergency preparedness. This report describes the model, known as the area coordinator system, and discusses its strengths and limitations, and whether it ought to be replicated in other areas of the country.(Disaster Med Public Health Preparedness. 2012;6:424-427)

scholarly journals 341 The Prevalence and Factors Associated with Anti-psychotic Prescribing on Admission to a Dementia Specific Nursing Home

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Andrew Eustace ◽  
Elaine Murray ◽  
Kelley Daly
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Psychotropic Drugs ◽  
Hospital Setting ◽  
Categorical Variables ◽  
Distributed Data ◽  
Continuous Variables ◽  
Exact Test ◽  
Diagnosis Of Dementia ◽  
Normally Distributed

Abstract Background The use of psychotropic medications and their adverse effects in frail adults has been debated extensively. However, it is unclear if antipsychotics are initiated in a nursing home or if the new resident arrives with the medication prescribed. The purpose of this study is to ascertain how many residents arrive already on antipsychotics and which factors, make them more likely to be on this medication. Methods All admission notes to the centre between 1st Jan 2018 and 31st Dec 2018 were reviewed. Inclusion criteria was any person admitted with a diagnosis of dementia. Exclusion criteria was anyone who had psychiatric diagnosis such as bipolar disorder or schizophrenia. We collected data on age, gender, referral pathway (hospital or community), MMSE, Barthel, Cohen Mansfield Agitation Inventory (CMAI) For comparisons of characteristics between the two groups (psychotropic drugs at admission: yes/no), the independent samples t-test (normally distributed data) or the Mann-Whitney U test (non-normally distributed data) was used for continuous variables and Fisher’s exact test was used for categorical variables. Results There was a statistically significant relationship between source of admission and whether or not the patient was receiving psychotropic drugs on admission (p=0.017). 88.0% of patients on psychotropic drugs on admission came from an acute hospital setting. In contrast, only 4.0% of patients receiving psychotropic drugs on admission came from home Patients on psychotropic drugs at admission had higher CMAI scores compared to patients not on psychotropic drugs. Patients on psychotropic drugs at admission were younger (mean(SD): 76.2(8.7) years) than patients not of psychotropic drugs (mean(SD): 82.9(8.3). Conclusion Prevalence of prescribing antipsychotics outside of nursing homes is high with many residents being admitted already on these medications. Efforts should be put in place on admission to nursing homes to reduce and stop antipsychotics which have been initiated in the community and hospital setting.

Factors Influencing Models of End-of-Life Care in Nursing Homes: Results of a Survey of Nursing Home Administrators

2004 ◽  
Vol 7 (5) ◽  
pp. 668-675 ◽  
Author(s):  
Kristen N. Rice ◽  
Eric A. Coleman ◽  
Ron Fish ◽  
Cari Levy ◽  
Jean S. Kutner
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Nursing Home Administrators ◽  
Factors Influencing

scholarly journals THE SUPPORT OF AUTONOMY FOR NURSING HOME RESIDENTS WITH DEMENTIA: OBSERVATION OF MORNING CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S73-S73
Author(s):  
Linda J Hoek ◽  
Hilde Verbeek ◽  
Erica De Vries ◽  
Jolanda C Van Haastregt ◽  
Ramona Backhaus ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Relational Autonomy ◽  
Staff Members ◽  
People With Dementia ◽  
Centered Care ◽  
Field Notes ◽  
Almost All ◽  
Physical Care

Abstract People with dementia in nursing homes need their social environment in supporting their autonomy. This study explored how this relational autonomy is supported by staff for residents with dementia during morning care in nursing homes. Structured observations (n=1815) were carried out to assess how resident choice is supported within staff-resident interaction. Observation of morning care consisted of four main categories: ‘getting up’, ‘physical care’, ‘physical appearance’ and ‘breakfast’. In addition, qualitative field notes were taken to support observations. In total, 55 residents with dementia were included from eight nursing home wards in The Netherlands. Results indicated that resident autonomy during morning care was only limitedly supported. Individual staff members took over tasks, regardless of resident’s individual capabilities to make a choice. Staff controlled resident’s choice for almost all observed categories. The findings of this study implicate that person-centered care during morning routine can be improved by addressing individual needs

scholarly journals Qualitative Assessment of Resident Obesity in Nursing Homes by Medical Providers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 241-241
Author(s):  
John Harris ◽  
Steven Handler ◽  
Alison Trinkoff ◽  
David Wolf ◽  
Nicholas Castle
Keyword(s):  
Weight Loss ◽  
Nursing Home ◽  
Nursing Homes ◽  
Nurse Practitioners ◽  
Dietary Habits ◽  
Qualitative Assessment ◽  
Medical Providers ◽  
Structured Interviews ◽  
Nursing Home Administrators ◽  
Common Diagnosis

Abstract We present qualitative themes from an ongoing five-year AHRQ-funded project (R01HS026943) examining the various ways nursing homes provide care for residents with obesity to determine the most effective way to prevent adverse safety events for residents with obesity. Obesity is a common diagnosis among short- and long-stay residents, and in the past, nursing home administrators have reported concerns from admissions issues to negative resident outcomes. No studies have examined the medical provider’s perspective on health of residents with obesity. In this abstract, we present three emergent themes from semi-structured interviews of medical providers (n=6) (nursing home medical directors, staff physicians, nurse practitioners) across the U.S. First, residents with obesity often have several complex and challenging medical conditions that require more services and health monitoring than most residents. Significant medical issues include diabetes, hypertension, cardiovascular disease, arthritis, and sleep apnea. Second, medical providers observe that it is difficult to provide daily custodial and nursing care, but the actual medical harm from substandard care is hard to quantify. Third, medical providers would like to help residents with obesity to lose weight and live healthier lives. There is, however, not an easy way to facilitate weight loss, due to limited resident physical activity, concerns about unhealthy weight loss, and difficulty changing established dietary habits of residents. These findings are limited by sample size, though themes have been consistent within the current participants. Comparing and contrasting these themes with other stakeholder groups (residents, nurse aides, administrators) interviews in the future will strengthen these findings.

scholarly journals Challenges to Admitting Residents: Perspectives from Rural Nursing Home Administrators and Staff

2021 ◽  
Vol 58 ◽  
pp. 004695802110051
Author(s):  
Carrie Henning-Smith ◽  
Dori Cross ◽  
Adrita Rahman
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Behavioral Health ◽  
Transitional Care ◽  
Capacity Constraints ◽  
Health Conditions ◽  
High Quality ◽  
Rural Residents ◽  
Nursing Home Administrators ◽  
Rural Nursing

Rural residents are older, on average, than urban residents, with more underlying health conditions and higher rates of disability. Rural nursing homes face unique challenges admitting medically-complex patients and meeting their needs throughout their stay. These challenges may be amplified for certain health conditions. Greater geographic distances also strain transitional care coordination practices with health system referral hubs in urban areas. In this study, we assess perceptions of difficulty rural nursing homes encounter in admitting and serving individuals with dementia, obesity, mental and behavioral health conditions, and medically complex conditions. Using a survey of nursing home administrators located in non-metropolitan counties across the U.S. (n = 209), we assessed the self-reported degree of difficulty identified in serving each of the 4 type of conditions, coupled with qualitative analysis of open-ended questions identifying specific challenges. Rural nursing homes have capacity constraints owing to lower population density, limited financial resources, and unique challenges recruiting and retaining workforce to rural areas. Nursing home administrators reported the most challenges to providing high-quality care to residents with mental and behavioral health challenges, followed by obesity. For specific challenges, administrators focused primarily on staffing concerns, as well as space and equipment needs. Rural nursing home administrators identified challenges related to specific conditions and capacity constraints. To ensure appropriate and high-quality nursing home placement for rural residents, and to minimize the disruption of transitions into nursing home settings, more attention is needed on addressing the constraints identified by rural nursing home administrators in this study.

Management attitudes and technology adoption in long-term care facilities

2014 ◽  
Vol 28 (3) ◽  
pp. 344-365 ◽  
Author(s):  
Karabi C. Bezboruah ◽  
Darla Paulson ◽  
Jason Smith
Keyword(s):  
Decision Making ◽  
Nursing Home ◽  
Nursing Homes ◽  
Technology Acceptance ◽  
It Adoption ◽  
Health It ◽  
Term Care ◽  
Case Study Methodology ◽  
Content Type ◽  
Nursing Home Administrators

Purpose – The purpose of this paper is to explore the attitudes of nursing home administrators and key managerial staff toward health information technology (health IT). Design/methodology/approach – This research is exploratory in nature, and applies qualitative case-study methodology to further understand health IT adoption by nursing homes through multiple in-depth semi-structured interviews of management, and direct observations of employee behavior at each participating facility. A modified Technology Acceptance Model is used to examine the attitudes and perceptions of administrators. Findings – This study finds that there are differences in the level of health IT adoption by nursing homes. While some administrators are aware of health IT and are implementing or updating their IT systems in a gradual but haphazard manner, others exhibited a lack of interest in implementing change. Overall, there is a lack of systematic planning and decision-making toward health IT adoption. Adoption is not evidence-based, instead driven primarily by real and perceived regulatory requirements combined with a lack of information about, or consideration of, the real costs and benefits of implementing health IT. Research limitations/implications – Including six in-depth case studies, the sample for this study is small for generalizing the findings. Yet, it contributes to the literature on the slow process of health IT adoption by nursing homes. Moreover, the findings provide guidelines for future research. Practical implications – This study demonstrates that nursing home administrators must systematically plan the adoption of health IT, and such decision making should be evidenced-based and participatory so that employees can voice their opinions that could prevent future resistance. Originality/value – This study is original and advances knowledge on the reasons for the slow adoption of health IT in nursing homes. It finds that lack of adequate information regarding the utility and benefits of health IT in management adoption decisions can result in haphazard implementation or no adoption at all. This finding has significant value for policy makers’ practitioners for improving accessibility of information regarding the use of health IT in nursing homes that could address the health IT adoption challenge in this industry.

scholarly journals What Is The Impact Of Job Burnout On Nursing Home Administrators?

2018 ◽  
Vol 13 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Felicia L. Wilson
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Emotional Exhaustion ◽  
Response Rate ◽  
The State ◽  
Job Burnout ◽  
Nursing Home Administrators ◽  
Professional Efficacy ◽  
The Impact ◽  
Nursing Home Industry

The nursing home industry is facing a crisis that appears to only get worse as each year progresses. The issue at hand is attracting and retaining qualified nursing home administrators to run efficient nursing homes. There is an overwhelming amount of data that highlights the devastating effects of job burnout on professionals. Job burnout has been found to impact the longevity of professionals. The purpose of this research was to examine the impact of job burnout among Georgia’s nursing home administrators. Participants in the study were licensed nursing home administrators (N= 363) who are employed in the state of Georgia. I received 141 completed surveys for a response rate of 38%. This study found that nursing home administrators show moderate levels emotional exhaustion, low cynicism, and high professional efficacy.

Measuring Caregiver Retention in Nursing Homes

2021 ◽  
Author(s):  
Nicholas G Castle
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Quality Indicators ◽  
Policy Makers ◽  
Nursing Home Administrators ◽  
Licensed Practical Nurses ◽  
Practical Nurses ◽  
Nursing Home Caregivers ◽  
Design And Methods ◽  
The Relationship

Abstract Background and Objectives Retention of nursing home caregivers is examined. This represents the concept of continuously employing the same caregivers in the same facility for a defined period of time. In this research, several measures of caregiver retention are examined and the utility of these measures for practitioners and policy makers is discussed. Research Design and Methods A survey of nursing home administrators conducted in 2016 was used to collect staffing data from 2,898 facilities. This was matched with Nursing Home Compare and the Certification and Survey Provider Enhanced Reporting data. The association of four measures of retention for each of three of types of caregivers with six quality indicators was examined. Results The descriptive statistics show rates of retention at five-years for Nurse Aides [NAs], Registered Nurses [RNs], and Licensed Practical Nurses [LPNs] to be low. The regression estimates show some support for the relationship that high caregiver retention is associated with better overall quality. The relationship was strongest for NAs and RNs. Support was also found for the notion that different measures of retention were more/less associated with quality. The three- and five-year retention measures had the strongest associations with the quality indicators. Discussion and Implications The findings presented provide some evidence that caregiver retention may be an important metric that can be used as a means of improving quality of care in nursing homes. However, the findings also show practitioners and policy makers should be more nuanced in the use of caregiver retention metrics.

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