WorldWideScience

Sample records for demented nursing home

  1. "The good life" for demented persons living in nursing homes

    NARCIS (Netherlands)

    Kalis, A.|info:eu-repo/dai/nl/304823244; van Delden, J.J.M.; Schermer, M.H.N.

    2004-01-01

    Background: This study investigated which concepts regarding “the good life” are used in mission statements of nursing homes providing care for demented patients. Method: All 317 Dutch nursing homes caring for demented patients were asked to participate; of these, 69% responded. Their mission

  2. "The good life" for demented persons living in nursing homes.

    Science.gov (United States)

    Kalis, Annemarie; van Delden, Johannes J M; Schermer, Maartje H N

    2004-12-01

    This study investigated which concepts regarding "the good life" are used in mission statements of nursing homes providing care for demented patients. All 317 Dutch nursing homes caring for demented patients were asked to participate; of these, 69% responded. Their mission statements were qualitatively analyzed on content. Whether different types of nursing home differed significantly in the content of their mission statements was investigated by means of chi2 analyses. Six main concepts were found that are considered important for a good life: 1) autonomy and freedom, 2) individuality and lifestyle, 3) relationships and social networks, 4) warmth and safety and familiarity, 5) developing capacities and giving meaning to life and 6) subjective experience and feelings of well-being. It was found that mission statements specifically developed for demented patients attach less importance to the concepts 1) autonomy and freedom and 2) individuality and lifestyle, than mission statements which are also aimed at non-demented residents. Most mission statements turned out to be highly eclectic in content. Nursing homes with a separate statement for demented residents seem to acknowledge the special position of demented residents and the tension between dementia and the ideal of autonomy. Although the eclecticism found in mission statements is understandable, a coherent view on the good life for demented residents should aim for a sound internal structure, and make choices between values. Only then can mission statements provide real guidance for everyday care.

  3. The development of a multidisciplinary fall risk evaluation tool for demented nursing home patients in the Netherlands

    Directory of Open Access Journals (Sweden)

    de Witte Luc P

    2006-03-01

    Full Text Available Abstract Background Demented nursing home patients are at high risk for falls. Falls and associated injuries can have a considerable influence on the autonomy and quality of life of patients. The prevention of falls among demented patients is therefore an important issue. In order to intervene in an efficient way in this group of patients, it is important to systematically evaluate the fall risk profile of each individual patient so that for each patient tailor-made preventive measures can be taken. Therefore, the objective of the present study is to develop a feasible and evidence based multidisciplinary fall risk evaluation tool to be used for tailoring preventive interventions to the needs of individual demented patients. Methods To develop this multidisciplinary fall risk evaluation tool we have chosen to combine scientific evidence on the one hand and experts' opinions on the other hand. Firstly, relevant risk factors for falling in elderly persons were gathered from the literature. Secondly, a group of Dutch experts in the field of falls and fall prevention in the elderly were consulted to judge the suitability of these risk factors for use in a multidisciplinary fall risk evaluation tool for demented nursing home patients. Thirdly, in order to generate a compact list of the most relevant risk factors for falling in demented elderly, all risk factors had to fulfill a set of criteria indicating their relevance for this specific target population. Lastly the final list of risk factors resulting from the above mentioned procedure was presented to the expert group. The members were also asked to give their opinion about the practical use of the tool. Results The multidisciplinary fall risk evaluation tool we developed includes the following items: previous falls, use of medication, locomotor functions, and (correct choice and use of assistive and protective devices. The tool is developed for the multidisciplinary teams of the nursing homes

  4. Examining practical nursing experiences to discover ways in which to retain and invigorate the remaining functions of the elderly with a demented and complex disability in nursing homes.

    Science.gov (United States)

    Park, Min-Sun; Lim, Sun-Young; Kim, Eun-Young; Lee, Su-Jung; Chang, Sung-Ok

    2017-05-23

    The bedridden elderly with moderate-to-severe dementia account for a large proportion of the residents in nursing homes and form a specialized group requiring customized care in order to encourage their remaining functions, which determine the quality of their residual life. The purpose of this study was to search for ways to invigorate and foster the remaining functions of this complex-disability group, based on practical nursing strategies in nursing homes. The qualitative thematic analysis was done by conducting in-depth interviews with 29 nurses working at 11 different nursing homes in South Korea. This study proposed four main themes and 19 sub themes as keys for providing specialized nursing care to the elderly with physical and cognitive disabilities. The main themes encourage the residents' remaining functions: (i) accurate identification of an elderly resident's physical, cognitive, and behavioral baseline is necessary in order to determine their functional levels; (ii) nurses provide meticulous management to support the remaining functions in order to prevent further deterioration; (iii) optimized know-how, based on accumulated experience and knowledge, is reflected in nursing strategies that maximize the effects of nursing interventions; and (iv) steady compliance with nursing guidelines and standards in nursing homes creates the best therapeutic environment and brings unexpected positive changes in the elderly's status. A practical nursing strategy to target the group with a demented and complex disability in nursing homes was developed through thematic analysis of the empirical knowledge of nurses. The findings provide new insights for developing specialized nursing interventions and practical nursing models in long-term care facilities. © 2017 Japan Academy of Nursing Science.

  5. Nursing Homes

    Science.gov (United States)

    ... newsletter! Aging & Health A to Z Nursing Homes Basic Facts & Information Nursing homes have changed dramatically over the past several ... how accessible are they? How close is the nursing home to family members? How close ... much do basic services cost? What services are covered? What additional ...

  6. Nursing Home

    OpenAIRE

    Allocca Hernandez, Giacomo Antonio

    2016-01-01

    Getting old involves a lot of changes in life. Family and social relations change and mobility can decrease. These variations require new settings, and of course special care. A nursing home is a place dedicated to help with this situation. Sometimes nursing homes can be perceived as mere institutions by society, and even by future residents. Inside, senior citizens are suppose to spend the rest of their lives doing the same activities day after day. How can we improve these days? Archite...

  7. Nursing Home Checklist

    Science.gov (United States)

    ... nursing home: ____________________________________________________ Address: ________________________________________________________________ Phone number: __________________________________________________________ Date of visit: _____________________________________________________________ Basic information Yes No Notes Is the nursing home Medicare certified? Is the nursing home Medicaid ...

  8. Nursing-care dependency : Development of an assessment scale for demented and mentally handicapped patients

    NARCIS (Netherlands)

    Dijkstra, Ate; Buist, Girbe; Dassen, T

    1996-01-01

    This article describing the first phase in the development of an assessment scale of nursing-care dependency (NCD) for Dutch demented and mentally handicapped patients focuses on the background to the study and the content validation of the nursing-care dependency scale. The scale aims to

  9. Learning from other lands. Caring for elderly demented Koreans.

    Science.gov (United States)

    Lee, H; Kim, S; You, K S

    1997-09-01

    The aims of the study reported here were to describe the socio-demographic characteristics of caregivers of demented elders in Korea and their care recipients and to compare the positive and negative meanings and outcomes of the caregiving experiences of caregivers who had admitted their elderly demented relative to a nursing home (G1: n = 24) and caregivers still caring for their elderly demented relatives at home (G2: n = 30). Most caregivers were female (80%), married (89%), and related to the care receiver as daughter-in-law (39%), daughter (22%), wife (15%), son (13%), or neighbor (6%). Social class differences were found between the home care and nursing home groups: the upper classes were significantly more likely to have placed their demented elder in a nursing home, whereas the low social classes were more likely to keep taking care of their demented elder at home instead of placing them in a nursing home. Caregivers who had admitted their relative to a nursing home (G1) reported significantly more difficulties from disturbed sleep, disrupted children's studies, and limited personal life when they were caring for the elder at home (p care group (G2) had significantly greater satisfaction in serving as a model for their children and practicing religion (p care receiver than those who have placed their demented elder in a nursing home, although the difference in this case was not significant.

  10. Meals in nursing homes

    DEFF Research Database (Denmark)

    Kofod, Jens Erik; Birkemose, A.

    2004-01-01

    of nursing home improves the residents' meal situation with a positive effect on nutrition. The aim of this work is to test the general hypothesis that (i) residents appreciate the meal situation in these nursing homes and (ii) nutritional status of the residents is improved in this type of nursing home......Undernutrition is present among 33% of nursing home residents in Denmark. Hence, it is relevant to examine the meal situation at nursing homes to single out factors that may increase or reduce the residents' food intake. in the ongoing Danish nursing home debate it is claimed that a new type....... This study was carried out in four Danish nursing homes at various locations in Denmark. The methods used are qualitative interviews and observations at four nursing homes in combination with measurement of body mass index (BMI) at two of the four nursing homes. Undernutrition is defined as a BMI below 20...

  11. Meals in nursing homes

    DEFF Research Database (Denmark)

    Kofod, Jens Erik; Birkemose, A.

    2004-01-01

    . This study was carried out in four Danish nursing homes at various locations in Denmark. The methods used are qualitative interviews and observations at four nursing homes in combination with measurement of body mass index (BMI) at two of the four nursing homes. Undernutrition is defined as a BMI below 20......Undernutrition is present among 33% of nursing home residents in Denmark. Hence, it is relevant to examine the meal situation at nursing homes to single out factors that may increase or reduce the residents' food intake. in the ongoing Danish nursing home debate it is claimed that a new type...... of nursing home improves the residents' meal situation with a positive effect on nutrition. The aim of this work is to test the general hypothesis that (i) residents appreciate the meal situation in these nursing homes and (ii) nutritional status of the residents is improved in this type of nursing home...

  12. Blood Concentrations of Homocysteine and Methylmalonic Acid among Demented and Non-Demented Swedish Elderly with and without Home Care Services and Vitamin B12 Prescriptions

    Directory of Open Access Journals (Sweden)

    Nils-Olof Hagnelius

    2012-09-01

    Full Text Available Background and Aims: Total plasma homocysteine (tHcy has been suggested as a risk factor of dementia. Our aim was to investigate potential differences in tHcy status in relation to the prescription of vitamin B12 and dementia diagnosis. We examined whether vitamin B12 prescriptions, a family history of dementia, or the need for home care service might be associated with tHcy values. Methods: A cross-sectional monocenter study comprising 926 consecutive subjects attending our Memory Care Unit was conducted. Results: Demented subjects being prescribed vitamin B12 had higher serum vitamin B12 (p = 0.025 but also higher tHcy (p 12 prescriptions. tHcy levels were significantly higher in non-demented subjects receiving home care service (p = 0.007. This group also had lower serum albumin (dementia: p 12 prescriptions (dementia with/without vitamin B12 prescription: p = 0.561; non-dementia with/without vitamin B12 prescription: p = 0.710. Conclusion: Despite vitamin B12 prescriptions, demented subjects had higher tHcy and methylmalonate values. The elevated metabolite values could not be explained by differences in renal function. Thus, elderly subjects on vitamin B12 prescription appear to have unmet nutritional needs.

  13. Community Nursing Home (CNH)

    Data.gov (United States)

    Department of Veterans Affairs — The Community Nursing Home (CNH) database contains a list of all Community Nursing Home facilities under local contract to Veterans Health Administration (VHA). CNH...

  14. National Nursing Home Survey

    Science.gov (United States)

    The National Nursing Home Survey provides includes characteristics such as size of nursing home facilities, ownership, Medicare/Medicaid certification, occupancy rate, number of days of care provided, and expenses.

  15. Nursing Home Quality Initiative

    Data.gov (United States)

    U.S. Department of Health & Human Services — This Nursing Home Quality Initiative (NHQI) website provides consumer and provider information regarding the quality of care in nursing homes. NHQI discusses quality...

  16. Nursing Home Quality Initiative

    Data.gov (United States)

    U.S. Department of Health & Human Services — This Nursing Home Quality Initiative (NHQI) website provides consumer and provider information regarding the quality of care in nursing homes. NHQI discusses...

  17. Predictors of neuropsychiatric symptoms in nursing home patients : influence of gender and dementia severity

    NARCIS (Netherlands)

    Zuidema, Sytse U; de Jonghe, Jos F M; Verhey, Frans R J; Koopmans, Raymond T C M

    2009-01-01

    INTRODUCTION: The aim of the study was to assess the influence of dementia severity and gender on neuropsychiatric symptoms in demented nursing home patients. METHODS: Neuropsychiatric symptoms were assessed in a large sample of 1319 Dutch nursing home patients using the Cohen-Mansfield Agitation In

  18. [Nurse home visits in France].

    Science.gov (United States)

    Monguillon, Dominique; Gracia, Pierre-Benjamin

    2011-10-01

    Nurse home visits in France. More and more nurses carry out home visits, either as freelance nurses or employees of a nurse home visits service, a home hospital care structure or a nursing care centre. These home visits are both demanded by patients and encouraged by the health authorities. As a consequence, the service is expanding every year.

  19. Alternatives to Nursing Homes

    Science.gov (United States)

    ... think you need home care, talk to your family to see if they can help with your care or help arrange for other care providers. There are also some home health care agencies that can help with nursing or attendant care in your home. Medicare only ...

  20. Nursing Home Compare Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — These are the official datasets used on the Medicare.gov Nursing Home Compare Website provided by the Centers for Medicare and Medicaid Services. These data allow...

  1. Nursing Home Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — The data that is used by the Nursing Home Compare tool can be downloaded for public use. This functionality is primarily used by health policy researchers and the...

  2. Nursing Home Data Compendium

    Data.gov (United States)

    U.S. Department of Health & Human Services — The compendium contains figures and tables presenting data on all Medicare- and Medicaid-certified nursing homes in the United States as well as the residents in...

  3. Feeling at home in nursing homes.

    NARCIS (Netherlands)

    Veer, A.J.E. de; Kerkstra, A.

    2001-01-01

    Aim. The purpose of this study was to examine determinants of feeling at home and in particular the privacy in nursing homes in The Netherlands. The first question was to what extent nursing homes differed in the degree residents feel at home and experience privacy. The second question was whether f

  4. [Psychiatric distress and related risk factors of family caregivers who care for the demented elderly at home].

    Science.gov (United States)

    Doi, Y; Ogata, K

    2000-01-01

    The objectives of our study were to assess psychiatric distress of caregivers who had been caring for the demented elderly at home and to examine the association of caregivers' psychiatric distress with putative risk factors. Subjects were 294 caregivers living in Amakusa, Kumamoto Prefecture of Japan, whose spouses, parents or other family members were registered at Amakusa Public Health Center as demented elderly. In 1998, Survey on Caregivers' Mental Health was conducted using the General Health Questionnaire (GHQ12) as a measurement for general psychiatric state of caregivers. Two hundred and eighty-two caregivers responded to interviews with complaints of the following psychological symptoms: feelings of unhappiness (55.7%), of stress (41.8%), insomnia (29.4%) and depressed mood (29.1%). Seventy-six caregivers (27.2%) were identified as being above the cut-off point 4 for psychiatric distress caseness. Multivariate logistic regression analysis indicated caregivers' psychiatric distress was statistically associated with caregivers' age, the caregivers' perception of the severity of dementia, the number of years devoted to caregiving at home and perceived financial state. Being 50 to 69 years (OR = 0.37, 95% CI: 0.17-0.81) and being 70 years or older (OR = 0.35, 95% CI: 0.14-0.83) were negatively associated with caseness as compared to being 20 to 49 years. Caseness was positively related to the severity of the elderly's demented state (OR = 6.93, 95% CI: 1.99-24.19), 1 year to 2 years devoted to caregiving at home (OR = 3.26, 95% CI: 1.02-10.38), no family or social support (OR = 2.99, 95% CI: 1.12-7.96) and lower perceived financial state (always OR = 6.99, 95% CI: 2.77-17.64, sometimes OR = 2.41, 95% CI: 1.19-4.85). Reduction of caregivers' psychiatric distress is important for not merely the enhancement of quality of care for demented elders and caregivers' life but for the prevention of elder abuse or neglect. Our study suggests that a comprehensive

  5. Legal Issues in Nursing Homes.

    Science.gov (United States)

    Kapp, Marshall B.

    This paper examines the variety of legal rules and processes which have been established to assess and ensure that the quality of care provided in nursing homes satisfies an acceptable level. It begins with a general overview of nursing home law. Areas discussed in this section include: (1) sources of nursing home law; (2) theories of liability;…

  6. Prevalence of neuropsychiatric symptoms in a large sample of Dutch nursing home patients with dementia

    NARCIS (Netherlands)

    Zuidema, Sytse U; Derksen, Els; Verhey, Frans R J; Koopmans, Raymond T C M

    2007-01-01

    OBJECTIVE: To estimate the prevalence of neuropsychiatric symptoms of dementia patients in Dutch nursing homes. METHODS: Cross-sectional study in a large sample of 1322 demented patients living in 59 dementia special care units (SCUs) in The Netherlands. Symptoms were observed by licensed vocational

  7. [Aromatherapy in nursing homes].

    Science.gov (United States)

    Barré, Lucile

    2015-01-01

    Pierre Delaroche de Clisson hospital uses essential oils as part of its daily organisation for the treatment of pain and the development of palliative care. The setting up of this project, in nursing homes and long-term care units, is the fruit of a complex mission carried out by a multidisciplinary team, which had to take into account the risks involved and overcome a certain amount of reluctance.

  8. Factor substitution in nursing homes.

    Science.gov (United States)

    Cawley, John; Grabowski, David C; Hirth, Richard A

    2006-03-01

    This paper studies factor substitution in one important sector: the nursing home industry. Specifically, we measure the extent to which nursing homes substitute materials for labor when labor becomes relatively more expensive. From a policy perspective, factor substitution in this market is important because materials-intensive methods of care are associated with greater risks of morbidity and mortality among nursing home residents. Studying longitudinal data from 1991 to 2000 on nearly every nursing home in the United States, we use the method of instrumental variables (IV) to address measurement error in nursing home wages. The results from the IV models yield evidence of factor substitution: higher nursing home wages are associated with greater use of psychoactive drugs and lower quality.

  9. Nursing home and nursing home physician: the Dutch experience.

    NARCIS (Netherlands)

    Schols, J.M.G.A.; Crebolder, H.F.J.M.; Weel, C. van

    2004-01-01

    Dutch nursing home care today includes a broad range of institutional and outreaching care functions. Medical care is an essential part of this care. Nursing home medicine in The Netherlands has developed as an officially acknowledged medical specialty. This is unique because The Netherlands is the

  10. Truth telling and truthfulness in the care for patients with advanced dementia: an ethnographic study in Dutch nursing homes.

    Science.gov (United States)

    Hertogh, Cees M P M; The, B Anne Mei; Miesen, Bere M L; Eefsting, Jan A

    2004-10-01

    The purpose of this study was to investigate and analyze the moral tension that exists in the care for demented nursing home patients, between the principle of respect for autonomy and the value that is attached to respect for the subjective world of the patient. To this end an ethnographical field study was carried out by two researchers in two Dutch nursing homes. Among the central topics that evolved were the different moral problems that nurses experience concerning truth telling and acting truthfully in relation to demented patients. In situations unrelated to the dementia and its diagnosis, the right to be informed is in principle respected, even if the information is sometimes painful. More specific questions of demented patients about their situation are a regular cause of embarrassment for their carers, who rely on various treatment strategies to deal with such questions. These strategies are often successful. However, when they fail, the nurses are faced with a problem they cannot solve, namely the loss of a common shared world and the resulting unmentionable truth about the diagnosis of dementia, as objective basis and legitimization for their approach to the demented patient. We conclude that in the training and professional support given to nurses, more attention should be paid to (awareness of) the moral problems that arise from this loss of a common shared world, so that they can react to the subjective world of demented patients without feeling that they are deceiving them.

  11. Implementing guidelines in nursing homes

    DEFF Research Database (Denmark)

    Diehl, Heinz; Graverholt, Birgitte; Espehaug, Birgitte

    2016-01-01

    BACKGROUND: Research on guideline implementation strategies has mostly been conducted in settings which differ significantly from a nursing home setting and its transferability to the nursing home setting is therefore limited. The objective of this study was to systematically review the effects o...

  12. Nursing Home Nomads: A Study of Transfers.

    Science.gov (United States)

    Retsinas, Joan

    Researchers have divided nursing home residents into long-stayers and short-stayers. While long-stayers rarely return home, they do not necessarily stay long in one institution. Instead, they may transfer from nursing home to nursing home. Although many studies have examined the impact of relocation on nursing home residents, few studies have…

  13. Nursing Home Work Practices and Nursing Assistants' Job Satisfaction

    Science.gov (United States)

    Bishop, Christine E.; Squillace, Marie R.; Meagher, Jennifer; Anderson, Wayne L.; Wiener, Joshua M.

    2009-01-01

    Purpose: To estimate the impact of nursing home work practices, specifically compensation and working conditions, on job satisfaction of nursing assistants employed in nursing homes. Design and Methods: Data are from the 2004 National Nursing Assistant Survey, responses by the nursing assistants' employers to the 2004 National Nursing Home Survey,…

  14. Rehabilitation in the nursing home.

    Science.gov (United States)

    Joseph, C L; Wanlass, W

    1993-11-01

    Despite the considerable challenges to providing high-quality rehabilitation in a long-term care facility, growing demographic and fiscal pressures are likely to push the nursing home into the forefront of rehabilitation for the frail elderly. Model programs have been implemented in recent years that present alternative ways to increase access to skilled services and improve quality of care in nursing homes without a drastic increase in costs. The teaching nursing home program has supported projects to make longterm care facilities centers for education, innovative clinical care, and research, thus bringing nursing homes into the mainstream of the medical establishment. A majority of US medical schools have recognized the need for training in long-term care and have formed affiliations with nursing homes. The Department of Veterans Affairs has a large national system of nursing homes, which has made a significant contribution to the training of health professionals in many fields. Demonstration projects such as the Social Health Maintenance Organization and On Lok have sought to decrease the fragmentation of health care services for the elderly and bring nursing homes into a continuum of care. The adoption of the OBRA regulations is building a base for comprehensive assessment and improved provision of care in nursing homes nationwide. Nursing home rehabilitation has the potential to decrease institutionalization in the short-term resident, whereas maintenance therapy can improve quality of life and decrease the cost of caring for patients who must be institutionalized. But to achieve this potential, significant barriers must be overcome. Negative attitudes about aging and nursing homes percolate through all levels of health care from lack of reimbursement at the federal and state levels to the professional priorities that continue to favor "high-tech" medicine and stigmatize nursing homes and those who work in them, to low expectations of caregivers and the

  15. Fall prevention in nursing homes

    DEFF Research Database (Denmark)

    Andresen, Mette; Hauge, Johnny

    2006-01-01

    that the number of hospitalization after a fall injury will become an even greater task for the Danish hospitals, The aim of the study was to show if there is a relationship between physically frail elderly nursing home resident’s subjective evaluation of fall-risk and an objective evaluation of their balance....... Further, to suggest tools for fall prevention in nursing home settings on the basis of the results of this study and the literature. A quantitative method inspired by the survey method was used to give an overview of fall patterns, subjective and objective evaluations of fallrisk. Participants were 16...... physically frail elderly nursing home residents from three different nursing homes. Measures: a small staff-questionnaire about incidences and places where the participants had falling-episodes during a 12 month period, The Falls Effi cacy Scale Swedish version (FES(S)) and Berg Balance Scale (BBS) Results...

  16. Happy in a nursing home?

    NARCIS (Netherlands)

    Cretien van Campen; Debbie Verbeek-Oudijk

    2017-01-01

    Original title: Gelukkig in een verpleeghuis? Life in Dutch residential nursing and care homes is changing. The number of frail older persons in the Netherlands is increasing. Older people are increasingly living independently for longer, and only the most frail older persons move to a nursing or

  17. Nursing Jobs in Nursing Homes

    Science.gov (United States)

    Torpey, Elka Maria

    2011-01-01

    The need for practical nurses who focus on caring for older people is growing. According to the U.S. Census Bureau, the number of people ages 65 and older is expected to increase from 40 million to 72 million between 2010 and 2030. And the U.S. Bureau of Labor Statistics (BLS) projects that this increasing population will result in job growth for…

  18. Nursing home-acquired pneumonia.

    Science.gov (United States)

    El Solh, Ali A

    2009-02-01

    Nursing home-acquired pneumonia (NHAP) was first described in 1978. Since then there has been much written regarding NHAP and its management despite the lack of well-designed studies in this patient population. The most characteristic features of patients with NHAP are the atypical presentation, which may lead to delay in diagnosis and therapy. The microbial etiology of pneumonia encompasses a wide spectrum that spans microbes recovered from patients with community-acquired pneumonia to organisms considered specific only to nosocomial settings. Decision to transfer a nursing home patient to an acute care facility depends on a host of factors, which include the level of staffing available at the nursing home, patients' advance directives, and complexity of treatment. The presence of risk factors for multidrug-resistant pathogens dictates approach to therapy. Prevention remains the cornerstone of reducing the incidence of disease. Despite the advance in medical services, mortality from NHAP remains high.

  19. Ambiguities: residents' experience of 'nursing home as my home'.

    Science.gov (United States)

    Nakrem, Sigrid; Vinsnes, Anne G; Harkless, Gene E; Paulsen, Bård; Seim, Arnfinn

    2013-09-01

    Residential care in nursing homes continues to be necessary for those individuals who are no longer able to live at home. Uncovering what nursing home residents' view as quality of care in nursing homes will help further understanding of how best to provide high quality, person-centred care. To describe residents' experiences of living in a nursing home related to quality of care. The study utilises a descriptive exploratory design. In-depth interviews were undertaken with 15 residents who were not cognitively impaired, aged 65 and over and living in one of four nursing homes. The interviews were transcribed verbatim and analysed by categorising of meaning. Residents perceived the nursing home as their home, but at the same time not 'a home'. This essential ambiguity created the tension from which the categories of perceptions of quality emerged. Four main categories of quality of care experience were identified: 'Being at home in a nursing home', 'Paying the price for 24-hour care', 'Personal habits and institutional routines', and 'Meaningful activities for a meaningful day'. Ambiguities concerning the nursing home as a home and place to live, a social environment in which the residents experience most of their social life and the institution where professional health service is provided were uncovered. High-quality care was when ambiguities were managed well and a home could be created within the institution. Implication for practice. Achieving quality care in nursing homes requires reconciling the ambiguities of the nursing home as a home. This implies helping residents to create a private home distinct from the professional home, allowing residents' personal habits to guide institutional routines and supporting meaningful activities. Using these resident developed quality indicators is an important step in improving nursing home services. © 2012 Blackwell Publishing Ltd.

  20. An international definition for "nursing home"

    NARCIS (Netherlands)

    Sanford, A.M.; Orrell, M.; Tolson, D.; Abbatecola, A.M.; Arai, H.; Bauer, J.M.; Cruz-Jentoft, A.J.; Dong, B.; Ga, H.; Goel, A.; Hajjar, R.; Holmerova, I.; Katz, P.R.; Koopmans, R.T.; Rolland, Y.; Visvanathan, R.; Woo, J.; Morley, J.E.; Vellas, B.

    2015-01-01

    There is much ambiguity regarding the term "nursing home" in the international literature. The definition of a nursing home and the type of assistance provided in a nursing home is quite varied by country. The International Association of Gerontology and Geriatrics and AMDA foundation developed a su

  1. Ensuring Quality Nursing Home Care

    Science.gov (United States)

    ... your healthcare provider about your medications, symptoms, and health problems. May 2013 Ensuring Quality Nursing Home Care Expert information from Healthcare Professionals Who Specialize in the Care of Older Adults After you’ve placed your family member in a facility KEEP VISITING! Seeing family ...

  2. Action research in nursing homes

    DEFF Research Database (Denmark)

    Andersen, John; Bilfeldt, Annette

    2016-01-01

    quality in a joint effort between care workers, residents at the nursing home, and researchers. It concludes that the project led to empowerment of the residents and staff and played an important role in the development of democratic knowledge building about better quality and ethics in elder care....

  3. Sexual aggression between residents in nursing homes: literature synthesis of an underrecognized problem.

    Science.gov (United States)

    Rosen, Tony; Lachs, Mark S; Pillemer, Karl

    2010-10-01

    Evidence exists suggesting that most sexual aggression against older adults occurs in long-term care facilities. Fellow residents are the most common perpetrators, often demonstrating inappropriate hypersexual behavior caused by dementing illness. This resident-to-resident sexual aggression (RRSA) is defined as sexual interactions between long-term care residents that, in a community setting, at least one of the recipients would be likely to construe as unwelcome and that have high potential to cause physical or psychological distress in one or both of the involved residents. Although RRSA may be common, and physical and psychological consequences for victims may be significant, this phenomenon has received little direct attention from researchers. This is a review of the existing literature and relevant related research examining elder sexual abuse and hypersexual behavior that describes the epidemiological features of this phenomenon, including risk factors for perpetrators and victims. The legitimate and recognized need for nursing home residents, even those with advanced dementing illness, to express themselves sexually makes preventing and managing sexual aggression in nursing homes more challenging. This review discusses the ethical dilemma this situation creates and the need to evaluate the capacity to consent to sexual activity of residents with dementing illness and to re-evaluate capacity as the diseases progress. Suggestions are offered for managing incidents of RRSA and for future research, including the importance of designing effective interventions. © 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.

  4. Nursing Homes as Teaching Institutions: Legal Issues.

    Science.gov (United States)

    Kapp, Marshall B.

    1984-01-01

    Discusses the trend toward affiliation of nursing homes with educational programs as clinical teaching institutions for medical, nursing, and allied health students. Reviews potential ethical and legal issues for the nursing home administrator, professional staff member, educator, and student, including informed consent, supervisory…

  5. Family caregivers' experiences in nursing homes

    DEFF Research Database (Denmark)

    Lohne, Vibeke; Høy, Bente; Wilhelm Rehnsfeldt, Arne

    2014-01-01

    This qualitative study is focusing on dignity in nursing homes from the perspective of family caregivers. Dignity is a complex concept and central to nursing. Dignity in nursing homes is a challenge, according to research. Family caregivers are frequently involved in their family members’ daily e...

  6. Assisted Living Facilities - MDC_NursingHome

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — Label (point) feature class of Miami-Dade County Nursing Homes Facilities. As of May 2004 the Office of Emergency Management (OEM) will provide updates for Nursing...

  7. Assisted Living Facilities - MDC_NursingHome

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — Label (point) feature class of Miami-Dade County Nursing Homes Facilities. As of May 2004 the Office of Emergency Management (OEM) will provide updates for Nursing...

  8. Some Aspects of Burnout in Nursing Homes

    OpenAIRE

    2016-01-01

    Nursing personnel in nursing homes for elderly citizens are exposed to a number of factors that contribute to possible burnout syndrome. For this reason, the set objective of the research was to measure the degree of burnout, check the correlation between the burnout syndrome and satisfaction at work, and psychosomatic symptoms, as well as to figure out the main characteristics of burnout syndrome among the nursing personnel in nursing homes for the elderly in Slovenia.

  9. Nursing Home Staff Turnover: Impact on Nursing Home Compare Quality Measures

    Science.gov (United States)

    Castle, Nicholas G.; Engberg, John; Men, Aiju

    2007-01-01

    Purpose: We used data from a large sample of nursing homes to examine the association between staff turnover and quality. Design and Methods: The staff turnover measures came from primary data collected from 2,840 nursing homes in 2004 (representing a 71% response rate). Data collection included measures for nurse aides, licensed practical nurses,…

  10. Family caregivers' experiences in nursing homes

    DEFF Research Database (Denmark)

    Lohne, Vibeke; Høy, Bente; Wilhelm Rehnsfeldt, Arne

    2014-01-01

    This qualitative study is focusing on dignity in nursing homes from the perspective of family caregivers. Dignity is a complex concept and central to nursing. Dignity in nursing homes is a challenge, according to research. Family caregivers are frequently involved in their family members’ daily...... experiences at the nursing home. This Scandinavian application study has a descriptive and explorative design. Twenty-nine family caregivers were included. A phenomenological-hermeneutic approach was used to understand the meaning of the narrated text. The interpretations revealed two main themes: “One should......, but still important in nursing homes. It seems therefore important to further investigate experiences of family caregivers in the context of nursing homes....

  11. The process of a group intervention for caregivers of demented persons living at home: conceptual framework, components, and characteristics.

    Science.gov (United States)

    Lévesque, L; Gendron, C; Vézina, J; Hébert, R; Ducharme, F; Lavoie, J-P; Gendron, M; Voyer, L; Préville, M

    2002-08-01

    Most earlier group interventions for caregivers of demented persons lacked a theoretical basis to guide the intervention process and focused on providing information and practical advice and encouraging the expression of feelings. This article presents the process of a group intervention with emphasis on its conceptual framework, components and characteristics. As caregivers are exposed to numerous daily stressful demands, the intervention's conceptual framework was derived from Lazarus and Folkman's transactional theory of stress and coping and Folkman's Coping Effectiveness Training Program. The central aim of the intervention was to improve the ability of caregivers to cope with the stressful demands at the core of caring for a demented person, rather than to focus on information and the task-oriented aspects of caring. The two components of the intervention deal with the cognitive appraisal of stressors and coping strategies, with a view to determining which strategies are most appropriate on the basis of the changeability of stressors. Three coping strategies were proposed: problem solving (problem-focused coping to deal with changeable stressors), reframing (emotion-focused coping to manage the emotional response to unchangeable stressors), and seeking social support (problem- or emotion-focused coping). The most salient characteristics of this group intervention were its intensity (15 meetings) and its focus on the caregivers' daily reality, which provided concrete reference points for the discussion of conceptual notions.

  12. Nursing home work practices and nursing assistants' job satisfaction.

    Science.gov (United States)

    Bishop, Christine E; Squillace, Marie R; Meagher, Jennifer; Anderson, Wayne L; Wiener, Joshua M

    2009-10-01

    To estimate the impact of nursing home work practices, specifically compensation and working conditions, on job satisfaction of nursing assistants employed in nursing homes. Data are from the 2004 National Nursing Assistant Survey, responses by the nursing assistants' employers to the 2004 National Nursing Home Survey, and county-level data from the Area Resource File. Multinomial logistic regression was used to estimate effects of compensation and working conditions on nursing assistants' overall job satisfaction, controlling for personal characteristics and local labor market characteristics. Wages, benefits, and job demands, measured by the ratio of nursing assistant hours per resident day, were associated with job satisfaction. Consistent with previous studies, job satisfaction was greater when nursing assistants felt respected and valued by their employers and had good relationships with supervisors. Nursing assistants were more satisfied when they had enough time to complete their work, when their work was challenging, when they were not subject to mandatory overtime, and where food was not delivered to residents on trays. This is the first investigation of nursing assistant job satisfaction using a nationally representative sample of nursing assistants matched to information about their employing nursing homes. The findings corroborate results of previous studies in showing that compensation and working conditions that provide respect, good relationships with supervisors, and better staffing levels are important to nursing assistant job satisfaction.

  13. Intergrated dental care in nursing homes

    NARCIS (Netherlands)

    Gerritsen, P.F.M.

    2015-01-01

    The thesis deals with integrated dental care in nursing homes. First, the dental treatment needs were ascertained of 432 residents in three Dutch nursing homes that offer integrated dental care. Dentist researchers intra-orally examined the residents and found that 72% required dental treatment.

  14. Intergrated dental care in nursing homes

    NARCIS (Netherlands)

    Gerritsen, P.F.M.

    2015-01-01

    The thesis deals with integrated dental care in nursing homes. First, the dental treatment needs were ascertained of 432 residents in three Dutch nursing homes that offer integrated dental care. Dentist researchers intra-orally examined the residents and found that 72% required dental treatment. How

  15. 38 CFR 17.57 - Use of community nursing homes.

    Science.gov (United States)

    2010-07-01

    ... homes. 17.57 Section 17.57 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Community Nursing Home Care Facilities § 17.57 Use of community nursing homes. (a) Nursing home care in a contract public or private nursing home facility may be authorized for the following...

  16. Stroke and Nursing Home care: a national survey of nursing homes.

    LENUS (Irish Health Repository)

    Cowman, Seamus

    2010-01-01

    BACKGROUND: Although stroke is recognised as a major factor in admission to nursing home care, data is lacking on the extent and nature of the disabilities and dependency in nursing homes arising from stroke. A national study conducted in nursing homes can quantify the number of residents with stroke in nursing homes, their disability and levels of dependency. METHODS: A cross-sectional survey research design was used. A total of 572 public and private nursing homes were identified nationally and a stratified random selection of 60 nursing homes with 3,239 residents was made. In half of the nursing homes (n = 30) efforts were made to interview all residents with stroke Survey instruments were used to collect data from residents with stroke and nursing home managers on demography, patient disability, and treatment. RESULTS: Across all nursing homes (n = 60), 18% (n = 570) of the residents had previously had a stroke. In homes (n = 30), where interviews with residents with stroke (n = 257), only 7% (n = 18) residents were capable of answering for themselves and were interviewed. Data on the remaining 93% (n = 239) residents were provided by the nursing home manager. Nurse Managers reported that 73% of residents with stroke had a high level of dependency. One in two residents with stroke was prescribed antidepressants or sedative medication. Only 21% of stroke residents were prescribed anticoagulants, 42% antiplatelets, and 36% cholesterol lowering medications. Stroke rehabilitation guidelines were lacking and 68% reported that there was no formal review process in place. CONCLUSIONS: This study provides seminal findings on stroke and nursing home services in Ireland. We now know that one in six nursing home residents in a national survey are residents with a stroke, and have a wide range of disabilities. There is currently little or no structured care (beyond generic care) for stroke survivors who reside in nursing homes in Ireland.

  17. Stroke and Nursing Home care: a national survey of nursing homes

    Directory of Open Access Journals (Sweden)

    McGee Hannah

    2010-01-01

    Full Text Available Abstract Background Although stroke is recognised as a major factor in admission to nursing home care, data is lacking on the extent and nature of the disabilities and dependency in nursing homes arising from stroke. A national study conducted in nursing homes can quantify the number of residents with stroke in nursing homes, their disability and levels of dependency. Methods A cross-sectional survey research design was used. A total of 572 public and private nursing homes were identified nationally and a stratified random selection of 60 nursing homes with 3,239 residents was made. In half of the nursing homes (n = 30 efforts were made to interview all residents with stroke Survey instruments were used to collect data from residents with stroke and nursing home managers on demography, patient disability, and treatment. Results Across all nursing homes (n = 60, 18% (n = 570 of the residents had previously had a stroke. In homes (n = 30, where interviews with residents with stroke (n = 257, only 7% (n = 18 residents were capable of answering for themselves and were interviewed. Data on the remaining 93% (n = 239 residents were provided by the nursing home manager. Nurse Managers reported that 73% of residents with stroke had a high level of dependency. One in two residents with stroke was prescribed antidepressants or sedative medication. Only 21% of stroke residents were prescribed anticoagulants, 42% antiplatelets, and 36% cholesterol lowering medications. Stroke rehabilitation guidelines were lacking and 68% reported that there was no formal review process in place. Conclusions This study provides seminal findings on stroke and nursing home services in Ireland. We now know that one in six nursing home residents in a national survey are residents with a stroke, and have a wide range of disabilities. There is currently little or no structured care (beyond generic care for stroke survivors who reside in nursing homes in Ireland.

  18. Deprivation of Dignity in Nursing Home Residents

    DEFF Research Database (Denmark)

    Høy, Bente

    2012-01-01

    deepened knowledge in how to maintain and promote dignity in nursing home residents. The purpose of this paper is to present results concerning the question: How is nursing home residents’ dignity maintained or deprived from the perspective of close family caregivers? In this presentation we only focus...... on deprivation of dignity. Methodology: The overall design of this study is modified clinical application research. The study took place at six different nursing home residences in Sweden, Denmark and Norway. Data collection methods were individual research interviews. All together the sample consisted of 28...

  19. Reducing energy costs in nursing homes

    Energy Technology Data Exchange (ETDEWEB)

    1981-01-01

    The handbook presents ideas and techniques for energy conservation in nursing homes. Case studies were developed of nursing homes located in different parts of the US. The typical nursing home assessed was proprietary, of intermediate-care level, medicaid-certified, and had less than 200 beds. Specific energy conservation measures were analyzed to determine the energy and dollar savings that could be realized. These include reducing heat loss through the building shell; reducing hot water costs; recovering the heat generated by dryers; reducing lighting costs; reducing heating and cooling costs, and analyzing fuels and fuel rates. A case for converting electric clothes dryers to gas was analyzed. (MCW)

  20. Organization and financing of home nursing in the European Union.

    NARCIS (Netherlands)

    Kerkstra, A.; Hutten, J.B.F.

    1996-01-01

    The aim of this study was to provide an overview of the organization and financing of home nursing in the 15 member states in the European Union. Home nursing was defined as the nursing care provided at the patients' home by professional home nursing organizations. Data were gathered by means of thr

  1. Organization and financing of home nursing in the European Union.

    NARCIS (Netherlands)

    Kerkstra, A.; Hutten, J.B.F.

    1996-01-01

    The aim of this study was to provide an overview of the organization and financing of home nursing in the 15 member states in the European Union. Home nursing was defined as the nursing care provided at the patients' home by professional home nursing organizations. Data were gathered by means of

  2. Long-Term Effects of a Nursing Home Education Project

    Science.gov (United States)

    Patterson, Robert D.; Gurian, Bennett S.

    1976-01-01

    A survey was conducted by a mental health center to evaluate the effects of a nursing home education project which attempted 1) to teach mental health professionals and nursing home staff how to set up in-service education programs in nursing homes, and 2) to teach nursing home staff mental health principles. (Author/EJT)

  3. Organization and financing of home nursing in the European Union.

    NARCIS (Netherlands)

    Kerkstra, A.; Hutten, J.B.F.

    1996-01-01

    The aim of this study was to provide an overview of the organization and financing of home nursing in the 15 member states in the European Union. Home nursing was defined as the nursing care provided at the patients' home by professional home nursing organizations. Data were gathered by means of thr

  4. Patient safety culture in Norwegian nursing homes.

    Science.gov (United States)

    Bondevik, Gunnar Tschudi; Hofoss, Dag; Husebø, Bettina Sandgathe; Deilkås, Ellen Catharina Tveter

    2017-06-20

    Patient safety culture concerns leader and staff interaction, attitudes, routines, awareness and practices that impinge on the risk of patient-adverse events. Due to their complex multiple diseases, nursing home patients are at particularly high risk of adverse events. Studies have found an association between patient safety culture and the risk of adverse events. This study aimed to investigate safety attitudes among healthcare providers in Norwegian nursing homes, using the Safety Attitudes Questionnaire - Ambulatory Version (SAQ-AV). We studied whether variations in safety attitudes were related to professional background, age, work experience and mother tongue. In February 2016, 463 healthcare providers working in five nursing homes in Tønsberg, Norway, were invited to answer the SAQ-AV, translated and adapted to the Norwegian nursing home setting. Previous validation of the Norwegian SAQ-AV for nursing homes identified five patient safety factors: teamwork climate, safety climate, job satisfaction, working conditions and stress recognition. SPSS v.22 was used for statistical analysis, which included estimations of mean values, standard deviations and multiple linear regressions. P-values homes. In multiple linear regression analysis, we found that increasing age and job position among the healthcare providers were associated with significantly increased mean scores for the patient safety factors teamwork climate, safety climate, job satisfaction and working conditions. Not being a Norwegian native speaker was associated with a significantly higher mean score for job satisfaction and a significantly lower mean score for stress recognition. Neither professional background nor work experience were significantly associated with mean scores for any patient safety factor. Patient safety factor scores in nursing homes were poorer than previously found in Norwegian general practices, but similar to findings in out-of-hours primary care clinics. Patient safety culture

  5. Nursing home staffing, turnover, and case mix.

    Science.gov (United States)

    Harrington, Charlene; Swan, James H

    2003-09-01

    This study examined the predictors of total nurse and registered nurse (RN) staffing hours per resident day separately in all free-standing California nursing homes (1,555), using staffing data from state cost reports in 1999. This study used a two-stage least squares model, taking into account nursing turnover rates, resident case mix levels, and other factors. As expected, total nurse and RN staffing hours were negatively associated with nurse staff turnover rates and positively associated with resident case mix. Facilities were resource dependent in that a high proportion of Medicare residents predicted higher staffing hours, and a higher proportion of Medicaid residents predicted lower staffing hours and higher turnover rates. Nursing assistant wages were positively associated with total nurse staffing hours. For-profit facilities and high-occupancy rate facilities had lower total nurse and RN staffing hours. Medicaid reimbursement rates and multifacility organizations were positively associated with RN staffing hours.

  6. Eldercare at Home: Choosing a Nursing Home

    Science.gov (United States)

    ... Does the resident and/or his or her family participate in developing the resident's care plan? Are there capable nursing staff members always available to assess a resident's changing health status and to act efficiently in an emergency ...

  7. Nursing Practice Environment and Registered Nurses' Job Satisfaction in Nursing Homes

    Science.gov (United States)

    Choi, JiSun; Flynn, Linda; Aiken, Linda H.

    2012-01-01

    Purpose: Recruiting and retaining registered nurses (RNs) in nursing homes is problematic, and little research is available to guide efforts to make nursing homes a more attractive practice environment for RNs. The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs…

  8. Clinical update on nursing home medicine: 2013.

    Science.gov (United States)

    Messinger-Rapport, Barbara J; Gammack, Julie K; Thomas, David R; Morley, John E

    2013-12-01

    This is the seventh article in the series of Clinical Updates on Nursing Home Care. The topics covered are antiresorptive drugs, hip fracture, hypertension, orthostatic hypotension, depression, undernutrition, anorexia, cachexia, sarcopenia, exercise, pain, and behavioral and psychological symptoms of dementia.

  9. Home Care Nursing Improves Cancer Symptom Management

    Science.gov (United States)

    Home care nursing (HCN) improves the management of symptoms in breast and colorectal cancer patients who take the oral chemotherapy drug capecitabine, according to a study published online November 16 in the Journal of Clinical Oncology.

  10. Dental caries in Victorian nursing homes.

    Science.gov (United States)

    Silva, M; Hopcraft, M; Morgan, M

    2014-09-01

    The poor oral health of nursing home residents is the cause of substantial morbidity and has major implications relating to health care policy. The aim of this study was to measure dental caries experience in Australians living in nursing homes, and investigate associations with resident characteristics. Clinical dental examinations were conducted on 243 residents from 19 nursing homes in Melbourne. Resident characteristics were obtained from nursing home records and interviews with residents, family and nursing home staff. Two dental examiners assessed coronal and root dental caries using standard ICDAS-II criteria. Residents were elderly, medically compromised and functionally impaired. Most required assistance with oral hygiene and professional dental care was rarely utilized. Residents had high rates of coronal and root caries, with a mean 2.8 teeth with untreated coronal caries and 5.0 root surfaces with untreated root caries. Functional impairment and irregular professional dental care were associated with higher rates of untreated tooth decay. There were no significant associations with medical conditions or the number of medications taken. Nursing home residents have high levels of untreated coronal and root caries, particularly those with high needs due to functional impairment but poor access to professional services. © 2014 Australian Dental Association.

  11. [Home nursing care for depressed elderly people].

    Science.gov (United States)

    Floch, Catherine

    2011-01-01

    The freelance nurse must be adaptable and reactive in order to meet the needs of a depressed or suicidal elderly person. In addition to her own particular relationship with the patient, the nurse must activate a network of other professionals who can carry out home visits.

  12. Hypertension in the nursing home.

    Science.gov (United States)

    Aronow, Wilbert S

    2008-09-01

    Hypertension in a nursing home patient is a systolic blood pressure of 140 mm Hg or higher and 130 mm Hg or higher in a patient with diabetes mellitus or chronic renal insufficiency, or a diastolic blood pressure of 90 mm Hg or higher and 80 mm Hg or higher in a patient with diabetes mellitus or chronic renal insufficiency. Numerous prospective, double-blind, randomized, placebo-controlled studies have demonstrated that antihypertensive drug therapy reduces the development of new coronary events, stroke, and congestive heart failure in older persons. The goal of treatment of hypertension in elderly persons is to lower the blood pressure to less than 140/90 mm Hg and to less than 130/80 mm Hg in older persons with diabetes mellitus or chronic renal insufficiency. Elderly persons with diastolic hypertension should have their diastolic blood pressure reduced to 80 to 85 mm Hg. Diuretics should be used as initial drugs in the treatment of older persons with hypertension and no associated medical conditions. The selection of antihypertensive drug therapy in persons with associated medical conditions depends on their associated medical conditions. If the blood pressure is more than 20/10 mm Hg above the goal blood pressure, drug therapy should be initiated with 2 antihypertensive drugs, one of which should be a thiazide-type diuretic. Other coronary risk factors must be treated in patients with hypertension.

  13. Nursing assistant beliefs about their roles and nursing home residents: implications for nursing home social work practice.

    Science.gov (United States)

    Chung, Gawon

    2010-01-01

    The purpose of this study is to examine beliefs and assumptions held by nursing assistants working in nursing homes using a qualitative approach. Unchallenged notions about residents and the roles held by nursing assistants influence their way of interacting with residents, which inevitably influences quality of care in nursing homes. When nursing assistants have an opportunity to be heard and mentored by social workers, they can address and resolve the dilemma of providing informal care as a formal caregiver by discussing what is acceptable and appropriate in nursing home care.

  14. Nursing home spending, staffing, and turnover.

    Science.gov (United States)

    Kash, Bita A; Castle, Nicholas G; Phillips, Charles D

    2007-01-01

    Recent work on nursing home staffing and turnover has stressed the importance of ownership and resources. However, few studies have examined spending behaviors, which might also influence staffing levels and staff turnover rates. This study investigates whether spending behaviors measured by financial ratios are associated with staffing levels and staff turnover in nursing homes. We analyzed cross-sectional data from 1,014 Texas homes. Data were from the 2002 Texas Nursing Facility Medicaid Cost Report and the 2003 Area Resource File. First, we examined differences in financial ratios by ownership type. Next, the effect of 10 financial ratios on staffing levels and turnover rates for registered nurses, licensed vocational nurses, and certified nursing assistants was examined using robust regression models. Descriptive data indicated that expense ratios related to resident care activities and staff development were significantly higher among not-for-profit than for-profit homes. Higher profits were associated with lower staffing levels, but not higher turnover rates. Administrative expenses (a measure of management capacity) had a negative impact both on staffing levels and staff turnover for licensed vocational nurses and certified nursing assistants, but they did not affect registered nurse staffing. Employee benefit expenses exhibited a positive impact on registered nurse and licensed vocational nurse staffing levels. The addition of information on financial ratios to models predicting staffing indicators reduced the effect of ownership on these indicators. Solutions to the staffing and turnover problem should focus on more effective management practices. Certain levels of administrative and staff benefit expenses may be necessary to improve professional staff recruitment and reduce both staffing and turnover costs. Differences in these financial ratios may partially explain the role played by ownership in determining staffing levels and turnover.

  15. Nurse managers' perspectives of structural and process characteristics related to residents' advance directives in nursing homes.

    Science.gov (United States)

    Krok, Jessica; Dobbs, Debra; Hyer, Kathryn; Polivka-West, LuMarie

    2011-11-01

    This article examines associations between nursing home structural and process characteristics and presence of advance directives and trends over 5 years of advance directives in Florida nursing homes. Our results underscore the importance of nursing homes' processes in facilitating discussions of nursing home residents' end-of-life care preferences. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Nursing assistant turnover in nursing homes and need satisfaction.

    Science.gov (United States)

    Caudill, M; Patrick, M

    1989-06-01

    1. Level of Maslow's Hierarchy of Needs is basic physiological needs measured by salary, adequate housing, and food. Attainment of these needs increased the length of stay of nursing assistants in nursing homes. 2. Safety and security (level 2) influenced length of stay of nursing assistants. Those with benefits of retirement, vacation, and holiday pay tended to have less turnover. 3. Praise by the patient and family was most important to nursing assistants. Belonging to a peer group and praise by charge nurse also decreased turnover of nursing assistants (level 3). 4. Level 4, self-esteem measured by input into decisions and being able to criticize, increased length of stay of nursing assistants.

  17. Physicians' experiences with demented patients with advance euthanasia directives in the Netherlands.

    Science.gov (United States)

    Rurup, Mette L; Onwuteaka-Philipsen, Bregje D; van der Heide, Agnes; van der Wal, Gerrit; van der Maas, Paul J

    2005-07-01

    To estimate the incidence of (compliance with) advance euthanasia directives of patients suffering from dementia in the Netherlands and to gain knowledge about the experiences of physicians. Retrospective interview study. Physicians in the Netherlands. Four hundred ten physicians. Physicians were interviewed about their demented patients who had an advance euthanasia directive. Nursing home physicians were interviewed more extensively. Approximately 2,200 demented patients with an advance euthanasia directive die annually after being treated by a physician who knows about this directive. In 76% of such cases, compliance with the directive was discussed, but euthanasia was seldom performed. In two-thirds of the cases of demented nursing home patients with an advance euthanasia directive, the physician was able to identify during the course of the disease a situation for which the patient had intended the directive. One-quarter of the nursing home physicians thought that their most recent patient suffered unbearably to a (very) high degree, and half of them thought that the patient suffered hopelessly to a (very) high degree. In three-quarters of the cases, the relatives did not want the nursing home physician to comply with the directive, but they did want to respect the patient's wishes by forgoing life-prolonging treatment, which occurred in approximately 90% of cases. Most nursing home physicians think that the suffering of patients with dementia can be unbearable and hopeless as a consequence of dementia, but most physicians do not consider dementia to be grounds for euthanasia, unless perhaps the patient has an additional illness.

  18. Hospice in the Nursing Home: Perspectives of Front Line Nursing Home Staff

    Science.gov (United States)

    Unroe, Kathleen T.; Cagle, John G.; Dennis, M. E.; Lane, Kathleen A.; Callahan, Christopher M.; Miller, Susan

    2014-01-01

    Objective Use of hospice has been associated with improved outcomes for nursing home residents and attitudes of nursing home staff towards hospice influences hospice referral. The objective of this study is to describe attitudes of certified nursing assistants (CNAs), nurses, and social workers towards hospice care in nursing homes. Design, Setting and Participants We conducted a survey of 1,859 staff from 52 Indiana nursing homes. Measurements Study data include responses to 6 scaled questions and 3 open-ended qualitative prompts. In addition, respondents who cared for a resident on hospice in the nursing home were asked how often hospice: 1) makes their job easier; 2) is responsive when a patient has symptoms or is actively dying; 3) makes care coordination smooth; 4) is needed; 5) taught them something; 6) is appreciated by patients/families. Responses were dichotomized as always/often or sometimes/never. Results 1229 surveys met criteria for inclusion. Of respondents, 48% were CNAs, 49% were nurses, and 3% were social workers; 83% reported caring for a nursing home patient on hospice. The statement with the highest proportion of always/often rating was ‘patient/family appreciate added care’ (84%); the lowest was ‘hospice makes my job easier’ (54%). More social workers responded favorably regarding hospice responsiveness and coordination of care compared with CNAs (p=.03 and p=.05 respectively). Conclusion A majority of staff responded favorably regarding hospice care in nursing homes. About 1/3 of nursing home staff rated coordination of care lower than other aspects, and many qualitative comments highlighted examples of when hospice was not responsive to patient needs, representing important opportunities for improvement. PMID:25239013

  19. Losing Items in the Psychogeriatric Nursing Home

    Directory of Open Access Journals (Sweden)

    J. van Hoof PhD

    2016-09-01

    Full Text Available Introduction: Losing items is a time-consuming occurrence in nursing homes that is ill described. An explorative study was conducted to investigate which items got lost by nursing home residents, and how this affects the residents and family caregivers. Method: Semi-structured interviews and card sorting tasks were conducted with 12 residents with early-stage dementia and 12 family caregivers. Thematic analysis was applied to the outcomes of the sessions. Results: The participants stated that numerous personal items and assistive devices get lost in the nursing home environment, which had various emotional, practical, and financial implications. Significant amounts of time are spent on trying to find items, varying from 1 hr up to a couple of weeks. Numerous potential solutions were identified by the interviewees. Discussion: Losing items often goes together with limitations to the participation of residents. Many family caregivers are reluctant to replace lost items, as these items may get lost again.

  20. From Nursing Home to Hospital and Return

    DEFF Research Database (Denmark)

    Nygaard, Hanne

    ½ month the structured interview guide was used to interview 17 nursing home residences when acute admitted to Acute Medical Unit (AMU) at Bispebjerg Hospital and again after discharge. Systematic meaning categorisation was used to analyse the structured interviews. Result: The experience of security...... and confidence is highly prioritised by the elderly. In periods of good health they generally experience high level of security and confidence at the nursing home. However, in periods with acute illness or exacerbation of their chronic disease the elderly finds confidence in being hospitalised and near......Background: In Denmark, approximate 4% of the population nursing homes. Many suffer from several chronic medical conditions including dementia. Hence, their well-being and health depends on the help and care they receive. On average they have two acute hospital admissions...

  1. Sampling Challenges in Nursing Home Research

    Science.gov (United States)

    Tilden, Virginia P.; Thompson, Sarah A.; Gajewski, Byron J.; Buescher, Colleen M.; Bott, Marjorie J.

    2012-01-01

    Background Research on end-of-life care in nursing homes is hampered by challenges in retaining facilities in samples through study completion. Large-scale longitudinal studies in which data are collected on-site can be particularly challenging. Objectives To compare characteristics of nursing homes that dropped from study to those that completed the study. Methods 102 nursing homes in a large geographic 2-state area were enrolled in a prospective study of end-of-life care of residents who died in the facility. The focus of the study was the relationship of staff communication, teamwork, and palliative/end-of-life care practices to symptom distress and other care outcomes as perceived by family members. Data were collected from public data bases of nursing homes, clinical staff on site at each facility at two points in time, and from decedents’ family members in a telephone interview. Results 17 of the 102 nursing homes dropped from the study before completion. These non-completer facilities had significantly more deficiencies and a higher rate of turnover of key personnel compared to completer facilities. A few facilities with a profile typical of non-completers actually did complete the study after an extraordinary investment of retention effort by the research team. Discussion Nursing homes with a high rate of deficiencies and turnover have much to contribute to the goal of improving end-of-life care, and their loss to study is a significant sampling challenge. Investigators should be prepared to invest extra resources to maximize retention. PMID:23041332

  2. [Nursing care at home and secularism].

    Science.gov (United States)

    Lecointre, Brigitte

    2015-12-01

    The question of secularism, long-time confined to schools and the relationships between the Church and State, is today being raised in the field of public health. Nurses are directly affected and are integrating this dimension of secularism into their care practices. A private practice nurse describes the effect these changes are having on her practice in patients' homes. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  3. Nursing home care quality: a cluster analysis.

    Science.gov (United States)

    Grøndahl, Vigdis Abrahamsen; Fagerli, Liv Berit

    2017-02-13

    Purpose The purpose of this paper is to explore potential differences in how nursing home residents rate care quality and to explore cluster characteristics. Design/methodology/approach A cross-sectional design was used, with one questionnaire including questions from quality from patients' perspective and Big Five personality traits, together with questions related to socio-demographic aspects and health condition. Residents ( n=103) from four Norwegian nursing homes participated (74.1 per cent response rate). Hierarchical cluster analysis identified clusters with respect to care quality perceptions. χ(2) tests and one-way between-groups ANOVA were performed to characterise the clusters ( pclusters were identified; Cluster 1 residents (28.2 per cent) had the best care quality perceptions and Cluster 2 (67.0 per cent) had the worst perceptions. The clusters were statistically significant and characterised by personal-related conditions: gender, psychological well-being, preferences, admission, satisfaction with staying in the nursing home, emotional stability and agreeableness, and by external objective care conditions: healthcare personnel and registered nurses. Research limitations/implications Residents assessed as having no cognitive impairments were included, thus excluding the largest group. By choosing questionnaire design and structured interviews, the number able to participate may increase. Practical implications Findings may provide healthcare personnel and managers with increased knowledge on which to develop strategies to improve specific care quality perceptions. Originality/value Cluster analysis can be an effective tool for differentiating between nursing homes residents' care quality perceptions.

  4. Nursing home diversification requires caution by hospitals.

    Science.gov (United States)

    Monroe, S M

    1988-12-01

    Hospital executives considering diversifying into long-term care for the elderly need to understand the ways the nursing home acquisition market and the long-term care industry have changed in the past two years and how to best respond to those changes. Diversification into the nursing home business must be carefully planned, taking into account such factors as state Medicaid reimbursement policies; the respective advantages of buying an existing facility or constructing a new one; the need for executives with expertise in long-term care; and the financial requirements of the proposal.

  5. Common Viruses a Deadly Threat At Nursing Homes

    Science.gov (United States)

    ... 163048.html Common Viruses a Deadly Threat at Nursing Homes RSV and human metapneumovirus need to be ... News) -- Common viruses pose a serious threat in nursing homes, often sabotaging standard infection control measures, a ...

  6. Baccalaureate-educated Registered Nurses in nursing homes: Experiences and opinions of administrators and nursing staff.

    Science.gov (United States)

    Backhaus, Ramona; Verbeek, Hilde; van Rossum, Erik; Capezuti, Elizabeth; Hamers, Jan P H

    2017-07-12

    To understand how nursing homes employ baccalaureate-educated Registered Nurses (BRNs) and how they view the unique contributions of baccalaureate-educated Registered Nurses to staff and residents in their organizations. Although providing care for nursing home residents is complex and thus requires a high level of skills, organizations often struggle to recruit and retain BRNs. Some nursing home organizations do not employ baccalaureate-educated Registered Nurses at all. Among those that do, it is unknown how well these organizations make use of baccalaureate-educated Registered Nurses' expertise or if their roles are different from those of other staff. A qualitative study, consisting of 26 individual and three group interviews was conducted in the Netherlands. Interviews were conducted at the board-, management- and staff-level in six nursing home organizations. Data were collected between January 2016-May 2016. Organizations employed baccalaureate-educated Registered Nurses to fulfil an informal leadership role for direct care teams. Organizations that do not employ baccalaureate-educated Registered Nurses were unable to articulate their role in the nursing home setting. Difficulties baccalaureate-educated Registered Nurses experienced during role implementation depended on role clarity, the term used to refer to the baccalaureate-educated Registered Nurse, the extent to which nurses received support, openness from direct care teams and baccalaureate-educated Registered Nurses' own behaviour. The unique contribution of baccalaureate-educated Registered Nurses perceived by respondents differed between and in organizations. Our findings suggest that there is no "one size fits all" approach to employing baccalaureate-educated Registered Nurses in nursing homes. To ensure the satisfaction of both baccalaureate-educated Registered Nurses and the organizations that employ them, careful implementation and evaluation of their role is crucial. © 2017 John Wiley & Sons

  7. Subsidies, Quality, and Regulation in the Nursing Home Industry

    OpenAIRE

    Gertler, Paul J

    1985-01-01

    This paper analyzes the impact of the Medicaid patient subsidy and Certificate of Need (CON) cost containment programs on nursing home behavior.The analysis is complicated by the fact the both proprietary and "not for profit" nursing homes exist, and by the problem that qualityis not directly observed. Medicaid pays the for the care of the financially indigent by directly reimbursing nursing homes at a predetermined rate. As a result, nursing homes can price discriminate between patients who ...

  8. Mental Illness In Nursing Homes: Variations Across States

    OpenAIRE

    Grabowski, David C.; Aschbrenner, Kelly A.; Feng, Zhanlian; Mor, Vincent

    2009-01-01

    The institutionalization of individuals with mental illness in nursing homes is an important policy concern. Using nursing home Minimum Data Set assessments from 2005, we found large cross-state variation in both the rates of mental illness among nursing home admissions and the estimated rates of nursing home admissions among persons with mental illness. We also found that newly admitted individuals with mental illness were younger and more likely to become long-stay residents. Taken together...

  9. Certified Nursing Assistants’ Explanatory Models of Nursing Home Resident Depression

    OpenAIRE

    Piven, Mary Lynn; Anderson, Ruth A.; Colón-Emeric, Cathleen S.; Sandelowski, Margarete

    2008-01-01

    In this study, we explored how Certified Nursing Assistants (CNAs) understood resident depression. Interviews with 18 CNAs, working in two nursing homes were guided by Kleinman’s Explanatory Models of Illness framework. Interview data were content analyzed and CNAs’ descriptions of depression were compared to the MDS 2.0 Mood Screen and to DSM-IV-TR Depression Criteria. CNAs identified causes, signs, and symptoms of depression, but they were unsure about the duration and normalcy of depressio...

  10. 38 CFR 59.140 - Nursing home care requirements.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Nursing home care... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.140 Nursing home care... equipped for adequate nursing care, comfort, and privacy of residents. Resident rooms must: (1)...

  11. Quality management systems and clinical outcomes in Dutch nursing homes.

    NARCIS (Netherlands)

    Wagner, C.; Klein Ikkink, K.; Wal, G. van der; Spreeuwenberg, P.; Bakker, D.H. de; Groenewegen, P.P.

    2006-01-01

    The objective of the article is to explore the impact quality management systems and quality assurance activities in nursing homes have on clinical outcomes. The results are based on a cross-sectional study in 65 Dutch nursing homes. The management of the nursing homes as well as the residents (N =

  12. Quality management systems and clinical outcomes in Dutch nursing homes

    NARCIS (Netherlands)

    Wagner, Cordula; Klein Ikkink, Karen; Wal, Gerrit van der; Spreeuwenberg, Peter; Bakker, Dinny Herman de; Groenewegen, Peter Paulus

    2006-01-01

    The objective of the article is to explore the impact quality management systems and quality assurance activities in nursing homes have on clinical outcomes. The results are based on a cross-sectional study in 65 Dutch nursing homes. The management of the nursing homes as well as the residents (N= 1

  13. Increase in drug use after admission to Dutch nursing homes.

    NARCIS (Netherlands)

    Koopmans, R.T.C.M.; Borgh, J.P. van der; Bor, J.H.J.; Hekster, Y.A.

    2003-01-01

    OBJECTIVE: To study changes in drug use after admission to Dutch nursing homes. SETTING: Six nursing homes near the city of Nijmegen, The Netherlands. DESIGN: Prospective longitudinal study. METHODS: All patients who had been newly admitted to the nursing home were included in the study. Age,

  14. Mountbellew Nursing Home, Mountbellew, Galway.

    LENUS (Irish Health Repository)

    Coffey, Alice

    2016-01-28

    Nurses\\' knowledge regarding advance directives may affect their administration and completion in end-of-life care. Confidence among nurses is a barrier to the provision of quality end-of-life care. This study investigated nurses\\' knowledge of advance directives and perceived confidence in end-of-life care, in Hong Kong, Ireland, Israel, Italy and the USA using a cross-sectional descriptive design (n = 1089). In all countries, older nurses and those who had more professional experience felt more confident managing patients\\' symptoms at end-of-life and more comfortable stopping preventive medications at end-of-life. Nurses in the USA reported that they have more knowledge and experience of advance directives compared with other countries. In addition, they reported the highest levels of confidence and comfort in dealing with end-of-life care. Although legislation for advance directives does not yet exist in Ireland, nurses reported high levels of confidence in end-of-life care.

  15. Clinical update on nursing home medicine: 2012.

    Science.gov (United States)

    Messinger-Rapport, Barbara J; Cruz-Oliver, Dulce M; Thomas, David R; Morley, John E

    2012-09-01

    This article is the sixth in the series of clinical updates on nursing home care. The topics covered are management of hypertension, antidepressant medications in people with dementia, peripheral arterial disease, probiotics in prevention, and treatment of Clostridium difficile-associated diarrhea, frailty, and falls.

  16. Older persons in nursing and care homes

    NARCIS (Netherlands)

    Debbie Verbeek-Oudijk; Cretien van Campen

    2017-01-01

    Original title: Ouderen in verpleeghuizen en verzorgingshuizen For centuries, there have been institutions where the most vulnerable and oldest members of society could go for shelter, food and care. In modern Dutch society, these institutions take the form of nursing and residential care homes.

  17. Nursing home employee attitudes towards AIDS.

    Science.gov (United States)

    Sarvela, P D; Moore, J R

    1989-01-01

    This article examines nursing home employee attitudes toward issues related to AIDS and is based on data collected from 343 employees from 13 nursing homes in rural, small towns in sourthern Illinois during the spring of 1988. Results suggested that a large majority of the employees had negative attitudes toward people with AIDS. For example, 67% of the sample indicated that it was more important to limit the spread of AIDS rather than to protect the rights of people with AIDS. Furthermore, 42% suggested that AIDS patients should be sent to sanitariums to protect others from AIDS. Greater than half of the sample (56%) responded that they would feel uncomfortable around people with AIDS. About one third (32%) felt that being around someone with AIDS would put their health in danger, and 21% would be afraid to even take care of a family member with AIDS. With regard to job-specific AIDS attitudes, 51% indicated that health-care workers should be able to refuse to work with AIDS patients, and another 46% felt that hospitals and nursing homes should be able to refuse to admit people with AIDS. In addition to these and other results, this article presents a brief discussion concerning possible educational strategies which might be implemented in this setting to reduce the negative attitudes of these employees. Considerations are also presented for nursing home administrators, who face the problem of developing effective policies for dealing with the rising number of AIDS patients who will be admitted to their facilities.

  18. Malnutrition and mealtime ambiance in nursing homes

    NARCIS (Netherlands)

    Nijs, K.A.N.D.; Graaf, de C.; Staveren, van W.A.; Groot, de C.P.G.M.

    2009-01-01

    Inadequate nutritional intake is the predominant cause of malnutrition in older persons. It is one of the most common and devastating conditions in nursing home residents. It is multifactorial and treatment or nutrition care plans should try to address the main causes. Such plans often include means

  19. Pressure sore prevention in nursing homes.

    Science.gov (United States)

    Clay, M

    Staff working in nursing homes are caring for increasingly dependent residents who are consequently at great risk of developing pressure sores. Mary Clay offers a guide to the essential principles of pressure sore prevention as a teaching aid for all caring staff.

  20. Visual functioning in nursing home residents

    NARCIS (Netherlands)

    Sinoo, Marianne; Kort, Helianthe; Duijnstee, Mia

    2012-01-01

    Older adults experience visual problems owing to biological ageing or eye disease. In the Netherlands, the prevalence of visual impairments is the highest in the subgroup of nursing home residents (41.3%). These impairments influence quality of life in terms of limiting daily activities and particip

  1. Measuring Staff Turnover in Nursing Homes

    Science.gov (United States)

    Castle, Nicholas G.

    2006-01-01

    Purpose: In this study the levels of staff turnover reported in the nursing home literature (1990-2003) are reviewed, as well as the definitions of turnover used in these prior studies. With the use of primary data collected from 354 facilities, the study addresses the various degrees of bias that result, depending on how staff turnover is defined…

  2. Registered Nurse Staffing Mix and Quality of Care in Nursing Homes: A Longitudinal Analysis

    Science.gov (United States)

    Kim, Hongsoo; Harrington, Charlene; Greene, William H.

    2009-01-01

    Purpose: To examine the relationship between registered nurse (RN) staffing mix and quality of nursing home care measured by regulatory violations. Design and Methods: A retrospective panel data study (1999-2003) of 2 groups of California freestanding nursing homes. One group was 201 nursing homes that consistently met the state's minimum standard…

  3. Is There Evidence of Cream Skimming among Nursing Homes following the Publication of the Nursing Home Compare Report Card?

    Science.gov (United States)

    Mukamel, Dana B.; Ladd, Heather; Weimer, David L.; Spector, William D.; Zinn, Jacqueline S.

    2009-01-01

    Purpose: A national quality report card for nursing homes, Nursing Home Compare, has been published since 2002. It has been shown to have some, albeit limited, positive impact on quality of care. The objective of this study was to test empirically the hypothesis that nursing homes have responded to the publication of the report by adopting cream…

  4. Nursing home disaster planning and response: a policy perspective.

    Science.gov (United States)

    Zork, Freya

    2014-12-01

    Nursing home residents are among the most vulnerable members of a community threatened by disaster. In the past, insufficient planning has resulted in preventable morbidity and mortality for nursing home residents during disasters. State and federal policies have evolved over the past decade to improve oversight of nursing home disaster planning. However, continued political advocacy is critically necessary to promote the safety of nursing home residents during potential emergencies and, especially, naturally occurring disasters. Opportunities exist to improve nursing home disaster response, including better preparation and training and dedicated resources for data management and oversight. Copyright 2014, SLACK Incorporated.

  5. [Prevalence of depression and dementia among nursing home residents].

    Science.gov (United States)

    Lolk, Annette; Andersen, Kjeld

    2015-03-16

    The population of older adults will increase in the coming years and the number of elderly in nursing homes is expected to rise considerably. The most frequent psychiatric diseases among nursing home residents are depression and dementia. We examined the prevalence of depression and dementia in nursing home populations reported in literature reviews. The included studies were published from 1986 to 2014. At least one out of ten persons living in a nursing home seems to have depression and more have depressive symptoms. Three out of four residents in nursing homes suffer from dementia.

  6. Scope of a nursing diagnostic list for fulfilling basic human needs in home-visit nursing.

    Science.gov (United States)

    Esaki, Fusako; Muranaka, Yoko; Tamaki, Miyoko; Akiba, Kimiko; Aoki, Ryouko

    2006-01-01

    Inscriptions on 291 nursing diagnosis items regarding 100 home convalescents were subjected to analysis. The 291-item nursing diagnosis was found to be consistent with a previously reported nursing diagnosis developed by the authors from Henderson's 14 items covering basic nursing practice. Additionally, the analysis indicated a need for nursing diagnosis items for family members, as caregivers for the patients recuperating at home.

  7. Loneliness and nursing home admission among rural older adults.

    Science.gov (United States)

    Russell, D W; Cutrona, C E; de la Mora, A; Wallace, R B

    1997-12-01

    In this study, the authors tested the relation between loneliness and subsequent admission to a nursing home over a 4-year time period in a sample of approximately 3,000 rural older Iowans. Higher levels of loneliness were found to increase the likelihood of nursing home admission and to decrease the time until nursing home admission. The influence of extremely high loneliness on nursing home admission remained statistically significant after controlling for other variables, such as age, education, income, mental status, physical health, morale, and social contact, that were also predictive of nursing home admission. Several mechanisms are proposed to explain the link between extreme loneliness and nursing home admission. These include loneliness as a precipitant of declines in mental and physical health and nursing home placement as a strategy to gain social contact with others. Implications for preventative interventions are discussed.

  8. Private investment purchase and nursing home financial health.

    Science.gov (United States)

    Orfaly Cadigan, Rebecca; Stevenson, David G; Caudry, Daryl J; Grabowski, David C

    2015-02-01

    To explore the impact of nursing home acquisition by private investment firms on nursing home costs, revenue, and overall financial health. Merged data from the Medicare Cost Reports and the Online Survey, Certification, and Reporting system for the period 1998-2010. Regression specification incorporating facility and time fixed effects. We found little impact on the financial health of nursing homes following purchase by private investment companies. However, our findings did suggest that private investment firms acquired nursing home chains in good financial health, possibly to derive profit from the company's real estate holdings. Private investment acquired facilities are an important feature of today's nursing home sector. Although we did not observe a negative impact on the financial health of nursing homes, this development raises important issues about ownership oversight and transparency for the entire nursing home sector. © Health Research and Educational Trust.

  9. Pressure ulcers: knowledge and attitude of nurses and nursing assistants in Belgian nursing homes.

    NARCIS (Netherlands)

    Demarre, L.; Vanderwee, K.; Defloor, T.; Verhaeghe, S.; Schoonhoven, L.; Beeckman, D.

    2012-01-01

    AIMS: To gain insight into the knowledge and attitudes of nurses and nursing assistants and to study the correlation between knowledge, attitudes and the compliance with the pressure ulcer prevention guidelines provided to residents at risk of pressure ulcers in nursing homes. BACKGROUND: There is a

  10. Pressure ulcers: knowledge and attitude of nurses and nursing assistants in Belgian nursing homes.

    NARCIS (Netherlands)

    Demarre, L.; Vanderwee, K.; Defloor, T.; Verhaeghe, S.; Schoonhoven, L.; Beeckman, D.

    2012-01-01

    AIMS: To gain insight into the knowledge and attitudes of nurses and nursing assistants and to study the correlation between knowledge, attitudes and the compliance with the pressure ulcer prevention guidelines provided to residents at risk of pressure ulcers in nursing homes. BACKGROUND: There is a

  11. Lego serious play as a method to determine the sense of home in the nursing home

    NARCIS (Netherlands)

    MD E.J.M. Wouters; Joost van Hoof

    2016-01-01

    Purpose For most people, nursing homes are a place they reside for the rest of their lives. Therefore, a nursing home, apart from providing good care, has to provide for a sense of home (1). Mostly professionals are responsible for this sense of home. The aim of this study was to explore how

  12. Rates, variability, and associated factors of polypharmacy in nursing home patients

    Science.gov (United States)

    Beloosesky, Yichayaou; Nenaydenko, Olga; Gross Nevo, Revital Feige; Adunsky, Abraham; Weiss, Avraham

    2013-01-01

    Objectives To determine the rate and variability of polypharmacy in nursing home (NH) residents and investigate its relationship to age, sex, functional status, length of stay, and comorbidities. Methods We conducted a cross sectional, multicenter study that included six nursing homes. Demographic, clinical characteristics, Charlson comorbidity index (CCI), the number and classes of chronic medications, rate of polypharmacy >5 drugs (per day) and polypharmacy >7 drugs (per day) were recorded. Results Nine hundred and ninety-three residents were included; 750 (75.5%) fully dependent residents and 243 (24.5%) mobile demented residents requiring institutional care. The mean age was 85.04±7.55 (65–108) years. The mean rates of polypharmacy >5 drugs and polypharmacy >7 drugs were 42.6% and 18.6%, respectively. Differences in polypharmacy >5 drugs and polypharmacy >7 drugs were observed in NHs 24.7%–56% and 4.9%–30.4%, respectively (Ppolypharmacy were found between sex and fully dependent versus mobile demented residents. The most common medications taken were for gastrointestinal, neurological, and cardiovascular disorders. Regression analysis revealed four independent variables for polypharmacy >5 drugs: groups aged 75–84 and >85 relative to 65–74, odds ratio (OR) 0.46 (95% confidence interval [CI] 0.27–0.78) P=0.004, OR 0.35 (95% confidence interval 0.19–0.53), respectively, P2 years, OR 0.51 (95% CI 0.36–0.73) Ppolypharmacy in NHs are high with significant variability. Variability rates of polypharmacy, distinct residents’ characteristics, and excessive use of certain drug groups may indicate that a decrease in medication is potentially feasible. PMID:24348028

  13. The economies of scale for nursing home care.

    Science.gov (United States)

    Chen, Li-Wu; Shea, Dennis G

    2004-03-01

    Using a modified hybrid short-term operating cost function and a national sample of nursing homes in 1994, the authors examined the scale economies of nursing home care. The results show that scale economies exist for Medicare postacute care, with an elasticity of -0.15 and an optimal scale of around 4,000 patient days annually. However, more than 68 percent of nursing homes in the analytic sample produced Medicare days at a level below the optimal scale. The financial pressures resulting from the implementation of a prospective payment system for Medicare skilled nursing facilities may further reduce the quantity of Medicare days served by nursing homes. In addition, the results show that chain-owned nursing homes do not have lower short-term operating costs than do independent facilities. This indicates that the rationale behind recent increasing horizontal integration among nursing homes may not be seeking greater cost efficiency but some other consideration.

  14. Maintaining dignity. The perspective of nursing home residents

    DEFF Research Database (Denmark)

    Høy, Bente

    2014-01-01

    Purpose. The overall purpose of this cross-country Nordic study was to gain further knowledge about dignity in nursing homes and the circumstances which may have an impact on it. The aim of this part of the study is to present the results, exploring nursing home residents’ experiences on how...... dignity is maintained. Background. Elderly living in nursing homes are vulnerable which appeal to nursing care ethics and emphasise the importance of care for human dignity. There have been several attempts to define dignity as a theoretical concept, but few studies on how dignity is maintained from...... the perspective of the nursing home residents. Method. This qualitative study has an explorative design, based on qualitative individual research interviews. Twenty-eight nursing home residents were included from six nursing homes in Scandi-navia. A phenomenological-hermeneutic approach, inspired by Ricoeur...

  15. The 24-h recall instrument for home nursing to measure the activity profile of home nurses: development and psychometric testing.

    Science.gov (United States)

    De Vliegher, Kristel; Aertgeerts, Bert; Declercq, Anja; Gosset, Christiane; Heyden, Isabelle; Van Geert, Michel; Moons, Philip

    2015-01-01

    Home health care today is challenged by a shift from an acute to a chronic health-care model, moving the focus of care from the hospital to home-care setting. This increased focus on care at home emphasizes the need for an efficient, effective, and transparent management of home health care. However, it is not precisely known what home-care nurses do; what kind of care is received by patients; what the performance of home nurses is; and what the impact of the increasing need for home nursing is on the current and future role of home nurses. In this respect, it is necessary to gain a clear insight into the activity profile of home nurses, but there is no gold standard to measure their activities. This study reports on the development and psychometric testing of the '24-hour recall instrument for home nursing' to measure the activity profile of home nurses. Five home nurses in Belgium, simultaneously with the researcher, registered the performed activities in a total of 69 patients, using the 24-h recall instrument for home nursing. The validity and the interrater reliability of this instrument were high: the proportions that observed agreement were very high; the strength of kappa agreement was substantial to almost perfect; the prevalence index showed great variety; and the bias index was low. The findings in this study support the validity evidence based on test content and the interrater reliability of the 24-h recall instrument. This instrument can help to shape practice and policy by making the home nursing profession more transparent: a clear insight into the kind of care that is provided by home nurses and is received by the patients in primary care contributes to the development of a clear definition of the role of home nurses in health care.

  16. The Roles and Functions of Medical Directors in Nursing Homes.

    Science.gov (United States)

    Nanda, Aman

    2015-03-03

    The medical director is an important member of the healthcare team in a nursing home, and is responsible for overall coordination of care and for implementation of policies related to care of the residents in a nursing home. The residents in nursing homes are frail, medically complex, and have multiple disabilities. The medical director has an important leadership role in assisting nursing home administration in providing quality care that is consistent with current standards of care. This article provides an overview of roles and functions of the medical director, and suggests ways the medical director can be instrumental in achieving excellent care in today's nursing facilities.

  17. The influence of nurse wage differentials on nursing home staffing and resident care decisions.

    Science.gov (United States)

    Zinn, J S

    1993-12-01

    This study examines the extent to which nursing homes adjust staffing and care practices relative to local market conditions. Weighted two-stage least squares regression results suggest that facilities employ more nonprofessional nursing staff in markets in which professional nurse wages are higher. RN staffing levels are higher in markets with a higher percentage of self-pay nursing home residents and a lower percentage of for-profit nursing homes. Controlling for resident characteristics, the use of labor-saving practices is higher in markets with higher average nursing home wages, suggesting that there are economic incentives to hire fewer nursing personnel.

  18. Passive solar nursing home for Northern Kentucky

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, J.G.; Ward, J.D.

    1980-01-01

    This project is a 32-bed nursing home designed as an addition to an existing facility. Passive solar strategies included direct gain room windows and clerestories which admit light to phase change salt pouches in the ceilings of patient rooms. Corridors are skykighted; and the heating, ventilating, and conditioning system is comprised of water-source heat pumps and a 5000 gallon storage tank in conjunction with an air to air heat recovery wheel.

  19. Measuring End-of-Life Care Processes in Nursing Homes

    Science.gov (United States)

    Temkin-Greener, Helena; Zheng, Nan; Norton, Sally A.; Quill, Timothy; Ladwig, Susan; Veazie, Peter

    2009-01-01

    Purpose: The objectives of this study were to develop measures of end-of-life (EOL) care processes in nursing homes and to validate the instrument for measuring them. Design and Methods: A survey of directors of nursing was conducted in 608 eligible nursing homes in New York State. Responses were obtained from 313 (51.5% response rate) facilities.…

  20. Measuring End-of-Life Care Processes in Nursing Homes

    Science.gov (United States)

    Temkin-Greener, Helena; Zheng, Nan; Norton, Sally A.; Quill, Timothy; Ladwig, Susan; Veazie, Peter

    2009-01-01

    Purpose: The objectives of this study were to develop measures of end-of-life (EOL) care processes in nursing homes and to validate the instrument for measuring them. Design and Methods: A survey of directors of nursing was conducted in 608 eligible nursing homes in New York State. Responses were obtained from 313 (51.5% response rate) facilities.…

  1. The costs of turnover in nursing homes

    Science.gov (United States)

    Mukamel, Dana B.; Spector, William D.; Limcangco, Rhona; Wang, Ying; Feng, Zhanlian; Mor, Vincent

    2009-01-01

    Background Turnover rates in nursing homes have been persistently high for decades, ranging upwards of 100%. Objectives To estimate the net costs associated with turnover of direct care staff in nursing homes. Data and sample 902 nursing homes in California in 2005. Data included Medicaid cost reports, the Minimum Data Set (MDS), Medicare enrollment files, Census and Area Resource File (ARF). Research Design We estimated total cost functions, which included in addition to exogenous outputs and wages, the facility turnover rate. Instrumental variable (IV) limited information maximum likelihood techniques were used for estimation to deal with the endogeneity of turnover and costs. Results The cost functions exhibited the expected behavior, with initially increasing and then decreasing returns to scale. The ordinary least square estimate did not show a significant association between costs and turnover. The IV estimate of turnover costs was negative and significant (p=0.039). The marginal cost savings associated with a 10 percentage point increase in turnover for an average facility was $167,063 or 2.9% of annual total costs. Conclusion The net savings associated with turnover offer an explanation for the persistence of this phenomenon over the last decades, despite the many policy initiatives to reduce it. Future policy efforts need to recognize the complex relationship between turnover and costs. PMID:19648834

  2. The costs of turnover in nursing homes.

    Science.gov (United States)

    Mukamel, Dana B; Spector, William D; Limcangco, Rhona; Wang, Ying; Feng, Zhanlian; Mor, Vincent

    2009-10-01

    Turnover rates in nursing homes have been persistently high for decades, ranging upwards of 100%. To estimate the net costs associated with turnover of direct care staff in nursing homes. DATA AND SAMPLE: Nine hundred two nursing homes in California in 2005. Data included Medicaid cost reports, the Minimum Data Set, Medicare enrollment files, Census, and Area Resource File. We estimated total cost functions, which included in addition to exogenous outputs and wages, the facility turnover rate. Instrumental variable limited information maximum likelihood techniques were used for estimation to deal with the endogeneity of turnover and costs. The cost functions exhibited the expected behavior, with initially increasing and then decreasing returns to scale. The ordinary least square estimate did not show a significant association between costs and turnover. The instrumental variable estimate of turnover costs was negative and significant (P = 0.039). The marginal cost savings associated with a 10% point increase in turnover for an average facility was $167,063 or 2.9% of annual total costs. The net savings associated with turnover offer an explanation for the persistence of this phenomenon over the last decades, despite the many policy initiatives to reduce it. Future policy efforts need to recognize the complex relationship between turnover and costs.

  3. Family Perceptions of Geriatric Foster Family and Nursing Home Care.

    Science.gov (United States)

    Braun, Kathryn L.; Rose, Charles L.

    1987-01-01

    Relatives (N=62) of matched pairs of patients in geriatric foster homes and nursing homes rated care provided to their relatives. Significantly more foster family patients had positive pre-placement attitudes than did nursing home patients. Upon follow-up, relatives of foster patients reported seeing more patient improvement, satisfaction,…

  4. Comparing Public Quality Ratings for Accredited and Nonaccredited Nursing Homes.

    Science.gov (United States)

    Williams, Scott C; Morton, David J; Braun, Barbara I; Longo, Beth Ann; Baker, David W

    2017-01-01

    Compare quality ratings of accredited and nonaccredited nursing homes using the publicly available Centers for Medicare and Medicaid Services (CMS) Nursing Home Compare data set. This cross-sectional study compared the performance of 711 Joint Commission-accredited (TJC-accredited) nursing homes (81 of which also had Post-Acute Care Certification) to 14,926 non-Joint Commission-accredited (non-TJC-accredited) facilities using the Nursing Home Compare data set (as downloaded on April 2015). Measures included the overall Five-Star Quality Rating and its 4 components (health inspection, quality measures, staffing, and RN staffing), the 18 Nursing Home Compare quality measures (5 short-stay measures, 13 long-stay measures), as well as inspection deficiencies, fines, and payment denials. t tests were used to assess differences in rates for TJC-accredited nursing homes versus non-TJC-accredited nursing homes for quality measures, ratings, and fine amounts. Analysis of variance models were used to determine differences in rates using Joint Commission accreditation status, nursing home size based on number of beds, and ownership type. An additional model with an interaction term using Joint Commission accreditation status and Joint Commission Post-Acute Care Certification status was used to determine differences in rates for Post-Acute Care Certified nursing homes. Binary variables (eg, deficiency type, fines, and payment denials) were evaluated using a logistic regression model with the same covariates. After controlling for the influences of facility size and ownership type, TJC-accredited nursing homes had significantly higher star ratings than non-TJC-accredited nursing homes on each of the star rating component subscales (P homes with Post-Acute Care Certification performed statistically better on the overall star rating, as well as 3 of the 4 subscales (P homes had statistically fewer deficiencies than non-TJC-accredited nursing homes (P homes accredited by The

  5. Priorities for the professional development of registered nurses in nursing homes: a Delphi study.

    Science.gov (United States)

    Cooper, Emily; Spilsbury, Karen; McCaughan, Dorothy; Thompson, Carl; Butterworth, Tony; Hanratty, Barbara

    2017-01-08

    To establish a consensus on the care and professional development needs of registered nurses (RNs) employed by UK care homes. Two-stage, online modified Delphi study. A panel (n = 352) of individuals with experience, expertise or interest in care home nursing: (i) care home nurses and managers; (ii) community healthcare professionals (including general practitioners, geriatricians, specialist and district nurses); and (iii) nurse educators in higher education. RNs employed by nursing homes require particular skills, knowledge, competence and experience to provide high-quality care for older residents. The most important responsibilities for the nursing home nurse were: promoting dignity, personhood and wellbeing, ensuring resident safety and enhancing quality of life. Continuing professional development priorities included personal care, dementia care and managing long-term conditions. The main barrier to professional development was staff shortages. Nursing degree programmes were perceived as inadequately preparing nurses for a nursing home role. Nursing homes could improve by providing supportive learning opportunities for students and fostering challenging and rewarding careers for newly RNs. If nurses employed by nursing homes are not fit for purpose, the consequences for the wider health and social-care system are significant. Nursing homes, the NHS, educational and local authorities need to work together to provide challenging and rewarding career paths for RNs and evaluate them. Without well-trained, motivated staff, a high-quality care sector will remain merely an aspiration.

  6. Hospice Use Among Nursing Home Patients

    Science.gov (United States)

    Unroe, Kathleen Tschantz; Sachs, Greg A.; Hickman, Susan E.; Stump, Timothy E.; Tu, Wanzhu; Callahan, Christopher M.

    2013-01-01

    Objectives Among hospice patients who lived in nursing homes, we sought to: (1) report trends in hospice use over time, (2) describe factors associated with very long hospice stays (>6 months), and (3) describe hospice utilization patterns. Design, setting, and participants We conducted a retrospective study from an urban, Midwest cohort of hospice patients, aged ≥65 years, who lived in nursing homes between 1999 and 2008. Measurements Demographic data, clinical characteristics, and health care utilization were collected from Medicare claims, Medicaid claims, and Minimum Data Set assessments. Patients with overlapping nursing home and hospice stays were identified. χ2 and t tests were used to compare patients with less than or longer than a 6-month hospice stay. Logistic regression was used to model the likelihood of being on hospice longer than 6 months. Results A total of 1452 patients received hospice services while living in nursing homes. The proportion of patients with noncancer primary hospice diagnoses increased over time; the mean length of hospice stay (114 days) remained high throughout the 10-year period. More than 90% of all patients had 3 or more comorbid diagnoses. Nearly 20% of patients had hospice stays longer than 6 months. The hospice patients with stays longer than 6 months were observed to have a smaller percentage of cancer (25% vs 30%) as a primary hospice diagnosis. The two groups did not differ by mean cognitive status scores, number of comorbidities, or activities of daily living impairments. The greater than 6 months group was much more likely to disenroll before death: 33.9% compared with 13.8% (P < .0001). A variety of patterns of utilization of hospice across settings were observed; 21 % of patients spent some of their hospice stay in the community. Conclusions Any policy proposals that impact the hospice benefit in nursing homes should take into account the difficulty in predicting the clinical course of these patients, varying

  7. Organizational relationships between nursing homes and hospitals and quality of care during hospital-nursing home patient transfers.

    Science.gov (United States)

    Boockvar, Kenneth S; Burack, Orah R

    2007-07-01

    To identify organizational factors and hospital and nursing home organizational relationships associated with more-effective processes of care during hospital-nursing home patient transfer. Mailed survey. Medicare- or Medicaid-certified nursing homes in New York State. Nursing home administrators, with input from other nursing home staff. Key predictor variables were travel time between the hospital and the nursing home, affiliation with the same health system, same corporate owner, trainees from the same institution, pharmacy or laboratory agreements, continuous physician care, number of beds in the hospital, teaching status, and frequency of geriatrics specialty care in the hospital. Key dependent variables were hospital-to-nursing home communication, continuous adherence to healthcare goals, and patient and family satisfaction with hospital care. Of 647 questionnaires sent, 229 were returned (35.4%). There was no relationship between hospital-nursing home interorganizational relationships and communication, healthcare goal adherence, and satisfaction measures. Geriatrics specialty care in the hospital (r=0.157; P=.04) and fewer hospital beds (r=-0.194; P=.01) were each associated with nursing homes more often receiving all information needed to care for patients transferred from the hospital. Teaching status (r=0.230; P=.001) and geriatrics specialty care (r=0.185; P=.01) were associated with hospital care more often consistent with healthcare goals established in the nursing home. No management-level organizational relationship between nursing home and hospital was associated with better hospital-to-nursing home transfer process of care. Geriatrics specialty care and characteristics of the hospital were associated with better hospital-to-nursing home transfer processes.

  8. Nursing Students' Clinical Learning Environment in Norwegian Nursing Homes: Lack of Innovative Teaching and Learning Strategies

    OpenAIRE

    Berntsen, Karin; Bjørk, Ida Torunn; Brynildsen, Grethe

    2017-01-01

    Background: Nursing students hesitate to choose aged care as a career, and the aged care sectors are on an edge regarding nursing positions. Clinical learning environments may influence nursing students’ career choices. Few studies have explored learning environments in nursing homes, although students increasingly have placements there. Objectives: The aim was to produce information for developing nursing students’ learning opportunities in nursing homes. Design: A cross-sectional survey des...

  9. Accuracy of nurse aides' functional health assessments of nursing home residents.

    Science.gov (United States)

    Hartig, M T; Engle, V F; Graney, M J

    1997-05-01

    Nurse aides provide assessments of nursing home residents' functional health for use in care planning and quality assurance. Nurse practitioner assessments can serve as a standard for analysis of nurse aides' accuracy. This study compared nurse aide to nurse practitioner assessments of nursing home residents' functional health with regard to possible bias and extent of correlation. Nurse aides' accuracy in assessing nursing home residents' activities of daily living was evaluated by comparisons to assessments performed by a master's-prepared nurse practitioner using four functional assessment instruments: the Barthel Index, the Katz Index of Activities of Daily Living, the Multidimensional Observation Scale for Elderly Subjects, and the Scaled Outcome Criteria. Data were collected in a 159-bed nonprofit nursing home licensed for skilled and intermediate care. Residents had a wide variety of functional and cognitive abilities and disabilities. Ninety-six nursing home residents provided data for the study. Functional health assessments by 24 nurse aides, each assessing 4 different nursing home residents, were compared to those of 1 nurse practitioner. Statistical analysis of accuracy used paired samples t-tests and Pearson product moment correlation coefficients. Nurse aide assessments and nurse practitioner assessments were highly correlated. Most functional health assessments evidenced no significant nurse aide bias. When bias was present it usually resulted from nurse aides electing more optimistic choices when using an assessment instrument that offered fewer response levels for rating residents. Nurse aides can accurately use well-calibrated instruments to assess nursing home residents' functional health. Demonstration of assessment accuracy in nurse aides, who provide the majority of direct care for nursing home residents, documented a valuable clinical resource for planning and evaluating resident care.

  10. Nursing Home Resident Symptomatology Triggering Transfer: Avoiding Unnecessary Hospitalizations

    OpenAIRE

    Ashcraft, Alyce S.; Jane Dimmitt Champion

    2012-01-01

    The purpose of this study was to describe nursing home resident symptomatology and medical diagnoses associated with nursing home to hospital transfers. A retrospective chart review of documented transfers was conducted at a 120-bed, nonprofit urban Continuing Care Retirement Center nursing home facility located in the southwestern United States. The transferred residents (n = 101) had seventy different medical diagnoses prior to hospital transfer with hypertension, coronary artery disease, a...

  11. Organizational Characteristics Associated with Staff Turnover in Nursing Homes

    Science.gov (United States)

    Castle, Nicholas G.; Engberg, John

    2006-01-01

    Purpose: The association between certified nurse aide, licensed practical nurse, and registered nurse turnover and the organizational characteristics of nursing homes are examined. Design and Methods: Hypotheses for eight organizational characteristics are examined (staffing levels, top management turnover, resident case mix, facility quality,…

  12. Licensed Nurse and Nursing Assistant Recognition of Delirium in Nursing Home Residents With Dementia

    Science.gov (United States)

    Steis, Melinda R; Behrens, Liza; Colancecco, Elise M; Mogle, Jacqueline; Mulhall, Paula M; Hill, Nikki L; Fick, Donna M; Kolankowski, Ann M

    2016-01-01

    Many nursing home residents experience delirium. Nursing home personnel, especially nursing assistants, have the opportunity to become familiar with residents’ normal cognitive function and to recognize changes in a resident’s cognitive function over time. The purpose of this study was to determine the accuracy of delirium recognition by licensed nurses and nursing assistants from eight nursing homes over a 12-month period. Participants were asked to complete five case vignette assessments at three different time points (in 6-month intervals) to test their ability to identify different subtypes of delirium and delirium superimposed on dementia (DSD). A total of 760 case vignettes were completed across the different time points. Findings reveal that staff recognition of delirium was poor. The case vignette describing hyperactive DSD was correctly identified by the greatest number participants, and the case vignette describing hypoactive DSD was correctly identified by the least number of participants. Recognition of the case vignette describing hypoactive delirium improved over time. Nursing assistants performed similarly to the licensed nurses, indicating that all licensed nursing home staff require further education to correctly recognize delirium in older adults. PMID:28042285

  13. Implementation of Electronic Health Records in US Nursing Homes.

    Science.gov (United States)

    Bjarnadottir, Ragnhildur I; Herzig, Carolyn T A; Travers, Jasmine L; Castle, Nicholas G; Stone, Patricia W

    2017-08-01

    While electronic health records have emerged as promising tools to help improve quality of care, nursing homes have lagged behind in implementation. This study assessed electronic health records implementation, associated facility characteristics, and potential impact on quality indicators in nursing homes. Using national Centers for Medicare & Medicaid Services and survey data for nursing homes, a cross-sectional analysis was conducted to identify variations between nursing homes that had and had not implemented electronic health records. A difference-in-differences analysis was used to estimate the longitudinal effect of electronic health records on commonly used quality indicators. Data from 927 nursing homes were examined, 49.1% of which had implemented electronic health records. Nursing homes with electronic health records were more likely to be nonprofit/government owned (P = .04) and had a lower percentage of Medicaid residents (P = .02) and higher certified nursing assistant and registered nurse staffing levels (P = .002 and .02, respectively). Difference-in-differences analysis showed greater quality improvements after implementation for five long-stay and two short-stay quality measures (P = .001 and .01, respectively) compared with those who did not implement electronic health records. Implementation rates in nursing homes are low compared with other settings, and better-resourced facilities are more likely to have implemented electronic health records. Consistent with other settings, electronic health records implementation improves quality in nursing homes, but further research is needed to better understand the mechanism for improvement and how it can best be supported.

  14. Experience of a Medicaid nursing home entry cohort

    Science.gov (United States)

    Ray, Wayne A.; Federspiel, Charles F.; Baugh, David K.; Dodds, Suzanne

    1989-01-01

    Long-term care cost-containment policies have focused on reducing the numbers of persons entering nursing homes. To provide insight and background for such efforts, the authors studied the experience of Medicaid nursing home entry cohorts in three individual States. They found substantial interstate variation in rates of nursing home entry and subsequent patterns of discharge, suggesting the operation of fundamentally different policies for provision of Medicaid nursing home services. Analysis of the cost effectiveness and quality of care implications of these policies may provide guidance for future cost-containment efforts. PMID:10313279

  15. The Judaic-Christian origin of nursing homes.

    Science.gov (United States)

    Brandeis, Gary H; Oates, Daniel J

    2007-06-01

    Many nursing homes today have a religious heritage. While governmental regulations control how much of the care is delivered, the foundations and goals of many homes predate governmental rules and payment policies. This paper explores the basis of Jewish and Christian thought in providing groundwork for religiously based nursing homes. Although the underlying principles are similar, differences in approach and execution for the formation of these homes exist.

  16. Caring in nursing homes to promote autonomy and participation.

    Science.gov (United States)

    Hedman, Maria; Häggström, Elisabeth; Mamhidir, Anna-Greta; Pöder, Ulrika

    2017-01-01

    Autonomy and participation are threatened within the group of older people living in nursing homes. Evidence suggests that healthcare personnel act on behalf of older people but are still excluding them from decision-making in everyday care. The purpose was to describe registered nurses' experience of caring for older people in nursing homes to promote autonomy and participation. A descriptive design with a phenomenological approach was used. Data were collected by semi-structured individual interviews. Analysis was inspired by Giorgi's method. Participants and research context: A total of 13 registered nurses from 10 nursing homes participated. Ethical considerations: Ethical approval was obtained from the Regional Research Ethics Committee. Informed consent was achieved and confidentiality guaranteed. The essence of caring for older people in nursing homes to promote autonomy and participation consisted of registered nurses' awareness of older people's frailty and the impact of illness to support health and well-being, and awareness of acknowledgement in everyday life and trusting relationships. Paying attention to older people by being open to the persons' wishes were aspects that relied on registered nurses' trusting relationships with older people, their relatives and surrounding healthcare personnel. The awareness reflected challenges in caring to promote older people's right to autonomy and participation in nursing homes. Registered nurses' strategies, hopes for and/or concerns about development of everyday life in nursing homes were revealed and mirrored their engagement in caring for older people. Awareness of older people's frailty in nursing homes and the importance of maintained health and well-being were described as the main source for promoting autonomy and participation. Everyday life and care in nursing homes needs to be addressed from both older people's and healthcare personnel's perspectives, to promote autonomy and participation for residents

  17. Effect of electric toothbrush on residents' oral hygiene: a randomized clinical trial in nursing homes.

    Science.gov (United States)

    Fjeld, Katrine G; Mowe, Morten; Eide, Hilde; Willumsen, Tiril

    2014-04-01

    A single-blinded, randomized controlled clinical trial was performed to investigate the effect of electric toothbrushes (ET) compared with manual toothbrushes (MT) on residents in nursing homes and to evaluate the caregiver's opinion on ET. A sample of 180 nursing-home residents were given either a new ET or a new MT. Oral examinations were performed to measure dental hygiene, using the Oral Hygiene Index-Simplified (OHI-S). Both groups received the same instructions for use. After 2 months participants were re-examined. Questionnaires were then sent to their caregivers. Participants' mean age was 86.1 ± 7.7 yr, and the mean number of remaining teeth was 20 ± 5.6. No specific intervention effect was found for ET. Both groups showed identical improvements in the OHI-S, from 1.27 ± 0.63 at baseline (the mean value for all participants) to 1.01 ± 0.53 after 2 months. Of 152 caregivers who responded to the questionnaire, the majority evaluated ET to be beneficial and less time-consuming compared with MT, also for demented residents. In a frail population, no difference is found in the effect of ET compared with MT. However, the ET appears to be a useful aid for residents who receive assistance with dental hygiene.

  18. Multidisciplinary nutritional support for undernutrition in nursing home and home-care

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Gøgsig Christensen, Annette; Stenbæk Hansen, Birthe

    2016-01-01

    Objective To assess the effect of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care identified with the validated Eating Validation Scheme (EVS). Methods An 11 wk cluster randomized trial with a home-care (3 clusters) or nursing home (3 clusters...... means of EuroQol-5D-3L), physical performance (30-seconds chair stand), nutritional status (weight and hand-grip strength), oral care, fall incidents, hospital admissions, rehabilitation stay, moving to nursing homes (participants from home-care), and mortality. Results Respectively, 55 (46 from 2 home.......3] versus 1.3 [0.5], P = 0.021) was observed. There was a almost significant difference in mortality (2% versus 13%, P = 0.079). Conclusions Multidisciplinary nutritional support in older adults in nursing home and home-care could have a positive effect on quality of life, muscle strength, and oral care....

  19. [Current Status of Home Visit Programs: Activities and Barriers of Home Care Nursing Services].

    Science.gov (United States)

    Oh, Eui Geum; Lee, Hyun Joo; Kim, Yukyung; Sung, Ji Hyun; Park, Young Su; Yoo, Jae Yong; Woo, Soohee

    2015-10-01

    The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

  20. Nurse Assistant Communication Strategies About Pressure Ulcers in Nursing Homes.

    Science.gov (United States)

    Alexander, Gregory L

    2015-07-01

    There is growing recognition of benefits of sophisticated information technology (IT) in nursing homes (NHs). In this research, we explore strategies nursing assistants (NAs) use to communicate pressure ulcer prevention practices in NHs with variable IT sophistication measures. Primary qualitative data were collected during focus groups with NAs in 16 NHs located across Missouri. NAs (n = 213) participated in 31 focus groups. Three major themes referencing communication strategies for pressure ulcer prevention were identified, including Passing on Information, Keeping Track of Needs and Information Access. NAs use a variety of strategies to prioritize care, and strategies are different based on IT sophistication level. NA work is an important part of patient care. However, little information about their work is included in communication, leaving patient records incomplete. NAs' communication is becoming increasingly important in the care of the millions of chronically ill elders in NHs. © The Author(s) 2014.

  1. The relationship between nursing staff levels, skill mix, and deficiencies in Maryland nursing homes.

    Science.gov (United States)

    Lerner, Nancy B

    2013-01-01

    The objective of this data analysis was to explore whether nurse staffing levels and skill mix influenced the number and severity of nursing home deficiencies in Maryland nursing homes. Nursing staff levels and skill mix in relation to quality outcomes in nursing homes have been explored with inconsistent results. Two multiple regression analyses were done to explore factors influencing deficiencies and the severity of the deficiencies found during the annual survey process. The factors influencing the number of deficiencies were the number of nursing home beds (β = .29), nursing assistant hours per patient-day (β = -.206), and the location of the nursing home (β = -.138). The only factor influencing the severity of the deficiencies was RN hours per patient-day (β = -.199). In conclusion, it was determined that RN staffing, although not associated with the number of deficiencies, is associated with deficiency severity.

  2. Direct costs of dementia in nursing homes

    Directory of Open Access Journals (Sweden)

    Hilma eCaravau

    2015-07-01

    Full Text Available Dementia represents an economical burden to societies nowadays. Total dementia expenses are calculated by the sum of direct and indirect costs. Through the stages of the diseases, as the patients may require institutionalization or a formal caregiver, the direct costs tend to increase. This study aims to analyze the direct costs of dementia in Portuguese nursing homes in 2012, compare the spending between seniors with and without dementia, and propose a predictive costs model. The expenses analysis was based on (1 the use of emergency rooms and doctor’s appointments, either in public or private institutions; (2 days of hospitalization; (3 medication; (4 social services use; (5 the need for technical support; and (6 the utilization of rehabilitation services. The sample was composed of 72 people, half with dementia and half without. The average annual expense of a patient with dementia was €15,287 thousand, while the cost of a patient without dementia was about €12,289 thousand. The variables ‘ability to make yourself understood’, ‘self-performance: getting dressed’ and ‘thyroid disorders’ were found to be statistically significant in predicting the expenses’ increase. In nursing homes, in 2012, the costs per patient with dementia were 1, 2 times higher than per patient without dementia.

  3. Geriatric Training Needs of Nursing-Home Physicians

    Science.gov (United States)

    Lubart, Emily; Segal, Refael; Rosenfeld, Vera; Madjar, Jack; Kakuriev, Michael; Leibovitz, Arthur

    2009-01-01

    Medical care in nursing homes is not provided by board-licensed geriatricians; it mainly comes from physicians in need of educational programs in the field of geriatrics. Such programs, based on curriculum guidelines, should be developed. The purpose of this study was to seek input from nursing home physicians on their perceived needs for training…

  4. The availability of allied health care in Dutch nursing homes.

    NARCIS (Netherlands)

    Boer, M.E. de; Leemrijse, C.J.; Ende, C.H.M. van den; Ribbe, M.W.; Dekker, J.

    2007-01-01

    Purpose. To determine the availability of allied health care in nursing homes in the Netherlands, and its dependency on characteristics of the nursing home. Methods. Structured surveys by telephone were carried out in a sample of 100 from a country total of 286 somatic (for somatic patients only) an

  5. The availability of allied health care in Dutch nursing homes.

    NARCIS (Netherlands)

    Boer, M.E. de; Leemrijse, C.J.; Ende, C.H.M. van den; Ribbe, M.W.; Dekker, J.

    2007-01-01

    Purpose. To determine the availability of allied health care in nursing homes in the Netherlands, and its dependency on characteristics of the nursing home. Methods. Structured surveys by telephone were carried out in a sample of 100 from a country total of 286 somatic (for somatic patients only) an

  6. What home healthcare nurses should know about fraud and abuse.

    Science.gov (United States)

    Michael, Janet E

    2003-08-01

    Home care nurses provide a critical link in all services provided by a home health agency. This article outlines basic information nurses can use to understand fraud and abuse regulations, see the importance of corporate compliance programs, and recognize the potential impact a focus on fraud and abuse has on their practice.

  7. Patients' Anticipation of Stress in Nursing Home Care.

    Science.gov (United States)

    Stein, Shayna; And Others

    1985-01-01

    Examined anticipation of stresses in 223 patients recently admitted to nursing homes, who completed the stresses in Institutional Care Scale (SIC). Factor analysis revealed five factors significantly related to psychological and physical variables. Suggests using SIC for admission screening in nursing homes. Appendix contains the SIC. (NRB)

  8. The silent customers: measuring customer satisfaction in nursing homes.

    Science.gov (United States)

    Kleinsorge, I K; Koenig, H F

    1991-12-01

    Nursing home administrators concerned with customer satisfaction and quality of care need a tool to assess and monitor ongoing satisfaction of nursing home residents and family members. The authors report a preliminary effort to develop such a survey using focus groups.

  9. Organizational Climate Determinants of Resident Safety Culture in Nursing Homes

    Science.gov (United States)

    Arnetz, Judith E.; Zhdanova, Ludmila S.; Elsouhag, Dalia; Lichtenberg, Peter; Luborsky, Mark R.; Arnetz, Bengt B.

    2011-01-01

    Purpose of the Study: In recent years, there has been an increasing focus on the role of safety culture in preventing costly adverse events, such as medication errors and falls, among nursing home residents. However, little is known regarding critical organizational determinants of a positive safety culture in nursing homes. The aim of this study…

  10. Body weight changes in elderly psychogeriatric nursing home residents

    NARCIS (Netherlands)

    Knoops, K.T.B.; Slump, E.; Groot, de C.P.G.M.; Wouters-Wesseling, W.; Brouwer, M.L.; Staveren, van W.A.

    2005-01-01

    Objective. This study was undertaken to identify predictors of body weight change in nursing home patients with possible to severe dementia. Methods. For 24 weeks, 108 elderly residents of a nursing home were followed. Body weight was measured every 2 weeks. Other anthropometric characteristics, die

  11. Use of Pets in Therapy with Elderly Nursing Home Residents.

    Science.gov (United States)

    Sutton, Diana M.

    In order to test the effectiveness of the use of pets with the elderly in a nursing home setting, three concurrent studies were conducted. The 29 residents participating in the experiment were selected by nursing home personnel as meeting the criteria of being depressed and withdrawn, and receiving no regular (weekly) visitors. Study I compared…

  12. Organizational Climate Determinants of Resident Safety Culture in Nursing Homes

    Science.gov (United States)

    Arnetz, Judith E.; Zhdanova, Ludmila S.; Elsouhag, Dalia; Lichtenberg, Peter; Luborsky, Mark R.; Arnetz, Bengt B.

    2011-01-01

    Purpose of the Study: In recent years, there has been an increasing focus on the role of safety culture in preventing costly adverse events, such as medication errors and falls, among nursing home residents. However, little is known regarding critical organizational determinants of a positive safety culture in nursing homes. The aim of this study…

  13. Characteristics of Nursing Homes Perceived to Be Effective and Efficient

    Science.gov (United States)

    Winn, Sharon; McCaffree, Kenneth M.

    1976-01-01

    Characteristics of nursing homes perceived as effective and efficient by other administrators and persons in state government are compared to characteristics of nursing homes across the nation. Facilities perceived as efficient and effective had more staff, were certified for more levels of care, had more beds, and higher occupancy rates. (Author)

  14. Workplace Stress and Ethical Challenges Experienced by Nursing Staff in a Nursing Home

    Science.gov (United States)

    Vondras, Dean D.; Flittner, Diane; Malcore, Sylvia A.; Pouliot, Gregory

    2009-01-01

    This research explores the workplace stress and ethical challenges reported by healthcare staff in a nursing home. A brief self-report survey was administered to 44 members of the nursing staff in a not-for-profit nursing home. The survey included items that elicited identification of specific workplace stressors and ethical challenges and global…

  15. Diversion, transition programs target nursing homes' status quo.

    Science.gov (United States)

    Reinhard, Susan C

    2010-01-01

    As millions of Americans age and exercise their preference for long-term care in the least restrictive environment, policymakers search for ways to increase community-based services. A new federal program--Money Follows the Person--is off to a slow but promising start. The program's "downstream" approach moves residents out of nursing homes and into community care settings. For example, states with mature nursing home transition programs have managed to relocate 25-35 percent of their nursing home residents to assisted living. Other programs successfully using "upstream" strategies to keep people out of nursing homes have not been widely copied. The challenge for policymakers is to maintain funding and flexibility so that nursing homes are no longer the default option for older adults and people with disabilities.

  16. PAYER SOURCE FOR SINGLE, ELDERLY WOMEN IN NURSING HOMES.

    Science.gov (United States)

    Nakagawa, Sage; O'Lawrence, Henry

    2015-01-01

    This study seeks to determine the payer source for single, elderly women in nursing homes by using secondary data from the 2004 National Nursing Home Survey was extracted and analyzed for the aforementioned hypotheses. By determining the payer source for single, elderly women, the next generation of women can prepare for high nursing home costs by saving earlier or investing in long-term care insurance. The analyses indicated self-pay and Medicaid was the primary sources for elderly women in nursing homes. Marital status did not have an impact on the payer source for elderly women. Single women did not have different payer sources than married elderly women. However, the study did not focus on payer sources for single, elderly women in nursing homes, but the demographic population as a whole.

  17. Diabetes knowledge in nursing homes and home-based care services: a validation study of the Michigan Diabetes Knowledge Test adapted for use among nursing personnel

    OpenAIRE

    Haugstvedt, Anne; Aarflot, Morten; Igland, Jannicke; Landbakk, Tilla; Graue, Marit

    2016-01-01

    Background Providing high-quality diabetes care in nursing homes and home-based care facilities requires suitable instruments to evaluate the level of diabetes knowledge among the health-care providers. Thus, the aim of this study was to examine the psychometric properties of the Michigan Diabetes Knowledge Test adapted for use among nursing personnel. Methods The study included 127 nursing personnel (32 registered nurses, 69 nursing aides and 26 nursing assistants) at three nursing homes and...

  18. Implementing best practice in medication management in a nursing home

    OpenAIRE

    2012-01-01

    Medication management is one of the major roles of a nurse leader in any health care setting particularly in the nursing homes. Evidence suggests that errors do occur at any stage of the medication use process (prescribing, documenting/transcribing, dispensing, administering and monitoring) and these might pose significant risks to older people in nursing homes. Thus, this change project was carried out to reduce the incidence of medication errors, ensure resident’s safety and promote complia...

  19. Special issue: nursing home nurses conceptualize how to care for residents with cardiac vulnerability.

    Science.gov (United States)

    Kim, Mi So; Kim, Hyun Ju; Choi, Jung Eun; Kim, Su Jin; Chang, Sung Ok

    2015-03-24

    With ageing, older people face cardiovascular problems as the major cause of disability and death. Although immediate medical attention is a major factor in determining outcomes of cardiac problems, lack of personnel (i.e. registered nurse, certified nursing assistant and home care aide) in nursing homes without residing doctor limits the awareness of such problems, thus making it difficult to initiate timely and appropriate intervention. The aim of this study was to conceptualize critical care for nursing home residents with cardiac vulnerability and develop practical knowledge in nursing practice. Conventional content analysis was performed on date from interviews with 30 nurses from 10 nursing homes in South Korea between July and November 2010. The analysis revealed three major cardiac problems resulting from residents' cardiac vulnerability: angina, myocardial infarction (MI) and cardiogenic shock. Through content analysis, we extracted 6 themes and 21 subthemes for nurses' conceptualization of critical care for nursing home residents with cardiac vulnerability. In nursing homes without a residing doctor, nurses assessed the physical, functional and cognitive conditions along with the responses and symptoms of residents when emergency situations related to the cardiac problems occurred. Moreover, with a lack of infrastructures of a hospital, nurses provided critical care to the elderly by using personal practice strategies based on their personal experience in facilities along with practical knowledge of nurses while following the management principles of emergencies. We found that nurses conceptualized critical nursing care for cardiac problems at nursing homes, which are different from those of general hospitals. The results of this study will provide basis for the development of care guidelines and educational materials that can be used by novice nurses or nursing students. © 2015 British Association of Critical Care Nurses.

  20. The concept of restraints in nursing home practice: a mixed method study in nursing homes for people with dementia.

    NARCIS (Netherlands)

    Zwijsen, S.A.; Depla, M.F.I.A.; Niemeijer, A.R.; Francke, A.L.; Hertogh, C.M.P.M.

    2011-01-01

    Introduction: Although in most developed countries the use of restraints is regulated and restricted by law, the concept of restraint in nursing home care remains ambiguous. This study aims to explore how care professionals and family members of nursing home residents with dementia in the

  1. Caring relationships in home-based nursing care - registered nurses' experiences.

    Science.gov (United States)

    Wälivaara, Britt-Marie; Sävenstedt, Stefan; Axelsson, Karin

    2013-01-01

    The caring relationship between the nurse and the person in need of nursing care has been described as a key concept in nursing and could facilitate health and healing by involving the person's genuine needs. The aim of this study was to explore registered nurses' experiences of their relationships with persons in need of home-based nursing care. Individual interviews with nurses (n=13 registered nurses and 11 district nurses) working in home-based nursing care were performed. A thematic content analysis was used to analyze the transcribed interviews and resulted in the main theme Good nursing care is built on trusting relationship and five sub-themes, Establishing the relationship in home-based nursing care, Conscious efforts maintains the relationship, Reciprocity is a requirement in the relationship, Working in different levels of relationships and Limitations and boundaries in the relationship. A trusting relationship between the nurse and the person in need of healthcare is a prerequisite for good home-based nursing care whether it is based on face-to-face encounters or remote encounters through distance-spanning technology. A trusting relationship could reduce the asymmetry of the caring relationship which could strengthen the person's position. The relationship requires conscious efforts from the nurse and a choice of level of the relationship. The trusting relationship was reciprocal and meant that the nurse had to communicate something about themself as the person needs to know who is entering the home and who is communicating through distance-spanning technology.

  2. Waiting to go into a Danish Nursing Home - Generations Review

    DEFF Research Database (Denmark)

    Kofod, Jens Erik

    2006-01-01

    that their relationship toward their home care assistant became increasingly important as they waited to go into the nursing home. Assessments for home care were constrained by municipal authorities and their regulations, and the overall attitude was that the needs of older people were not being appropriately defined...

  3. Nursing home nurses' perceptions of emergency transfers from nursing homes to hospital: A review of qualitative studies using systematic methods.

    Science.gov (United States)

    O'Neill, Barbara; Parkinson, Lynne; Dwyer, Trudy; Reid-Searl, Kerry

    2015-01-01

    The aim is to describe nursing home nurses' perceptions around emergency transfers to hospital. Transfers are costly and traumatic for residents, and efforts are underway to avoid hospitalization. Nurses play a key role in transfers, yet their views are underreported. A systematic review of qualitative studies was undertaken, guided by Joanna Briggs Institute methods. From seven reviewed studies, it was clear nursing home nurses are challenged by the complexity of the transfer process and understand their need for appropriate clinical knowledge, skills and resources. Communication is important, yet nurses often use persuasive and targeted communication. Ambiguity, strained relationships and negative perceptions of residents' experiences around hospitalization contribute to conflict and uncertainty. Nurses are more confident when there is a plan. Transferring a resident is a complex process and special skills, knowledge and resources are required, but may be lacking. Efforts to formalize the transfer process and improve communication and collaboration amongst all stakeholders is needed and would be well received. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Nursing homes and end-of-life care in Japan.

    Science.gov (United States)

    Ikegami, Naoki; Ikezaki, Sumie

    2013-10-01

    To describe end-of-life care in Japanese nursing homes by comparing facility and characteristics of residents dying in nursing homes with those who had been transferred and had died in hospitals, and by comparing the quality of end-of-life care with hospitals and with their respective counterparts in the United States. National sample of 653 nursing homes with responses from 371 (57%) on their facility characteristics, 241 (37%) on their resident characteristics, and 92 (14%) on the residents' quality of life. All 5 hospitals in a city 80 miles from Tokyo cooperated. Nursing home staff answered questionnaires on facility and resident characteristics. Resident level data were obtained from 1158. The questionnaire on the quality of care was responded to by 256 (63%) of the decedents' families in nursing homes and 205 (48%) in hospitals. Facility characteristics included items on physicians, nurse staffing, and the facility's end-of-life care policy. Resident characteristics included basic demographics, level of dementia, and resident's and family's preference for the site of death. The Toolkit was used to measure the quality of end-of-life care. The proportion of those dying within the nursing home was related to the facility's policy on end-of-life care and the family's preference. The quality of end-of-life care in nursing homes was generally better than in hospitals, and than in their respective counterparts in the United States. Financial incentives by the Japanese government to promote end-of-life care in nursing homes may have contributed to increasing the proportion of deaths within the facility. The quality of care in nursing homes was evaluated as being better than hospitals. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

  5. Nursing Home Physician Specialists: A Response to the Workforce Crisis in Long-Term Care

    OpenAIRE

    Katz, Paul R.; Karuza, Jurgis; Intrator, Orna; Mor, Vincent

    2009-01-01

    Marginalization of physicians in the nursing home threatens the overall care of increasingly frail nursing home residents who have medically complex illnesses. The authors propose that creating a nursing home medicine specialty, which recognizes the nursing home as a unique practice site, would go a long way toward remedying existing problems with care in skilled nursing facilities and would best serve the needs of the 1.6 million nursing home residents in the United States. Reviewing what is...

  6. Registered nurse retention strategies in nursing homes: a two-factor perspective.

    Science.gov (United States)

    Hunt, Selina R; Probst, Janice C; Haddock, Kathlyn S; Moran, Robert; Baker, Samuel L; Anderson, Ruth A; Corazzini, Kirsten

    2012-01-01

    As the American population ages and the proportion of individuals over the age of 65 expands, the demand for high-quality nursing home care will increase. However, nursing workforce instability threatens care quality and sustainability in this sector. Despite increasing attention to nursing home staff turnover, far less is known about registered nurse (RN) retention. In this study, the relationships between retention strategies, employee benefits, features of the practice environment, and RN retention were explored. Further, the utility of Herzberg's two-factor theory of motivation as a framework for nursing home retention studies was evaluated. This study was a secondary analysis of the nationally representative 2004 National Nursing Home Survey. The final sample of 1,174 participating nursing homes were either certified by Medicare or Medicaid or licensed by state agencies. We used a weighted multinomial logistic regression using an incremental approach to model the relationships. Although most nursing homes offered some combination of retention programs, the majority of strategies did not have a significant association with the level of RN retention reported by facilities. Director of nursing tenure and other extrinsic factors had the strongest association with RN retention in adjusted analyses. To improve RN retention, organizations may benefit greatly from stabilizing nursing home leadership, especially the director of nursing position. Second, managers of facilities with poor retention may consider adding career ladders for advancement, awarding attendance, and improving employee benefits. As a behavioral outcome of motivation and satisfaction, retention was not explained as expected using Herzberg's two-factor theory.

  7. Explaining differences in remuneration rates of nursing homes in Germany.

    Science.gov (United States)

    Mennicken, Roman; Augurzky, Boris; Rothgang, Heinz; Wasem, Jürgen

    2014-05-01

    Remuneration rates of German nursing homes are prospectively negotiated between long-term care insurance (LTCI) and social assistance on the one side and nursing homes on the other. They differ considerably across regions while there is no evidence for substantial differences in care provision. This article explains the differences in the remuneration rates by observable characteristics of the nursing home, its residents and its region with a special focus on the largest federal state of North Rhine Westphalia, in which the most expensive nursing homes are located. We use data from the German Federal Statistical Office for 2005 on all nursing homes that offer full-time residential care for the elderly. We find that differences in remuneration rates can partly be explained by exogenous factors. Controls for residents, nursing homes and district characteristics explain roughly 30 % of the price difference; 40 % can be ascribed to a regionally different kind of negotiation between nursing homes and LTCI. Thirty percent of the raw price difference remains unexplained by observable characteristics.

  8. Culture change and nursing home quality of care.

    Science.gov (United States)

    Grabowski, David C; O'Malley, A James; Afendulis, Christopher C; Caudry, Daryl J; Elliot, Amy; Zimmerman, Sheryl

    2014-02-01

    Culture change models are intended to improve the quality of life for nursing home residents, but the impact of these models on quality of care is unknown. We evaluated the impact of the implementation of nursing home culture change on the quality of care, as measured by staffing, health-related survey deficiencies, and Minimum Data Set (MDS) quality indicators. From the Pioneer Network, we have data on whether facilities were identified by experts as "culture change" providers in 2004 and 2009. Using administrative data, we employed a panel-based regression approach in which we compared pre-post quality outcomes in facilities adopting culture change between 2004 and 2009 against pre-post quality outcomes for a propensity score-matched comparison group of nonadopters. Nursing homes that were identified as culture change adopters exhibited a 14.6% decrease in health-related survey deficiency citations relative to comparable nonadopting homes, while experiencing no significant change in nurse staffing or various MDS quality indicators. This research represents the first large-scale longitudinal evaluation of the association of culture change and nursing home quality of care. Based on the survey deficiency results, nursing homes that were identified as culture change adopters were associated with better care although the surveyors were not blind to the nursing home's culture change efforts. This finding suggests culture change may have the potential to improve MDS-based quality outcomes, but this has not yet been observed.

  9. Terminal patients in Belgian nursing homes: a cost analysis.

    Science.gov (United States)

    Simoens, Steven; Kutten, Betty; Keirse, Emmanuel; Vanden Berghe, Paul; Beguin, Claire; Desmedt, Marianne; Deveugele, Myriam; Léonard, Christian; Paulus, Dominique; Menten, Johan

    2013-06-01

    Policy makers and health care payers are concerned about the costs of treating terminal patients. This study was done to measure the costs of treating terminal patients during the final month of life in a sample of Belgian nursing homes from the health care payer perspective. Also, this study compares the costs of palliative care with those of usual care. This multicenter, retrospective cohort study enrolled terminal patients from a representative sample of nursing homes. Health care costs included fixed nursing home costs, medical fees, pharmacy charges, other charges, and eventual hospitalization costs. Data sources consisted of accountancy and invoice data. The analysis calculated costs per patient during the final month of life at 2007/2008 prices. Nineteen nursing homes participated in the study, generating a total of 181 patients. Total mean nursing home costs amounted to 3,243 € per patient during the final month of life. Total mean nursing home costs per patient of 3,822 € for patients receiving usual care were higher than costs of 2,456 € for patients receiving palliative care (p = 0.068). Higher costs of usual care were driven by higher hospitalization costs (p < 0.001). This study suggests that palliative care models in nursing homes need to be supported because such care models appear to be less expensive than usual care and because such care models are likely to better reflect the needs of terminal patients.

  10. Trending health information technology adoption among New York nursing homes.

    Science.gov (United States)

    Abramson, Erika L; Edwards, Alison; Silver, Michael; Kaushai, Rainu

    2014-11-01

    Federal policies are incentivizing hospitals and providers to adopt and meaningfully use electronic health records (EHRs). Nursing homes are not eligible for incentives. However, understanding health information technology (HIT) adoption among nursing homes will be critical to developing HIT policies for this sector. Our objective was to assess the pace of EHR adoption, changes in computerized function adoption, and participation in health information exchange by New York state nursing homes over time. We used a repeated, cross-sectional study design. We surveyed all New York state nursing homes between February and May 2013, comparing results to the same survey administered in 2012. We received responses from 472 of 630 nursing homes (74.9%). Rates of EHR adoption increased from 48.6% to 56.3% (P = .03). Participation in health information exchange remained unchanged (54.5% to 55.3%, P = .8). The top barriers to EHR adoption cited were: a) the initial cost of HIT investment (67.9%, n = 133), b) lack of technical IT staff (46.4%, n = 91), and c) lack of fiscal incentives (45.8%, n = 88). Comparing nursing homes with EHRs in 2012 to nursing homes with EHRs in 2013, the availability of many types of computerized functionalities significantly increased, although no gains were seen for order entry or clinical tools. While some gains are being made by nursing homes, HIT adoption generally lags behind that of other sectors. Public policy focusing on building HIT infrastructure is essential to ensure that nursing homes keep up with other healthcare segments.

  11. Changing to primary nursing in a nursing home in Finland: experiences of residents, their family members and nurses.

    Science.gov (United States)

    Laakso, S; Routasalo, P

    2001-02-01

    The aim of the study was to find out how nursing home residents, their families and nurses experienced the change to primary nursing in the nursing home. This study was carried out in a nursing home in Finland. Following years of functional nursing, the change to primary nursing had started 18 months prior to data collection. The transition was preceded by staff training, planning for the change to primary nursing and discussions with staff members. Meetings were also arranged with family members to inform them of what was happening and why. Staff implemented the changeover independently with the support of the institution's management. The data were gathered in focused interviews. There were five interview themes: change in the nursing home, the position of the resident in the nursing home, the relationship between the resident and nurse, the relationship between family member and nurse, and the role of the nurse as provider of nursing care. Residents reported no major changes in nursing care or in their relationship with nurses. However, family members had noticed changes in the behaviour of the nursing staff. Staff members had become friendlier, spent more time with the residents and showed a strong job motivation. Cooperation between nurses and family members had changed very little. Some nurses in the early stages of the change tended to show signs of resistance. Others said that there had been many changes during the past year, that they acted more independently and could use their own decision-making authority more freely than before. They treated residents as individuals and gave them a greater say in decision-making. They felt responsible for the development of the workplace as a collectivity. Primary nursing is one way in which nurses and family members can work more closely in the best interests of older residents. The findings of this study speak in favour of making the change from functional to primary nursing and at the same time highlight certain

  12. A qualitative study of the relationships between residents and nursing homes nurses.

    Science.gov (United States)

    Palacios-Ceña, Domingo; Losa-Iglesias, Marta Elena; Gómez-Calero, Cristina; Cachón-Pérez, José Miguel; Brea-Rivero, Miguel; Fernández-de-las-Peñas, César

    2014-02-01

    To explore the relationships between residents and nurses in Spanish nursing homes. The nurses are one of the elements conditioning the life of the nursing home resident, influencing sense of security and mediating the relationships among residents. A qualitative phenomenological approach was applied. An initial purposeful sampling of Spanish residents from nursing homes in the southern area of Madrid was conducted. The study included nursing home residents, aged 60 and over, with no cognitive impairment and who were able to communicate verbally in Spanish. Data were collected using unstructured and semi-structured interviews, researcher field notes, and personal diaries and letters from the residents. Data collection was concluded once theoretical saturation was reached, and data were analysed using the Giorgi proposal. Two main themes emerged: (1) 'meeting the nursing home nurses,' residents interact with nurses and establish relationships with them. The relationship is perceived as positive yet distant, and at times it is difficult to establish a closer relationship; and (2) 'managing relationships with the nursing home nurses,' residents learn to manage their relationships with the nurses, acquiring new behaviours to get closer to them, avoiding confrontations and helping each other. Residents manage their relationships with nurses using multiple behavioural strategies. They perceive these adjustments as necessary to facilitate daily life or avoid problems and/or confrontations. Deepening the relationships between residents and nurses could improve the management of nursing homes. Dialogue and active listening with residents must be incorporated into the daily nursing care. It should be given the same attention to all residents, with special attention to residents with cognitive and functional difficulties. © 2013 John Wiley & Sons Ltd.

  13. 42 CFR 431.704 - Nursing homes designated by other terms.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Nursing homes designated by other terms. 431.704... Programs for Licensing Nursing Home Administrators § 431.704 Nursing homes designated by other terms. If a State licensing law does not use the term “nursing home,” the CMS Administrator will determine the term...

  14. Nurses' clinical decision-making for preserving nursing home residents' remaining abilities.

    Science.gov (United States)

    Kim, Hyun Ju; Choi, Jung Eun; Kim, Mi So; Kim, Su Jin; Chang, Sung Ok

    2016-05-01

    This study was conducted to clarify and conceptualise nurses' clinical decision-making for preserving the remaining abilities of nursing home residents suffering from physical-cognitive functional decline. Older adults experience physical, psychological and social changes, but their remaining abilities differ across individuals. This study used a qualitative research to gain a deeper understanding of nursing homes nurses' clinical decision-making. In-depth interviews with 32 experienced nurses were undertaken. The data were analysed using conventional content analysis. Six categories and 58 subcategories of nursing practice related to managing the remaining abilities of residents with physical-cognitive functional decline were generated. The results of this study revealed five themes: (1) seeing residents' potential, (2) physical, emotional and psychosocial care in daily routines, (3) keeping personalised charts, (4) encouraging, promoting and physical and emotional support and (5) preparing residents for more independent living. The results were categorised into nurses' personal strategies based on their experience, practical nursing knowledge, nursing interventions and nursing evaluation criteria. The themes reflected positive views on the residents' functional abilities and the nursing homes nurses' perception that their goal was to help residents achieve their highest level of independence. Preserving nursing home residents' remaining abilities represents nurses' optimistic view of residents' functional status. Routine care tailored for preserving the remaining abilities of individual nursing home residents with physical-cognitive functional decline is needed. Preserving the remaining abilities of nursing home resident is supported by therapeutic interactions including close contact as well as physical and emotional support. Nurses' main goal in working with residents with remaining abilities is improving their independence. © 2016 John Wiley & Sons Ltd.

  15. Architectural factors influencing the sense of home in nursing homes: An operationalization for practice

    Directory of Open Access Journals (Sweden)

    A. Eijkelenboom

    2017-06-01

    Full Text Available Various studies have shown that the architecture and design of a nursing home can have a profound impact on the sense of home of old people residing in the nursing home, next to psychological and social factors. However, adequate guidance on how these factors can be operationalized in practice is not provided for architects and interior designers. This study investigated which architectural factors contribute to a sense of home and how these can be implemented in the design guidelines. Two existing data sets were used, combining the most recent evidence from the literature and experiences of residents, family caregivers, and professional staff of Dutch nursing homes. These analyses resulted in theoretical implications for the private space, quasi-public space, the look and feel of the nursing home, and the outdoors. Furthermore, these analyses were used for the design of a demonstration apartment that integrates the factors of the sense of home. This description was concluded by a checklist for practice, in which design guidelines were formulated. A holistic understanding of which factors influence the sense of home could lead to improvements of the sense of home of nursing home residents.

  16. Job satisfaction of rural public and home health nurses.

    Science.gov (United States)

    Juhl, N; Dunkin, J W; Stratton, T; Geller, J; Ludtke, R

    1993-03-01

    Based on Vroom's expectancy theory, this study was conducted to identify differences in job satisfaction between nurses working in public health settings, and staff nurses and administrators working in both settings. Questionnaires containing an adaptation of a job satisfaction scale were mailed to all 258 registered nurses practicing in public health and home health settings (response rate 57%) in a rural midwestern state. Respondents were asked to rate their satisfaction with various dimensions of their jobs, as well as how important each aspect was to them. Although both groups of nurses reported low satisfaction with salary, public health nurses were significantly less satisfied with their salaries than were home health nurses (F = 32.96, P < or = 0.001); home health nurses, however, were significantly less satisfied with benefits/rewards (F = 11.85, P < or = 0.001), task requirements (F = 8.37, P < or = 0.05), and professional status (F = 5.30, P < or = 0.05). Although administrators did not differ significantly from staff nurses on job satisfaction, they did perceive organizational climate (F = 4.50, P < or = 0.05) to be an important feature of satisfaction. These differences may be partially explained by divergent salaries, roles, and responsibilities between public health and home health nurses.

  17. Nursing Home - Pain - Percentage of Residents Reporting Pain

    Data.gov (United States)

    U.S. Department of Health & Human Services — Adequate pain management is an important indicator of quality of care and quality of life. Nursing home staff should check patients regularly to see if they are...

  18. Transforming nursing home culture: evidence for practice and policy.

    Science.gov (United States)

    Zimmerman, Sheryl; Shier, Victoria; Saliba, Debra

    2014-02-01

    The nursing home culture change movement aims to improve resident quality of life and quality of care by emphasizing the deinstitutionalization of nursing home culture and focusing on person-centered care. This article briefly reviews the history of culture change, discusses some of the challenges related to culture change in nursing homes, and overviews the conceptualization and select models of culture change. Building from this background, it critiques current understanding, identifies critical research questions, and notes key issues arising during a workshop that addressed existing and emerging evidence in the field. This review and analysis provide a context for how 9 accompanying papers in this supplemental issue of The Gerontologist fill identified evidence gaps and provide evidence for future practice and policies that aim to transform nursing home culture.

  19. Can family caregiving substitute for nursing home care?

    Science.gov (United States)

    Charles, Kerwin Kofi; Sevak, Purvi

    2005-11-01

    Informal care should be a substitute for nursing homes but empirical evidence often suggests the opposite. This may be because informal care receipt is positively correlated with unobserved negative health characteristics. We exploit variation in children's characteristics as instruments for informal care to provide Two-Stage Least Squares (TSLS) estimates of nursing home use among a sample of 6855 individuals from the 1993-2000 waves of the AHEAD survey. While OLS results suggest informal care is associated with greater future nursing home risk, TSLS estimates show that receipt of informal care statistically and substantially reduces the risk of nursing home entry. This finding has implications for Medicaid and private long-term care insurance markets.

  20. An exploration of occupation in nursing home residents with dementia

    LENUS (Irish Health Repository)

    Morgan-Brown, Mark

    2011-05-01

    Objectives: This study evaluated the sitting room environment of two nursing homes in Ireland, using interactive occupation and social engagement as outcome measures and defining these rooms as occupational spaces.\\r\

  1. Legionnaires' Hiding in Hospital, Nursing Home Plumbing Systems: CDC

    Science.gov (United States)

    ... gov/news/fullstory_166302.html Legionnaires' Hiding in Hospital, Nursing Home Plumbing Systems: CDC Effective water management, sanitation programs can reduce the risk of exposure to this deadly bacteria To use the sharing ...

  2. Competition, information, and quality: Evidence from nursing homes.

    Science.gov (United States)

    Zhao, Xin

    2016-09-01

    Economic theory suggests that competition and information can both be important for product quality, and yet evidence on how they may interact to affect quality is sparse. This paper estimates the impact of competition between nursing homes on their quality, and how this impact varies when consumers have better access to information. The effect of competition is identified using exogenous variation in the geographical proximity of nursing homes to their potential consumers. The change in information transparency is captured by the launch of the Five-Star Quality Rating System in 2009, which improved access to the quality information of nursing homes. We find that while the effect of competition on nursing home quality is generally rather limited, this effect becomes significantly stronger with increased information transparency. The results suggest that regulations on public quality reporting and on market structure are policy complements, and should be considered jointly to best improve quality.

  3. Antidepressant treatment of depression in rural nursing home residents.

    Science.gov (United States)

    Kerber, Cindy Sullivan; Dyck, Mary J; Culp, Kennith R; Buckwalter, Kathleen

    2008-09-01

    Under-diagnosis and under-treatment of depression are major problems in nursing home residents. The purpose of this study was to determine antidepressant use among nursing home residents who were diagnosed with depression using three different methods: (1) the Geriatric Depression Scale, (2) Minimum Data Set, and (3) primary care provider assessments. As one would expect, the odds of being treated with an antidepressant were about eight times higher for those diagnosed as depressed by the primary care provider compared to the Geriatric Depression Scale or the Minimum Data Set. Men were less likely to be diagnosed and treated with antidepressants by their primary care provider than women. Depression detected by nurses through the Minimum Data Set was treated at a lower rate with antidepressants, which generates issues related to interprofessional communication, nursing staff communication, and the need for geropsychiatric role models in nursing homes.

  4. NURSING HOME CONTROL OF PHYSICIAN RESOURCES (NHCOPR)

    Science.gov (United States)

    Intrator, Orna; Lima, Julie; Wetle, Terrie Fox

    2014-01-01

    Objective Physician services are increasingly recognized as important contributors to quality care provision in nursing homes (NHs), but knowledge of ways in which NHs manage/ control physician resources is lacking. Data Primary data from surveys of NH Administrators and Directors of Nursing from a nationally representative sample of 1,938 freestanding U.S. NHs in 2009–2010 matched to Online Survey Certification and Reporting (OSCAR), aggregated NH Minimum Data Set (MDS) assessments and Medicare claims, and data from the Area Resource File (ARF). Methods The concept of NH Control of Physician Resources (NHCOPR) was measured using NH Administrators’ reports of management implementation of rules, policies, and procedures aimed at coordinating work activities. The NHCOPR scale was based on measures of formal relationships, physician oversight and credentialing. Scale values ranged from weakest (0) to tightest (3) control. Several hypotheses of expected associations between NHCOPR and other measures of NH and market characteristics were tested. Principal Findings The full NHCOPR score averaged 1.58 (SD=0.77) on the 0–3 scale. Nearly 30% of NHs had weak control (NHCOPR 2). NHCOPR exhibited good face- and predictive-validity as exhibited by positive associations with more beds, more Medicare services, cross coverage and number of physicians in the market. Conclusions The NHCOPR scale capturing NH’s formal structure of control of physician resources can be useful in studying the impact of NH’s physician resources on residents’ outcomes with potential for targeted interventions by education and promotion of NH administration of physician staff. PMID:24508327

  5. [Training and representation of dementia of workers in nursing homes].

    Science.gov (United States)

    Sanchez, Stéphane; Gallin, Aurélie; Stefanuto, Muriel; Treffel, Sylvie; Antoine, Marc; Denormandie, Philippe

    2016-01-01

    Training could be a lever for improving the quality of care of residents with dementia in nursing homes by changing social representations. Beyond a simple assessment of acquired knowledge, a change of social representations could be indicative of a true appropriation of the content of the training. A study was carried out to assess the impact of training on nursing home caregivers' representations of dementia and Alzheimer's disease.

  6. General practitioners' experiences as nursing home medical consultants

    OpenAIRE

    Kirsebom, Marie; Hedström, Mariann; Pöder, Ulrika; Wadensten, Barbro

    2017-01-01

    OBJECTIVE: To describe general practitioners' experiences of being the principal physician responsible for a nursing home. METHOD: Fifteen general practitioners assigned to a nursing home participated in semi-structured qualitative interviews. Data were analysed using systematic text condensation. RESULT: Medical assessment is the main duty of general practitioners. Advance care planning together with residents and family members facilitates future decisions on medical treatment and end-of-li...

  7. Heat pumps in nursing homes; Warmtepompen in verzorgingshuizen

    Energy Technology Data Exchange (ETDEWEB)

    Dieleman, M. [Erbeko raadgevende ingenieurs, Hilversum (Netherlands)

    1996-04-01

    The most important options for the sector nursing homes to save 20-30% energy are the combined generation of heat and power (CHP or cogeneration) and the use of heat pumps. Cogeneration is cost-effective for a natural gas consumption of 200,000 m{sup 3} per year. The heat pump is a good option for both small and large nursing homes. 2 tabs.

  8. Higher prices, higher quality? Evidence from German nursing homes.

    Science.gov (United States)

    Herr, Annika; Hottenrott, Hanna

    2016-02-01

    This study investigates the relationship between prices and quality of 7400 German nursing homes. We use a cross section of public quality reports for all German nursing homes, which had been evaluated between 2010 and 2013 by external institutions. Our analysis is based on multivariate regressions in a two stage least squares framework, where we instrument prices to explain their effect on quality controlling for income, nursing home density, demographics, labour market characteristics, and infrastructure at the regional level. Descriptive analysis shows that prices and quality do not only vary across nursing homes, but also across counties and federal states and that quality and prices correlate positively. Second, the econometric analysis, which accounts for the endogenous relation between negotiated price and reported quality, shows that quality indeed positively depends on prices. In addition, more places in nursing homes per people in need are correlated with both lower prices and higher quality. Finally, unobserved factors at the federal state level capture some of the variation of reported quality across nursing homes. Our results suggest that higher prices increase quality. Furthermore, since reported quality and prices vary substantially across federal states, we conclude that the quality and prices of long-term care facilities may well be compared within federal states but not across. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Care on demand in nursing homes: a queueing theoretic approach.

    Science.gov (United States)

    van Eeden, Karin; Moeke, Dennis; Bekker, René

    2016-09-01

    Nursing homes face ever-tightening healthcare budgets and are searching for ways to increase the efficiency of their healthcare processes without losing sight of the needs of their residents. Optimizing the allocation of care workers plays a key role in this search as care workers are responsible for the daily care of the residents and account for a significant proportion of the total labor expenses. In practice, the lack of reliable data makes it difficult for nursing home managers to make informed staffing decisions. The focus of this study lies on the 'care on demand' process in a Belgian nursing home. Based on the analysis of real-life 'call button' data, a queueing model is presented which can be used by nursing home managers to determine the number of care workers required to meet a specific service level. Based on numerical experiments an 80/10 service level is proposed for this nursing home, meaning that at least 80 percent of the clients should receive care within 10 minutes after a call button request. To the best of our knowledge, this is the first attempt to develop a quantitative model for the 'care on demand' process in a nursing home.

  10. Nursing home negotiations and narrations in challenging, transnational situations

    DEFF Research Database (Denmark)

    Blaakilde, Anne Leonora; Swane, Christine E.; Algreen-Petersen, Eva

    Nursing home negotiations and narrations in challenging, transnational situations In the city of Copenhagen a public nursing home is developing a new profile that aims at attracting older migrants and refugees together with other ethnic Danes in order to spend their last months or years in an ins......Nursing home negotiations and narrations in challenging, transnational situations In the city of Copenhagen a public nursing home is developing a new profile that aims at attracting older migrants and refugees together with other ethnic Danes in order to spend their last months or years...... in an institutional setting. For more than 100 years Denmark has offered public nursing homes to frail older persons and hence represents a culture where institutional caretaking is accepted and expected. Today, the major part of homecare and nursing homes in Denmark are public or subsidised by state....... The methodological approach is phenomenological through ethnographic fieldwork and qualitative interviews. The aim is to follow the discourses and practices related to concepts of diversity as they may change during the three years, as well as the everyday life communication, care routines and rituals related...

  11. Effects of introducing a nursing guideline on depression in psychogeriatric nursing home residents.

    OpenAIRE

    Verkaik, R.; Francke, A.; Berno, M. van; Bensing, J.; Miel, R.

    2010-01-01

    Introduction: The prevalence rate of depression in psychogeriatric nursing home residents with dementia is recently estimated at 19%. Comorbid depression in dementia has been associated with decreased quality of life, greater health care utilization and higher mortality rates. The effects of introducing an evidence based nursing guideline on psychogeriatric nursing home wards were studied. Main principles of the guideline were (1) increasing individualized pleasant activities, (2) decreasing ...

  12. The provision of diabetes care in nursing homes in Galway city and county: a survey of nursing homes

    LENUS (Irish Health Repository)

    Hurley, Lorna

    2014-03-01

    In addition to the increasing prevalence of diabetes, our population is growing older and living longer. This survey aimed to determine the care provided to residents with diabetes in Nursing Homes.\\r\

  13. The effects of a nursing guideline on depression in psychogeriatric nursing home residents with dementia.

    NARCIS (Netherlands)

    Verkaik, R.; Francke, A.L.; Meijel, B. van; Spreeuwenberg, P.M.M.; Ribbe, M.W.; Bensing, J.M.

    2011-01-01

    OBJECTIVE: To study the effects of introducing a nursing guideline on depression in residents with dementia of psychogeriatric nursing home wards. METHODS: A multi-center controlled clinical trial with randomization at ward level was used to study the effects of the guideline introduction. Nursing t

  14. Technology for Improving Medication Monitoring in Nursing Homes

    Science.gov (United States)

    2005-01-01

    Education Foundation. The Geriatric Risk Assessment MedGuide™ (GRAM™) software19 specifically alerts prescribers and nursing facility staff to...developed and delivered inservice programs for nursing staff of the 13 facilities that received the intervention as part of the AHRQ-funded study. The in...Research and Education Foundation who have encouraged innovations in the delivery of quality pharmaceutical care to nursing home residents. Author

  15. Influence patterns and determinant attributes in nursing home choice situations.

    Science.gov (United States)

    Jarboe, G R; McDaniel, C D

    1985-01-01

    Factor analysis revealed that nursing home characteristics fall roughly into two categories: those relating to the care directly provided by the facility and those which are generally unrelated to the quality of care. Not all influences (doctors, discharge planners, retirement home administrators and responsible parties) respond alike to these characteristics. Therefore, a marketing mix directed uniformly to all segments may be suboptimal.

  16. A Comparative Analysis of the Relationship between Communication Apprehension and Loneliness for Elderly Nursing Home and Non-Nursing Home Residents.

    Science.gov (United States)

    Downs, Valerie C.; And Others

    1988-01-01

    Utilizes the socio-environmental perspective to compare feelings of communication apprehension and perceived loneliness between nursing home and non-nursing home residents. Finds that communication apprehension consistently and significantly predicts perceived loneliness for non-nursing home residents, but fails to predict perceived loneliness for…

  17. Swedish district nurses' attitudes to implement information and communication technology in home nursing.

    Science.gov (United States)

    Nilsson, Carina; Skär, Lisa; Söderberg, Siv

    2008-01-01

    The use of information and communication technology has increased in the society, and can be useful in nursing care. The aim of this study was to describe district nurses' attitudes regarding the implementation of information and communication technology in home nursing. The first and third authors performed five focus group discussions with 19 district nurses' from five primary healthcare centres in northern Sweden. During the focus group discussions, the following topics were discussed: the current and future use of information and communication technology in home nursing; expectations, advantages, disadvantages and hindrances in the use of information and communication technology in home nursing; and the use of information and communication technology from an ethical perspective. The transcribed focus group discussions were analysed using qualitative content analysis. The results showed that district nurses' attitudes were positive regarding the use of information and communication technology in their work. They also asked for possibilities to influence the design and its introduction. However, the use of information and communication technology in home nursing can be described as a complement to communication that could not replace human physical encounters. Improvements and risks, as well as the importance of physical presence in home nursing were considered vital. The results revealed that the use of information and communication technology requires changes in the district nurses' work situation.

  18. 78 FR 46421 - Proposed Information Collection (Per Diem for Nursing Home Care of Veterans in State Homes; Per...

    Science.gov (United States)

    2013-07-31

    ... AFFAIRS Proposed Information Collection (Per Diem for Nursing Home Care of Veterans in State Homes; Per Diem for Adult Day Care of Veterans in State Homes): Comment Request AGENCY: Veterans Health... the notice. This notice solicits comments on information needed to ensure that nursing home and adult...

  19. Turnover, staffing, skill mix, and resident outcomes in a national sample of US nursing homes.

    Science.gov (United States)

    Trinkoff, Alison M; Han, Kihye; Storr, Carla L; Lerner, Nancy; Johantgen, Meg; Gartrell, Kyungsook

    2013-12-01

    The authors examined the relationship of staff turnover to selected nursing home quality outcomes, in the context of staffing and skill mix. Staff turnover is a serious concern in nursing homes as it has been found to adversely affect care. When employee turnover is minimized, better care quality is more likely in nursing homes. Data from the National Nursing Home Survey, a nationally representative sample of US nursing homes, were linked to Nursing Home Compare quality outcomes and analyzed using logistic regression. Nursing homes with high certified nursing assistant turnover had significantly higher odds of pressure ulcers, pain, and urinary tract infections even after controlling for staffing, skill mix, bed size, and ownership. Nurse turnover was associated with twice the odds of pressure ulcers, although this was attenuated when staffing was controlled. This study suggests turnover may be more important in explaining nursing home (NH) outcomes than staffing and skill mix and should therefore be given greater emphasis.

  20. The Factors Influencing the Sense of Home in Nursing Homes: A Systematic Review from the Perspective of Residents

    OpenAIRE

    Rijnaard, M. D.; J. van Hoof; Janssen, B.M.; Verbeek, H.; Pocornie, W.; Eijkelenboom, A; Beerens, H.C.; Molony, S. L.; Wouters, E. J. M.

    2016-01-01

    Purpose. To provide an overview of factors influencing the sense of home of older adults residing in the nursing home. Methods. A systematic review was conducted. Inclusion criteria were (1) original and peer-reviewed research, (2) qualitative, quantitative, or mixed methods research, (3) research about nursing home residents (or similar type of housing), and (4) research on the sense of home, meaning of home, at-homeness, or homelikeness. Results. Seventeen mainly qualitative articles were i...

  1. An outbreak of Streptococcus pneumoniae in an Italian nursing home.

    Directory of Open Access Journals (Sweden)

    Riccardo Papalia

    2015-09-01

    Full Text Available Streptococcus pneumoniae is the main cause of community-acquired pneumonia worldwide; pneumonia occurs sporadically in most cases, but rare outbreaks have been reported. We  describe an outbreak occurred in a 21-guests nursing home for elders in Aosta (Italy; outbreak occurred in april 2014 over a 2 weeks period, resulting in 12 out 20 guests affected (all with high fever and respiratory symptoms, two deaths (at home, nine patients referred  to Hospital Emergency Room, and eight admissions. Urinary streptococcus antigen was positive in seven out of eight patient tested. None of the nursing home guests were vaccinated against Streptococcus pneumoniaeThe Hospital Medical Direction and Public Health Service gave support and adopted strategies to contain the outbreak spread.We underline the need for pneumococcal vaccination in nursing homes/ Long-term care facilities; accurate check of hygiene behaviours in those setting is also mandatory.   

  2. Motivators for physical activity among ambulatory nursing home older residents.

    Science.gov (United States)

    Chen, Yuh-Min; Li, Yueh-Ping

    2014-01-01

    The purpose of this study was to explore self-identified motivators for regular physical activity among ambulatory nursing home older residents. A qualitative exploratory design was adopted. Purposive sampling was performed to recruit 18 older residents from two nursing homes in Taiwan. The interview transcripts were analyzed by qualitative content analysis. Five motivators of physical activity emerged from the result of analysis: eagerness for returning home, fear of becoming totally dependent, improving mood state, filling empty time, and previously cultivated habit. Research on physical activity from the perspectives of nursing home older residents has been limited. An empirically grounded understanding from this study could provide clues for promoting and supporting lifelong engagement in physical activity among older residents. The motivators reported in this study should be considered when designing physical activity programs. These motivators can be used to encourage, guide, and provide feedback to support older residents in maintaining physical activity.

  3. Swedish district nurses' attitudes to implement information and communication technology in home nursing

    OpenAIRE

    Nilsson, Carina; Skär, Lisa; Söderberg, Siv

    2008-01-01

    The use of information and communication technology has increased in the society, and can be useful in nursing care. The aim of this study was to describe district nurses' attitudes regarding the implementation of information and communication technology in home nursing. The first and third authors performed five focus group discussions with 19 district nurses' from five primary healthcare centres in northern Sweden. During the focus group discussions, the following topics were discussed: the...

  4. The effects of a nursing guideline on depression in psychogeriatric nursing home residents with dementia.

    OpenAIRE

    Verkaik, R.; Francke, A.L.; Meijel, B. van; Spreeuwenberg, P.M.M.; Ribbe, M.W.; Bensing, J M

    2011-01-01

    OBJECTIVE: To study the effects of introducing a nursing guideline on depression in residents with dementia of psychogeriatric nursing home wards. METHODS: A multi-center controlled clinical trial with randomization at ward level was used to study the effects of the guideline introduction. Nursing teams were trained in applying the guideline to their own residents diagnosed with depression in dementia. Key elements of the nursing guideline are increasing individualized pleasant activities and...

  5. The introduction of a nursing guideline on depression at psychogeriatric nursing home wards: effects on Certified Nurse Assistants.

    NARCIS (Netherlands)

    Verkaik, R.; Francke, A.L.; Meijel, B. van; Spreeuwenberg, P.M.M.; Ribbe, M.W.; Bensing, J.M.

    2011-01-01

    Background: To improve care for residents with depression in dementia, an evidence based nursing guideline was developed. Using the guideline has already shown positive effects on depression in psychogeriatric nursing home residents. Objective: To study the effects of the introduction of the nursing

  6. 75 FR 39641 - Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes

    Science.gov (United States)

    2010-07-12

    ... and Medicaid Programs; Civil Money Penalties for Nursing Homes AGENCY: Centers for Medicare & Medicaid... when nursing homes are not in compliance with Federal participation requirements in accordance with the... requirements for these facilities, generally referred to as ``nursing home(s),'' ``facility'' or ``facilities...

  7. Ineffective Staff, Ineffective Supervision, or Ineffective Administration? Why Some Nursing Homes Fail to Provide Adequate Care.

    Science.gov (United States)

    Sheridan, John E.; And Others

    1992-01-01

    This study involved 530 nursing staff working in 25 for-profit and nonprofit nursing homes, 2 of which failed to meet residential care standards. Nursing home climate in failed homes was perceived as being significantly lower in human relations and higher in laissez-faire and status orientation dimensions that the climate in the successful homes.…

  8. Hand hygiene compliance among the nursing staff in freestanding nursing homes in Taiwan: a preliminary study.

    Science.gov (United States)

    Liu, Wen-I; Liang, Shu-Yuan; Wu, Shu-Fang Vivienne; Chuang, Yeu-Hui

    2014-02-01

    This study aimed to explore the hand hygiene compliance among the nursing staff in Taiwanese freestanding nursing homes. A descriptive observational research design was used. A total of 782 opportunities for hand hygiene were observed by one trained research assistant in two freestanding nursing homes. The hand-hygiene observation tool was used to assess hand hygiene practice. The overall hand hygiene compliance among nursing staff in nursing homes was only 11.3%. Results further showed that the compliance was greater after contact with body fluids (odds ratio = 6.9, confidence interval (CI) = 3.75-9.88, P = 0.000) and lower before the performance of aseptic procedures (odds ratio = 0.15, CI = 0.04-0.63, P = 0.003) when compared with other activities. Hand hygiene compliance was relatively low among the nursing staff in freestanding nursing homes in Taiwan. To comprehensively analyze this issue, further research involving a larger number of nursing homes and strategies to improve compliance with hand hygiene among the nursing staff at these institutions is needed. © 2013 Wiley Publishing Asia Pty Ltd.

  9. Institutional loyalty and job satisfaction among nurse aides in nursing homes.

    Science.gov (United States)

    Grau, L; Chandler, B; Burton, B; Kolditz, D

    1991-02-01

    The high rate of turnover among nurse aides employed in nursing homes has been associated with the low job status and the poor job benefits accorded workers. However, this is not always the case. Competitive benefit packages and limited labor market opportunities increase the likelihood that nurse aides in some nursing homes may stay on the job despite their dissatisfaction with it. The present study investigated "institutional loyalty," an attitudinal proxy for job turnover, among 219 nurse aides for its relationship to a number of job-related factors. Somewhat unexpectedly, the quality of the social environment of the nursing home was found to be as important as attitudes toward job benefits in accounting for institutional loyalty.

  10. Communication skills training in a nursing home: Effects of a brief intervention on residents and nursing aides

    NARCIS (Netherlands)

    S. Sprangers (Suzan); K. Dijkstra (Katinka); A. Romijn-Luijten (Anna)

    2015-01-01

    textabstractEffective communication by nursing home staff is related to a higher quality of life and a decrease in verbal and physical aggression and depression in nursing home residents. Several communication intervention studies have been conducted to improve communication between nursing home sta

  11. Where should Momma go? Current nursing home performance measurement strategies and a less ambitious approach

    OpenAIRE

    Lieberman Trudy; Hawes Catherine; Phillips Charles D; Koren Mary

    2007-01-01

    Abstract Background Nursing home performance measurement systems are practically ubiquitous. The vast majority of these systems aspire to rank order all nursing homes based on quantitative measures of quality. However, the ability of such systems to identify homes differing in quality is hampered by the multidimensional nature of nursing homes and their residents. As a result, the authors doubt the ability of many nursing home performance systems to truly help consumers differentiate among ho...

  12. Working in and around the 'chain of command': power relations among nursing staff in an urban nursing home.

    Science.gov (United States)

    Jervis, Lori L

    2002-03-01

    By most accounts, the discipline of nursing enjoys considerable hegemony in US nursing homes. Not surprisingly, the ethos of this setting is influenced, in large part, by nursing's value system. This ethos powerfully impacts both the residents who live in nursing homes and the staff who work there. Using ethnographic methods, this project explored power relations among nursing assistants and nurses in an urban nursing home in the United States. Factors contributing to tensions among nursing staff were the stigma attached to nursing homes and those who work in them, as well as the long history of class conflict and power struggles within the discipline of nursing. The latter struggles, in turn, reflected nursing's quest for professional status in the face of medicine's hegemony over health-care. Ultimately, these factors coalesced to produce a local work environment characterized by conflict--and by aides' resistance to nurses' domination.

  13. [What are the Prerequisites for a Successful Cooperation between Nursing Homes and Physicians? - Results of a Mixed-methods Cross-Sectional Study in Bavarian Nursing Homes].

    Science.gov (United States)

    Karsch-Völk, M; Lüssenheide, J; Linde, K; Schmid, E; Schneider, A

    2016-11-01

    Aim: This mixed-methods cross-sectional study examined the cooperation between nursing home staff and physicians in Bavarian nursing homes in order to understand which organisational and communication measures are resulting in satisfying teamwork among professional groups in nursing homes. Methods: In 3 interview rounds nursing home staff, general practitioners, medical specialists, dentists, nursing home residents, and relatives in 52 nursing homes were interviewed using a questionnaire that was enhanced after every round. Additionally, focus group interviews have been performed in 2 nursing homes. Results: 443 persons involved in patient care, 50 residents and 47 relatives participated in the structured interviews. 22 persons attended the focus group interviews. 65% of the nursing homes required regular visits of general practitioners and 36% or, respectively, 27% required regular or on demand visits of specialists. 47% of the nursing home staff that was asked about this issue stated that it would make their work easier if only a small number of physicians were in charge of their institution. Measures for improvement of medical care in nursing homes most frequently suggested by interview partners responsible for patient care were: better communication (9%), better remuneration of physicians' nursing home visits (7%, nurses and physicians) and less bureaucracy and regular physicians' visits (5% in each question). Conclusion: Because of the composition of our study sample it cannot be assumed that the results are representative for all Bavarian nursing homes. Confidence in one another, low number of persons in charge, binding agreements and regular physicians' nursing home visits are essential for a successful cooperation between providing physicians and nursing home staff. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Unintentional Discontinuation of Chronic Medications for Seniors in Nursing Homes

    Science.gov (United States)

    Stall, Nathan M.; Fischer, Hadas D.; Wu, C. Fangyun; Bierman, Arlene S.; Brener, Stacey; Bronskill, Susan; Etchells, Edward; Fernandes, Olavo; Lau, Davina; Mamdani, Muhammad M.; Rochon, Paula; Urbach, David R.; Bell, Chaim M.

    2015-01-01

    Abstract Transitions of care leave patients vulnerable to the unintentional discontinuation of medications with proven efficacy for treating chronic diseases. Older adults residing in nursing homes may be especially susceptible to this preventable adverse event. The effect of large-scale policy changes on improving this practice is unknown. The objective of this study was to analyze the effect of a national medication reconciliation accreditation requirement for nursing homes on rates of unintentional medication discontinuation after hospital discharge. It was a population-based retrospective cohort study that used linked administrative records between 2003 and 2012 of all hospitalizations in Ontario, Canada. We identified nursing home residents aged ≥66 years who had continuous use of ≥1 of the 3 selected medications for chronic disease: levothyroxine, HMG-CoA reductase inhibitors (statins), and proton pump inhibitors (PPIs). In 2008 medication reconciliation became a required practice for accreditation of Canadian nursing homes. The main outcome measures included the proportion of patients who restarted the medication of interest after hospital discharge at 7 days. We also performed a time series analysis to examine the impact of the accreditation requirement on rates of unintentional medication discontinuation. The study included 113,088 adults aged ≥66 years who were nursing home residents, had an acute hospitalization, and were discharged alive to the same nursing home. Overall rates of discontinuation at 7-days after hospital discharge were highest in 2003–2004 for all nursing homes: 23.9% for thyroxine, 26.4% for statins, and 23.9% for PPIs. In most of the cases, these overall rates decreased annually and were lowest in 2011–2012: 4.0% for thyroxine, 10.6% for statins, and 8.3% for PPIs. The time series analysis found that nursing home accreditation did not significantly lower medication discontinuation rates for any of the 3 drug groups. From 2003

  15. Trajectories of At-Homeness and Health in Usual Care and Small House Nursing Homes

    Science.gov (United States)

    Molony, Sheila L.; Evans, Lois K.; Jeon, Sangchoon; Rabig, Judith; Straka, Leslie A.

    2011-01-01

    Background: Long-term care providers across the United States are building innovative environments called "Green House" or small-house nursing homes that weave humanistic person-centered philosophies into clinical care, organizational policies, and built environments. Purpose: To compare and contrast trajectories of at-homeness and health over…

  16. Feasibility of using quadriceps-strengthening exercise to improve pain and sleep in a severely demented elder with osteoarthritis – a case report

    Directory of Open Access Journals (Sweden)

    Richards Kathy

    2002-10-01

    Full Text Available Abstract Background Osteoarthritis (OA of the knee, which is prevalent among older adults in nursing homes, causes significant pain and suffering, including disturbance of nocturnal sleep. One nonpharmacologic treatment option is quadriceps-strengthening exercise, however, the feasibility of such a treatment for reducing pain from OA in severely demented elders has not been studied. This report describes our test of the feasibility of such an exercise program, together with its effects on pain and sleep, in a severely demented nursing home resident. Case presentation The subject was an elderly man with severe cognitive impairment (Mini-Mental Status Exam score 4 and knee OA (Kellgren-Lawrence radiographic grade 4. He was enrolled in a 5-week, 10-session standardized progressive-resistance training program to strengthen the quadriceps, and completed all sessions. Pain was assessed with the Western Ontario and MacMaster OA Index (WOMAC pain subscale, and sleep was assessed by actigraphy. The patient was able to perform the exercises, with a revision to the protocol. However, the WOMAC OA pain subscale proved inadequate for measuring pain in a patient with low cognitive functioning, and therefore the effects on pain were inconclusive. Although his sleep improved after the intervention, the influence of his medications and the amount of daytime sleep on his nighttime sleep need to be considered. Conclusions A quadriceps-strengthening exercise program for treating OA of the knee is feasible in severely demented elders, although a better outcome measure is needed for pain.

  17. In pursuit of the common thread : Nursing content in patient records with special reference to nursing home care

    OpenAIRE

    Ehrenberg, Anna

    2000-01-01

    The purpose of this thesis was to study different aspects of nursing content in patient records with special reference to nursing home care. The thesis focused on the content, comprehensiveness, accuracy and auditing of records, as well as the practice and perceptions of nurses in relation to recording. A national sample of nurses was asked to complete a questionnaire. The effects on recording and nurses' practice and perceptions in nursing homes following educational intervention were studie...

  18. Tetanus immunity in nursing home residents of Bolu, Turkey

    Directory of Open Access Journals (Sweden)

    Tamer Ali

    2005-01-01

    Full Text Available Abstract Background Tetanus is a serious but vaccine-preventable disease and fatality rate of the disease is high in the neonates and the elderly. The aim of this study was to detect the tetanus antibody prevalence in the over sixty-year age residents of the nursing homes in Bolu. Methods A voluntary-based study was done in the residents of two nursing homes in Bolu, Turkey. Blood samples were taken from 71 volunteers residing in there nursing homes. Tetanus IgG antibodies were measured by a commercial ELISA kit. Results Among overall subjects, only 11 (15.7 % had the protective tetanus antibody titers at the time of the study. Totally, 10 subjects were examined in emergency rooms due to trauma or accidents within the last ten years and, four (40% of them had protective antibody levels. Of the remaining 61 subjects only 7 (11% had protective antibody levels (p Conclusions Tetanus antibody level is below the protective level in the majority of the over-sixty-year-age subjects residing in the nursing homes. Each over sixty-year age person in our country should be vaccinated. Until this is accomplished, at least, nursing home residents should be vaccinated during registration.

  19. Effects of snoezelen, integrated in 24 h dementia care, on nurse-patient communication during morning care.

    NARCIS (Netherlands)

    Weert, J.C.M. van; Dulmen, A.M. van; Spreeuwenberg, P.M.M.; Ribbe, M.W.; Bensing, J.M.

    2005-01-01

    OBJECTIVE: To investigate the effectiveness of snoezelen, integrated in 24-hour care, on the communication of Certified Nursing Assistants (CNAs) and demented nursing home residents during morning care. METHODS: A quasi-experimental pre- and post-test design was conducted, comparing sic psychogeriat

  20. Effects of snoezelen, integrated in 24 h dementia care, on nurse-patient communication during morning care

    NARCIS (Netherlands)

    Weert, van J.C.M.; Dulmen, van A.M.; Spreeuwenberg, P.M.M.; Ribbe, M.W.; Bensing, J.M.

    2005-01-01

    OBJECTIVE: To investigate the effectiveness of snoezelen, integrated in 24-hour care, on the communication of Certified Nursing Assistants (CNAs) and demented nursing home residents during morning care. METHODS: A quasi-experimental pre- and post-test design was conducted, comparing sic psychogeriat

  1. Local Medicaid home- and community-based services spending and nursing home admissions of younger adults.

    Science.gov (United States)

    Thomas, Kali S; Keohane, Laura; Mor, Vincent

    2014-11-01

    We used fixed-effect models to examine the relationship between local spending on home- and community-based services (HCBSs) for cash-assisted Medicaid-only disabled (CAMOD) adults and younger adult admissions to nursing homes in the United States during 2001 through 2008, with control for facility and market characteristics and secular trends. We found that increased CAMOD Medicaid HCBS spending at the local level is associated with decreased admissions of younger adults to nursing homes. Our findings suggest that states' efforts to expand HCBS for this population should continue.

  2. Communication skills training in a nursing home: effects of a brief intervention on residents and nursing aides.

    Science.gov (United States)

    Sprangers, Suzan; Dijkstra, Katinka; Romijn-Luijten, Anna

    2015-01-01

    Effective communication by nursing home staff is related to a higher quality of life and a decrease in verbal and physical aggression and depression in nursing home residents. Several communication intervention studies have been conducted to improve communication between nursing home staff and nursing home residents with dementia. These studies have shown that communication skills training can improve nursing aides' communication with nursing home residents. However, these studies tended to be time-consuming and fairly difficult to implement. Moreover, these studies focused on the communicative benefits for the nursing home residents and their well-being, while benefits and well-being for the nursing aides were neglected. The current study focused on implementing a brief communication skills training program to improve nursing aides' (N=24) communication with residents with dementia (N=26) in a nursing home. The effects of the training on nursing aides' communication, caregiver distress, and job satisfaction and residents' psychopathology and agitation were assessed relative to a control group condition. Nursing aides in the intervention group were individually trained to communicate effectively with residents during morning care by using short instructions, positive speech, and biographical statements. Mixed ANOVAs showed that, after training, nursing aides in the intervention group experienced less caregiver distress. Additionally, the number of short instructions and instances of positive speech increased. Providing nursing aides with helpful feedback during care aids communication and reduces caregiver burden, even with a brief intervention that requires limited time investments for nursing home staff.

  3. Communication skills training in a nursing home: effects of a brief intervention on residents and nursing aides

    Science.gov (United States)

    Sprangers, Suzan; Dijkstra, Katinka; Romijn-Luijten, Anna

    2015-01-01

    Effective communication by nursing home staff is related to a higher quality of life and a decrease in verbal and physical aggression and depression in nursing home residents. Several communication intervention studies have been conducted to improve communication between nursing home staff and nursing home residents with dementia. These studies have shown that communication skills training can improve nursing aides’ communication with nursing home residents. However, these studies tended to be time-consuming and fairly difficult to implement. Moreover, these studies focused on the communicative benefits for the nursing home residents and their well-being, while benefits and well-being for the nursing aides were neglected. The current study focused on implementing a brief communication skills training program to improve nursing aides’ (N=24) communication with residents with dementia (N=26) in a nursing home. The effects of the training on nursing aides’ communication, caregiver distress, and job satisfaction and residents’ psychopathology and agitation were assessed relative to a control group condition. Nursing aides in the intervention group were individually trained to communicate effectively with residents during morning care by using short instructions, positive speech, and biographical statements. Mixed ANOVAs showed that, after training, nursing aides in the intervention group experienced less caregiver distress. Additionally, the number of short instructions and instances of positive speech increased. Providing nursing aides with helpful feedback during care aids communication and reduces caregiver burden, even with a brief intervention that requires limited time investments for nursing home staff. PMID:25653513

  4. Nursing Staffs' Views on Physical and Psychosocial Care Provision in Slovenian Nursing Homes.

    Science.gov (United States)

    Habjanić, Ana; Elo, Satu; Micetić-Turk, Dusanka; Isola, Arja

    2015-12-01

    The aim of this study was to explore nursing staffs' perceptions of the physical and psychological care needs of elderly residents, their views on the relative importance of these needs and their perceived ability to meet them. The literature reveals that the quality of elder care in nursing homes should comprise both physical and psychosocial care. Despite this, the nursing staffs' perceptions of the physical and psychosocial care provision have not often been researched. As a method cross-sectional research design was used, with structured questionnaires and unstructured interviews. Our sample consisted of members of the nursing staff from four nursing homes in Slovenia (survey: N = 148; interview: N = 16). The resulting data was processed by means of statistical analysis and conventional content analysis. The nursing staff reported more knowledge of, skills with and willingness to meet residents'physical needs than psychosocial needs. On the other hand, communication, conversation, self-care and a home-like environment were considered by nursing staff as marking quality elder care. Consequently, nursing home administrators should try to strengthen psychosocial care provision to improve the residents' quality of life. Conversation, as the most often recognised aspect of psychosocial care, should be promoted, since improvements in this area would not be costly, and each nursing staff member may decide individually how best to include more conversation in the daily routines of elder care provision.

  5. Teaching home care electronic documentation skills to undergraduate nursing students.

    Science.gov (United States)

    Nokes, Kathleen M; Aponte, Judith; Nickitas, Donna M; Mahon, Pamela Y; Rodgers, Betsy; Reyes, Nancy; Chaya, Joan; Dornbaum, Martin

    2012-01-01

    Although there is general consensus that nursing students need knowledge and significant skill to document clinical findings electronically, nursing faculty face many barriers in ensuring that undergraduate students can practice on electronic health record systems (EHRS). External funding supported the development of an educational innovation through a partnership between a home care agency staff and nursing faculty. Modules were developed to teach EHRS skills using a case study of a homebound person requiring wound care and the Medicare-required OASIS documentation system. This article describes the development and implementation of the module for an upper-level baccalaureate nursing program located in New York City. Nursing faculty are being challenged to develop creative and economical solutions to expose nursing students to EHRSs in nonclinical settings.

  6. Working experiences of nursing aides in nursing homes: A qualitative study

    Directory of Open Access Journals (Sweden)

    Yan-ping Wei

    2015-12-01

    Conclusion: A reasonable work arrangement, positive psychological intervention, and the strengthening of professional, medical and social supports are recommended to improve the work quality and satisfaction of nursing aides in elderly homes.

  7. A conceptual model for culture change evaluation in nursing homes.

    Science.gov (United States)

    Hartmann, Christine W; Snow, A Lynn; Allen, Rebecca S; Parmelee, Patricia A; Palmer, Jennifer A; Berlowitz, Dan

    2013-01-01

    This article describes the development and particulars of a new, comprehensive model of nursing home culture change, the Nursing Home Integrated Model for Producing and Assessing Cultural Transformation (Nursing Home IMPACT). This model is structured into four categories, "meta constructs," "care practices," "workplace practices," and "environment of care," with multiple domains under each. It includes detailed, triangulated assessment methods capturing various stakeholder perspectives for each of the model's domains. It is hoped that this model will serve two functions: first, to help practitioners guide improvements in resident care by identifying particular areas in which culture change is having positive effects, as well as areas that could benefit from modification; and second, to emphasize the importance in culture change of the innumerable perspectives of residents, family members, staff, management, and leadership. Published by Mosby, Inc.

  8. Autonomy among physically frail older people in nursing home settings

    DEFF Research Database (Denmark)

    Andresen, Mette; Puggaard, Lis

    2008-01-01

    -dimension in the Measure of Actualisation of Potential test. Programmes were based on participants' individual assessment of their most important daily activities. Staff at all nursing homes who usually organize physical training, social or creative activities carried out individually tailored programmes using their usual...... methods and equipment. Participants in each nursing home were divided by lot into either a control group or an intervention group. The control groups received their usual care and treatment. DISCUSSION: This study is designed to assess the status of perceived autonomy at baseline and to provide......BACKGROUND: Experiencing autonomy is recognised to promote health and well-being for all age groups. Perceived lack of control has been found to be detrimental to physical and mental health. There is a lack of evidence-based knowledge elucidating how frail older people in nursing home settings...

  9. Family Members’ Experience with Hospice in Nursing Homes

    Science.gov (United States)

    Gage, L. Ashley; Washington, Karla T.; Oliver, Debra Parker; Lewis, Alexandra; Kruse, Robin L.; Demiris, George

    2014-01-01

    Research has documented numerous benefits and challenges associated with receipt of hospice care in nursing homes; however, study of this partnership from the perspective of residents’ family members has been limited. The purpose of this qualitative investigation was to explore family members’ experience with hospice services received in the nursing home setting. Researchers conducted a secondary data analysis of 175 family member interviews using a thematic analytic approach. Findings highlighted the critical role of communication in supporting residents and their family members. Care coordination, support and oversight, and role confusion also impacted family members’ experience of hospice care in the nursing home. Efforts directed at enhancing communication and more clearly articulating the roles of members of the health care team are indicated. PMID:25422516

  10. Nursing home residents and celebrities: a tale of morality.

    Science.gov (United States)

    Claessens, Nathalie

    2014-01-01

    In contemporary Western societies, characterized by global aging and an omnipresent celebrity culture, little is known about the role of celebrities for older adults. This study bridges gerontology and celebrity studies to explore a social role that celebrities can fulfill for nursing home residents: triggering moral discussions. This potential role is examined in four focus groups with 27 nursing home residents in Flanders (Belgium). Here, 20 celebrity pictures are employed to evoke moral discussions, with a focus on adultery and homosexuality. These discussions are subjected to a framing analysis. Results show that celebrities can trigger moral discussions among the nursing home residents. The residents' adultery and homosexuality frames show that they mostly retain dominant values from their youth, often combining them with contemporary dominant values. Further, the residents' frames prove to be relativistic, which can be linked to their multitude of life experiences and complex emotional skills.

  11. Family Members' Experience With Hospice in Nursing Homes.

    Science.gov (United States)

    Gage, L Ashley; Washington, Karla; Oliver, Debra Parker; Kruse, Robin; Lewis, Alexandra; Demiris, George

    2016-05-01

    Research has documented numerous benefits and challenges associated with receipt of hospice care in nursing homes; however, study of this partnership from the perspective of residents' family members has been limited. The purpose of this qualitative investigation was to explore family members' experience with hospice services received in the nursing home setting. Researchers conducted a secondary data analysis of 175 family member interviews using a thematic analytic approach. Findings highlighted the critical role of communication in supporting residents and their family members. Care coordination, support and oversight, and role confusion also impacted family members' experience of hospice care in the nursing home. Efforts directed at enhancing communication and more clearly articulating the roles of members of the health care team are indicated.

  12. Why do nursing homes close? An analysis of newspaper articles.

    Science.gov (United States)

    Fisher, Andrew; Castle, Nicholas

    2012-01-01

    Using Non-numerical Unstructured Data Indexing Searching and Theorizing (NUD'IST) software to extract and examine keywords from text, the authors explored the phenomenon of nursing home closure through an analysis of 30 major-market newspapers over a period of 66 months (January 1, 1999 to June 1, 2005). Newspaper articles typically represent a careful analysis of staff impressions via interviews, managerial perspectives, and financial records review. There is a current reliance on the synthesis of information from large regulatory databases such as the Online Survey Certification And Reporting database, the California Office of Statewide Healthcare Planning and Development database, and Area Resource Files. Although such databases permit the construction of studies capable of revealing some reasons for nursing home closure, they are hampered by the confines of the data entered. Using our analysis of newspaper articles, the authors are able to add further to their understanding of nursing home closures.

  13. Nursing home error and level of staff credentials.

    Science.gov (United States)

    Scott-Cawiezell, Jill; Pepper, Ginette A; Madsen, Richard W; Petroski, Greg; Vogelsmeier, Amy; Zellmer, Dave

    2007-02-01

    Providing safe nursing home care is both a clinical and fiscal challenge in many countries. The fiscal realities result in the addition of other workers, such as medication technicians or aides (CMT/A), to the health care team. The purpose of this study was to determine the impact of various levels of credentialing among nursing home staff who deliver medications (RN, LPN, or CMT/A) on medication error. In addition, the impact of distractions and interruptions was explored. Using naïve observation, 39 medication administrators representing various levels of credentialing were unobtrusively observed to determine the number of medication errors, distractions, and interruptions in five nursing homes. There were no differences in medication error rates by level of credential. However, RNs had more interruptions during their medication administration, and these increased interruptions were associated with increased medication error rates when wrong time errors were excluded (p = .0348).

  14. Educating nursing assistants to communicate more effectively with nursing home residents with dementia.

    Science.gov (United States)

    McCallion, P; Toseland, R W; Lacey, D; Banks, S

    1999-10-01

    This article describes the development and evaluation of a Nursing Assistant Communication Skills Program (NACSP). NACSP was designed to help nursing assistants (NAs) interact more effectively with nursing home residents with moderate and severe dementia. In two skilled-care nursing homes, NAs in four units were randomly assigned by unit to NACSP or to a wait-list control condition (UC) and were assessed at baseline, 3 months, and 6 months. NACSP resulted in improvement in the well-being of nursing home residents being cared for by NAs who had received the NACSP training. It was also found that NACSP resulted in greater knowledge of caregiving responses and reduced turnover rates among NAs, but the program had no impact on their knowledge of dementia. To disseminate the NACSP program, a leader manual, an accompanying training videotape, and a workbook for participants were developed.

  15. Collaboration and control: nurses' constructions of the role of family in nursing home care.

    Science.gov (United States)

    Bauer, Michael

    2006-04-01

    This paper reports a study examining how nursing home staff experienced working with residents' families. Working collaboratively with the family in residential aged care to provide care is consistent with nursing philosophy. The quality of the experience, however, is frequently fraught with problems for both the family and staff involved. Little research has focused on the nature of family involvement in nursing homes from the perspective of nursing home staff. The study adopted a naturalistic paradigm. Data were collected from 30 nursing home staff members drawn from a range of metropolitan and rural facilities in Victoria, Australia by means of conversational in-depth interviews. Issues concerned with how participants constructed the role of the family in the nursing home were explored. The data were collected in 2001-2002. Four key elements are presented in this paper: (1) Making the transition; (2) Forming ties; (3) Keeping them at a distance and (4) Unacceptable behaviour. Some nursing home staff have developed a substantive family orientation and had adopted practices which were inclusive of the family. Equally, many attitudes which cast the family into an adversarial and competitive role were noted, and many staff members outlined practices which were indicative of a need to control the family. A rhetoric of family partnerships is prevalent in some nursing homes. The activities of staff in these homes are still primarily geared towards provision of physical care, and families' needs become secondary to getting the work done. A new model of practice is needed that sees working collaboratively with families as a legitimate and necessary part of the staff role.

  16. Risk factors for burnout among caregivers working in nursing homes.

    Science.gov (United States)

    Kandelman, Nadia; Mazars, Thierry; Levy, Antonin

    2017-05-25

    (i) To assess the level of burnout in nursing home caregivers within a unique healthcare network in France and (ii) to evaluate potential risk factors in this population. Burnout syndrome occurs frequently among nursing home caregivers and has strong detrimental effects on the quality of health care for residents. We used an observational survey to study burnout in nursing home caregivers. The survey was used to quantify burnout level (Maslach Burnout Inventory) and potential risk factors and was implemented from October 2013-April 2014. A logistic regression was used to explore the association between burnout and its risk factors. Three hundred and sixty questionnaires were delivered to caregivers in 14 nursing homes within a unique healthcare network. The response rate was 37% (132/360), and 124/132 (94%) surveys were analysed. Caregiver burnout rate was 40% (49/124). Median age was 41 years (range, 20-70) and most caregivers were female. The most common profession (n = 54; 44%) was nurse caregiver and 90% (n = 112) had an antecedent of bullying by a resident. Risk factors identified were as follows: the presence of institutional protocols (death announcement [OR: 3.7] and pain assessment [OR: 2.8]), working in a profit-making establishment (OR: 2.6) and the antecedent of bullying by a resident (OR: 6.2). Factors most negatively associated with burnout included: practising pastimes (OR: 0.4) and working as a nurse (OR: 0.3). The only significant risk factor in the multivariate analysis was the antecedent of bullying by a resident (OR: 5.3). Several specific risk factors for burnout in nursing home caregivers were identified. In high-risk populations of healthcare professionals, screening and management of risk factors is crucial for preventing burnout. © 2017 John Wiley & Sons Ltd.

  17. Rehabilitation versus Nursing Home Nurses' Low Back and Neck-Shoulder Complaints.

    Science.gov (United States)

    Alperovitch-Najenson, Deborah; Sheffer, Dvora; Treger, Iuly; Finkels, Tova; Kalichman, Leonid

    2015-01-01

    To compare the prevalence of those complaints in nurses working in rehabilitation departments and nursing homes, and to evaluate factors associated with them. A cross-sectional study in rehabilitation and in nursing home departments. Data were obtained from questionnaires relating to basic demographics, prevalence of musculoskeletal complaints, potentially harmful positions and actions and job satisfaction. Multivariate analyses demonstrated higher work-related musculoskeletal complaints for nurses in rehabilitation than nursing home nurses (p=.012 for low back pain; ppain). Trunk bending, static posture, repetitive tasks, and recognition of superiors were associated with low back pain. Freedom to choose work techniques and degree of diversity at work were associated with neck-shoulder pain. Differences between the nurse groups as to work tasks might be a reason for differences in musculoskeletal complaints. Further comparisons between nurses working in different fields might reveal more accurate potential risk factors for work-related musculoskeletal complaints. Instruction for static/awkward posture avoidance, by using mechanical aids and designing a friendlier environment, should be part of a nursing staff injury prevention strategy. © 2014 Association of Rehabilitation Nurses.

  18. Nursing home nurses' experiences of resident transfers to the emergency department: no empathy for our work environment difficulties.

    Science.gov (United States)

    Tsai, Hsiu-Hsin; Tsai, Yun-Fang; Huang, Hsiu-Li

    2016-03-01

    To explore the experiences of nursing home nurses when they transfer residents from nursing homes to the emergency department in Taiwan. The transfer of residents between nursing homes and emergency departments challenges continuity of care. Understanding nursing home nurses' experiences during these transfers may help to improve residents' continuity of care. However, few empirical data are available on these nurses' transfer experiences worldwide, and none could be found in Asian countries. Qualitative descriptive study. Data were collected from August 2012-June 2013 in audiotaped, individual, in-depth interviews with 25 nurses at five nursing homes in Taiwan. Interview transcripts were analysed by constant comparative analysis. Analysis of interview transcripts revealed that the core theme of nursing home nurses' transfer experience was discontinuity in nursing home to emergency department transitions. This core theme comprised three themes: discontinuity in family involvement, discontinuity in medical resources and expectations, and discontinuity in nurses' professional role. Nursing home nurses need a working environment that is better connected to residents' family members and more immediate and/or easier access to acute care for residents. Communication between nurses and residents' family could be improved by using text messages or social media by mobile phones, which are widely used in Taiwan and worldwide. To improve access to acute care, we suggest developing a real-time telehealth transfer system tailored to the medical culture and policies of each country. This system should facilitate communication among nursing home staff, family members and hospital staff. Our findings on nurses' experiences during transfer of nursing home residents to the emergency department can be used to design more effective transfer policies such as telemedicine systems in Taiwan and other Asian countries or in those with large populations of Chinese immigrants. © 2016 John

  19. General practitioners' reasoning about using mobile distance-spanning technology in home care and in nursing home care.

    Science.gov (United States)

    Wälivaara, Britt-Marie; Andersson, Staffan; Axelsson, Karin

    2011-03-01

    The trend for health care and nursing care turns from hospital to health care and nursing care at home. Studies have shown that health care professionals have no access to patient records in home and nursing home settings. Technological development creates opportunities for a host of mobile technology solutions. The aim of this study was to describe the reasoning among general practitioners (GPs) about the use of mobile distance-spanning technology (MDST) in care at home and in nursing homes. Seventeen GPs were divided in five groups for a group interview. The interviews were tape-recorded and transcribed verbatim. The qualitative content analysis resulted in four areas about the MDST, MDST has an impact on GPs' work, the nurses' profession, and the patient and the family, with nine adherent categories. The findings were interpreted and formulated in the theme: MDST should be used with caution. The results show quite a few expressions about the MDST as useful and valuable in health care at home and in nursing home settings; however, in every category, there were text that we interpreted as caution when using the MDST. The MDST cannot be used in all situations and cannot replace human meetings in health care and nursing care at home and in nursing homes. The MDST should primarily be a tool for the profession, and understanding the professions' reasoning about technology use in health care at home and in nursing home settings must be the base for implementing MDST.

  20. Leadership, staffing and quality of care in nursing homes

    Directory of Open Access Journals (Sweden)

    Havig Anders

    2011-11-01

    Full Text Available Abstract Background Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78. Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses

  1. Medicare and Medicaid: Stronger Enforcement of Nursing Home Requirements Needed.

    Science.gov (United States)

    1987-07-22

    diet as prescribed, (2) rehabilita- tive nursing care as needed, and (3) proper care to prevent decubitus ulcers ( bedsores ) and deformities; and is (1...residents had bedsores , and that one of the residents had a bedsore on the hip that was four inches in diameter with muscle visible. The surveyor also...Weaknesses in Enforcement System Allow Repeat Offenders to Avoid Penalty of the four had bedsores . The nursing home’s plan of correction stated that a

  2. Sexual Abuse of Older Nursing Home Residents: A Literature Review

    Directory of Open Access Journals (Sweden)

    Wenche Malmedal

    2015-01-01

    Full Text Available Despite an increasing literature related to elder abuse, sexual abuse of older persons in general and of vulnerable adults living in nursing homes in particular is still sparsely described. The purpose of this study was to assess the state of knowledge on the subject of sexual abuse against older nursing home residents through a literature review. Systematic searches in reference databases including Cinahl, Medline, OVID Nursing Database, ISI Web of Science, PsycINFO, Cochrane Library, and SveMed + were conducted. Through several phases of selection of the articles, using strict inclusion and exclusion criteria, six articles were chosen for a deeper examination. Findings from the review show that sexual abuse occurs in nursing homes and that both older women and men are victims of sexual abuse. Perpetrators appear mainly to be staff and other residents and mainly to be men, but also women abuse both older men and older women. Findings from the literature review show that there is a need for knowledge and further research on the topic of sexual abuse against older residents in nursing homes. Furthermore, there is a need for good policies and reporting systems, as an important step in seriously addressing sexual abuse against older persons.

  3. Resource dependence and institutional elements in nursing home TQM adoption.

    Science.gov (United States)

    Zinn, J S; Weech, R J; Brannon, D

    1998-06-01

    To examine the contextual attributes that influence nursing home TQM adoption, as informed by resource dependence and institutional theories. A survey of licensed nursing home administrators in the Commonwealth of Pennsylvania during 1994-1995, the Medicare and Medicaid Annual Certification Survey (MMACS) data file, and the Area Resource File (ARF). Because the dependent variable (TQM adoption vs. non-adoption) is dichotomous, the model was estimated using logistic regression. Of the 615 facilities that were mailed surveys, 241 (39.2%) returned completed questionnaires. No significant differences were observed between respondents and nonrespondents in size, for-profit status, system membership, registered nurse staffing, cited licensure deficiencies, Medicare census, or Medicaid census. Perceived competition, Medicare's share of total hospital discharges in the market, and facility Medicare census were significant predictors of TQM adoption. Our results provide limited support for the association between some rational adaptive and institutional factors and TQM adoption in nursing homes. Perceived competition and the influence of the Medicare program both at the facility and the market level are associated with TQM adoption. However, other factors associated with TQM adoption in other industries, such as size, are not associated with TQM adoption in the nursing homes in this study.

  4. Full moon: does it influence agitated nursing home residents?

    Science.gov (United States)

    Cohen-Mansfield, J; Marx, M S; Werner, P

    1989-07-01

    This study examined the effect of the full moon on agitation manifested by nursing home residents (N = 24). Observations of agitation were recorded on a behavioral mapping instrument, and occurrence of the full moon was operationalized in the three ways most commonly cited in the literature. The hypothesis that elderly nursing home residents become increasingly agitated during a full moon was not supported by this study. In all analyses, agitation was observed less often when the full moon was full than during the other three lunar phases, although differences were not statistically significant.

  5. Overcoming challenges of conducting research in nursing homes.

    Science.gov (United States)

    Jenkins, Catharine; Smythe, Analisa; Galant-Miecznikowska, Magdalena; Bentham, Peter; Oyebode, Jan

    2016-05-27

    In the UK, one third of the 850,000 people with dementia live in care homes. This article explores the process of carrying out research in nursing homes, identifying barriers and enabling factors, and making recommendations for researchers. The authors' experiences derive from an ongoing study investigating the effect of educational interventions to promote and embed person-centred care, designed for nurses caring for the people with dementia in nursing homes. Design issues arose from the need to use cluster randomisation which requires a large sample size, implementation fidelity, poor compliance and high numbers of participants lost to follow up. Further difficulties included gaining ethical approval, recruitment, raising concerns and the practicalities of participant retention. There are many benefits of conducting research in care homes, for the homes themselves, their staff and residents. These include training and education, networking and empowerment of staff and subsequent improved standards of care. For the research team, benefits include opportunities to contribute to an underserved setting, to advance care standards and improve nurses' working lives.

  6. General practitioners' experiences as nursing home medical consultants.

    Science.gov (United States)

    Kirsebom, Marie; Hedström, Mariann; Pöder, Ulrika; Wadensten, Barbro

    2017-03-01

    To describe general practitioners' experiences of being the principal physician responsible for a nursing home. Fifteen general practitioners assigned to a nursing home participated in semi-structured qualitative interviews. Data were analysed using systematic text condensation. Medical assessment is the main duty of general practitioners. Advance care planning together with residents and family members facilitates future decisions on medical treatment and end-of-life care. Registered Nurses' continuity and competence are perceived as crucial to the quality of care, but inadequate staffing, lack of medical equipment and less-than-optimal IT systems for electronic healthcare records are impediments to patient safety. The study highlights the importance of advance care planning together with residents and family members in facilitating future decisions on medical treatment and end-of-life care. To meet the increasing demands for more complex medical treatment at nursing homes and to provide high-quality palliative care, there would seem to be a need to increase Registered Nurses' staffing and acquire more advanced medical equipment, as well as to create better possibilities for Registered Nurses and general practitioners to access each other's healthcare record systems. © 2016 Nordic College of Caring Science.

  7. Tearmainn Bhride Nursing Home, Brideswell, Athlone, Roscommon.

    LENUS (Irish Health Repository)

    Yadav, B L

    2015-04-07

    Social skills training, a psychological approach, is used to ameliorate the deficits in social skills among patients with a severe mental illness. For the efficacy of social skills training in schizophrenia, the literature in other core psychiatric disciplines (i.e. psychology, psychiatry, etc) indicates some conflicting evidences and a limited quality of evidence in psychiatric nursing. With the exemption of a few individual nursing studies, no systematic review is available to date in psychiatric nursing literature. This systematic review of literature was undertaken to explore the efficacy of social skills training in schizophrenia.

  8. Overcoming Resistance to Culture Change: Nursing Home Administrators’ Use of Education, Training and Communication

    OpenAIRE

    Tyler, Denise A.; Lepore, Michael; Shield, Renee R.; LOOZE, JESSICA; Miller, Susan C.

    2013-01-01

    Nursing home culture change is becoming more prevalent and research has demonstrated its benefits for nursing home residents and staff, but little is known about the role of nursing home administrators in culture change implementation. The purpose of this study was to determine what barriers nursing home administrators faced in implementing culture change practices and to identify the strategies used to overcome these. We conducted in-depth individual interviews with 64 administrators identif...

  9. Nursing Staff Views of Barriers to Physical Restraint Reduction in Nursing Homes

    Directory of Open Access Journals (Sweden)

    Eun-Hi Kong, RN, PhD

    2012-12-01

    Conclusion: The findings of this study provide a valuable basis for developing restraint reduction education programs. Korean national leaders and nursing homes should develop and employ practice guidelines regarding restraints, support nursing staff to follow the guidelines, provide more practical and professional education, employ alternative equipment, use a multidisciplinary team approach, and engage volunteers in care support as well as employ more nursing staff to achieve restraint-free care.

  10. Faith and End of Life in Nursing Homes

    Directory of Open Access Journals (Sweden)

    Robert L. Rubinstein

    2011-01-01

    Full Text Available This paper explores the role of religious belief in the experiences of dying and death in a Catholic nursing home. The home appeals to residents and their families due to the active religious presence. Thus, religion is a salient element of the “local culture” which exists in this long-term care setting. The preeminence of faith within the organization and the personal religious convictions of staff, residents, and families may drive how death and dying are discussed and experienced in this setting, as well as the meanings that are attached to them. This paper examines the relationship between faith and the experience and meaning of death in this nursing home. We present themes that emerged from open-ended interviews with residents, family members, and staff, gathered between 1996 and 2004. The data indicate that people select the home due to their Catholic faith and the home's religious tone. Themes also show that belief in God and an afterlife helps shape the experience of dying and death for our informants. Our paper does not compare ease of dying with other nursing homes or within other belief systems.

  11. Working Conditions and Mental Health of Nursing Staff in Nursing Homes.

    Science.gov (United States)

    Zhang, Yuan; Punnett, Laura; Mawn, Barbara; Gore, Rebecca

    2016-07-01

    Nursing staff in nursing homes suffer from poor mental health, probably associated with stressful working conditions. Working conditions may distribute differently among nursing assistants, licensed practical nurses, and registered nurses due to their different levels in the organizational hierarchy. The objectives of this study were to evaluate the association between working conditions and mental health among different nursing groups, and examine the potential moderating effect of job group on this association. Self-administered questionnaires were collected with 1,129 nursing staff in 15 for-profit non-unionized nursing homes. Working conditions included both physical and psychosocial domains. Multivariate linear regression modeling found that mental health was associated with different working conditions in different nursing groups: physical safety (β = 2.37, p work-family conflict (β = -2.44, p work-family conflict (β = -4.17, p working conditions and mental health. Future workplace interventions to improve mental health should reach to nursing staff at different levels and consider tailored working condition interventions in different nursing groups.

  12. The Relationships Among Licensed Nurse Turnover, Retention, and Rehospitalization of Nursing Home Residents

    Science.gov (United States)

    Thomas, Kali S.

    2013-01-01

    Purpose: Individuals receiving postacute care in skilled nursing facilities often require complex, skilled care provided by licensed nurses. It is believed that a stable set of nursing personnel is more likely to deliver better care. The purpose of this study was to determine the relationships among licensed nurse retention, turnover, and a 30-day rehospitalization rate in nursing homes (NHs). Design and Methods: We combined two data sources: NH facility-level data (including characteristics of the facility, the market, and residents) and the Florida Nursing Home Staffing Reports (which provide staffing information for each NH) for 681 Florida NHs from 2002 to 2009. Using a two-way fixed effects model, we examined the relationships among licensed nurse turnover rates, retention rates, and 30-day rehospitalization rates. Results: Results indicate that an NH’s licensed nurse retention rate is significantly associated with the 30-day rehospitalization rate (est. = −.02, p = .04) controlling for demographic characteristics of the patient population, residents’ preferences for hospitalization, and the ownership characteristics of the NH. The NHs experiencing a 10% increase in their licensed nurse retention had a 0.2% lower rehospitalization rate, which equates to 2 fewer hospitalizations per NH annually. Licensed nurse turnover is not significantly related to the 30-day rehospitalization rate. Implications: These findings highlight the need for NH administrators and policy makers to focus on licensed nurse retention, and future research should focus on the measures of staff retention for understanding the staffing/quality relationship. PMID:22936529

  13. Evaluation of prescribing quality in nursing homes based on drug-specific indicators: The Bergen district nursing home (BEDNURS study

    Directory of Open Access Journals (Sweden)

    Sabine Ruths

    2009-09-01

    Full Text Available To examine prescribing quality among nursing home patients. Methods: A cross sectional study in 23 nursing homes, based on drug charts. The evaluation of prescribing quality was based on selected drug-specific indicators established by the Swedish National Board of Health and Welfare. Logistic regression analysis was used to examine associations between prescribing indicators and predictors related to patient (age, gender, drug number and institution (nurse and physician staff time characteristics. Results: A total of 1513 nursing home patients (76% women, mean age 85 years were included in the study. On average, the patients used 5.1 (SD 2.5 standing medications. Laxatives were most commonly used (58%, followed by loop-diuretics (35%, antidepressants (31%, and anti-thrombotic agents (27%. Altogether 850 (56% patients used at least one potentially inappropriate prescription (PIP, including long-term use of contact laxatives without proper indication (25%, long-acting benzodiazepines (17%, and anticholinergic drugs (16%. The number of drugs used was the most important determinant for any PIP as well as for all individual indicators (p<0.001. Relatively younger patients were more likely to receive any PIP, and in particular anticholinergic drugs, multiple psychotropic drugs, and interacting drugs (p<0.05. Conclusion: Prescribing quality assessment by use of drug-specific indicators revealed great potentials for improving drug therapy in Norwegian nursing homes.

  14. Motor Profile and Drug Treatment of Nursing Home Residents with Parkinson's Disease

    NARCIS (Netherlands)

    Weerkamp, Nico J.; Zuidema, Sytse U.; Tissingh, Gerrit; Poels, Petra J. E.; Munneke, Marten; Koopmans, Raymond T. C. M.; Bloem, Bastiaan R.

    2012-01-01

    Objectives To examine the clinical characteristics, motor impairments, and drug treatments of nursing home residents with Parkinson's disease (PD). Design Cross-sectional study. Setting Nursing homes in the southeast of the Netherlands. Participants Nursing home residents with PD and a Mini-Mental S

  15. 38 CFR 17.60 - Extensions of community nursing home care beyond six months.

    Science.gov (United States)

    2010-07-01

    ... nursing home care beyond six months. 17.60 Section 17.60 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Community Nursing Home Care Facilities § 17.60 Extensions of community nursing home care beyond six months. Directors of health care facilities may authorize, for...

  16. 78 FR 75959 - Agency Information Collection (Regulation on Reduction of Nursing Shortages in State Homes...

    Science.gov (United States)

    2013-12-13

    ... AFFAIRS Agency Information Collection (Regulation on Reduction of Nursing Shortages in State Homes; Application for Assistance for Hiring and Retaining Nurses at State Homes) Activities Under OMB Review AGENCY....'' SUPPLEMENTARY INFORMATION: Title: Regulation on Reduction of Nursing Shortages in State Homes; Application for...

  17. Nonmotor Symptoms in Nursing Home Residents with Parkinson's Disease : Prevalence and Effect on Quality of Life

    NARCIS (Netherlands)

    Weerkamp, Nico J.; Tissingh, Gerrit; Poels, Petra J. E.; Zuidema, Systse U.; Munneke, Marten; Koopmans, Raymond T. C. M.; Bloem, Bastiaan R.

    2013-01-01

    ObjectivesTo determine the prevalence of nonmotor symptoms (NMS) in nursing home (NH) residents with Parkinson's disease (PD) and to establish the association with quality of life. DesignCross-sectional. SettingNursing homes in the southeast of the Netherlands. ParticipantsNursing home residents wit

  18. Nonmotor symptoms in nursing home residents with Parkinson's disease: prevalence and effect on quality of life

    NARCIS (Netherlands)

    Weerkamp, N.J.; Tissingh, G.; Poels, P.J.P.; Zuidema, S.U.; Munneke, M.; Koopmans, R.T.C.M.; Bloem, B.R.

    2013-01-01

    OBJECTIVES: To determine the prevalence of nonmotor symptoms (NMS) in nursing home (NH) residents with Parkinson's disease (PD) and to establish the association with quality of life. DESIGN: Cross-sectional. SETTING: Nursing homes in the southeast of the Netherlands. PARTICIPANTS: Nursing home resid

  19. Risk of hip fracture in protected and unprotected falls in nursing homes in Norway

    NARCIS (Netherlands)

    Forsén, L; Søgaard, A J; Sandvig, S; Schuller, A; Røed, U; Arstad, C

    2004-01-01

    OBJECTIVES: To compare the probability of hip fracture in protected and unprotected falls in a real world setting in nursing homes. DESIGN: Observational study. SETTING: Seventeen nursing homes (965 beds) in Norway. SUBJECTS: All residents in the nursing homes with at least one fall during the inter

  20. 42 CFR 422.133 - Return to home skilled nursing facility.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Return to home skilled nursing facility. 422.133....133 Return to home skilled nursing facility. (a) General rule. MA plans must provide coverage of posthospital extended care services to Medicare enrollees through a home skilled nursing facility if...

  1. 76 FR 15105 - Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes

    Science.gov (United States)

    2011-03-18

    ... Services 42 CFR Part 488 Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes; Final... and Medicaid Programs; Civil Money Penalties for Nursing Homes AGENCY: Centers for Medicare & Medicaid... nursing homes are not in compliance with Federal participation requirements in accordance with...

  2. Nursing Home Staff Characteristics and Knowledge Gain from a Didactic Workshop on Depression and Behavior Management

    Science.gov (United States)

    Meeks, Suzanne; Burton, Elizabeth G.

    2004-01-01

    Depression is a prevalent and serious problem among nursing home residents. Nursing home staff members are gatekeepers for mental health treatment for residents, but may know little about depression and its management. We evaluated a didactic workshop for nursing home staff on depressive symptoms and management. Results for 58 staff participants…

  3. Physical Restraint Initiation in Nursing Homes and Subsequent Resident Health

    Science.gov (United States)

    Engberg, John; Castle, Nicholas G.; McCaffrey, Daniel

    2008-01-01

    Purpose: It is widely believed that physical restraint use causes mental and physical health decline in nursing home residents. Yet few studies exist showing an association between restraint initiation and health decline. In this research, we examined whether physical restraint initiation is associated with subsequent lower physical or mental…

  4. Poetry Therapy with Frail Elderly in a Nursing Home.

    Science.gov (United States)

    Silvermarie, Sue

    1988-01-01

    Describes a poetry group which encouraged the expression of memories and imagination among frail elderly residents of a nursing home over a period of nine months. Shows how it facilitated peer friendship formation, increased expression of affect, resulted in improved staff treatment of residents, and ended with the publication of an anthology. (SR)

  5. [The benefits of foot reflexology in nursing homes].

    Science.gov (United States)

    Simonnet, Karine

    2012-01-01

    Massages, following the foot reflexology method, were given to patients in a nursing home suffering from Alzheimer's disease or related disorders. A methodical assessment, on a small sample of patients, showed a significant reduction in neuropsychiatric manifestations, opening up new perspectives for non-medication based therapy for the care of elderly dependent people.

  6. Nursing Home Care Quality: Insights from a Bayesian Network Approach

    Science.gov (United States)

    Goodson, Justin; Jang, Wooseung; Rantz, Marilyn

    2008-01-01

    Purpose: The purpose of this research is twofold. The first purpose is to utilize a new methodology (Bayesian networks) for aggregating various quality indicators to measure the overall quality of care in nursing homes. The second is to provide new insight into the relationships that exist among various measures of quality and how such measures…

  7. The Coach Is in: Improving Nutritional Care in Nursing Homes

    Science.gov (United States)

    Rahman, Anna N.; Simmons, Sandra F.; Applebaum, Robert; Lindabury, Kate; Schnelle, John F.

    2012-01-01

    Purpose: This article describes and evaluates a long distance coaching course aimed at improving nutritional care in nursing homes (NHs). The course was structured to provide more support than traditional training programs offer. Methods: In a series of 6 monthly teleconferences led by an expert in NH nutritional care, participating NH staff…

  8. Understanding Nursing Home Worker Conceptualizations about Good Care

    Science.gov (United States)

    Chung, Gawon

    2013-01-01

    This study explored how direct care workers in nursing homes conceptualize good care and how their conceptualizations are influenced by external factors surrounding their work environment and the relational dynamics between them and residents. Study participants were drawn from a local service employees' union, and in-depth interviews were…

  9. Nonverbal communication of caregivers in Slovenian nursing homes.

    Science.gov (United States)

    Zaletel, Marija; Kovacev, Asja Nina; Mikus, Ruza Pandel; Kragelj, Lijana Zaletel

    2012-01-01

    This study aimed at determining the characteristics of nonverbal communication (NVC) of caregivers in Slovene nursing homes. The cross-sectional study was performed on 267 randomly selected caregivers from 27 randomly selected nursing homes. Facial expressions/head movements, hand gestures/trunk movements, and modes of speaking/paralinguistic signals were observed. The caregivers manifested altogether 11,324 NVC expressions. Those definitely reflecting positive attitude prevailed and accounted for 59.3% of all expressions, whereas those definitely reflecting negative attitude were very rare and accounted for 9.1% of all expressions, at a ratio of 6.5:1 (p<0.001). Differences were statistically highly significant between genders (men manifested negative attitude expressions significantly more frequently, 11.8%) and professions (social helpers manifested positive attitude expressions significantly less frequently, 56.4%; other professionals manifested negative attitude expressions significantly less frequently, 5.4%) (p<0.001). The results were similar within groups of NVC expressions. Although our study showed that caregivers in Slovene nursing homes use positive attitude expressions much more frequently than negative there is a reason for concern due to a general decline in positive values and beliefs in Slovene society. Promoting positive attitude NVC among new generations of caregivers in nursing homes need to become one of the most important contents of their life-long learning and training. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  10. Needed: Physical Educators on the Nursing Home Team.

    Science.gov (United States)

    Hooks, Bettie; Hooks, Edgar W., Jr.

    1981-01-01

    Social interaction and physical activity are important aspects of health maintenance for the aged. A holistic approach to the care of the elderly in nursing homes would involve a team of professionals who encourage residents to pursue such tasks as adaptation to loss, and maintenance of physical activity to retain function. (JN)

  11. Care Plan Improvement in Nursing Homes: An Integrative Review

    NARCIS (Netherlands)

    Mariani, E.; Chattat, R.; Vernooij-Dassen, M.; Koopmans, R.T.; Engels, Y.

    2017-01-01

    BACKGROUND: Care planning nowadays is a key activity in the provision of services to nursing home residents. A care plan describes the residents' needs and the actions to address them, providing both individualized and standardized interventions and should be updated as changes in the residents' con

  12. [Maintaining the proper distance for nurses working in the home].

    Science.gov (United States)

    Estève, Sonia

    2016-01-01

    Health professionals must be able to respond to many different situations which require technical knowledge and self-control. Particularly when working in the patient's home, nurses must know how to maintain a proper distance to protect themselves from burnout. In this respect, the practice analysis constitutes an adapted support tool. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  13. Ciprofloxacin : Use and resistance in Community, Nursing Home and Hospital

    NARCIS (Netherlands)

    van Hees, B.C.

    2011-01-01

    The aim of the studies described in this thesis was to analyze some aspects of ciprofloxacin use and clinical and (molecular) epidemiology of ciprofloxacin resistance in different settings, both within hospitals (chapter 3,4 and 6), community and nursing homes (chapter 2 and 5). With its broad

  14. Nursing Home Care Quality: Insights from a Bayesian Network Approach

    Science.gov (United States)

    Goodson, Justin; Jang, Wooseung; Rantz, Marilyn

    2008-01-01

    Purpose: The purpose of this research is twofold. The first purpose is to utilize a new methodology (Bayesian networks) for aggregating various quality indicators to measure the overall quality of care in nursing homes. The second is to provide new insight into the relationships that exist among various measures of quality and how such measures…

  15. Should Nursing Home Residents be Screened for Thyroid Function?

    Directory of Open Access Journals (Sweden)

    Ferit Kerim Küçükler

    2016-03-01

    Full Text Available Purpose: Thyroid dysfunctions, especially subclinical forms, which are more frequently seen in older populations, have been linked to increased morbidity and mortality. In the literature, there are few reports of thyroid functions among nursing home residents. Our aim was to investigate whether nursing home residents constitute a priority group for the evaluation of thyroid function. Material and Method: Hundred and ninety-two participants were enrolled in the study, 108 of them were nursing home participant (NP and 84 were dwelling participants (CP. All of the participants were evaluated in terms of thyroid functions and thyroid ultrasonography. Results: In the NP group, 89.8% were euthyroid, 3.7% were found to have subclinical hypothyroidism, 0.9% had overt hypothyroidism, 4.6% had subclinical hyperthyroidism, and 0.9% had overt hyperthyroidism. The corresponding rates in CP group were 83.3%, 9.5%, 0.0%, 7.1%, and 0.0%, respectively. At least one thyroid nodule was present in 64.2% and 78.3% of subjects of NP and CP groups, respectively. Discussion: There was no statistical difference between the two groups in terms of distribution of thyroid dysfunction and thyroid nodules. According to our results, living in nursing home has not any important effect on thyroid dysfunction or nodule.

  16. Restorative Virtual Environment Design for Augmenting Nursing Home Rehabilitation

    DEFF Research Database (Denmark)

    Bruun-Pedersen, Jon Ram; Serafin, Stefania; Kofoed, Lise

    2017-01-01

    to experience natural surroundings. Augmenting a conventional biking exercise with a recreational virtual environment (RVE) has shown to serve as an intrinsic motivation contributor to exercise for nursing home residents. RVEs might be able to provide some of the health benefits that regular nature experiences...

  17. Care Plan Improvement in Nursing Homes: An Integrative Review

    NARCIS (Netherlands)

    Mariani, E.; Chattat, R.; Vernooij-Dassen, M.; Koopmans, R.T.; Engels, Y.

    2017-01-01

    BACKGROUND: Care planning nowadays is a key activity in the provision of services to nursing home residents. A care plan describes the residents' needs and the actions to address them, providing both individualized and standardized interventions and should be updated as changes in the residents'

  18. Water homeostasis, frailty and congnitive function in the nursing home

    Science.gov (United States)

    The goal of this study is to develop and test a practical clinical method to assess frailty in nursing homes and to investigate the relationship between cognitive status of the elderly and the balance between water compartments of their body composition. This is a cross-sectional study, conducted a...

  19. Psychotropic drug prescriptions in Western European nursing homes

    NARCIS (Netherlands)

    Janus, Sarah I M; van Manen, Jeannette G; IJzerman, Maarten J; Zuidema, Sytse U

    2016-01-01

    BACKGROUND: Despite the numerous warnings of European and national drug agencies as well as clinical guidelines since the year 2004, psychotropic drugs are still frequently used in dementia. A systematic review comparing the use of psychotropic drugs in nursing homes from different European countrie

  20. Psychotropic drug prescriptions in Western European nursing homes

    NARCIS (Netherlands)

    Janus, Sarah I. M.; van Manen, Jeannette G.; IJzerman, Maarten J.; Zuidema, Sytse U.

    2016-01-01

    Background: Despite the numerous warnings of European and national drug agencies as well as clinical guidelines since the year 2004, psychotropic drugs are still frequently used in dementia. A systematic review comparing the use of psychotropic drugs in nursing homes from different European countrie

  1. Antibiotic prescribing in dutch nursing homes: how appropriate is it?

    NARCIS (Netherlands)

    Buul, L.W. van; Veenhuizen, R.B.; Achterberg, W.P.; Schellevis, F.G.; Essink, R.T.; Greeff, S.C. de; Natsch, S.S.; Steen, J.T. van der; Hertogh, C.M.P.M.

    2015-01-01

    OBJECTIVE: To investigate the appropriateness of decisions to prescribe or withhold antibiotics for nursing home (NH) residents with infections of the urinary tract (UTI), respiratory tract (RTI), and skin (SI). DESIGN: Prospective study. SETTING: Ten NHs in the central-west region of the Netherland

  2. Ciprofloxacin : Use and resistance in Community, Nursing Home and Hospital

    NARCIS (Netherlands)

    van Hees, B.C.

    2011-01-01

    The aim of the studies described in this thesis was to analyze some aspects of ciprofloxacin use and clinical and (molecular) epidemiology of ciprofloxacin resistance in different settings, both within hospitals (chapter 3,4 and 6), community and nursing homes (chapter 2 and 5). With its broad spect

  3. Antibiotic prescribing in Dutch nursing homes: how appropriate is it?

    NARCIS (Netherlands)

    Buul, L.W. van; Veenhuizen, R.B.; Achterberg, W.P.; Schellevis, F.G.; Essink, R.T.G.M.; Greeff, S.C. de; Natsch, S.; Steen, J.T. van der; Hertogh, C.M.P.M.

    2015-01-01

    Objective: To investigate the appropriateness of decisions to prescribe or withhold antibiotics for nursing home (NH) residents with infections of the urinary tract (UTI), respiratory tract (RTI), and skin (SI). Design: Prospective study. Setting: Ten NHs in the central-west region of the Netherland

  4. Medication administration in nursing homes: pharmacists' contribution to error prevention.

    Science.gov (United States)

    Verrue, Charlotte L; Mehuys, Els; Somers, Annemie; Van Maele, Georges; Remon, Jean Paul; Petrovic, Mirko

    2010-05-01

    The elderly use a large number of medications, which exposes them to an increased risk for medication-related errors, especially in nursing homes. The aim of this study was to investigate the impact of an educational session addressing good medication administration practices on the medication administration error rate in 2 nursing homes. A before-after study was performed, comparing outcome measurements 1 month before and 1 month after implementation of a formal training session on "good medication administration principles." Medication administration errors were detected using a direct observation method. Two experts (a geriatrician and a clinical pharmacist) scored the clinical relevance of these errors. The study was carried out between March 2007 and June 2007. In both nursing homes, the overall error rate (preparation errors and administration errors) decreased after the intervention. This decrease was significant both in nursing home 1 (P errors was rated highly likely to cause harm according to the experts. An educational session about good medication administration practices provided by a pharmacist is a very simple way to decrease medication administration error rates and to raise awareness on the possible clinical significance of the errors. Copyright (c) 2010 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

  5. Remote monitoring of nursing home residents using a humanoid robot.

    Science.gov (United States)

    Bäck, Iivari; Kallio, Jouko; Perälä, Sami; Mäkelä, Kari

    2012-09-01

    We studied the feasibility of using a humanoid robot as an assistant in the monitoring of nursing home residents. The robot can receive alarms via its wireless Internet connection and navigate independently to the room where the alarm originated. Once it has entered the room, the robot can transmit near real time images to the staff and also open a voice connection between the resident and the remote caregivers. This way the remote caregiver is able to check the situation in the room, and take appropriate actions. We tested the prototype robot in three private nursing homes in the Finnish county of South Ostrobothnia. During the testing, 2-4 alarms were produced by each participant and there were 29 alarms in total. The robot was able to navigate correctly to the room from which the alarm was sent and open the speech connection, as well as transmit images via the wireless Internet connection. The experiments provided evidence of the feasibility of using autonomous robots as assistants to nursing home staff in remote monitoring. The response from the nursing home residents was uniformly positive.

  6. How to Plan an Inservice Education for (Your) Nursing Home.

    Science.gov (United States)

    Dickman, Irving R., Ed.

    A guide to offer the nursing home administrator and his inservice education coordinator a source of information about the process of program planning in inservice education is presented. To plan a program, the following steps are necessary: (1) Know the problem; (2) Gather the facts; (3) Examine the facts; (4) Select the best solution; (5) Gain…

  7. A Post-Hospital Nursing Home Rehabilitation Program.

    Science.gov (United States)

    Petchers, Marcia K.; And Others

    1987-01-01

    Describes program of short-term rehabilitation care provided to elderly patients through collaboration between hospital and nursing home. Discusses program planning and implementation experiences, patient satisfaction, and rehabilitation outcomes. Notes that program, although successful, was discontinued due to financial and interorganizational…

  8. [Prevention of nosocomial infections and antibiotic resistance in nursing homes].

    Science.gov (United States)

    Bleckwenn, Markus; Hammerschmidt, Judith; Rösing, Claudia; Klaschik, Manuela

    2017-06-14

    Nosocomial infections and multidrug-resistant organisms are an increasing problem in nursing homes worldwide; therefore, new approaches for infection control need to be developed. This article gives an overview of infections in nursing homes, their medical treatment and previous measures for infection prevention. The article is based on a selective literature search including the literature database PubMed. In particular, scientific studies on the prevalence of nosocomial infections in German nursing homes, publications for medical care in long-term care facilities in Europe and international studies for infection prevention were evaluated. The basis for an effective reduction of infections is the establishment of a surveillance system. All participating medical professionals provide feedback about local infections and resistance situations and the presence of risk factors, such as urinary catheters or chronic wounds. Only then can targeted antibiotic strategies be adapted and the effectiveness of preventive measures, such as hand disinfection is continuously reviewed. So far, in particular multimodal, multidisciplinary prevention projects were successful. These included frequent staff training, reduction of urinary catheters and a rational use of antibiotics. Most prevention models have been previously tested in hospitals. A possible applicability of the results to the infection prevention in long-term care facilities has so far hardly been studied. Accordingly, further studies on infection control in nursing homes are absolutely necessary.

  9. Ciprofloxacin : Use and resistance in Community, Nursing Home and Hospital

    NARCIS (Netherlands)

    van Hees, B.C.

    2011-01-01

    The aim of the studies described in this thesis was to analyze some aspects of ciprofloxacin use and clinical and (molecular) epidemiology of ciprofloxacin resistance in different settings, both within hospitals (chapter 3,4 and 6), community and nursing homes (chapter 2 and 5). With its broad spect

  10. US and Dutch nurse experiences with fall prevention technology within nursing home environment and workflow: a qualitative study

    NARCIS (Netherlands)

    Vandenberg, Ann E.; van Beijnum, Bernhard J.F.; Overdevest, Vera G.P.; Capezuti, Elizabeth; Johnson II, Theodore M.

    2017-01-01

    Falls remain a major geriatric problem, and the search for new solutions continues. We investigated how existing fall prevention technology was experienced within nursing home nurses' environment and workflow. Our NIH-funded study in an American nursing home was followed by a cultural learning

  11. Effect of Nursing Home Staff Training on Quality of Patient Survival.

    Science.gov (United States)

    Linn, Margaret W.; And Others

    1989-01-01

    Assessed effects of nursing home staff training in care for the dying on quality of life of 306 terminally ill patients in 5 pairs of matched nursing homes assigned randomly to trained and not trained staff groups. Patients in trained homes had less depression and greater satisfaction with care than patients in control homes at 1 and 3 months.…

  12. Perceived barriers to communication between hospital and nursing home at time of patient transfer.

    Science.gov (United States)

    Shah, Faraaz; Burack, Orah; Boockvar, Kenneth S

    2010-05-01

    To identify perceived barriers to communication between hospital and nursing home at the time of patient transfer and examine associations between perceived barriers and hospital and nursing home characteristics. Mailed survey. Medicare- or Medicaid-certified nursing homes in New York State. Nursing home administrators, with input from other nursing home staff. Respondents rated the importance as a barrier to hospital-nursing home communication of (1) hospital providers' attitude, time, effort, training, payment, and familiarity with nursing home patients; (2) unplanned and off-hours transfers; (3) HIPAA privacy regulations; and (4) lost or failed information transmission. Associations were determined between barriers and the following organizational characteristics: (1) hospital-nursing home affiliations, pharmacy or laboratory agreements, cross-site staff visits, and cross-site physician care; (2) hospital size, teaching status, and frequency of geriatrics specialty care; (3) nursing home size, location, type, staffing, and Medicare quality indicators; and (4) hospital-to-nursing home communication, consistency of hospital care with health care goals, and communication quality improvement efforts. Of 647 questionnaires sent, 229 were returned (35.4%). The most frequently reported perceived barriers to communication were sudden or unplanned transfers (44.4%), transfers that occur at night or on the weekend (41.4%), and hospital providers' lack of effort (51.0%), lack of familiarity with patients (45.0%), and lack of time (43.5%). Increased hospital size, teaching hospitals, and urban nursing home location were associated with greater perceived importance of these barriers, and cross-site staff visits and hospital provision of laboratory and pharmacy services to the nursing home were associated with lower perceived importance of these barriers. Hospital and nursing home characteristics and interorganizational relationships were associated with nursing home

  13. Resident-to-resident violence triggers in nursing homes.

    Science.gov (United States)

    Snellgrove, Susan; Beck, Cornelia; Green, Angela; McSweeney, Jean C

    2013-11-01

    Certified nurses' assistants (CNAs) employed by a rural nursing home in Northeast Arkansas described their perceptions of resident-to-resident violence in order to provide insight on factors, including unmet needs, that may trigger the phenomenon. Semistructured interviews were conducted with 11 CNAs. Data were analyzed using content analysis and constant comparison. Two categories of triggers emerged from the data-active and passive. Active triggers involved the actions of other residents that were intrusive in nature, such as wandering into a residents' personal space, taking a resident's belongings, and so forth. Passive triggers did not involve the actions of residents but related to the internal and external environment of the residents. Examples were factors such as boredom, competition for attention and communication difficulties. Results indicate that there are factors, including unmet needs within the nursing home environment that may be identified and altered to prevent violence between residents.

  14. A qualitative study describing nursing home nurses sensemaking to detect medication order discrepancies.

    Science.gov (United States)

    Vogelsmeier, Amy; Anderson, Ruth A; Anbari, Allison; Ganong, Lawrence; Farag, Amany; Niemeyer, MaryAnn

    2017-08-04

    Medication reconciliation is a safety practice to identify medication order discrepancies when patients' transitions between settings. In nursing homes, registered nurses (RNs) and licensed practical nurses (LPNs), each group with different education preparation and scope of practice responsibilities, perform medication reconciliation. However, little is known about how they differ in practice when making sense of medication orders to detect discrepancies. Therefore, the purpose of this study was to describe differences in RN and LPN sensemaking when detecting discrepancies. We used a qualitative methodology in a study of 13 RNs and 13 LPNs working in 12 Midwestern United States nursing homes. We used both conventional content analysis and directed content analysis methods to analyze semi-structured interviews. Four resident transfer vignettes embedded with medication order discrepancies guided the interviews. Participants were asked to describe their roles with medication reconciliation and their rationale for identifying medication order discrepancies within the vignettes as well as to share their experiences of performing medication reconciliation. The analysis approach was guided by Weick's Sensemaking theory. RNs provided explicit stories of identifying medication order discrepancies as well as examples of clinical reasoning to assure medication order appropriateness whereas LPNs described comparing medication lists. RNs and LPNs both acknowledged competing demands, but when performing medication reconciliation, RNs were more concerned about accuracy and safety, whereas LPNs were more concerned about time. Nursing home nurses, particularly RNs, are in an important position to identify discrepancies that could cause resident harm. Both RNs and LPNs are valuable assets to nursing home care and keeping residents safe, yet RNs offer a unique contribution to complex processes such as medication reconciliation. Nursing home leaders must acknowledge the differences

  15. Top Nurse-Management Staffing Collapse and Care Quality in Nursing Homes

    Science.gov (United States)

    Hunt, Selina R.; Corazzini, Kirsten; Anderson, Ruth A.

    2014-01-01

    Director of nursing turnover is linked to staff turnover and poor quality of care in nursing homes; however the mechanisms of these relationships are unknown. Using a complexity science framework, we examined how nurse management turnover impacts system capacity to produce high quality care. This study is a longitudinal case analysis of a nursing home (n = 97 staff) with 400% director of nursing turnover during the study time period. Data included 100 interviews, observations and documents collected over 9 months and were analyzed using immersion and content analysis. Turnover events at all staff levels were nonlinear, socially mediated and contributed to dramatic care deficits. Federal mandated, quality assurance mechanisms failed to ensure resident safety. High multilevel turnover should be elevated to a sentinel event for regulators. Suggestions to magnify positive emergence in extreme conditions and to improve quality are provided. PMID:24652943

  16. Picture Your Nursing Home: Exploring the Sense of Home of Older Residents through Photography

    Science.gov (United States)

    van Hoof, J.; Verhagen, M. M.; Wouters, E. J. M.; Marston, H. R.; Rijnaard, M. D.; Janssen, B. M.

    2015-01-01

    The quality of the built environment can impact the quality of life and the sense of home of nursing home residents. This study investigated (1) which factors in the physical and social environment correlate with the sense of home of the residents and (2) which environmental factors are most meaningful. Twelve participants engaged in a qualitative study, in which photography was as a supportive tool for subsequent interviews. The data were analysed based on the six phases by Braun and Clarke. The four themes identified are (1) the physical view; (2) mobility and accessibility; (3) space, place, and personal belongings; and (4) the social environment and activities. A holistic understanding of which features of the built environment are appreciated by the residents can lead to the design and retrofitting of nursing homes that are more in line with personal wishes. PMID:26346975

  17. Picture Your Nursing Home: Exploring the Sense of Home of Older Residents through Photography

    Directory of Open Access Journals (Sweden)

    J. van Hoof

    2015-01-01

    Full Text Available The quality of the built environment can impact the quality of life and the sense of home of nursing home residents. This study investigated (1 which factors in the physical and social environment correlate with the sense of home of the residents and (2 which environmental factors are most meaningful. Twelve participants engaged in a qualitative study, in which photography was as a supportive tool for subsequent interviews. The data were analysed based on the six phases by Braun and Clarke. The four themes identified are (1 the physical view; (2 mobility and accessibility; (3 space, place, and personal belongings; and (4 the social environment and activities. A holistic understanding of which features of the built environment are appreciated by the residents can lead to the design and retrofitting of nursing homes that are more in line with personal wishes.

  18. Reinventing the home visit for undergraduate nursing students.

    Science.gov (United States)

    Pohl, Carla J; Malin, Shelly; Kennell, Lynn

    2014-12-01

    The Family Outreach Project was designed to teach senior-level undergraduate nursing students how to assess, care for, and develop care plans for children with chronic health conditions and their families. Nursing students (n=24) could attend one focus group conducted at the end of the semester as part of the evaluation of the America's Promise School Project. Responses were audiotaped and transcribed verbatim. Qualitative methods were used to identify themes. Comfort with the visit, professionalism of the students, and usefulness of the home visit to families was assessed. Analysis of focus group responses identified four major themes: learning experience, observations about home environment, concerns about having nothing to offer families, and difficulties with arranging and carrying out the home visits. Family responses (n=10) supported students' perception that families were knowledgeable about their children's chronic health conditions. Families indicated that students were professional and treated families respectfully. Copyright 2014, SLACK Incorporated.

  19. Modifiable risk factors for nursing home-acquired pneumonia.

    Science.gov (United States)

    Quagliarello, Vincent; Ginter, Sandra; Han, Ling; Van Ness, Peter; Allore, Heather; Tinetti, Mary

    2005-01-01

    This study sought to identify modifiable risk factors for pneumonia in elderly nursing home residents. A cohort of 613 elderly residents (age, >65 years) of 5 nursing homes in the New Haven, Connecticut, area was followed-up prospectively from February 2001 through March 2003. The primary outcome was radiographically documented pneumonia within a 12-month surveillance period. Baseline modifiable risk factors were evaluated for their independent association with pneumonia. Of 613 elderly nursing home residents, 131 (21%) died, and an additional 112 (18%) developed a radiographically documented case of pneumonia during the 12-month surveillance period. Among the 9 candidate modifiable risk factors that were evaluated individually in Cox proportional hazards models adjusting for covariates (i.e., nursing home facility, age, race, coexisting conditions, and immobility), inadequate oral care (hazard ratio [HR], 1.60; 95% confidence interval [CI], 1.06-2.35; P=.024) and swallowing difficulty (HR, 1.65; 95% CI, 1.04-2.62; P=.033) were associated with pneumonia. When modifiable risk factors were evaluated simultaneously in the same Cox proportional hazards model, inadequate oral care (HR, 1.55; 95% CI, 1.04-2.30; P=.030) and swallowing difficulty (HR, 1.61; 95% CI, 1.02-2.55; P=.043) remained independently associated with pneumonia, adjusting for the same covariates. Calculation of population-based attributable fractions showed that 21% of all cases of pneumonia in our cohort could have been avoided if inadequate oral care and swallowing difficulty were not present. Two biologically plausible and modifiable risk factors increased the risk of pneumonia in elderly nursing home residents. These results provide a framework for the development and testing of a targeted pneumonia prevention strategy.

  20. Treatment of heart failure in nursing home residents

    Institute of Scientific and Technical Information of China (English)

    Marille AMJ Daamen; Jan PH Hamers; Anton PM Gorgels; Frans ES Tan; Jos MGA Schols; Hans-Peter Brunner-la Rocca

    2016-01-01

    BackgroundFor the treatment of chronic heart failure (HF), both pharmacological and non-pharmacological treatment should be em-ployed in HF patients. Although HF is highly prevalent in nursing home residents, it is not clear whether the recommendations in the guide-lines for pharmacological therapy also are followed in nursing home residents. The aim of this study is to investigate how HF is treated in nursing home residents and to determine to what extent the current treatment corresponds to the guidelines.MethodsNursing home resi-dents of five large nursing home care organizations in the southern part of the Netherlands with a previous diagnosis of HF based on medical records irrespective of the left ventricle ejection fraction (LVEF) were included in this cross-sectional design study. Data were gathered on the (medical) records, which included clinical characteristics and pharmacological- and non-pharmacological treatment. Echocardiography was used as part of the study to determine the LVEF.ResultsOut of 501 residents, 112 had a diagnosis of HF at inclusion. One-third of them received an ACE-inhibitor and 40% used aβ-blocker. In 66%, there was a prescription of diuretics with a preference of a loop diuretic. Focusing on the residents with a LVEF£ 40%, only 46% of the 22 residents used an ACE-inhibitor and 64% aβ-blocker. The median daily doses of prescribed medication were lower than those that were recommended by the guidelines. Non-pharmacological interventions were recorded in almost none of the residents with HF.ConclusionsThe recommended medical therapy of HF was often not prescribed; if pre-scribed, the dosage was usually far below what was recommended. In addition, non-pharmacological interventions were mostly not used at all.

  1. Back disorders and lumbar load in nursing staff in geriatric care: a comparison of home-based care and nursing homes

    Directory of Open Access Journals (Sweden)

    Beck Barbara-Beate

    2009-12-01

    Full Text Available Abstract Background Back pain is one of the most frequent complaints in the nursing profession. Thus, the 12-month prevalence of pain in the lumbar spine in nursing staff is as high as 76%. Only a few representative studies have assessed the prevalence rates of back pain and its risk factors among nursing staff in nursing homes in comparison to staff in home-based care facilities. The present study accordingly investigates the prevalence in the lumbar and cervical spine and determines the physical workload to lifting and caring in geriatric care. Methods 1390 health care workers in nursing homes and home care participated in this cross sectional survey. The nursing staff members were examined by occupational physicians according to the principals of the multistep diagnosis of musculoskeletal disorders. Occupational exposure to daily care activities with patient transfers was measured by a standardised questionnaire. The lumbar load was calculated with the Mainz-Dortmund dose model. Information on ergonomic conditions were recorded from the management of the nursing homes. Comparisons of all outcome variables were made between both care settings. Results Complete documentation, including the findings from the occupational physicians and the questionnaire, was available for 41%. Staff in nursing homes had more often positive orthopaedic findings than staff in home care. At the same time the values calculated for lumbar load were found to be significant higher in staff in nursing homes than in home-based care: 45% vs. 6% were above the reference value. Nursing homes were well equipped with technical lifting aids, though their provision with assistive advices is unsatisfactory. Situation in home care seems worse, especially as the staff often has to get by without assistance. Conclusions Future interventions should focus on counteracting work-related lumbar load among staff in nursing homes. Equipment and training in handling of assistive devices

  2. Characteristics of Absenteeism in Nursing Home Staff.

    Science.gov (United States)

    Cohen-Mansfield, Jiska; Rosenthal, Alvin S.

    This study investigated factors associated with absenteeism among nursing staff (N=219) at a long-term care facility. Four absenteeism measures were calculated from personnel records for each month of the year: no pay (the sum of unscheduled, unpaid sick, and leave without pay), part day (the sum of arrived late and left early), paid sick, and…

  3. Mennonite Nursing Home passive solar demonstration

    Energy Technology Data Exchange (ETDEWEB)

    1984-03-01

    A long-term nursing care facility and retirement center was designed for passive solar heating. The system comprises thermal mass, thermal insulation, Trombe walls, and direct gain clerestories. Included here is a topical report, analysis of building performance, owner's perspective, designer's perspective, and summary of information dissemination activities. (MHR)

  4. Cognitive training for patients with dementia living in a sicilian nursing home: a novel web-based approach.

    Science.gov (United States)

    De Luca, Rosaria; Bramanti, Alessia; De Cola, Maria Cristina; Leonardi, Simona; Torrisi, Michele; Aragona, Bianca; Trifiletti, Antonino; Ferrara, Maria Danilo; Amante, Piero; Casella, Carmela; Bramanti, Placido; Calabrò, Rocco Salvatore

    2016-10-01

    Dementia is an increasing challenge for health care and social system in developed countries. Interventions with a cognitive focus, also using assistive technology, are leading to promising results in improving cognitive and behavior symptoms in individuals with dementia. Aim of our study was to evaluate the combined effects of the standard cognitive training in addition to web-based rehabilitation in dementia people living in a nursing home. We have studied twenty dementia people (10 females and 10 males) with a mild to moderate cognitive decline (MMSE 25 ± 3.4) associated to moderate behavioral alterations, and mainly due to vascular causes. These patients were randomly assigned to one of two groups (experimental or standard treatment-namely the control group). All participants in the experimental group completed the specific training, consisting of 24 sessions of web-based cognitive training, for 8 weeks, in addition to standard rehabilitation. Each participant was evaluated by a skilled neuropsychologist before and after each treatment. The experimental group had a statistically significant change of the Geriatric Depression Scale (p = 0.03), Constructive Apraxia (p Web-based cognitive rehabilitation can be useful in improving cognitive performance, besides psychological well-being, in demented individuals living in home care.

  5. [Prevention and treatment of osteoporosis in short stay departments of nursing homes: a nursing home physician's task

    NARCIS (Netherlands)

    Nordennen, R.T. van; Vanneste, V.G.G.

    2007-01-01

    This research shows that nursing home physicians might play an important part in the diagnostics and treatment of vitamin-D deficiency. 96 rehabilitating elderly who had undergone a hip operation were investigated. 36% had a vitamin-D deficiency (vitamin-D < 30 nmol/l). Vitamin-D deficiency was 5

  6. Staff exchange within and between nursing homes in The Netherlands and potential implications for MRSA transmission.

    Science.gov (United States)

    VAN Gaalen, R D; Hopman, H A; Haenen, A; VAN DEN Dool, C

    2017-03-01

    A recent countrywide MRSA spa-type 1081 outbreak in The Netherlands predominantly affected nursing homes, generating questions on how infection spreads within and between nursing homes despite a low national prevalence. Since the transfer of residents between nursing homes is uncommon in The Netherlands, we hypothesized that staff exchange plays an important role in transmission. This exploratory study investigated the extent of former (last 2 years) and current staff exchange within and between nursing homes in The Netherlands. We relied on a questionnaire that was targeted towards nursing-home staff members who had contact with residents. We found that 17·9% and 12·4% of the nursing-home staff formerly (last 2 years) or currently worked in other healthcare institutes besides their job in the nursing home through which they were selected to participate in this study. Moreover, 39·7% of study participants worked on more than one ward. Our study shows that, in The Netherlands, nursing-home staff form a substantial number of links between wards within nursing homes and nursing homes are linked to a large network of healthcare institutes through their staff members potentially providing a pathway for MRSA transmission between nursing homes and throughout the country.

  7. Cramers Court Nursing Home, Belgooly, Cork.

    LENUS (Irish Health Repository)

    Ryan, Fiona

    2010-11-01

    Patient self-testing (PST) of the international normalised ratio (INR) has a positive effect on anticoagulation control. This study investigated whether the benefits of PST (other than increased frequency of testing, e.g. patient education, empowerment, compliance etc.) could be \\'carried-over\\' into usual care management after a period of home-testing has ceased.

  8. Reducing Avoidable Hospital Transfers From Nursing Homes in Austria

    Science.gov (United States)

    Kada, Olivia; Janig, Herbert; Likar, Rudolf; Cernic, Karl; Pinter, Georg

    2017-01-01

    Hospital transfers from nursing homes (NHs) are frequent, burdensome for residents, and often avoidable. The evidence regarding the effectiveness of interventions to reduce avoidable transfers is limited, and most projects focus on nurses’ knowledge and skills. In the present project, interventions focusing on nurses and physicians are integrated, elaborated, and implemented in 17 NHs. Results of the 6 months preintervention period are reported. Hospital transfer rates (N = 1,520) and basic data on all residents (N = 1,238) were collected prospectively. Nurses’ preintervention knowledge and self-efficacy were assessed using standardized questionnaires (N = 330). Many hospital transfers were initiated by nurses without physician involvement, polypharmacy was common, and a high potential for reducing transfers by increasing physician presence was observed. Nurses showed rather low knowledge but high self-efficacy. The results are discussed against the background of the interventions including enhancement of physician presence and geriatric quality circles. PMID:28540338

  9. Content analysis of euthanasia policies of nursing homes in Flanders (Belgium).

    Science.gov (United States)

    Lemiengre, Joke; Dierckx de Casterlé, Bernadette; Denier, Yvonne; Schotsmans, Paul; Gastmans, Chris

    2009-08-01

    To describe the form and content of ethics policies on euthanasia in Flemish nursing homes and to determine the possible influence of religious affiliation on policy content. Content analysis of euthanasia policy documents. Of the 737 nursing homes we contacted, 612 (83%) completed and returned the questionnaire. Of 92 (15%) nursing homes that reported to have a euthanasia policy, 85 (92%) provided a copy of their policy. Nursing homes applied the euthanasia law with additional palliative procedures and interdisciplinary deliberations. More Catholic nursing homes compared to non-Catholic nursing homes did not permit euthanasia. Policies described several phases of the euthanasia care process as well as involvement of caregivers, patients, and relatives; ethical issues; support for caregivers; reporting; and procedures for handling advance directives. Our study revealed that euthanasia requests from patients are seriously considered in euthanasia policies of nursing homes, with great attention for palliative care and interdisciplinary cooperation.

  10. Making difficult decisions: the role of quality of care in choosing a nursing home.

    Science.gov (United States)

    Pesis-Katz, Irena; Phelps, Charles E; Temkin-Greener, Helena; Spector, William D; Veazie, Peter; Mukamel, Dana B

    2013-05-01

    We investigated how quality of care affects choosing a nursing home. We examined nursing home choice in California, Ohio, New York, and Texas in 2001, a period before the federal Nursing Home Compare report card was published. Thus, consumers were less able to observe clinical quality or clinical quality was masked. We modeled nursing home choice by estimating a conditional multinomial logit model. In all states, consumers were more likely to choose nursing homes of high hotel services quality but not clinical care quality. Nursing home choice was also significantly associated with shorter distance from prior residence, not-for-profit status, and larger facility size. In the absence of quality report cards, consumers choose a nursing home on the basis of the quality dimensions that are easy for them to observe, evaluate, and apply to their situation. Future research should focus on identifying the quality information that offers the most value added to consumers.

  11. 48 CFR 852.222-70 - Contract Work Hours and Safety Standards Act-nursing home care contract supplement.

    Science.gov (United States)

    2010-10-01

    ... Safety Standards Act-nursing home care contract supplement. 852.222-70 Section 852.222-70 Federal...—nursing home care contract supplement. As prescribed in 822.305, for nursing home care requirements, insert the following clause: Contract Work Hours and Safety Standards Act—Nursing Home Care...

  12. Nursing Home Medication Reconciliation: A Quality Improvement Initiative.

    Science.gov (United States)

    Tong, Monica; Oh, Hye Young; Thomas, Jennifer; Patel, Sheila; Hardesty, Jennifer L; Brandt, Nicole J

    2017-04-01

    The current quality improvement initiative evaluated the medication reconciliation process within select nursing homes in Washington, DC. The identification of common types of medication discrepancies through monthly retrospective chart reviews of newly admitted patients in two different nursing homes were described. The use of high-risk medications, namely antidiabetic, anticoagulant, and opioid agents, was also recorded. A standardized spreadsheet tool based on multiple medication reconciliation implementation tool kits was created to record the information. The five most common medication discrepancies were incorrect indication (21%), no monitoring parameters (17%), medication name omitted (11%), incorrect dose (10%), and incorrect frequency (8%). Antidiabetic agents in both sites were the most used high-risk medication. This initiative highlights that medication discrepancies on admission are common in nursing homes and may be clinically impactful. More attention needs to be given to work flow processes to improve medication reconciliation considering the increased risk for adverse drug events and hospitalizations. [Journal of Gerontological Nursing and Mental Health Services, 43(4), 9-14.].

  13. Beech Park Nursing Home, Dunmurry East, Kildare.

    LENUS (Irish Health Repository)

    Harnett, P J

    2009-06-01

    The term \\'performance management\\' has an aversive \\'managerial\\' aspect, is unappealing to many public sector staff and has an \\'image problem\\'. Perhaps as a consequence, it has failed to make a significant impact on Irish public sector workers, notably mental health nurses. In this paper, performance management is introduced and examined within an Irish healthcare context and with reference to its use in other countries. Some of the challenges faced by Irish mental health nurses and the potential benefits of working within a performance managed workplace are discussed. The paper concludes that performance management is likely to increasingly affect nurses, either as active agents or as passive recipients of a change that is thrust on them. The authors anticipate that the performance management \\'image problem\\' will give way to recognition that this is a fundamental change which has the potential to enable health services to change. This change will bring high standards of transparency, worker involvement in decision making, an explicit value base for health services and individual teams. It provides the potential for clear practice standards and high standards of transparency as well as worker welfare in all aspects, including supporting employment and career progression.

  14. Nursing home applications--reasons and possible interventions.

    Science.gov (United States)

    Chan, K M; Wong, S F; Yoong, T

    1998-10-01

    With a rapidly ageing population like Singapore, the need for nursing homes will increase. Admission to a nursing home may be for medical and/or social reasons. We carried out case studies with the Care Liaison Service (CLS) of the Ministry of Health to determine reasons why the elderly applied for nursing home admission, and whether it was possible to prevent an admission. During the 6-month study period, 331 applications were received, of which 280 (84.6%) were > or = 60 years. There was an equal distribution of male (50.4%) and female (49.6%) applicants. Applicants were predominantly Chinese (86.0%), followed by Indians (8.0%), Malays and other races (3.0% each). Most of the applicants were semi-ambulant (50.0%), fully ambulant (31.4%) and non-ambulant (18.6%). The most common medical problems of the applicants were neurological (e.g. stroke, normal pressure hydrocephalus, epilepsy), heart diseases (e.g. hypertension, ischaemic heart disease, heart failure), orthopaedic conditions (e.g. osteoarthritis, fractures neck of femur and other fractures), and psychiatric problems (e.g. dementia, depression and history of schizophrenia/paranoid psychosis). Fifty-seven applicants (20.4%) were selected for intervention. They were 'non-psychiatric' patients whose caregivers were willing but unable to look after them. About half (28, 49.1%) of these applicants required nursing home care. The remaining 29 patients (50.9%) had the potential of improving or able to remain at home with appropriate community services. These 29 patients were contacted by the CLS nurse and the following recommendations were made: 1) inpatient rehabilitation in a community hospital (7 patients); 2) rehabilitation and day care in a community-based day care centre (17 patients); 3) domiciliary medical care (4 patients), and 4) reassessment by psychiatrist to control psychotic symptoms (1 patient). Only 6 patients were willing to accept the new recommendations. This poor result may imply that attempts

  15. The association between the quality of life and depression of elderly in a nursing home institutional setting

    Directory of Open Access Journals (Sweden)

    Ľubica Ilievová

    2016-12-01

    Conclusions: Obtaining information on depression and the quality of life of elderly in nursing home settings should be introduced as a standard part of nursing activities in order to improve the quality of customer care in the nursing homes.

  16. Are residential and nursing homes adequately screening overseas healthcare workers?

    Directory of Open Access Journals (Sweden)

    Loveday Rachel

    2008-08-01

    Full Text Available Abstract Background There has been significant growth in the number of healthcare workers born outside the UK or recruited to the UK from countries with a high prevalence of TB, Hepatitis and other blood borne infections. Government policy recognises the need for occupational health procedures to facilitate treatment for these individuals and to reduce the risk of transmission of disease to patients. The aim of this study was to undertake a survey of nursing and residential homes in South East England, to assess whether homes had occupational health screening policies for healthcare workers who have originated from overseas, and what level of occupational health screening had been undertaken on these employees. Methods An anonymous survey was sent to all 500 homes in West Sussex assessing occupational health practices for "overseas health care workers", defined as health care workers who had been born outside the UK. Results Only one employer (0.8% reported they had an occupational health screening policy specific for healthcare workers who originate from overseas. Over 80% of homes who had recruited directly had no evidence of screening results for HIV, TB, Hepatitis B and C. The commonest countries of origin for staff were the UK, Philippines, Poland, South Africa, Zimbabwe, and India. Conclusion This study suggests that screening of overseas healthcare workers is not routine practice for residential or nursing care homes and requires further input from Primary Care Trust's, Health Care Commission, Commission for Social Care Inspection, and Professional bodies.

  17. Communication skills training in a nursing home: effects of a brief intervention on residents and nursing aides

    Directory of Open Access Journals (Sweden)

    Sprangers S

    2015-01-01

    Full Text Available Suzan Sprangers, Katinka Dijkstra, Anna Romijn-LuijtenInstitute of Psychology, Faculty of Social Sciences, Erasmus University Rotterdam, Rotterdam, the NetherlandsAbstract: Effective communication by nursing home staff is related to a higher quality of life and a decrease in verbal and physical aggression and depression in nursing home residents. Several communication intervention studies have been conducted to improve communication between nursing home staff and nursing home residents with dementia. These studies have shown that communication skills training can improve nursing aides’ communication with nursing home residents. However, these studies tended to be time-consuming and fairly difficult to implement. Moreover, these studies focused on the communicative benefits for the nursing home residents and their well-being, while benefits and well-being for the nursing aides were neglected. The current study focused on implementing a brief communication skills training program to improve nursing aides’ (N=24 communication with residents with dementia (N=26 in a nursing home. The effects of the training on nursing aides’ communication, caregiver distress, and job satisfaction and residents’ psychopathology and agitation were assessed relative to a control group condition. Nursing aides in the intervention group were individually trained to communicate effectively with residents during morning care by using short instructions, positive speech, and biographical statements. Mixed ANOVAs showed that, after training, nursing aides in the intervention group experienced less caregiver distress. Additionally, the number of short instructions and instances of positive speech increased. Providing nursing aides with helpful feedback during care aids communication and reduces caregiver burden, even with a brief intervention that requires limited time investments for nursing home staff.Keywords: dementia, psychopathology, agitation, caregiver

  18. PERCEPTIONS AND EXPERIENCES OF ELDERLY RESIDENTS IN A NURSING HOME

    Directory of Open Access Journals (Sweden)

    Renata Alessandra Evangelista

    2014-12-01

    Full Text Available The objective of this study was to evaluate the perception of the elderly residents of a long-stay nursing home on the process of institutionalization. We interviewed 14 subjects, five women and nine men, aged between 60 and 92 years. Data collection was conducted with a semi-structured sociodemographic interview, which presented the guiding question: “Tell me about how is your life, what do you do and how did you come to live here”. From the analysis, we found topics related to feelings of abandonment, loneliness, anger, ingratitude, living with chronic pain, satisfaction of property in the nursing home, productivity and social relationship. Given the thematic analysis, it was possible to group them into three categories such as: what the elderly feel, what the elderly perceive and what the elderly desire. As a result, we need public policies that addresses to the service provided by institutions regarding elderly expectations.

  19. Therapeutic robocat for nursing home residents with dementia: preliminary inquiry.

    Science.gov (United States)

    Libin, Alexander; Cohen-Mansfield, Jiska

    2004-01-01

    Traditional pet therapy enhances individual well-being. However, there are situations where a substitute artificial companion (i.e., robotic pet) may serve as a better alternative because of insufficient available resources to care for a real pet, allergic responses to pets, or other difficulties. This pilot study, which compared the benefits of a robotic cat and a plush toy cat as interventions for elderly persons with dementia, was conducted at a special care unit of a large, not-for-profit nursing home. Various aspects of a person's engagement and affect were assessed through direct observations. Though not identical, similar trends were seen for the two cats. Interacting with the cats was linked with decreased agitation and increased pleasure and interest. The study is intended to pave the way for future research on robotherapy with nursing home residents.

  20. Pneumonia in nursing homes and long-term care facilities.

    Science.gov (United States)

    Loeb, Mark B

    2005-12-01

    This article reviews the epidemiology of pneumonia in residents of nursing homes and other long-term care facilities (LTCFs). Streptococcus pneumoniae is the most important cause of pneumonia in residents of nursing homes and LTCFs. Factors suggestive of aspiration are the most important risk factors for pneumonia in this population. The clinical presentation of pneumonia among long-term care facility residents is challenging; residents tend to be older and more debilitated than their elderly community-dwelling counterparts. Data on optimal antimicrobial therapy in this setting is sparse. Functional status is an important predictor of outcome in this population. There are key management issues, such as site of care, which remain unresolved. Immunization with influenza and pneumococcal vaccines remains the mainstay of prevention.

  1. Quality assessment in nursing home facilities: measuring customer satisfaction.

    Science.gov (United States)

    Mostyn, M M; Race, K E; Seibert, J H; Johnson, M

    2000-01-01

    A national study designed to assess the reliability and validity of a nursing home customer satisfaction survey is summarized. One hundred fifty-nine facilities participated, each responsible for the distribution and collection of 200 questionnaires randomly sent to the home of the resident's responsible party. A total of 9053 completed questionnaires were returned, for an average adjusted response rate of 53%. The factor analysis identified 4 scales: Comfort and Cleanliness, Nursing, Food Services, and Facility Care and Services, each with high reliability. Based on a multiple regression analysis, the scales were shown to have good criterion-related validity, accounting for 64% of the variance in overall quality ratings. Comparisons based on select characteristics indicated significantly different satisfaction ratings among facilities. The results are interpreted as providing evidence for the construct validity of a multidimensional customer satisfaction scale with measured reliability and criterion-related validity. Moreover, the scale can be used to differentiate satisfaction levels among facilities.

  2. Visibility and findability of the nursing home compare website.

    Science.gov (United States)

    Liu, Darren; Lu, Chi-Jung

    2015-01-01

    Nursing Home Compare (NHC) is a federal government website providing information for selecting a nursing home. However, not many consumers were aware of or can locate the site. This study analyzed 50 official state and District of Columbia websites from September through December 2013. Using Google "inlink:" operator, this study evaluated the visibility and findability of NHC links in each state-level website. The results show that a link to NHC is available in all states except for Connecticut, Florida, and Michigan. Although it took only 4.7 clicks on average to the page with a NHC link, consumers may still have difficulty to find NHC from a state website. This article provides a snapshot of the visibility and findability of NHC and indicates a need for further investigation of promising website dissemination strategies not yet adequately evaluated.

  3. Music in the nursing home : hitting the right note! The provision of music to dementia patients with verbal and vocal agitation in Dutch nursing homes

    NARCIS (Netherlands)

    van der Geer, E. R.; Vink, A. C.; Schols, J. M. G. A.; Slaets, J. P. J.

    2009-01-01

    Background: The study aims to provide insight into the type of music being offered in Dutch nursing homes to patients with both dementia and verbal and vocal agitation. It also investigates the degree to which the music offered corresponds to the musical preferences of the nursing home residents. Me

  4. Comparing Catheter-Associated Urinary Tract Infection Prevention Programs Between Veterans Affairs Nursing Homes and Non-Veterans Affairs Nursing Homes.

    Science.gov (United States)

    Mody, Lona; Greene, M Todd; Saint, Sanjay; Meddings, Jennifer; Trautner, Barbara W; Wald, Heidi L; Crnich, Christopher; Banaszak-Holl, Jane; McNamara, Sara E; King, Beth J; Hogikyan, Robert; Edson, Barbara S; Krein, Sarah L

    2017-03-01

    OBJECTIVE The impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that US Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non-VA nursing homes. SETTING VA and non-VA nursing homes participating in the AHRQ Safety Program for Long-Term Care collaborative. METHODS Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention via a needs assessment questionnaire. RESULTS A total of 353 of 494 nursing homes from 41 states (71%; 47 VA and 306 non-VA facilities) responded. VA nursing homes reported more hours per week devoted to infection prevention-related activities (31 vs 12 hours; Phomes reported tracking CAUTI rates (94% vs 66%; Phomes reported having policies for appropriate catheter use (64% vs 81%; P=.004) and catheter insertion (83% vs 94%; P=.004). CONCLUSIONS Among nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems. Infect Control Hosp Epidemiol 2017;38:287-293.

  5. Neuropsychiatric symptoms in nursing home patients: factor structure invariance of the Dutch nursing home version of the neuropsychiatric inventory in different stages of dementia.

    NARCIS (Netherlands)

    Zuidema, S.U.; Jonghe, J.F. de; Verhey, F.R.J.; Koopmans, R.T.C.M.

    2007-01-01

    BACKGROUND/AIMS: To examine the influence of dementia stage and psychoactive medication use on the factor structure of the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) in Dutch nursing home patients. METHODS: The NPI-NH was administered to a large sample of 1,437 patients with mild to se

  6. Neuropsychiatric symptoms in nursing home patients : factor structure invariance of the Dutch nursing home version of the neuropsychiatric inventory in different stages of dementia

    NARCIS (Netherlands)

    Zuidema, Sytse U; de Jonghe, Jos F M; Verhey, Frans R J; Koopmans, Raymond T C M

    2007-01-01

    BACKGROUND/AIMS: To examine the influence of dementia stage and psychoactive medication use on the factor structure of the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) in Dutch nursing home patients. METHODS: The NPI-NH was administered to a large sample of 1,437 patients with mild to se

  7. Impact of human resource management practices on nursing home performance.

    Science.gov (United States)

    Rondeau, K V; Wagar, T H

    2001-08-01

    Management scholars and practitioners alike have become increasingly interested in learning more about the ability of certain 'progressive' or 'high-performance' human resource management (HRM) practices to enhance organizational effectiveness. There is growing evidence to suggest that the contribution of various HRM practices to impact firm performance may be synergistic in effect yet contingent on a number of contextual factors, including workplace climate. A contingency theory perspective suggests that in order to be effective, HMR policies and practices must be consistent with other aspects of the organization, including its environment. This paper reports on empirical findings from research that examines the relationship between HRM practices, workplace climate and perceptions of organizational performance, in a large sample of Canadian nursing homes. Data from 283 nursing homes were collected by means of a mail survey that included questions on HRM practices, programmes, and policies, on human resource aspects of workplace climate, as well as a variety of indicators that include employee, customer/resident and facility measures of organizational performance. Results derived from ordered probit analysis suggest that nursing homes in our sample which had implemented more 'progressive' HRM practices and which reported a workplace climate that strongly values employee participation, empowerment and accountability tended to be perceived to generally perform better on a number of valued organizational outcomes. Nursing homes in our sample that performed best overall were found to be more likely to not only have implemented more of these HRM practices, but also to report having a workplace climate that reflects the seminal value that it places on its human resources. This finding is consistent with the conclusion that simply introducing HRM practices or programmes, in the absence of an appropriately supportive workplace climate, will be insufficient to attain

  8. CPR in the nursing home: fool's errand or looming dilemma?

    LENUS (Irish Health Repository)

    Lyons, D

    2011-09-01

    The indications for CPR (cardiopulmonary resuscitation) have expanded greatly since the technique was introduced and theoretically it can be attempted on all prior to death. Policy initiatives (such as the British Medical Association\\/Royal College of Nursing guidelines) have attempted to provide a clinical rationale for the withholding of inappropriate CPR. Traditionally a care home was felt to be an inappropriate environment to attempt CPR but increased use of advance directives may bring the issue to the fore in this setting.

  9. [Interests of an olfactory stimulation activity in a nursing home].

    Science.gov (United States)

    Garnaud, Mahlia; Rexand, Franck

    2016-01-01

    The comparison between the memories productions of residents in a nursing home through two reminiscence activities, one including olfaction and not the other one, can highlight an increasing occurrence of recent memories in the case of olfactory activity. A longer talk time is also observed and a better self-esteem can be assessed. This suggests the possibility of a specific relational and psychotherapeutic work. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  10. Ciprofloxacin : Use and resistance in Community, Nursing Home and Hospital

    OpenAIRE

    van Hees, B.C.

    2011-01-01

    The aim of the studies described in this thesis was to analyze some aspects of ciprofloxacin use and clinical and (molecular) epidemiology of ciprofloxacin resistance in different settings, both within hospitals (chapter 3,4 and 6), community and nursing homes (chapter 2 and 5). With its broad spectrum against gram negative organisms and favorable pharmacokinetics, ciprofloxacin use has increased over the last two decades, as did resistance against ciprofloxacin. Chapter 2 describes a nation-...

  11. Nursing Home Medical Staff Organization and 30-Day Rehospitalizations

    Science.gov (United States)

    Lima, Julie C.; Intrator, Orna; Karuza, Jurgis; Wetle, Terrie; Mor, Vincent; Katz, Paul

    2013-01-01

    Objectives To examine the relationship between features of nursing home (NH) medical staff organization and residents’ 30-day rehospitalizations. Design Cross-sectional study combining primary data collected from a survey of medical directors, NH resident assessment data (minimum data set), Medicare claims, and the Online Survey Certification and Reporting (OSCAR) database. Setting A total of 202 freestanding US nursing homes. Participants Medicare fee-for-service beneficiaries who were hospitalized and subsequently admitted to a study nursing home. Measurements Medical staff organization dimensions derived from the survey, NH residents’ characteristics derived from minimum data set data, hospitalizations obtained from Part A Medicare claims, and NH characteristics from the OSCAR database and from www.ltcfocus.org. Study outcome defined within a 30-day window following an index hospitalization: rehospitalized, otherwise died, otherwise survived and not rehospitalized. Results Thirty-day rehospitalizations occurred for 3788 (20.3%) of the 18,680 initial hospitalizations. Death was observed for 884 (4.7%) of residents who were not rehospitalized. Adjusted by hospitalization, resident, and NH characteristics, nursing homes having a more formal appointment process for physicians were less likely to have 30-day rehospitalization (b = −0.43, SE = 0.17), whereas NHs in which a higher proportion of residents were cared for by a single physician were more likely to have rehospitalizations (b = 0.18, SE = 0.08). Conclusion This is the first study to show a direct relationship between features of NH medical staff organization and resident-level process of care. The relationship of a more strict appointment process and rehospitalizations might be a consequence of more formalized and dedicated medical practice with a sense of ownership and accountability. A higher volume of patients per physician does not appear to improve quality of care. PMID:22682694

  12. The Effect of Hospice on Hospitalizations of Nursing Home Residents

    Science.gov (United States)

    Zheng, Nan Tracy; Mukamel, Dana B.; Friedman, Bruce; Caprio, Thomas V.; Temkin-Greener, Helena

    2014-01-01

    Objectives Hospice enrollment is known to reduce risk of hospitalizations for nursing home residents who use it. We examined whether residing in facilities with a higher hospice penetration: 1) reduces hospitalization risk for non-hospice residents; and 2) decreases hospice-enrolled residents’ hospitalization risk relative to hospice-enrolled residents in facilities with a lower hospice penetration. Method Medicare Beneficiary File, Inpatient and Hospice Claims, Minimum Data Set Version 2.0, Provider of Services File and Area Resource File. Retrospective analysis of long-stay nursing home residents who died during 2005-2007. Overall, 505,851 non-hospice (67.66%) and 241,790 hospice-enrolled (32.34%) residents in 14,030 facilities nationwide were included. We fit models predicting the probability of hospitalization conditional on hospice penetration and resident and facility characteristics. We used instrumental variable method to address the potential endogeneity between hospice penetration and hospitalization. Distance between each nursing home and the closest hospice was the instrumental variable. Main Findings In the last 30 days of life, 37.63% of non-hospice and 23.18% of hospice residents were hospitalized. Every 10% increase in hospice penetration leads to a reduction in hospitalization risk of 5.1% for non-hospice residents and 4.8% for hospice-enrolled residents. Principal Conclusions Higher facility-level hospice penetration reduces hospitalization risk for both non-hospice and hospice-enrolled residents. The findings shed light on nursing home end-of-life care delivery, collaboration among providers and cost benefit analysis of hospice care. PMID:25304181

  13. Is There a Trade-off Between Quality and Profitability in United States Nursing Homes?

    Science.gov (United States)

    Godby, Tyler; Saldanha, Sarah; Valle, Jazmine; Paul, David P; Coustasse, Alberto

    Nursing home residents across the United States rely on quality care and effective services. Nursing homes provide skilled nurses and nursing aides who can provide services 24 hours a day for individuals who could not perform these tasks for themselves. Not-for-profit (NFP) versus for-profit (FP) nursing homes have been examined for utilization and efficacy; however, it has been shown that NFP nursing homes generally offer higher quality care and generate greater profit margins compared with FP nursing homes. The purpose of this research was to determine if NFP nursing homes provide enhanced quality care and a larger profit margin compared with FP nursing homes. Benefits and barriers in regard to financial stability and quality of care exist for both FP and NFP homes. Based on the findings of this review, it is suggested that NFP nursing homes have achieved higher quality of care because of a more effective balance of business aspects, as well as prioritizing resident well-being, and care quality over profit maximization in NFP homes.

  14. Role for a Labor-Management Partnership in Nursing Home Person-Centered Care

    Science.gov (United States)

    Leutz, Walter; Bishop, Christine E.; Dodson, Lisa

    2010-01-01

    Purpose: To investigate how a partnership between labor and management works to change the organization and focus of nursing home frontline work, supporting a transition toward person-centered care (PCC) in participating nursing homes. Design and Methods: Using a participatory research approach, we conducted case studies of 2 nursing homes…

  15. Current Dermatologic Care in Dutch Nursing Homes and Possible Improvements: A Nationwide Survey

    NARCIS (Netherlands)

    Lubeek, S.F.; Geer, E.R. van der; Gelder, M.M. van; Koopmans, R.T.; Kerkhof, P.C. van de; Gerritsen, M.J.

    2015-01-01

    OBJECTIVES: To assess the provision and need of dermatologic care among Dutch nursing home patients and to obtain recommendations for improvement. DESIGN: Cross-sectional nationwide survey. SETTING: All 173 nursing home organizations in the Netherlands. PARTICIPANTS: Physicians working in nursing

  16. Trade-off Between Quality, Price, and Profit Orientation in Germany's Nursing Homes.

    Science.gov (United States)

    Geraedts, Max; Harrington, Charlene; Schumacher, Daniel; Kraska, Rike

    International data suggest that for-profit nursing homes tend to provide lower quality than not-for-profit nursing homes. In Germany, the relationships between profit orientation, price and quality of nursing homes have not been investigated. We performed an observational study using secondary data from statutory quality audits of all nursing homes in Germany. The relationships were analyzed bivariately via Mann-Whitney U-Test and Kruskal-Wallis Test respectively, followed by a multivariate variance analysis which also covered the interaction effect between quality, price and type of ownership. 41 % of 10,168 German nursing homes were for-profit charging on average about 10 % less than not-for-profit homes. In five out of six quality categories under study, for-profit nursing homes provided lower quality than not-for-profit homes. Quality of care in all quality categories improved with increasing prices per day. However, for four out of six quality categories examined, the quality difference between for-profit and non-profit nursing homes existed independent of the price charged. When selecting a nursing home it is therefore advisable to consider the profit orientation of the institution. German legislation should require that statutory public quality reports contain details on the profit orientation of nursing homes.

  17. Psychiatric assessment of a nursing home population using audiovisual telecommunication.

    Science.gov (United States)

    Grob, P; Weintraub, D; Sayles, D; Raskin, A; Ruskin, P

    2001-01-01

    The purpose of this study was to demonstrate that psychiatric assessment of nursing home residents could be reliably carried out remotely via telecommunications. Twenty-seven nursing home residents each had two interviews consisting of the following three rating scales: the Mini-Mental State Examination (MMSE), the Geriatric Depression Scale (GDS), and the Brief Psychiatric Rating Scale (BPRS). The interviews were conducted by three trained psychiatrists, each of whom interviewed two-thirds of the subjects. Subjects were sequentially assigned to have either two in-person interviews (in-person group) or one in-person and one remote interview via telecommunication (remote group). Inter-rater reliability was calculated separately for each condition (in-person vs remote group) for each of the three rating scales. Intraclass correlations on the MMSE were .95 for the remote group and .83 for the in-person group. On the GDS, they were .82 for the remote group and .86 for the in-person group. Finally, on the BPRS, they were .81 for the remote group and .49 for the in-person group. There were no statistically significant differences in intraclass correlation on any of the three scales for the remote group compared with the in-person group, indicating that nursing home residents can be reliably assessed remotely via telecommunication.

  18. Death in nursing homes: a Danish qualitative study.

    Science.gov (United States)

    Gorlén, Tanja Fromberg; Gorlén, Thomas; Neergaard, Mette Asbjoern

    2013-05-01

    Little is known about the quality of end-of-life care in Danish nursing homes (NHs). This qualitative descriptive study based on semi-structured group interviews with nursing staff members in three NHs in Copenhagen, Denmark, aimed to describe the participants' perceptions of end-of-life care in Danish NHs, with particular focus on medication administration and collaboration with GPs. Four main categories of problematic issues emerged: medication (problems with 'as needed' medication and lack of knowledge of subcutaneous administration), interpersonal relations (difficulties in cooperation and communication between relatives and GPs), decision making (problems concerning termination of life-prolonging treatment and the need for early planning of end-of-life care), and professional development (documentation and education). Considerable improvements may be achieved primarily by educating and training nursing staff and GPs. More research is warranted to optimise end-of-life care in Danish NHs.

  19. 75 FR 45207 - Proposed Information Collection (Regulation on Reduction of Nursing Shortages in State Homes...

    Science.gov (United States)

    2010-08-02

    ... AFFAIRS Proposed Information Collection (Regulation on Reduction of Nursing Shortages in State Homes; Application for Assistance for Hiring and Retaining Nurses at State Homes) Activity: Comment Request AGENCY... information needed to determine State Veterans' Homes eligibility for funding for programs to recruit and...

  20. 78 FR 55778 - Proposed Information Collection (Regulation on Reduction of Nursing Shortages in State Homes...

    Science.gov (United States)

    2013-09-11

    ... AFFAIRS Proposed Information Collection (Regulation on Reduction of Nursing Shortages in State Homes; Application for Assistance for Hiring and Retaining Nurses at State Homes) Activity: Comment Request AGENCY... information needed to determine State Veterans' Homes eligibility for funding for programs to recruit and...

  1. Nursing staff views of barriers to physical restraint reduction in nursing homes.

    Science.gov (United States)

    Kong, Eun-Hi; Evans, Lois K

    2012-12-01

    There are few studies globally regarding the barriers to restraint-reduction. The purpose of this study was to describe the views of nursing staff (both nurses and geriatric care assistants) regarding the barriers to reducing physical restraint use in Korean nursing homes. Forty registered nurse and geriatric care assistant informants participated in the first round of interviews and 16 of them participated in second confirmatory interviews. All interviews were conducted on site, one-on-one and face-to-face, using semi-structured interview protocols. Qualitative descriptive method was used and qualitative content analysis was employed. Six themes were identified: (a) being too busy, (b) lack of resources, (c) beliefs and concerns, (d) lack of education, (e) differences and inconsistencies, and (f) relationship issues. The findings of this study provide a valuable basis for developing restraint reduction education programs. Korean national leaders and nursing homes should develop and employ practice guidelines regarding restraints, support nursing staff to follow the guidelines, provide more practical and professional education, employ alternative equipment, use a multidisciplinary team approach, and engage volunteers in care support as well as employ more nursing staff to achieve restraint-free care. Copyright © 2012. Published by Elsevier B.V.

  2. Effects of the Evidence-Based Nursing Care Algorithm of Dysphagia for Nursing Home Residents.

    Science.gov (United States)

    Park, Yeonhwan; Oh, Seieun; Chang, Heekyung; Bang, Hwal Lan

    2015-11-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Effects of the Evidence-Based Nursing Care Algorithm of Dysphagia for Nursing Home Residents" found on pages 30-39, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until October 31, 2018. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Explain the development and testing of the Evidence-Based Nursing Care Algorithm of

  3. Falls in nursing home residents receiving pharmacotherapy for anemia

    Directory of Open Access Journals (Sweden)

    Reardon G

    2012-10-01

    Full Text Available Gregory Reardon,1 Naushira Pandya,2 Robert A Bailey31Informagenics, LLC and The Ohio State University College of Pharmacy, Columbus, OH, USA; 2Department of Geriatrics, Nova Southeastern University College of Osteopathic Medicine, Ft Lauderdale, FL, USA; 3Janssen Scientific Affairs, LLC, Horsham, PA, USAPurpose: Falls are common among nursing home residents and have potentially severe consequences, including fracture and other trauma. Recent evidence suggests anemia may be independently related to these falls. This study explores the relationship between the use of anemia-related pharmacotherapies and falls among nursing home residents.Methods: Forty nursing homes in the United States provided data for analysis. All incidents of falls over the 6-month post-index follow-up period were used to identify the outcomes of falls (≥1 fall and recurrent falls (>1 fall. Logistic regression was used to analyze the relationship between falls and recurrent falls with each of the anemia pharmacotherapies after adjusting for potential confounders.Results: A total of 632 residents were eligible for analysis. More than half (57% of residents were identified as anemic (hemoglobin < 12 g/dL females, or <13 g/dL males. Of anemic residents, 50% had been treated with one or more therapies (14% used vitamin B12, 10% folic acid, 38% iron, 0.3% darbepoetin alfa [DARB], and 1.3% epoetin alfa [EPO]. Rates of falls/recurrent falls were 33%/18% for those receiving vitamin B12, 40%/16% for folic acid, 27%/14% for iron, 38%/8% for DARB, 18%/2% for EPO, and 22%/11% for those receiving no therapy. In the adjusted models, use of EPO or DARB was associated with significantly lower odds of recurrent falls (odds ratio = 0.06; P = 0.001. Other significant covariates included psychoactive medication use, age 75–84 years, age 85+ years, worsened balance score, and chronic kidney disease (P < 0.05 for all.Conclusion: Only half of the anemic residents were found to be using anemia

  4. Breastfeeding status and marketing practices of baby food manufactured in nursing homes.

    Science.gov (United States)

    Mathur, G P; Pandey, P K; Mathur, S; Mishra, V K; Singh, K; Bhatt, O P; Loomba, R K; Luthra, C; Taneja, S; Kapoor, R

    1993-11-01

    In January 1993 in Kanpur, India, a survey of 7 private nursing homes revealed that infant formula was given to most newborns (52.4%). The most common brands included Lactogen-I, Milk Care, Raptakos, Dexolac Special Care, and Lactodex. Staff at 5 nursing homes gave prelacteal feeds (water, glucose water, and infant formula) to newborns when they were separated from their mothers. Staff at only 2 nursing homes gave the newborn to the mother immediately after delivery. The longest period between delivery and giving the newborn to the mother was 24 hours. All but one of the nursing homes did not know about the government policy and the recent bill that bars free or low-cost infant formula supplies to hospitals. The administration of the nursing homes did not inform the procurement department, in writing, of the government policy. 4 nursing homes bought low-cost supplies of infant formula from the companies. The companies sold the infant formula to the nursing homes at a price 48.3% to 86.7% lower than the market price. Medical stores inside or outside the nursing homes sold the infant formula to parents at the other 3 homes. The nursing homes used, on average, 2-50 kg/month. Nestle (Lactogen-I) and Dalmia Industries (Milk Care) had a monopoly in infant formula in 4 and 3 nursing homes, respectively. Infant formula was in stock in 5 nursing homes. None of the nursing homes gave mothers free or low-cost infant formula at discharge. Lower than market price and increased number of calls to the hospitals and physicians by company personnel were marketing techniques used by the manufacturers to maintain market share. These results show that, despite government policy and the bill, hospitals continue to use infant formula. The government should use the mass media to increase awareness about its policy on infant foods and the concept of the Baby Friendly Hospital.

  5. Effects of introducing a nursing guideline on depression in psychogeriatric nursing home residents.

    NARCIS (Netherlands)

    Verkaik, R.; Francke, A.; Berno, M. van; Bensing, J.; Miel, R.

    2010-01-01

    Introduction: The prevalence rate of depression in psychogeriatric nursing home residents with dementia is recently estimated at 19%. Comorbid depression in dementia has been associated with decreased quality of life, greater health care utilization and higher mortality rates. The effects of introdu

  6. Effects of introducing a nursing guideline on depression in psychogeriatric nursing home residents.

    NARCIS (Netherlands)

    Verkaik, R.; Francke, A.; Berno, M. van; Bensing, J.; Miel, R.

    2010-01-01

    Introduction: The prevalence rate of depression in psychogeriatric nursing home residents with dementia is recently estimated at 19%. Comorbid depression in dementia has been associated with decreased quality of life, greater health care utilization and higher mortality rates. The effects of

  7. Effects of introducing a nursing guideline on depression in psychogeriatric nursing home residents.

    NARCIS (Netherlands)

    Verkaik, R.; Francke, A.; Berno, M. van; Bensing, J.; Miel, R.

    2010-01-01

    Introduction: The prevalence rate of depression in psychogeriatric nursing home residents with dementia is recently estimated at 19%. Comorbid depression in dementia has been associated with decreased quality of life, greater health care utilization and higher mortality rates. The effects of introdu

  8. Nursing home physician specialists: a response to the workforce crisis in long-term care.

    Science.gov (United States)

    Katz, Paul R; Karuza, Jurgis; Intrator, Orna; Mor, Vincent

    2009-03-17

    Marginalization of physicians in the nursing home threatens the overall care of increasingly frail nursing home residents who have medically complex illnesses. The authors propose that creating a nursing home medicine specialty, which recognizes the nursing home as a unique practice site, would go a long way toward remedying existing problems with care in skilled nursing facilities and would best serve the needs of the 1.6 million nursing home residents in the United States. Reviewing what is known about physician practice in nursing homes and hospitals, and taking a lead from the hospitalist movement, the specialty would be characterized in 3 dimensions: the degree of physicians' commitment, physicians' practice competencies, and the structure of the medical staff organization in which they practice. Challenges to the adoption of a nursing home specialist model include mainstream medicine's failure to recognize the nursing home as a legitimate medical practice, the need for the nursing home industry and policymakers to appreciate the links between physician practice and quality, and assurance of financial viability. Implications for quality of care, health policy, and research needs are discussed in this article.

  9. The Need for Higher Minimum Staffing Standards in U.S. Nursing Homes

    Science.gov (United States)

    Harrington, Charlene; Schnelle, John F.; McGregor, Margaret; Simmons, Sandra F.

    2016-01-01

    Many U.S. nursing homes have serious quality problems, in part, because of inadequate levels of nurse staffing. This commentary focuses on two issues. First, there is a need for higher minimum nurse staffing standards for U.S. nursing homes based on multiple research studies showing a positive relationship between nursing home quality and staffing and the benefits of implementing higher minimum staffing standards. Studies have identified the minimum staffing levels necessary to provide care consistent with the federal regulations, but many U.S. facilities have dangerously low staffing. Second, the barriers to staffing reform are discussed. These include economic concerns about costs and a focus on financial incentives. The enforcement of existing staffing standards has been weak, and strong nursing home industry political opposition has limited efforts to establish higher standards. Researchers should study the ways to improve staffing standards and new payment, regulatory, and political strategies to improve nursing home staffing and quality. PMID:27103819

  10. Home visits as a strategy for health promotion by nursing

    Directory of Open Access Journals (Sweden)

    Jucelia Salgueiro Nascimento

    2014-09-01

    Full Text Available Objective: To analyze the domiciliary visit performed by nurses in the Family Health Strategy as an activity to promote health. Methods: Exploratory/descriptive study with qualitative approach. The subjects were nine nurses of the Primary Health Units from Health Districts in Maceió-AL. Data was collected through semi-structured interviews in the months from April to August 2012 and were analyzed using content analysis and in light of the theoretical framework of Health Promotion. Results: The nurses recognize that the domiciliary visit can be a way to promote the health of individuals, families and community, but, in daily life, action maintains focus on disease, with curative actions of individual character, which do not take into account the social context where the user and his family are inserted. Conclusion: It is considered that the use of home visits by nurses in the family health strategy as a health promotion activity is still incipient because, although the nurses recognize the need for change in the model of care, in practice, it is observed that the focus of this action is directed to the biological model. doi:http://dx.doi.org/10.5020/18061230.2013.p513

  11. The nutritional situation in Swedish nursing homes - a longitudinal study.

    Science.gov (United States)

    Borgström Bolmsjö, Beata; Jakobsson, Ulf; Mölstad, Sigvard; Ostgren, Carl Johan; Midlöv, Patrik

    2015-01-01

    Poor nutritional status is widespread among the elderly and is associated with increased morbidity and mortality. The aim of this study was to longitudinally describe the nutritional status in elderly people living in nursing homes. Nutritional status was recorded longitudinally in elderly people living in 11 different nursing homes in Sweden. Participants were examined at baseline by specially trained nurses who also assisted with questionnaires and collected data for current medical treatment from patient records. Nutritional status was evaluated at baseline and after 24 months with the mini nutritional assessment (MNA). The study included 318 subjects. The mean age of the participants was 85.0 years (range 65-101). At baseline, 41.6% were well nourished, 40.3% at risk of malnutrition, and 17.7% malnourished according to the MNA. Survival was significantly lower in the malnourished group. After 24 months, almost half of the population had died. The group of participants who survived at 24 months represents a population of better nutritional state, where 10.6% were malnourished at baseline increasing to 24.6% after 24 months. After 24 months, 38.7% of the participants showed a decline in nutritional state. The group with deteriorating MNA scores had higher weight, BMI values, and a higher hospitalization rate. The prevalence of malnutrition in nursing home residents increased over time and it is important to evaluate nutritional state regularly. Nutritional interventions should be considered in better nourished groups, as well as in malnourished individuals, to prevent a decline in nutritional state.

  12. Longevity and admission to nursing home according to age after isolated coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Thorsteinsson, Kristinn; Andreasen, Jan J; Mortensen, Rikke N;

    2016-01-01

    significant predictors for living in a nursing home 1 year postoperatively. CONCLUSIONS: The majority of all patients selected for CABG surgery in Denmark between 1996-2012, including the elderly, were able to live independently at home without the need of home care for many years after CABG. The risk......OBJECTIVES: Data on nursing home admission in patient's ≥80 years after isolated coronary artery bypass grafting (CABG) are scarce. The purpose of this study was to evaluate longevity and subsequent admission to a nursing home stratified by age in a nationwide CABG cohort. METHODS: All patients who...... underwent isolated CABG from 1996 to 2012 in Denmark were identified through nationwide registers. The cumulative incidence of admission to a nursing home after CABG was estimated. A Cox regression model was constructed to identify predictors for living in a nursing home 1 year after CABG. Kaplan...

  13. Exploring correlates of turnover among nursing assistants in the National Nursing Home Survey.

    Science.gov (United States)

    Temple, April; Dobbs, Debra; Andel, Ross

    2011-01-01

    High turnover of nursing assistants (NAs) has implications for the quality of nursing home care. Greater understanding of correlates of NA turnover is needed to provide insight into possible retention strategies. This study examined nursing home organizational characteristics and specific job characteristics of staff in relation to turnover of NAs. Cross-sectional data on 944 nationally representative nursing homes were derived from the 2004 National Nursing Home Survey. Using a 3-month turnover rate, 25% of the facilities with the lowest turnover rates were classified as low turnover, 25% of the facilities with the highest turnover were classified as high turnover, and the remaining 50% of the facilities were classified as moderate turnover. Multinomial logistic regression was used to examine organizational and job characteristics associated with low and high turnover compared with moderate turnover. One organizational characteristic, staffing levels at or greater than 4.0 hours per patient day, was associated with greater odds of low NA turnover and reduced odds of high NA turnover. Job characteristics including higher wages and union membership were associated with greater odds of low NA turnover, whereas wages, fully paid health insurance, employee assistance benefits, and involvement in resident care planning were associated with reduced odds of high NA turnover. The results of this study suggest that job characteristics of NA staff may be particularly important for turnover. Specifically, the provision of competitive wages and benefits (particularly health insurance) and involvement of NAs in resident care planning could potentially reduce NA turnover, as could maintaining high levels of nurse staffing.

  14. Knowledge and Attitudes of Nursing Home Staff and Surveyors about the Revised Federal Guidance for Incontinence Care

    Science.gov (United States)

    DuBeau, Catherine E.; Ouslander, Joseph G.; Palmer, Mary H.

    2007-01-01

    Purpose: We assessed nursing home staff and state nursing home surveyors regarding their knowledge and attitudes about urinary incontinence, its management, and the revised federal Tag F315 guidance for urinary incontinence. Design and Methods: We conducted a questionnaire survey of a convenience sample of nursing home staff and state nursing home…

  15. 76 FR 70076 - Technical Revisions To Update Reference to the Required Assessment Tool for State Nursing Homes...

    Science.gov (United States)

    2011-11-10

    ... Tool for State Nursing Homes Receiving Per Diem Payments From VA AGENCY: Department of Veterans Affairs... diem from VA for providing nursing home care to veterans. The proposed rule would require State nursing... Required Assessment Tool for State Nursing Homes Receiving Per Diem Payments From VA.'' Copies of...

  16. Use of nursing homes by a high-risk long-term care population.

    OpenAIRE

    Manheim, L M; Hughes, S.L.

    1986-01-01

    Limited information exists concerning lifetime use of nursing home services by the aged. This article examines the longitudinal experience, over four years, of elderly individuals at high risk of institutionalization, and develops a simple model of nursing home use based on these observations. This model allows us to predict future lifetime use under alternative assumptions. The main observations drawn from this sample are that high-risk elderly tend to move from the community to nursing home...

  17. Impact of educational intervention on prescribing inappropriate medication to elderly nursing homes residents

    OpenAIRE

    Ilić Darko; Bukumirić Zoran; Janković Slobodan

    2015-01-01

    Introduction. Problems with polypharmacy, adverse drug reactions and non-adherence are especially frequent among elderly nursing home residents. Objective. The aim of our study was to evaluate effectiveness of a specific form of staff education on appropriateness of prescribing in a cluster of nursing homes for the elderly. Methods. The study was designed as before-and-after trial of educational intervention on appropriateness of prescribing in nursing home...

  18. The Effect of Self-Transcendence on Depression in Cognitively Intact Nursing Home Patients

    OpenAIRE

    Gørill Haugan; Siw Tone Innstrand

    2012-01-01

    Aims. This study's aim was to test the effects of self-transcendence on depression among cognitively intact nursing home patients. Background. Depression is considered the most frequent mental disorder among the elderly population. Specifically, the depression rate among nursing home patients is three to four times higher than that among community-dwelling elderly. Therefore, finding new and alternative ways to prevent and decrease depression is of great importance for nursing home patients' ...

  19. SmartNursing - a mobile application to improve communication in home care

    DEFF Research Database (Denmark)

    Nyborg, Mads; Bashir, Khurram; Maknickaite, Asta

    2013-01-01

    This paper presents SmartNursing system and discusses how increasing capabilities of smartphone could benefit employees in working environment. A SmartNursing system is developed for home nurses working environment to fulfil their needs. The solution helps to improve communication among nurses...

  20. Nightingale Nursing Home, Lowville, Ahascragh, Ballinasloe, Galway.

    LENUS (Irish Health Repository)

    Boland, Michael

    2012-05-14

    AbstractIntroductionRivaroxaban, a new oral anticoagulant, is currently licensed for use in patients undergoing orthopedic surgery. It is more efficacious than other anticoagulants such as low molecular weight heparin and does not require daily monitoring. It has also been shown to be efficacious in patients with venous thromboembolism and acute coronary syndrome. Although hemorrhage is a known side effect of this new anticoagulant, we could find no case reports in the literature of patients suffering severe hemorrhage whilst taking rivaroxaban. Thus, we describe the first case of potentially fatal hemorrhage in a patient taking rivaroxaban.Case presentationWe report the case of a 58-year-old Caucasian man with acute-onset severe per rectal bleeding who had undergone total hip arthroplasty four weeks prior to the onset of symptoms and was taking rivaroxaban in the postoperative period. Rivaroxaban was discontinued immediately but, having required nine units of packed red blood cells in a peripheral hospital due to a rapidly decreasing hemoglobin level, our patient was transferred to our tertiary referral center where he required a further eight units of packed red blood cells over a 48-hour period to manage his ongoing hemorrhage and maintain hemodynamic stability. No source of bleeding was found on computed tomography angiography and our patient’s condition improved over the following 48 hours with cessation of the hemorrhage. Our patient was discharged home well several days later. A follow-up colonoscopy one week after his discharge was normal.ConclusionAlthough advantageous with regard to its oral availability and ongoing use without the need for daily monitoring, rivaroxaban does not come without rare but severe side effects. When severe per rectal bleeding occurs in a patient taking rivaroxaban, discontinuation of the offending agent and aggressive hematological replacement are the mainstays of treatment, especially when no source of bleeding can be found

  1. Consequences from use of reminiscenc--a randomised intervention study in ten Danish nursing homes

    DEFF Research Database (Denmark)

    Gudex, Claire; Horsted, Charlotte; Jensen, Anders Møller

    2010-01-01

    Reminiscence is the systematic use of memories and recollections to strengthen self-identity and self-worth. The study aim was to investigate the consequences for nursing home residents and staff of integrating reminiscence into daily nursing care.......Reminiscence is the systematic use of memories and recollections to strengthen self-identity and self-worth. The study aim was to investigate the consequences for nursing home residents and staff of integrating reminiscence into daily nursing care....

  2. Job and organizational determinants of nursing home employee commitment, job satisfaction and intent to turnover.

    Science.gov (United States)

    Karsh, B; Booske, B C; Sainfort, F

    2005-08-15

    The purpose of this study was to examine whether job characteristics, the work environment, participation in quality improvement activities and facility quality improvement environment predicted employee commitment and job satisfaction in nursing homes, and whether those same predictors and commitment and satisfaction predicted turnover intention. A total of 6,584 nursing home employees from 76 nursing homes in a midwestern state participated. A self-administered questionnaire was used to collect the data. The results supported the hypotheses that job and organizational factors predicted commitment and satisfaction while commitment and satisfaction predicted turnover intentions. The implications for retaining nursing home employees are discussed.

  3. Structure, environment and strategic outcome: a study of Pennsylvania nursing homes.

    Science.gov (United States)

    Aaronson, W E; Zinn, J S; Rosko, M D

    1995-02-01

    This study applies Porter's model of competitive advantage to the nursing home industry. Discriminant analysis is used to identify organizational and environmental characteristics associated with nursing homes which have demonstrated valued strategic outcomes, and to distinguish the more successful nursing homes from their rivals. The results of the discriminant analysis suggest that nursing homes with superior payer mix outcomes are distinguishable from their less successful rivals in areas associated with a focused generic strategy. The study suggests that nursing homes which are better staffed, of smaller size and lower price are more likely to achieve high levels of self-pay utilization. Independent living units, continuing care retirement communities in particular, are likely to act synergistically with nursing home organizational characteristics to enhance competitive advantage by linking the value chain of the nursing home to that of retirement housing. Nursing homes with higher proportions of Medicare were found to provide a unique product when compared to their rivals. Profit status does not discriminate better self-pay strategic utilization, but for-profit facilities are more likely to pursue a Medicare strategy. Concern was raised that, as nursing homes become more strategically oriented, Medicaid access may become more problematic.

  4. Cardiac surgery nurse practitioner home visits prevent coronary artery bypass graft readmissions

    National Research Council Canada - National Science Library

    Hall, Michael H; Esposito, Rick A; Pekmezaris, Renee; Lesser, Martin; Moravick, Donna; Jahn, Lynda; Blenderman, Robert; Akerman, Meredith; Nouryan, Christian N; Hartman, Alan R

    2014-01-01

    We designed and tested an innovative transitional care program, involving cardiac surgery nurse practitioners, to improve care continuity after patient discharge home from coronary artery bypass graft (CABG...

  5. Association between pneumonia and oral care in nursing home residents.

    Science.gov (United States)

    El-Solh, Ali A

    2011-06-01

    Pneumonia remains the leading cause of death in nursing home residents. The accumulation of dental plaque and colonization of oral surfaces and dentures with respiratory pathogens serves as a reservoir for recurrent lower respiratory tract infections. Control of gingivitis and dental plaques has been effective in reducing the rate of pneumonia but the provision of dental care for institutionalized elderly is inadequate, with treatment often sought only when patients experience pain or denture problems. Direct mechanical cleaning is thwarted by the lack of adequate training of nursing staff and residents' uncooperativeness. Chlorhexidine-based interventions are advocated as alternative methods for managing the oral health of frail older people; however, efficacy is yet to be demonstrated in randomized controlled trials. Development and maintenance of an oral hygiene program is a critical step in the prevention of pneumonia. While resources may be limited in long-term-care facilities, incorporating oral care in daily routine practice helps to reduce systemic diseases and to promote overall quality of life in nursing home residents.

  6. Nursing home resident outcomes from the Res-Care intervention.

    Science.gov (United States)

    Resnick, Barbara; Gruber-Baldini, Ann L; Zimmerman, Sheryl; Galik, Elizabeth; Pretzer-Aboff, Ingrid; Russ, Karin; Hebel, J Richard

    2009-07-01

    To test the effectiveness of a restorative care (Res-Care) intervention on function, muscle strength, contractures, and quality of life of nursing home residents, with secondary aims focused on strengthening self-efficacy and outcome expectations. A randomized controlled repeated-measure design was used, and generalized estimating equations were used to evaluate status at baseline and 4 and 12 months after initiation of the Res-Care intervention. Twelve nursing homes in Maryland. Four hundred eighty-seven residents consented and were eligible: 256 from treatment sites and 231 from control sites. The majority were female (389, 80.1%) and white (325, 66.8%); 85 (17.4%) were married and the remaining widowed, single, or divorced/separated. Mean age was 83.8 +/- 8.2, and mean Mini-Mental State Examination score was 20.4 +/- 5.3. Res-Care was a two-tiered self-efficacy-based intervention focused on motivating nursing assistants and residents to engage in functional and physical activities. Barthel Index, Tinetti Gait and Balance, grip strength, Dementia Quality-of-Life Scale, self-efficacy, and Outcome Expectations Scales for Function. Significant treatment-by-time interactions (PTinetti Mobility Score and its gait and balance subscores and for walking, bathing, and stair climbing. The findings provide some evidence for the utility and safety of a Res-Care intervention in terms of improving function in NH residents.

  7. Compensation of home health, public health, and hospital nurses. Extrinsic and intrinsic rewards.

    Science.gov (United States)

    Hughes, K K; Marcantonio, R J

    1991-11-01

    Despite the proliferation of home health agencies and increased numbers of nurses working in these settings, little is known about home health nurses or how they might differ from their public health and hospital counterparts. The authors discuss differences in monetary compensation and skill usage, as well as the relationship between compensation and retention, among hospital, home health, and public health staff nurses. The results show that these nurses receive different intrinsic and extrinsic rewards and that their reasons for remaining with their employers are similar, yet unique. Implications for nurse administrators and educators are discussed, along with recommendations for further research.

  8. Partnership working by default: district nurses and care home staff providing care for older people.

    Science.gov (United States)

    Goodman, Claire; Robb, Nadia; Drennan, Vari; Woolley, Rosemary

    2005-11-01

    Older people residents in care homes that only offer residential care rely on primary health care services for medical and nursing needs. Research has investigated the demands that care homes staff and residents make on general practice, but not the involvement of other members of the primary health care team. This paper describes two consecutive studies completed in 2001 and 2003 that involved focus groups and survey methods of enquiry conducted in two settings: an England shire and inner London. The research questions that both studies had in common were (1) What is the contribution of district nursing and other primary care services to care homes that do not have on-site nursing provision? (2) What strategies promote participation and collaboration between residents, care home staff and NHS primary care nursing staff? and (3) What are the current obstacles and aids to effective partnership working and learning? A total of 74 community-based nurses and care home managers and staff took part in 10 focus groups, while 124 care home managers (73% of the 171 surveyed) and 113 district nurse team leaders (80% of the 142 surveyed) participated in the surveys. Findings from both studies demonstrated that nurses were the most frequent NHS professional visiting care homes. Although care home managers and district nurses believed that they had a good working relationship, they had differing expectations of what the nursing contribution should be and how personal and nursing care were defined. This influenced the range of services that older people had access to and the amount of training and support care home staff received from district nurses and the extent to which they were able to develop collaborative and reciprocal patterns of working. Findings indicate that there is a need for community-based nursing services to adopt a more strategic approach that ensures older people in care homes can access the services they are entitled to and receive equivalent health care to

  9. Individual and organizational factors related to work engagement among home-visiting nurses in Japan.

    Science.gov (United States)

    Naruse, Takashi; Sakai, Mahiro; Watai, Izumi; Taguchi, Atsuko; Kuwahara, Yuki; Nagata, Satoko; Murashima, Sachiyo

    2013-12-01

    The increasing number of elderly people has caused increased demand for home-visiting nurses. Nursing managers should develop healthy workplaces in order to grow their workforce. This study investigated the work engagement of home-visiting nurses as an index of workplace health. The aim of the present study was to reveal factors contributing to work engagement among Japanese home-visiting nurses. An anonymous, self-administered questionnaire was sent to 208 home-visiting nurses from 28 nursing agencies in three districts; 177 (85.1%) returned the questionnaires. The Job Demands-Resources model, which explains the relationship between work environment and employee well-being, was used as a conceptual guide. The authors employed three survey instruments: (i) questions on individual variables; (ii) questions on organizational variables; and (iii) the Utrecht Work Engagement Scale (Japanese version). Multiple regression analyses were performed in order to examine the relationships between individual variables, organizational variables, and work engagement. Nurse managers and nurses who felt that there was a positive relationship between work and family had significantly higher work engagement levels than others. The support of a supervisor was significantly associated with work engagement. Nurses in middle-sized but not large agencies had significantly higher work engagement than nurses in small agencies. Supervisor support and an appropriate number of people reporting to each supervisor are important factors in fostering work engagement among home-visiting nurses. © 2013 The Authors. Japan Journal of Nursing Science © 2013 Japan Academy of Nursing Science.

  10. Use of mental health services by nursing home residents after hurricanes.

    Science.gov (United States)

    Brown, Lisa M; Hyer, Kathryn; Schinka, John A; Mando, Ahed; Frazier, Darvis; Polivka-West, Lumarie

    2010-01-01

    A growing body of research supports the value of mental health intervention to treat people affected by disasters. This study used a mixed-methods approach to evaluate pre- and posthurricane mental health service use in Florida nursing homes. A questionnaire was administered to 258 directors of nursing, administrators, and owners of nursing homes, representing two-thirds of Florida's counties, to identify residents' mental health needs and service use. In four subsequent focus group meetings with 22 nursing home administrators, underlying factors influencing residents' use of services were evaluated. Although most nursing homes provided some type of mental health care during normal operations, disaster-related mental health services were not routinely provided to residents. Receiving facilities were more likely than evacuating facilities to provide treatment to evacuated residents. Nursing home staff should be trained to deliver disaster-related mental health intervention and in procedures for making referrals for follow-up evaluation and formal intervention.

  11. Nursing Homes That Increased The Proportion Of Medicare Days Achieved Gains In Quality

    Science.gov (United States)

    Lepore, Michael; Leland, Natalie E.

    2017-01-01

    Nursing homes are increasingly serving short-stay rehabilitation residents under Medicare skilled nursing facility coverage, which is substantially more generous than Medicaid coverage for long-stay residents. In relation to increasing short-stay resident care, potential exists for beneficial or detrimental effects on long-stay resident outcomes. We employ panel multivariate regression analyses using facility fixed-effects models to determine how increasing the proportion of Medicare days in nursing homes relates to changes in quality outcomes for long-stay residents. We find increasing the proportion of Medicare days in a nursing home is significantly associated with improved quality outcomes for long-stay residents. Findings reinforce prior research indicating that quality outcomes tend to be superior in nursing homes with greater financial resources. This study bolsters arguments for financial investments in nursing homes, including increases in Medicaid payment rates, to support better care. PMID:26643633

  12. Effects of Green House nursing homes on residents' families.

    Science.gov (United States)

    Lum, Terry Y; Kane, Rosalie A; Cutler, Lois J; Yu, Tzy-Chyi

    2008-01-01

    A longitudinal quasi-experimental study with two comparison groups was conducted to test the effects of a Green House (GH) nursing home program on residents' family members. The GHs are individual residences, each serving 10 elders, where certified nursing assistant (CNA)-level resident assistants form primary relationships with residents and family, family is encouraged to visits, and professionals adapted their roles to support the model. GH family were somewhat less involved in providing assistance to their residents although family contact did not differ among the settings at any time period. GH family were more satisfied with their resident's care and with their own experience as family members, and had no greater family burden. Issues in studying family outcomes are discussed as well as implications for roles of various personnel, including social service and activities staff in a GH model.

  13. Current marketing practices in the nursing home sector.

    Science.gov (United States)

    Calhoun, Judith G; Banaszak-Holl, Jane; Hearld, Larry R

    2006-01-01

    Marketing is widely recognized as an essential business function across all industries, including healthcare. While many long-term care facilities adopted basic healthcare marketing practices and hired marketing staff by the early 1990s, a paucity of research on nursing home marketing exists in the literature. This study examines the extent to which nursing homes have developed more formulated marketing and related communication and promotional strategies as market competition has increased in this sector during the past two decades. In addition, we explored managers' perceptions of their control over marketing decision making, the impact of competition on the use of marketing practices, and areas for enhanced competitive positioning. Administrators from 230 nursing homes in 18 Southeastern Michigan counties were surveyed regarding (1) the adoption level of approximately 40 literature-based, best-practice marketing strategies; (2) the types of staff involved with the marketing function; and (3) their perception of their level of control over marketing functions and of local competition. Results from 101 (44 percent) survey participants revealed that although respondents viewed their markets as highly competitive, their marketing practices remained focused on traditional and relatively constrained practices. In relation to the importance of customer relationship management, the majority of the administrators reported intensive efforts being focused on residents and their families, referrers, and staff, with minimal efforts being extended to insurers and other types of payers. A significant positive relation was found between the intensity of marketing initiatives and the size of the facility (number of beds), whereas significant negative correlations were revealed in relation to occupancy and the perceived level of control over the function.

  14. Care Plan Improvement in Nursing Homes: An Integrative Review.

    Science.gov (United States)

    Mariani, Elena; Chattat, Rabih; Vernooij-Dassen, Myrra; Koopmans, Raymond; Engels, Yvonne

    2017-01-01

    Care planning nowadays is a key activity in the provision of services to nursing home residents. A care plan describes the residents' needs and the actions to address them, providing both individualized and standardized interventions and should be updated as changes in the residents' conditions occur. The aim of this review was to identify the core elements of the implementation of changes in nursing homes' care plans, by providing an overview of the type of stakeholders involved, describing the implementation strategies used, and exploring how care plans changed. An integrative literature review was used to evaluate intervention studies taking place in nursing homes. Data were collected from PubMed, CINHAL-EBSCO, and PsycINFO. English language articles published between 1995 and April 2015 were included. Data analysis followed the strategy of Knafl and Whittemore. Twenty-six articles were included. The stakeholders involved were professionals, family caregivers, and patients. Only a few studies directly involved residents and family caregivers in the quality improvement process. The implementation strategies used were technology implementation, audit, training, feedback, and supervision. The majority of interventions changed the residents' care plans in terms of developing a more standardized care documentation that primarily focuses on its quality. Only some interventions developed more tailored care plans that focus on individualized needs. Care plans generally failed in providing both standardized and personalized interventions. Efforts should be made to directly involve residents in care planning and provide professionals with efficient tools to report care goals and actions in care plans.

  15. A three perspective study of the sense of home of nursing home residents: the views of residents, care professionals and relatives

    NARCIS (Netherlands)

    Hoof, Joost van; Verbeek, H.; Janssen, B.M.; Eijkelenboom, A.; Felix, E.; Nieboer, K.A.; Zwerts-Verhelst, E.L.M.; Sijstermans, J.J.W.M.; Wouters, Eveline

    2016-01-01

    Background The sense of home of nursing home residents is a multifactorial phenomenon which is important for the quality of living. This purpose of this study is to investigate the factors influencing the sense of home of older adults residing in the nursing home from the perspective of residents, r

  16. Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: protocol for a realist evaluation case study.

    Science.gov (United States)

    Lovink, Marleen Hermien; Persoon, Anke; van Vught, Anneke Jah; Schoonhoven, Lisette; Koopmans, Raymond Tcm; Laurant, Miranda Gh

    2017-06-08

    In developed countries, substituting physicians with nurse practitioners, physician assistants and nurses (physician substitution) occurs in nursing homes as an answer to the challenges related to the ageing population and the shortage of staff, as well as to guarantee the quality of nursing home care. However, there is great diversity in how physician substitution in nursing homes is modelled and it is unknown how it can best contribute to the quality of healthcare. This study aims to gain insight into how physician substitution is modelled and whether it contributes to perceived quality of healthcare. Second, this study aims to provide insight into the elements of physician substitution that contribute to quality of healthcare. This study will use a multiple-case study design that draws upon realist evaluation principles. The realist evaluation is based on four concepts for explaining and understanding interventions: context, mechanism, outcome and context-mechanism-outcome configuration. The following steps will be taken: (1) developing a theory, (2) conducting seven case studies, (3) analysing outcome patterns after each case and a cross-case analysis at the end and (4) revising the initial theory. The research ethics committee of the region Arnhem Nijmegen in the Netherlands concluded that this study does not fall within the scope of the Dutch Medical Research Involving Human Subjects Act (WMO) (registration number 2015/1914). Before the start of the study, the Board of Directors of the nursing home organisations will be informed verbally and by letter and will also be asked for informed consent. In addition, all participants will be informed verbally and by letter and will be asked for informed consent. Findings will be disseminated by publication in a peer-reviewed journal, international and national conferences, national professional associations and policy partners in national government. © Article author(s) (or their employer(s) unless otherwise stated

  17. Examining differences in nurses' language, accent, and comprehensibility in nursing home settings based on birth origin and country of education.

    Science.gov (United States)

    Wagner, Laura M; Brush, Barbara L; Castle, Nicholas G; Eaton, Michelle; Capezuti, Elizabeth

    2015-01-01

    As nursing homes turn abroad to fill vacancies, the diverse linguistic backgrounds of nurse hires are creating new challenges in comprehensibility between nurses, providers, and residents. Accents are a natural part of spoken language that may present difficulty even when the parties involved are speaking the same language. We surveyed 1,629 nurses working in 98 nursing homes (NHs) in five U.S. states to determine if and how language difficulties were perceived by nurses and others (e.g. physicians, residents and family members). We found that when participants were asked how often other care team members and residents/families had difficulty understanding them due to language use or accent, foreign born nurses were significantly more likely to report that they experienced difficulty at least some of the time across all groups. This study supports an assessment of nurses' language, accents, and comprehensibility in these settings.

  18. Physicians in Nursing Homes: Effectiveness of Physician Accountability and Communication

    Science.gov (United States)

    Lima, Julie C; Intrator, Orna; Wetle, Terrie

    2015-01-01

    Objectives To develop a measure of the perceptions of nursing home (NH) Directors of Nursing (DON) on the adequacy of physician care and to examine its variation as well as its construct validity. Design A nationwide cross-sectional study with primary data collection Setting 2043 NHs surveyed August 2009 – April 2011 Participants Directors of Nursing (DONs) and NH Administrators responded to questions pertaining to their perceptions of the care provided by physicians in their NH. Measurements Ten items were used to create three domains: medical staff attentiveness, physician communication, and staff concerns about physician practice. These were combined into an overall summary score measure called “Effectiveness of Physician Accountability and Communication” (EPAC). EPAC construct validity was ascertained from other DON questions and from a complementary survey of NH Administrators. RESULTS The established EPAC score is the first measure to capture specific components of the adequacy of physician care in NHs. EPAC exhibited good construct validity: more effective practices were correlated with greater physician involvement in discussions of Do-Not-Resuscitate orders, the frequency that the Medical Director checked on the medical care delivered by attending physician, the tightness of nursing home's control of its physician resources, and the DON's perception of whether or not avoidable hospitalizations and ER visits could be reduced with greater physician attention to resident needs. Conclusion As increased attention is given to the quality of care provided to vulnerable elders, effective measures of processes of care are essential. The EPAC measure provides an important new metric that can be used in these efforts. The goal is that future studies could use EPAC and its individual domains to shed light on the manner through which physician presence is related to resident outcomes in the NH setting. PMID:25858283

  19. Nutritional Status and Related Factors in Elderly Nursing Home Residents

    OpenAIRE

    Zahra Bostani Khalesi; Mahshid Bokaie

    2015-01-01

    Introduction: A challenge for health care providers is that there will be a distinct rise globally in the number of elderly people aged 80 years and over. Malnutrition is a well-known problem among elderly people. The aim of this study was to determine nutritional status and its associated risk factors in elderly nursing home residents in Tehran, Iran. Methods: The cross-sectional study was carried out among 385 elderly people aged 60 years or elder in 2014. All subjects who were attending to...

  20. Weathering the storm: challenges to nurses providing care to nursing home residents during hurricanes.

    Science.gov (United States)

    Hyer, Kathryn; Brown, Lisa M; Christensen, Janelle J; Thomas, Kali S

    2009-11-01

    This article documents the experience of 291 Florida nursing homes during the 2004 hurricane season. Using quantitative and qualitative methods, the authors described and compared the challenges nurses encountered when evacuating residents with their experiences assisting residents of facilities that sheltered in place. The primary concerns for evacuating facilities were accessing appropriate evacuation sites for residents and having ambulance transportation contracts honored. The main issue for facilities that sheltered in place was the length of time it took for power to be restored. Barriers to maintaining resident health during disasters for those who evacuated or sheltered in place are identified.

  1. [Behavior profile of psychogeriatric patients in substitute care projects: nursing home care and home for the aged].

    Science.gov (United States)

    Boom-Poels, P G

    1994-03-01

    This article describes behaviour profiles of psychogeriatric patients participating in some substitute care projects. The behaviour of 55 patients from five residential homes participating in these projects were rated on the Behaviour Rating Scale for Psychogeriatric Inpatients (GIP). These data were compared with GIP-data of two reference groups: elderly people in residential homes and patients in psychogeriatric nursing homes (supervision, intensive care and nursing care requiring patients). Patients in the projects have, compared to the other people in residential homes, more cognitive and social disabilities. Compared to the patients in nursing homes, the patients in the projects have less social, cognitive and psychomotor disabilities, but more emotional problems, like suspicious, melancholic and dependent behaviour. These results show that patients in substitute care projects have a specific behaviour profile. The profile can be used for careful selection of patients in these projects.

  2. Music Therapy Clinical Practice in Hospice: Differences Between Home and Nursing Home Delivery.

    Science.gov (United States)

    Liu, Xiaodi; Burns, Debra S; Hilliard, Russell E; Stump, Timothy E; Unroe, Kathleen T

    2015-01-01

    Hospice music therapy is delivered in both homes and nursing homes (NH). No studies to date have explored differences in music therapy delivery between home and NH hospice patients. To compare music therapy referral reasons and delivery for hospice patients living in NH versus home. A retrospective, electronic medical record review was conducted from a large U.S. hospice of patients receiving music therapy between January 1, 2006, and December 31, 2010. Among the 4,804 patients, 2,930 lived in an NH and 1,847 patients lived at home. Compared to home, NH hospice patients were more likely to be female, older, unmarried, and Caucasian. For home hospice patients, the top referral reasons were patient/family emotional and spiritual support, quality of life, and isolation. The most frequent referral reasons for NH hospice patients were isolation, quality of life, and patient/family emotional and spiritual support. Differences in music therapy delivery depended mainly on patients' primary diagnosis and location of care. Results suggest differences in referral reasons and delivery based on an interaction between location of care and patient characteristics. Delivery differences are likely a result of individualized assessment and care plans developed by the music therapist and other interdisciplinary team members to address the unique needs of the patient. Thus, it is important to have professionally trained music therapists assess and provide tailored music-based interventions for patients with different referral reasons and personal characteristics. This study also supports staffing decisions based on patient need rather than average daily census. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Respecting the Aging Self: Communication in the Nursing Home

    Directory of Open Access Journals (Sweden)

    Jean Tinney

    2015-06-01

    Full Text Available This article draws on findings of an ethnographic nursing home study that explores the role of communication in maintaining residents’ sense of self. These findings suggest that the nursing home can be a site for recovery for the aging self, despite loss and bereavement and the negative effects on self-esteem of pain, illness and loss of function. However, where care privileges the body over social and emotional needs, residents have inadequate opportunities for communication essential to make sense of being old and in care. The key to sustaining the aging self is empathetic communication that recognizes the individuality and value of each older person, no matter how reduced by present illness or incapacity, and at the same time respects residents’ rights of choice and personal control. Harried staff, often well-intentioned but unsupported by management, carry an unfair burden. Frequently called upon to do more with less, they find themselves faced with the competing pressures of work routines and residents’ emotional needs. In trying to balance these competing needs and provide opportunities for residents to exert personal control over their lives, they must protect both the residents and themselves from the results of “wrong” choices.

  4. Spiritual Needs of Elderly Living in Residential/Nursing Homes

    Directory of Open Access Journals (Sweden)

    Nora-Beata Erichsen

    2013-01-01

    Full Text Available While the research on spiritual needs of patients with chronic and life-threatening diseases increases, there is limited knowledge about psychosocial and spiritual needs of elderly living in residential/nursing homes. We were interested in which needs were of relevance at all, and how these needs are related to life satisfaction and mood states. For that purpose we enrolled 100 elderly living in residential/nursing homes (mean age years, 82% women and provided standardized questionnaires, that is, Spiritual Needs Questionnaire (SpNQ, Brief Multidimensional Life Satisfaction Scale (BMLSS, Quality of Life in Elders with Multimorbidity (FLQM questionnaire, and a mood states scale (ASTS. Religious needs and Existential needs were of low relevance, while inner peace needs were of some and needs for giving/generativity of highest relevance. Regression analyses revealed that the specific needs were predicted best by religious trust and mood states, particularly tiredness. However, life satisfaction and quality of life were not among the significant predictors. Most had the intention to connect with those who will remember them, although they fear that there is limited interest in their concerns. It remains an open issue how these unmet needs can be adequately supported.

  5. Adult protective service use and nursing home placement.

    Science.gov (United States)

    Lachs, Mark S; Williams, Christianna S; O'Brien, Shelley; Pillemer, Karl A

    2002-12-01

    Adult Protective Services (APS) is the official state entity charged with advocacy for older adults who are victims of elder abuse or self-neglect. However, it has been speculated that APS intervention may lead disproportionately to nursing home placement (NHP). These analyses seek to determine if APS use is an independent risk factor for NHP. The sample was 2,812 community-dwelling older adults who were aged 65 years or older in 1982 in the New Haven Established Populations for Epidemiologic Studies in the Elderly cohort, a subset of whom were referred to elder protective services over a 9-year follow-up period from cohort inception. NHP of cohort members over that time period was determined. Rates of subsequent NHP were: 69.2% for self-neglecting subjects, 52.3% for mistreated subjects, and 31.8% for subjects who had no contact with APS (p self-neglect (hazard ratio [HR], 5.23; 95% confidence interval [CI], 4.07-6.72), and for elder mistreatment (HR, 4.02; 95% CI, 2.50-6.47). These hazards far exceeded those for other medical, functional, and social factors. APS use is an independent risk factor for nursing home placement; persons identified by APS as self-neglecting are at the highest risk.

  6. Analgesic medication errors in North Carolina nursing homes.

    Science.gov (United States)

    Desai, Rishi J; Williams, Charrlotte E; Greene, Sandra B; Pierson, Stephanie; Caprio, Anthony J; Hansen, Richard A

    2013-06-01

    The objective of this study was to characterize analgesic medication errors and to evaluate their association with patient harm. The authors conducted a cross-sectional analysis of individual medication error incidents reported by North Carolina nursing homes to the Medication Error Quality Initiative (MEQI) during fiscal years 2010-2011. Bivariate associations between analgesic medication errors with patient factors, error-related factors, and impact on patients were tested with chi-square tests. A multivariate logistic regression model explored the relationship between type of analgesic medication errors and patient harm, controlling for patient- and error-related factors. A total of 32,176 individual medication error incidents were reported over a 2-year period in North Carolina nursing homes, 12.3% (n = 3949) of which were analgesic medication errors. Of these analgesic medication errors, opioid and nonopioid analgesics were involved in 3105 and 844 errors, respectively. Opioid errors were more likely to be wrong drug errors, wrong dose errors, and administration errors compared with nonopioid errors (P errors were found to have higher odds of patient harm compared with nonopioid errors (odds ratio [OR] = 3, 95% confodence interval [CI]: 1.1-7.8). The authors conclude that opioid analgesics represent the majority of analgesic error reports, and these error reports reflect an increased likelihood of patient harm compared with nonopioid analgesics.

  7. Durham Nursing Home solar project: a case study

    Energy Technology Data Exchange (ETDEWEB)

    Swartman, R.K.; Ali, T. [Solcan Ltd., London, ON (Canada)

    2004-08-01

    Based on an earlier report indicating that an optimal match for solar energy applications is to preheat hot water used in nursing homes, this paper discusses the construction of a solar water pre-heating system at the Rockwood Terrace Nursing Home in Durham, Ontario. Performance of the system, costs and financial viability are predicted with the use of the RETScreen project management tool. In addition, system requirements and load and energy requirements are also taken into consideration with this tool, thereby ensuring the unique nature of each project. Thirty solar collectors were mounted on steel racks 3 stories above the mechanical room. A heat exchanger, heated by antifreeze, circulates to and from the solar collectors. Potable water is circulated from hot water storage tanks to the heat exchanger. Solar pre-heated water is then piped into a hot water storage tank, with a gas fired water heater heating potable hot water in a recirculation loop. The paper concludes that both Watsun 13.2 and RETScreen are both good predictive tools, having only exceeded actual measured performances of the system and its energy savings by 8 and 9 per cent respectively. 4 refs., 4 figs.

  8. Assistive technology as an alternative to physical restraints in psychogeriatric nursing homes.

    NARCIS (Netherlands)

    Zwijsen, S.; Boekhorst, S. te; Hertogh, C.; Francke, A.

    2010-01-01

    Introduction: Assistive technology is proposed as an alternative to physical restraints in nursing home care for people with dementia. The number of nursing homes implementing assistive technology is steadily rising. However, research on usability is lacking. Objectives: This mixed methods study

  9. Influenza Vaccination in dutch Nursing Homes: is tacit consent morally justified?

    NARCIS (Netherlands)

    Verweij, M.F.; Hoven, M.A. van den

    2005-01-01

    Objectives: Efficient procedures for obtaining informed (proxy) consent may contribute to high influenza vaccination rates in nursing homes. Yet are such procedures justified? This study’s objective was to gain insight in informed consent policies in Dutch nursing homes; to assess how these may affe

  10. Psychometric Properties of a Korean Measure of Person-Directed Care in Nursing Homes

    Science.gov (United States)

    Choi, Jae-Sung; Lee, Minhong

    2014-01-01

    Objective: This study examined the validity and reliability of a person-directed care (PDC) measure for nursing homes in Korea. Method: Managerial personnel from 223 nursing homes in 2010 and 239 in 2012 were surveyed. Results: Item analysis and exploratory factor analysis for the first sample generated a 33-item PDC measure with eight factors.…

  11. Diagnostic accuracy of Parkinson's disease and atypical parkinsonism in nursing homes

    NARCIS (Netherlands)

    Weerkamp, N. J.; Tissingh, G.; Poels, P. J. E.; Zuidema, S. U.; Munneke, M.; Koopmans, R. T. C. M.; Bloem, B. R.

    2014-01-01

    Introduction: Management of Parkinson's disease (PD) and atypical parkinsonism in nursing homes depends on a timely and accurate diagnosis. However, little is known about the diagnostic accuracy of these parkinsonian syndromes in nursing homes. We examined this issue in a large group of Dutch nursin

  12. Prevalence and risk indicators of depression in elderly nursing home patients : the AGED study

    NARCIS (Netherlands)

    Jongenelis, K; Eisses, AMH; Beekman, ATF; Kluiter, H; Ribbe, MW

    2004-01-01

    Background: Depression is a common and disabling psychiatric disorder in later life. Particular frail nursing home patients seem to be at increased risk. Nursing home-based studies on risk indicators of depression are scarce. Methods: Prevalence and risk indicators of depression were assessed in 333

  13. Consequences of Empowered CNA Teams in Nursing Home Settings: A Longitudinal Assessment

    Science.gov (United States)

    Yeatts, Dale E.; Cready, Cynthia M.

    2007-01-01

    Purpose: Recent studies have concluded that there is a lack of "patient-centered" care in nursing homes and subsequently a need for nursing home culture change. As a result, a variety of new, promising initiatives have been introduced, with most of these incorporating the use of "empowered" employees. The purpose of this study…

  14. Course of neuropsychiatric symptoms in residents with dementia in nursing homes over 2-year period

    NARCIS (Netherlands)

    Wetzels, Roland B; Zuidema, Sytse U; de Jonghe, Jos F M; Verhey, Frans R J; Koopmans, Raymond T C M

    2010-01-01

    OBJECTIVE: To determine the course of neuropsychiatric symptoms (NPSs) in nursing home residents with dementia and to determine their variability across diagnosis. DESIGN: Prospective cohort study over 2 years. SETTING: Fourteen dementia special care units in nine nursing homes in The Netherlands. P

  15. A nursing home staff tool for the indoor visual environment: The content validity

    NARCIS (Netherlands)

    Jos M.G.A Schols; Dr. H.S.M. Kort; Marcel G.L.C. Loomans; Marianne M. Sinoo

    2016-01-01

    In the Netherlands, over 40% of nursing home residents are estimated to have visual impairments. This results in the loss of basic visual abilities. The nursing home environment fits more or less to residents’ activities and social participation. This is referred to as environmental fit. To raise

  16. Finding a useful conceptual basis for enhancing the quality of life of nursing home residents

    NARCIS (Netherlands)

    Gerritsen, D.L.; Steverink, N.; Ooms, M.E.; Ribbe, M.W.

    In this article it is depicted that before nursing home staff can effectively contribute to optimising the quality of life (QOL) of nursing home residents, it has to be clear what exactly QOL is and how it can be enhanced. The aim is to identify a QOL framework that provides tools for optimising QOL

  17. Patients' Perceptions of Nursing Home Stress Related to Quality of Care.

    Science.gov (United States)

    Stein, Shayna; And Others

    1986-01-01

    Examined whether newly admitted nursing home patients' anticipated stresses of institutional care would relate to their experiences of stress one and three months later, and whether patients' experiences of stress would correspond to independent judgments of the quality of the nursing homes. Patients experienced the kinds of stresses they…

  18. Home health nursing care services in Greece during an economic crisis.

    Science.gov (United States)

    Adamakidou, T; Kalokerinou-Anagnostopoulou, A

    2017-03-01

    The purpose of this review was to describe public home healthcare nursing services in Greece. The effectiveness and the efficiency of home healthcare nursing are well documented in the international literature. In Greece, during the current financial crisis, the development of home healthcare nursing services is the focus and interest of policymakers and academics because of its contribution to the viability of the healthcare system. A review was conducted of the existing legislation, the printed and electronic bibliography related to the legal framework, the structures that provide home health care, the funding of the services, the human resources and the services provided. The review of the literature revealed the strengths and weaknesses of the existing system of home health care and its opportunities and threats, which are summarized in a SWOT analysis. There is no Greek nursing literature on this topic. The development of home health nursing care requires multidimensional concurrent and combined changes and adjustments that would support and strengthen healthcare professionals in their practices. Academic and nursing professionals should provide guidelines and regulations and develop special competencies for the best nursing practice in home health care. At present, in Greece, which is in an economic crisis and undergoing reforms in public administration, there is an undeniable effort being made to give primary health care the position it deserves within the health system. There is an urgent need at central and academic levels to develop home healthcare services to improve the quality and efficiency of the services provided. © 2016 International Council of Nurses.

  19. Relationships of Assertiveness, Depression, and Social Support Among Older Nursing Home Residents

    Science.gov (United States)

    Segal, Daniel

    2005-01-01

    This study assessed the relationships of assertiveness, depression, and social support among nursing home residents. The sample included 50 older nursing home residents (mean age=75 years; 75% female; 92% Caucasian). There was a significant correlation between assertiveness and depression (r=-.33), but the correlations between social support and…

  20. Nursing Home Residents vs. Researcher: Establishing Their Needs while Finding Your Way

    DEFF Research Database (Denmark)

    Bruun-Pedersen, Jon Ram

    2017-01-01

    Residents at nursing homes need to exercise to retain self-efficacy. But all the while, many do not seem to want to prioritize exercise routines over leisure activities. The first part of this chapter analyzes the potential reasons for this lack of exercise commitment at a nursing home in Copenha...

  1. Fostering dignity in the care of nursing home residents through slow caring

    DEFF Research Database (Denmark)

    Lohne, Vibeke; Høy, Bente; Lillestø, Britt

    2016-01-01

    Background: Physical impairment and dependency on others may be a threat to dignity. Research questions: The purpose of this study was to explore dignity as a core concept in caring, and how healthcare personnel focus on and foster dignity in nursing home residents. Research design: This study has...... personnel, maintaining human dignity requires slow caring in nursing homes, as an essential approach....

  2. Coming Together for Change: Workshops for Women in the Nursing Home.

    Science.gov (United States)

    Lee, Janet; Carr, Marylea Benware

    1994-01-01

    Describes series of therapeutic and educational workshops conducted with women nursing home residents with twin goals of improving self-esteem and self-reliance and facilitating community building and networking. Also notes that nursing home staff trainings were conducted whereby staff were encouraged to articulate their needs and those of…

  3. Family participation in care plan meetings : Promoting a collaborative organizational culture in nursing homes

    NARCIS (Netherlands)

    Dijkstra, Ate

    In this study, the author evaluated a project in The Netherlands that aimed to promote family members' participation in care plan meetings at a psychogeriatric nursing home. The small-scale pilot project, which was conducted in four wards of the nursing home, was designed to involve families in

  4. Cross-national comparison of prescribing patterns in Australian and dutch nursing homes

    NARCIS (Netherlands)

    Taxis, Katja; Kochen, Sjoerd; Geerens, Sanne; Wouters, Hans; Boersma, Froukje; Maring, Jan G.; Mulder, Hans; Pavlovic, Jugoslav; Stevens, Gerard; McLachlan, Andrew J.; Pont, Lisa

    2014-01-01

    Background: Prescribing quality is a major issue in nursing home patients. Few cross-national comparisons of prescribing patterns have been carried out in this population. Objectives: To compare prevalence of medication use in nursing home patients between Australia and The Netherlands. Methods: An

  5. [The handling of acute life-threatening choking in geriatric and nursing home patients

    NARCIS (Netherlands)

    Poelgeest, A. van; Melis, R.J.F.; Ritmeijer, C.; Olde Rikkert, M.G.M.

    2006-01-01

    It is unknown how often choking occurs in geriatric wards and in nursing homes and what the treatment and outcomes are in regular practice. A questionnaire was sent to Dutch geriatricians (N = 130), nursing home physicians (N = 130), and trainees for these disciplines (N = 215), in order to gain inf

  6. Prevalence and risk indicators of depression in elderly nursing home patients : the AGED study

    NARCIS (Netherlands)

    Jongenelis, K; Eisses, AMH; Beekman, ATF; Kluiter, H; Ribbe, MW

    2004-01-01

    Background: Depression is a common and disabling psychiatric disorder in later life. Particular frail nursing home patients seem to be at increased risk. Nursing home-based studies on risk indicators of depression are scarce. Methods: Prevalence and risk indicators of depression were assessed in 333

  7. Teaching a Course in Abnormal Psychology and Behavior Intervention Skills for Nursing Home Aides.

    Science.gov (United States)

    Glenwick, David S.; Slutzsky, Mitchel R.; Garfinkel, Eric

    2001-01-01

    Describes an 11-week course given at a nursing home to nursing home aides that focused on abnormal psychology and behavior intervention skills. Discusses the course goals, class composition, and course description. Addresses the problems and issues encountered with teaching this course to a nontraditional population in an unconventional setting.…

  8. [Study on knowledge and practices related to malnutrition in the elderly to the nursing home].

    Science.gov (United States)

    Brys, Mélissa; Coppieters, Yves; De Breucker, Sandra

    2014-12-01

    The prevalence of malnutrition in nursing homes varies between 50% and 90% in Belgium. There are multiple causes of malnutrition and one of the consequences is the impact on the workload of nursing home staff. The purpose of this study is to better understand the knowledge and the practices of the nursing home staff who would influence the nutritional status of elderly in nursing homes. This study is divided into a quantitative approach with a self-administered questionnaire and a qualitative approach by non-participant observation. We observed that 29% of nursing home staff have good knowledge about the malnutrition and that 64% have good practices in providing nutrition to the elderly. People with good knowledge tend to have better practices. 38% of the nursing home staff engage in continued professional development in the field. There is no systematic screening, nutritional assessment and nutritional intervention in nursing homes. It is of great importance to ensure nursing home staff are aware of this problem through training.

  9. Inservice Education: Consultation and Related Services for Nursing Home Personnel. Final Report.

    Science.gov (United States)

    United Hospital Fund of New York, NY.

    A project to demonstrate how a team of instructor/consultants could function on a regional basis to help upgrade inservice education programs in nursing homes was conducted. The design of this Nursing Home Training Program was structured to allow for changes in demonstrated services in accordance with reactions of participants. An advisory and an…

  10. Effectiveness of Advanced Illness Care Teams for Nursing Home Residents with Dementia

    Science.gov (United States)

    Chapman, Dennis G.; Toseland, Ronald W.

    2007-01-01

    This study evaluated the effectiveness of advanced illness care teams (AICTs) for nursing home residents with advanced dementia. The AICTs used a holistic approach that focused on four domains: (1) medical, (2) meaningful activities, (3) psychological, and (4) behavioral. The authors recruited 118 residents in two nursing homes for this study and…

  11. Organizational and Individual Conditions Associated with Depressive Symptoms among Nursing Home Residents over Time

    Science.gov (United States)

    Cassie, Kimberly M.; Cassie, William E.

    2012-01-01

    Purpose: To examine the effect of organizational culture and climate on depressive symptoms among nursing home residents. Design and Methods: Using a pooled cross-sectional design, this study examines a sample of 23 nursing homes, 1,114 employees, and 5,497 residents. Depressive symptoms were measured using the Minimum Data Set, Depression Rating…

  12. Relationships of Assertiveness, Depression, and Social Support Among Older Nursing Home Residents

    Science.gov (United States)

    Segal, Daniel

    2005-01-01

    This study assessed the relationships of assertiveness, depression, and social support among nursing home residents. The sample included 50 older nursing home residents (mean age=75 years; 75% female; 92% Caucasian). There was a significant correlation between assertiveness and depression (r=-.33), but the correlations between social support and…

  13. BE-ACTIV: A Staff-Assisted Behavioral Intervention for Depression in Nursing Homes

    Science.gov (United States)

    Meeks, Suzanne; Looney, Stephen W.; Van Haitsma, Kimberly; Teri, Linda

    2008-01-01

    Purpose: This article (a) describes a 10-week, behavioral, activities-based intervention for depression that can be implemented in nursing homes collaboratively with nursing home activities staff and (b) presents data related to its development, feasibility, and preliminary outcomes. Design and Methods: We developed BE-ACTIV, which stands for…

  14. Family Support in Nursing Homes Serving Residents with a Mental Health History

    Science.gov (United States)

    Frahm, Kathryn; Gammonley, Denise; Zhang, Ning Jackie; Paek, Seung Chun

    2010-01-01

    Using 2003 nursing home data from the Minimum Data Set (MDS) database, this study investigated the role of family support among nursing homes serving residents with a mental health history. Exploratory factor analysis was used to create and test a conceptual model of family support using indicators located within the MDS database. Families were…

  15. Evidence-Based Health Promotion in Nursing Homes: A Pilot Intervention to Improve Oral Health

    Science.gov (United States)

    Cadet, Tamara J.; Berrett-Abebe, Julie; Burke, Shanna L.; Bakk, Louanne; Kalenderian, Elsbeth; Maramaldi, Peter

    2016-01-01

    Nursing home residents over the age of 65 years are at high risk for poor oral health and related complications such as pneumonia and adverse diabetes outcomes. A preliminary study found that Massachusetts' nursing homes generally lack the training and resources needed to provide adequate oral health care to residents. In this study, an…

  16. Resident, nursing home, and state factors affecting the reliability of Minimum Data Set quality measures.

    Science.gov (United States)

    Wu, Ning; Mor, Vincent; Roy, Jason

    2009-01-01

    Nursing home quality measures impact policy decisions such as reimbursement or consumer choice. Quality indicators in the United States are collected through the federally mandated Minimum Data Set (MDS). Bias in MDS data collection or coding can thus have a negative impact on policy applications. To understand whether bias was present in coding, the authors studied 5174 pairs of MDS assessments that were independently collected by nursing home staff and study nurses from 206 nursing homes. The authors developed multivariate multilevel models to identify nursing home and resident characteristics that were significantly associated with the data quality of multiple MDS measures of nursing home quality. The outcomes were coding differences between nursing home staff and study nurses. Resident characteristics explained little of the variation in coding differences among facilities, while facilities characteristics explained 4% to 20% of the variation and state location further explained 13% to 34% of the variation. A generalized effect of nursing home state location tended to be consistent across measures. States that overidentified problems also tended to have worse quality indicators and vice versa. Comparisons of MDS-based quality indicators reflect differences in assessment practices at least as much as true quality differences. Efforts to standardize assessment practices across states are needed.

  17. Improved education and training for nursing assistants: keys to promoting the mental health of nursing home residents.

    Science.gov (United States)

    Glaister, Judy A; Blair, Charles

    2008-08-01

    The mental health of older adults contributes to their overall well-being. However, numerous studies have reported substantial prevalence of mental health problems, especially depression, in nursing home residents. Due to the poor quality of education and training provided to nursing home front-line caregivers, most of whom are nursing assistants, many residents experiencing depression are not recognized as such and consequently receive no treatment. Emphasizing the aging process and mental health components in education and training programs for nursing assistants could have a positive impact on the detection and treatment of depression in residents.

  18. Hospice family members’ perceptions and experiences with end-of-life care in the nursing home

    Science.gov (United States)

    Washington, Karla; Kruse, Robin L.; Albright, David L; Lewis, Alexandria; Demiris, George

    2014-01-01

    Objective Despite the fact that more than 25% of Americans die in nursing homes, end-of-life care has consistently been found to be less than adequate in this setting. Even for those residents on hospice, end-of-life care has been found to be problematic. This study had two research questions; 1) How do family members of hospice nursing home residents differ in their anxiety, depression, quality of life, social networks, perceptions of pain medication, and health compared to family members of community dwelling hospice patients? 2) What are family members’ perceptions of and experiences with end-of-life care in the nursing home setting? Methods This study is a secondary mixed methods analysis of interviews with family members of hospice nursing home residents and a comparative statistical analysis of standard outcome measures between family members of hospice patients in the nursing home and family member of hospice patients residing in the community. Results Outcome measures for family members of nursing home residents were compared (n=176) with family members of community dwelling hospice patients (n=267). The family members of nursing home residents reported higher quality of life however, levels of anxiety, depression, perceptions of pain medicine, and health were similar for hospice family members in the nursing home and in the community. Lending an understanding to the stress for hospice family members of nursing home residents concerns were found with collaboration between the nursing home and the hospice, nursing home care that did not meet family expectations, communication problems, and resident care concerns including pain management. Some family members reported positive end-of-life care experiences in the nursing home setting. Conclusion These interviews identify a multitude of barriers to quality end-of-life care in the nursing home setting, and demonstrate that support for family members is an essential part of quality end-of-life care for

  19. Home care nurses' experiences with and perceptions of elder self-neglect.

    Science.gov (United States)

    Johnson, Yvonne O'Connell

    2015-01-01

    Self-neglect is a poorly understood phenomenon evident to home healthcare nurses who describe older adults who self-neglect as disheveled, unkempt individuals living in cluttered, filthy homes. In spite of the concerns nurses report about these individuals and their situations, individuals who self-neglect give no indication there is any reason for concern for their welfare, and in fact some refuse intervention. The purpose of this study was to determine how home healthcare nurses perceive elder self-neglect, their experiences with this phenomenon, and to explore the steps nurses take when self-neglect is suspected.

  20. Where should Momma go? Current nursing home performance measurement strategies and a less ambitious approach

    Directory of Open Access Journals (Sweden)

    Lieberman Trudy

    2007-06-01

    Full Text Available Abstract Background Nursing home performance measurement systems are practically ubiquitous. The vast majority of these systems aspire to rank order all nursing homes based on quantitative measures of quality. However, the ability of such systems to identify homes differing in quality is hampered by the multidimensional nature of nursing homes and their residents. As a result, the authors doubt the ability of many nursing home performance systems to truly help consumers differentiate among homes providing different levels of quality. We also argue that, for consumers, performance measurement models are better at identifying problem facilities than potentially good homes. Discussion In response to these concerns we present a proposal for a less ambitious approach to nursing home performance measurement than previously used. We believe consumers can make better informed choice using a simpler system designed to pinpoint poor-quality nursing homes, rather than one designed to rank hundreds of facilities based on differences in quality-of-care indicators that are of questionable importance. The suggested performance model is based on five principles used in the development of the Consumers Union 2006 Nursing Home Quality Monitor. Summary We can best serve policy-makers and consumers by eschewing nursing home reporting systems that present information about all the facilities in a city, a state, or the nation on a website or in a report. We argue for greater modesty in our efforts and a focus on identifying only the potentially poorest or best homes. In the end, however, it is important to remember that information from any performance measurement website or report is no substitute for multiple visits to a home at different times of the day to personally assess quality.

  1. The environmental design of residential care facilities: A sense of home through the eyes of nursing home residents.

    NARCIS (Netherlands)

    van Dijck-Heinen, C.J.M.L.; Wouters, E.J.M.; Janssen, B.M.; van Hoof, J.

    2014-01-01

    C.J.M.L. van Dijck-Heinen, E.J.M. Wouters, B.M. Janssen, J. van Hoof (2014) The environmental design of residential care facilities: A sense of home through the eyes of nursing home residents. International Journal for Innovative Research in Science & Technology 1(4): 57-69

  2. Drivers of change: Learning from the lived experiences of nursing home social workers.

    Science.gov (United States)

    Lee, Ahyoung Anna; Lee, Sharon Narae; Armour, Marilyn

    2016-01-01

    In response to the growing attention to integrated health care and the cultural change movement in nursing homes, this study examines the lived experiences of nursing home social workers to better understand their role perceptions, job satisfaction, and relationship with other staff members. Hermeneutic phenomenology was used in order to understand the lived experience of being a nursing home social worker. Ten nursing home social workers were recruited from a southern state and individual interviews were conducted. From the interviews, four themes emerged: challenge, coping, mattering, and rewarding. Guided by identity negotiation theory and social identity theory, these findings are discussed. Also, implications for social work education, nursing home administration, and policy is discussed.

  3. The relationship between weight status and the need for health care assistance in nursing home residents

    DEFF Research Database (Denmark)

    Beck, Anne Marie

    2012-01-01

    Objective: The purpose of this study was to evaluate the relationship between underweight status and weight loss events on the need for health care assistance among a sample of Danish nursing home residents over 12-months. Design: Longitudinal, repeated measures design with three data collection...... points at baseline (2004) and six and 12 months post baseline. Setting: 11 Danish nursing home facilities. Participants: 441 Danish nursing home residents over the age of 65. Measurements: Resident Assessment Instrument (RAI-NH) data were abstracted for each participant at each of three data collection...... of this study suggest that elderly nursing home residents with a low BMI or weight loss may add to the substantial and costly burden of nursing home care due to the associated need for higher levels of ADL assistance....

  4. Overcoming resistance to culture change: nursing home administrators' use of education, training, and communication.

    Science.gov (United States)

    Tyler, Denise A; Lepore, Michael; Shield, Renee R; Looze, Jessica; Miller, Susan C

    2014-01-01

    Nursing home culture change is becoming more prevalent, and research has demonstrated its benefits for nursing home residents and staff-but little is known about the role of nursing home administrators in culture change implementation. The purpose of this study was to determine what barriers nursing home administrators face in implementing culture change practices, and to identify the strategies used to overcome them. The authors conducted in-depth individual interviews with 64 administrators identified through a nationally representative survey. Results showed that a key barrier to culture change implementation reported by administrators was staff, resident, and family member resistance to change. Most nursing home administrators stressed the importance of using communication, education and training to overcome this resistance. Themes emerging around the concepts of communication and education indicate that these efforts should be ongoing, communication should be reciprocal, and that all stakeholders should be included.

  5. Competitive spillovers across non-profit and for-profit nursing homes.

    Science.gov (United States)

    Grabowski, David C; Hirth, Richard A

    2003-01-01

    The importance of non-profit institutions in the health care sector has generated a vast empirical literature examining quality differences between non-profit and for-profit nursing homes. Recent theoretical work has emphasized that much of this empirical literature is flawed in that previous studies rely solely on dummy variables to capture the effects of ownership rather than accounting for the share of non-profit nursing homes in the market. This analysis considers whether competitive spillovers from non-profits lead to higher quality in for-profit nursing homes. Using instrumental variables to account for the potential endogeneity of non-profit market share, this study finds that an increase in non-profit market share improves for-profit and overall nursing home quality. These findings are consistent with the hypothesis that non-profits serve as a quality signal for uninformed nursing home consumers.

  6. Video Communication With Cognitively Intact Nursing Home Residents: A Scoping Review.

    Science.gov (United States)

    Schuster, Amy M; Hunter, Elizabeth G

    2017-05-01

    Limited research exists examining video communication among cognitively intact nursing home residents to connect with family. This scoping review evaluated existing literature for video communication usage with nursing home residents, family, and nursing homes. A comprehensive search was completed using PubMed and EBSCOhost (including AgeLine, CINAHL, and PsycINFO) between 1972 and 2016 to locate English-language articles. The analysis identified five eligible studies (four involved an intervention, one assessed family views) meeting inclusion criteria. Findings included, seeing family members separated by distance, seeing other parts of their life, and visually monitoring resident's health. Participants described frustration with technology limitations, such as video or audio lag. Current literature does not show a comprehensive assessment of video communication usage for residents, family, and nursing homes. Future studies should address the complexity of the intersection of the person, nursing home, and families in terms of potential benefits and capability of video communication use with residents.

  7. Expressing sexuality in nursing homes. The experience of older women: A qualitative study.

    Science.gov (United States)

    Palacios-Ceña, Domingo; Martínez-Piedrola, Rosa María; Pérez-de-Heredia, Marta; Huertas-Hoyas, Elisabet; Carrasco-Garrido, Pilar; Fernández-de-Las-Peñas, Cesar

    In nursing homes, a number of barriers to the expression of sexuality exist, such as the lack of privacy, certain attitudes on behalf of the staff and the family, the lack of a sexual partner, and physical limitations. The aim of this study was to describe the lived experience of sexuality in elderly Spanish women residing in nursing homes. A qualitative phenomenological approach was followed. Data were collected over an 18-month period between 2013 and 2015. Purposeful sampling was conducted with Spanish residents in nursing homes in Madrid. Data were collected using unstructured and semi-structured interviews. The data were analyzed using thematic analysis. Twenty female residents participated. Three main themes emerged from the data: a) expressing sexuality, b) sexuality as a duty and c) respecting vows. Female residents reported key elements influencing how they manage their sexuality in Nursing Homes. These results serve to improve our understanding regarding the expression of sexuality in older female nursing home residents.

  8. Geothermal greenhouse-heating facilities for the Klamath County Nursing Home, Klamath Falls, Oregon

    Energy Technology Data Exchange (ETDEWEB)

    1982-02-01

    The Klamath County Nursing Home, located in Klamath Falls, Oregon, was constructed in 1976. The building of 55,654 square feet currently houses care facilities for approximately 120 persons. During the initial planning for the Nursing Home, the present site was selected primarily on the basis of its geothermal resource. This resource (approx. 190/sup 0/F) currently provides space and domestic hot water heating for the Nursing Home, Merle West Medical Center and the Oregon Institute of Technology. The feasibility of installing a geothermal heating system in a planned greenhouse for the Nursing Home is explored. The greenhouse system would be tied directly to the existing hot water heating system for the Nursing Home.

  9. Home visits by Family Health Strategy nurses and community health agents

    Directory of Open Access Journals (Sweden)

    Luciana Valadão Alves Kebian

    2014-03-01

    Full Text Available The objective of this article was to describe the practice of nurses and community health agents within the context of the Family Health Strategy home visits. This is a descriptive study with a qualitative approach. Data collection was performed between January and March of 2010, through semi-structured interviews with eight nurses and seven community health agents from two family health units in the city of Rio de Janeiro. Data were submitted to content analysis. Low interaction was observed between nurses and community health agents in the home visits. Work overload and violence are the main hindrances identified for performing home visits. It was found that the home visit planning was unsystematic. Permanent education should be intensified with the purpose to discuss, following a problem-posing approach, the roles and attributions of each team member in the home visit, as well as the systematization of this activity. Descriptors: Family Health; Nursing; Community Health Workers; Home Visit.

  10. Longevity and admission to nursing home according to age after isolated coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Thorsteinsson, Kristinn; Andreasen, Jan Jesper; Torp-Pedersen, Christian

    2015-01-01

    O5 Longevity and admission to nursing home according to age after isolated coronary artery bypass surgery: A nationwide cohort study Kristinn Thorsteinsson, Jan Jesper Andreasen, Christian Torp Pedersen, Kirsten Fonager, Rikke Nørmark Mortensen, Kristian Kragholm, Gunnar Gislason, Lars Køber....... Aalborg, Denmark Background: Data on nursing home admission in patients >80 years of age after isolated coronary artery bypass grafting (CABG) are scarce. Aim: The purpose of this study was to evaluate longevity and subsequent admission to nursing home stratified by age in a nationwide CABG cohort...... after surgery ( HR 11.00, 95% CI 6.81-17.80). Neither urgent nor emergent surgeries were significant predictors for living in a nursery home 1 year after surgery. Conclusion: Elderly patients undergoing CABG stay in their homes for many years after surgery. The risk of nursing home admission is small...

  11. Changes in the personal dignity of nursing home residents: a longitudinal qualitative interview study.

    Science.gov (United States)

    Oosterveld-Vlug, Mariska G; Pasman, H Roeline W; van Gennip, Isis E; Willems, Dick L; Onwuteaka-Philipsen, Bregje D

    2013-01-01

    Most nursing home residents spend the remainder of their life, until death, within a nursing home. As preserving dignity is an important aim of the care given here, insight into the way residents experience their dignity throughout their entire admission period is valuable. To investigate if and how nursing home residents' personal dignity changes over the course of time, and what contributes to this. A longitudinal qualitative study. Multiple in-depth interviews, with an interval of six months, were carried out with 22 purposively sampled nursing home residents of the general medical wards of four nursing homes in The Netherlands. Transcripts were analyzed following the principles of thematic analysis. From admission onwards, some residents experienced an improved sense of dignity, while others experienced a downward trend, a fluctuating one or no change at all. Two mechanisms were especially important for a nursing home resident to maintain or regain personal dignity: the feeling that one is in control of his life and the feeling that one is regarded as a worthwhile person. The acquirement of both feelings could be supported by 1) finding a way to cope with one's situation; 2) getting acquainted with the new living structures in the nursing home and therefore feeling more at ease; 3) physical improvement (with or without an electric wheelchair); 4) being socially involved with nursing home staff, other residents and relatives; and 5) being amongst disabled others and therefore less prone to exposures of disrespect from the outer world. Although the direction in which a resident's personal dignity develops is also dependent on one's character and coping capacities, nursing home staff can contribute to dignity by creating optimal conditions to help a nursing home resident recover feelings of control and of being regarded as a worthwhile person.

  12. Changes in the personal dignity of nursing home residents: a longitudinal qualitative interview study.

    Directory of Open Access Journals (Sweden)

    Mariska G Oosterveld-Vlug

    Full Text Available BACKGROUND: Most nursing home residents spend the remainder of their life, until death, within a nursing home. As preserving dignity is an important aim of the care given here, insight into the way residents experience their dignity throughout their entire admission period is valuable. AIM: To investigate if and how nursing home residents' personal dignity changes over the course of time, and what contributes to this. DESIGN: A longitudinal qualitative study. METHODS: Multiple in-depth interviews, with an interval of six months, were carried out with 22 purposively sampled nursing home residents of the general medical wards of four nursing homes in The Netherlands. Transcripts were analyzed following the principles of thematic analysis. RESULTS: From admission onwards, some residents experienced an improved sense of dignity, while others experienced a downward trend, a fluctuating one or no change at all. Two mechanisms were especially important for a nursing home resident to maintain or regain personal dignity: the feeling that one is in control of his life and the feeling that one is regarded as a worthwhile person. The acquirement of both feelings could be supported by 1 finding a way to cope with one's situation; 2 getting acquainted with the new living structures in the nursing home and therefore feeling more at ease; 3 physical improvement (with or without an electric wheelchair; 4 being socially involved with nursing home staff, other residents and relatives; and 5 being amongst disabled others and therefore less prone to exposures of disrespect from the outer world. CONCLUSION: Although the direction in which a resident's personal dignity develops is also dependent on one's character and coping capacities, nursing home staff can contribute to dignity by creating optimal conditions to help a nursing home resident recover feelings of control and of being regarded as a worthwhile person.

  13. Facility characteristics as independent prognostic factors of nursing home-acquired pneumonia

    OpenAIRE

    Lim, Che Wan; Choi, Younghoon; An, Chang Hyeok; Park, Sang Joon; Hwang, Hee-Jin; Chung, Jae Ho; Min, Joo-Won

    2016-01-01

    Background/Aims: Recently, the incidence of nursing home-acquired pneumonia (NHAP) has been increasing and is now the leading cause of death among nursing home residents. This study was performed to identify risk factors associated with NHAP mortality, focusing on facility characteristics. Methods: Data on all patients ≥ 70 years of age admitted with newly diagnosed pneumonia were reviewed. To compare the quality of care in nursing facilities, the following three groups were defined: patients...

  14. Nursing home financial performance: the role of ownership and chain affiliation.

    Science.gov (United States)

    Weech-Maldonado, Robert; Laberge, Alex; Pradhan, Rohit; Johnson, Christopher E; Yang, Zhou; Hyer, Kathryn

    2012-01-01

    The nursing home industry serves one of the most vulnerable populations, and its financial sustainability is a matter of public concern. However, limited empirical evidence exists on the impact of ownership and chain affiliation on nursing home financial performance. The aim of this study was to examine the joint effects of ownership and chain affiliation on the financial performance of the nursing home industry for the study period 1999-2004 on a national sample of 11,236 nursing homes per year. Data included the Medicare Cost Reports; the Online Survey, Certification, and Reporting file; and the Area Resource File. Dependent variables included operating and total margins. Independent variables included four ownership/chain affiliation combinations: for-profit chain, for-profit independent, not-for-profit chain, and not-for-profit independent. Random effects generalized least square regressions were performed. Results show that for-profit nursing homes delivered better financial performance than not-for-profit facilities did across both operating and total margins. However, the relationship between chain affiliation and financial performance was more nuanced. In the case of operating margin, chain-affiliated facilities delivered superior financial performance irrespective of ownership type; however, in the case of total margin, independents outperformed chain-affiliated facilities among for-profits. Our findings show an interactive effect of ownership and chain affiliation on nursing home financial performance, suggesting the pursuit of different organizational strategies by different ownership/chain affiliation subgroups (for-profit chain, for-profit independent, not-for-profit chain, and not-for-profit independent), with implications for financial performance. For-profit independent nursing homes managed to be the top performing group in terms of overall financial despite the operating financial advantage of for-profit chain-affiliated nursing homes. Similarly

  15. Postflood disaster management and the home health nurse: using theory to guide practice.

    Science.gov (United States)

    Hunter Revell, Susan M; McCurry, Mary K

    2010-07-01

    Few frameworks exist to guide home health nurses during the response and recovery phases of disasters such as flooding. The Double ABCX Model of Family Adaptation is offered as an example of a guiding framework for nurses in postflood management. Phases of the model are linked to the nursing process, and management strategies are applied to individuals and families living in the community. Postcrisis decision-making is detailed through the discussion of nursing diagnoses, interventions, and evaluation. Implications highlight the value of using a theoretical framework to guide practice, develop knowledge, and clarify the home health nurse's role in postflood management.

  16. 38 CFR 17.46 - Eligibility for hospital, domiciliary or nursing home care of persons discharged or released from...

    Science.gov (United States)

    2010-07-01

    ..., domiciliary or nursing home care of persons discharged or released from active military, naval, or air service... Hospital, Domiciliary and Nursing Home Care § 17.46 Eligibility for hospital, domiciliary or nursing home care of persons discharged or released from active military, naval, or air service. (a) In...

  17. Evaluation of the implementation of an 'oral hygiene protocol' in nursing homes: a 5-year longitudinal study

    NARCIS (Netherlands)

    Visschere, L. de; Baat, C. de; Schols, J.M.; Deschepper, E.; Vanobbergen, J.

    2011-01-01

    OBJECTIVES: To explore the long-term effects of the implementation of an oral hygiene protocol in nursing homes. METHODS: Out of 14 nursing homes (Flanders) seven nursing homes were randomly allocated to the intervention group and confirmed to implement an 'oral hygiene protocol'. The remaining nurs

  18. Medication administration to the diabetic clients of the Helsinki Deaconess's institute nursing homes : Medication administration

    OpenAIRE

    2014-01-01

    Diabetic clients in nursing care homes are among the most vulnerable members of the society, as they depend on their care home staff for almost all of their entire needs. A combination of complex medical conditions may result in the need to take multiple medications with some taking up to eight medications on average. Medication system in nursing home passes through many steps before it actually reaches the client. This may result in an increase in medication error. The purpose of this st...

  19. The Factors Influencing the Sense of Home in Nursing Homes: A Systematic Review from the Perspective of Residents

    Directory of Open Access Journals (Sweden)

    M. D. Rijnaard

    2016-01-01

    Full Text Available Purpose. To provide an overview of factors influencing the sense of home of older adults residing in the nursing home. Methods. A systematic review was conducted. Inclusion criteria were (1 original and peer-reviewed research, (2 qualitative, quantitative, or mixed methods research, (3 research about nursing home residents (or similar type of housing, and (4 research on the sense of home, meaning of home, at-homeness, or homelikeness. Results. Seventeen mainly qualitative articles were included. The sense of home of nursing home residents is influenced by 15 factors, divided into three themes: (1 psychological factors (sense of acknowledgement, preservation of one’s habits and values, autonomy and control, and coping; (2 social factors (interaction and relationship with staff, residents, family and friends, and pets and activities; and (3 the built environment (private space and (quasi-public space, personal belongings, technology, look and feel, and the outdoors and location. Conclusions. The sense of home is influenced by numerous factors related to the psychology of the residents and the social and built environmental contexts. Further research is needed to determine if and how the identified factors are interrelated, if perspectives of various stakeholders involved differ, and how the factors can be improved in practice.

  20. Dental care and treatment needs of elderly in nursing homes in Saarland: perceptions of the homes managers.

    Science.gov (United States)

    Rabbo, Mohammad Abed; Mitov, Gergo; Gebhart, Florian; Pospiech, Peter

    2012-06-01

    To investigate nursing home managers' perceptions and attitudes towards oral health care and access to dental services for aged care facility residents. Questionnaires containing 28 closed-ended questions were mailed to all 114 nursing homes in Saarland, Germany. Descriptive statistics were calculated for response items. Facility response rate was 39%. None of the nursing homes in this study offered systematic dental health care. Initial dental screening was carried out only in one facility. In 81%, dental examinations only took place if required. Although stationary dental equipment was available only in one home, dental treatment was carried out in 71% of the cases by a dentist in the nursing home. Eighty-four per cent of the homes' managements rated the state of the dentition of the inhabitants as satisfying. Over half of the managers indicated satisfaction with the know-how of their nursing staff concerning oral hygiene procedures. The most significant barriers to provision of dental care in the facilities according to their managers were staff shortage, lack of interest of the inhabitants and financial concerns. The results of this study showed an urgent need for estimating a programme for systematic dental care for institutionalised elder people in the federal state of Saarland. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

  1. Quality of care in Norwegian nursing homes - typology of family perceptions.

    Science.gov (United States)

    Vinsnes, Anne G; Nakrem, Sigrid; Harkless, Gene E; Seim, Arnfinn

    2012-01-01

    This study aimed to elucidate the understandings and beliefs about quality held by family members of residents of Norwegian nursing homes. The objective reported in the study considers how family member judge factors that enhance or hamper high care quality. The percentage of those who will require care in a nursing home some time before the end of their lives will increase dramatically in the next 20 years. Therefore, anticipating this pressure to expand nursing home availability, it is urgent that these services are developed from a keen understanding of what creates the best value. Care quality from the family's perspective is just one piece of the nursing home experience that must be understood for optimal value in care to be realised. Qualitative methodology. Three focus group interviews; purposive sampling was used to recruit the 16 family members of residents in nursing homes. Three domains emerged that served as anchors for a typology of family perceptions of the quality care continuum: resident contentment, suitability of staff and environmental context. Each domain was developed with categories describing high- to low-quality markers, which were then clarified by enhancing and hindering factors. This typology provides a family perspective framework that may be useful to nursing leadership at all levels of the nursing home organisation to identify important quality of care strengths as well as markers of poor care. Overall, the typology is offered to expand nurses' understanding of quality, both practically and conceptually, to provide the best value in nursing care. © 2011 Blackwell Publishing Ltd.

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

    Science.gov (United States)

    Mor, Vincent; Volandes, Angelo E; Gutman, Roee; Gatsonis, Constantine; Mitchell, Susan L

    2017-04-01

    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

  3. [Raising awareness among freelance nurses of infection prevention in home health care].

    Science.gov (United States)

    Joly, Fabienne; Touati, Samia

    2013-02-01

    An alternative to conventional hospitalisation, home health care involves technical procedures which can carry a high risk of infection. In the home, infection prevention is a central element of safety of care. A home health care structure in the Lille region is working to raise awareness among freelance nursing partners and encourage them to follow a quality improvement approach.

  4. 77 FR 64386 - Agency Information Collection Activities (Per Diem for Nursing Home Care of Veterans in State...

    Science.gov (United States)

    2012-10-19

    ... AFFAIRS Agency Information Collection Activities (Per Diem for Nursing Home Care of Veterans in State Homes; Per Diem for Adult Day Care of Veterans in State Homes) Under OMB Review AGENCY: Veterans Health... day health services care to Veterans. VA requires facilities providing nursing home and adult...

  5. The Impact of Organizational Innovations in Nursing Homes on Staff Perceptions: A Secondary Data Analysis.

    Science.gov (United States)

    Adams, Joost; Verbeek, Hilde; Zwakhalen, Sandra M G

    2017-01-01

    The shift in nursing home care for patients with dementia from traditional task-driven environments towards patient-centered small-scale environments has implications for nursing practice. Information about its implications for nursing staff is lacking, and only a few studies have addressed staff perceptions. We sought to explore staff perceptions of required skills and to determine differences in job satisfaction, motivation, and job characteristics of staff working in both care settings. A secondary data analysis was conducted. The data source used was drawn from a larger study testing the effects of small-scale living (Verbeek et al., 2009). Nursing staff working on a permanent basis and who were directly involved in care were eligible to participate in the study. Data on job satisfaction, motivation, and job characteristics of nursing staff working in typical small-scale and traditional care environments were derived using a questionnaire. Data were analyzed using descriptive statistics. Differences between nursing staff job satisfaction, motivation, and job characteristics were tested using multilinear regression analysis. In total, 138 staff members were included (81 staff members working in traditional nursing home wards and 57 staff members working in small-scale nursing home wards). The findings showed that in typical small-scale nursing homes, job satisfaction and job motivation were significantly higher compared to those in typical traditional nursing homes. Job autonomy and social support were also significantly higher, while job demands were significantly lower in these small-scale nursing homes. Social support was found to be the most significant predictor of job motivation and job satisfaction in both types of typical nursing homes. Nursing staff working in traditional care environments more often expressed the intention to switch to small-scale environments. Based on the findings of this study, it can be concluded that nursing homes environments

  6. Nurse and Medical Provider Perspectives on Antibiotic Stewardship in Nursing Homes.

    Science.gov (United States)

    Scales, Kezia; Zimmerman, Sheryl; Reed, David; Beeber, Anna Song; Kistler, Christine E; Preisser, John S; Weiner, Bryan J; Ward, Kimberly; Fann, Amy; Sloane, Philip D

    2017-01-01

    To examine perspectives on antibiotic use and antibiotic stewardship of nurses and medical providers in nursing homes (NHs). Cross-sectional survey. NHs in North Carolina (N = 31). Nursing staff (n = 182) and medical providers (n = 50). Respondents completed a self-administered questionnaire about their perspectives on antibiotic use in their NH, the influence of residents and families on antibiotic prescribing decisions, and readiness to improve antibiotic stewardship. Open-ended questions on barriers to antibiotic stewardship were also asked. Linear mixed modeling was used to analyze differences between respondent groups and to test for associations with individual and organizational characteristics. All respondents supported reducing antibiotic use, although medical providers' support was significantly stronger (P = .005). When asked about their perception of residents' and family members' preference for antibiotic use in the case of suspected infection and the influence of that preference on antibiotic-prescribing decisions, respondents indicated that residents and families favor antibiotic use and influence prescribing decisions. Nurses reported a stronger perception than medical providers that families prefer antibiotics (P = .04) and influence prescribing decisions (P = .02). All respondents reported commitment and efficacy to change practices (mean 4.0-4.1 for nurses and 3.6-3.9 for medical providers on a 5-point scale). Four significant associations related to organizational and individual characteristics were found: directors of nursing and specialist nurses reported greater self-efficacy for changing practice than other nurses (P = .003), medical providers with a subspecialty (e.g., geriatrics) reported greater self-efficacy (P = .007) and commitment to change (P = .001) than those without a subspecialty, and medical providers specializing in hospice and palliative care rated family influence (P = .006) higher than those with other subspecialties

  7. The relation between quality of co-ordination of nursing care and quality of life in Dutch nursing homes.

    NARCIS (Netherlands)

    Holtkamp, C.C.M.; Kerkstra, A.; Ribbe, M.W.; Campen, C. van; Ooms, M.E.

    2000-01-01

    Quality of life of nursing home residents is a critical consideration in international health care policies and health care decisions. Yet, there is little relevant research to support decisions about client-tailored and effective nursing care for this population. Because of the permanency of their

  8. Nurse Preparation and Organizational Support for Supervision of Unlicensed Assistive Personnel in Nursing Homes: A Qualitative Exploration

    Science.gov (United States)

    Siegel, Elena O.; Young, Heather M.; Mitchell, Pamela H.; Shannon, Sarah E.

    2008-01-01

    Purpose: Nursing supervision of the routine daily care (e.g., grooming, feeding, and toileting) that is delegated to unlicensed assistive personnel (UAP) is critical to nursing home service delivery. The conditions under which the supervisory role is organized and operationalized at the work-unit level, taking into account workloads, registered…

  9. Nursing home social services directors who report thriving at work.

    Science.gov (United States)

    Liu, Jinyu; Bern-Klug, Mercedes

    2013-01-01

    Nationally representative data from a sample (n = 928) of full-time nursing home social services directors were used to investigate whether knowing characteristics of the social environment at work can help to explain which directors report job thriving. Two-thirds of directors reported they were thriving in their jobs. Multiple regression results show that thriving is increased by job autonomy, being treated like an important part of the team, having enough time to identify and meet resident psychosocial needs, not having to do things that others could do, and being clear what the social services role is. Findings suggest that addressing these aspects of the social environment and social services role will likely contribute to increasing a sense of thriving at work among social services staff members.

  10. Determinants for the use of psychotropics among nursing home residents

    DEFF Research Database (Denmark)

    Sørensen, Lisbeth Uhrskov; Foldspang, A; Gulmann, N C

    2001-01-01

    on the Anatomical Therapeutical Chemical (ATC) classification index, psychotropics were categorised into neuroleptics, benzodiazepines and antidepressants. Two hundred and eight-eight residents were diagnosed using the GMS–AGECAT. One hundred and eighteen staff members were interviewed about the residents......'s Activities of Daily Living (ADL), behavioural problems (Nursing Home Behavior Problem Scale), orientation, communication skills and if the resident had any psychiatric disorder. Multiple logistic regression was used to select the items that determined the use of psychotropics. Results Fifty-six percent...... of the residents received a psychotropic, 21% received neuroleptics, 38% received benzodiazepines and 24% received antidepressants. In the multivariate analysis, staff assessment of the resident's mental health was a determinant for the use of all types of specific psychotropics, whereas a GMS–AGECAT diagnosis...

  11. Agreeableness and activity engagement in nursing home residents with dementia.

    Science.gov (United States)

    Hill, Nikki L; Kolanowski, Ann; Kürüm, Esra

    2010-09-01

    Residents with dementia are the least likely to be engaged in the nursing home and often spend most of their time doing nothing at all. However, resident participation in meaningful activities is important to promote both physical and psychological health. Tailoring activities to individual functional abilities and personality preferences improves both the time and level of participation. This pilot study used an analysis of covariance procedure to test the relationship between the personality trait of agreeableness and engagement when activities are ideally tailored to ability and interest. No significant difference was found between the high and low agreeableness groups, indicating that residents were more engaged when activities were individually tailored, regardless of their agreeableness level. Although low agreeableness may pose a challenge when implementing activities for people with dementia, the results of this study suggest that tailoring activities to functional ability and interest may overcome the effects.

  12. Identity cues and dementia in nursing home intervention.

    Science.gov (United States)

    Vézina, Aline; Robichaud, Line; Voyer, Philippe; Pelletier, Daniel

    2011-01-01

    This study examines the identity cues that family caregivers and healthcare personnel use with seniors living with dementia and living in nursing homes. The identity cues represent biographical knowledge used to stimulate the dementia sufferer, trigger signals and incite interaction. Our grounded approach hinges on three objectives: to identify and categorize identity cues; to document their uses; and to gain a better understanding of their effectiveness. We interviewed nine family caregivers and 12 healthcare workers. Qualitative data indicates that the participants use identity cues that evoke seniors' sociological, relational and individual characteristics. These identity cues play a central role in communication and constitute important information that the family caregivers can share with healthcare personnel. They sustain memory, facilitate care and reinforce seniors' self-value. These results help to define identity, foster a greater role for family caregivers, and constitute a sound basis for the implementation of personalized interventions.

  13. Professional caregivers' work with the dying in nursing homes

    DEFF Research Database (Denmark)

    Nielsen, Karen Tind; Glasdam, Stinne

    2013-01-01

    International studies on the death of elderly nursing home residents show the complexity in the understanding of the professionals who care for the dying. The aim of this study is to explore the discourses about professional caregivers caring for those dying in Denmark in the last decade...... of the professional caregivers – a complex low-status work’; (2) ‘the education of the professionals – the way to ensure a good death or possessing the right qualifications’ and (3) ‘the vulnerable professionals’. The study concludes that an economical/political discourse is dominating and sets up the frames within...... which the professionals care for dying residents, although the medical, the social/critical and the religious discourses attempt to speak against it. All positions articulate that the professional caregivers' job has a low status and that it is not possible to provide an optimal care due to lack of time...

  14. Indicators of a new depression diagnosis in nursing home residents.

    Science.gov (United States)

    Phillips, Lorraine J; Rantz, Marilyn; Petroski, Gregory F

    2011-01-01

    Depression affects approximately 30% to 40% of nursing home residents but frequently goes unrecognized. Using the Missouri Minimum Data Set, we aimed to determine whether changes in clinical status, other than mood changes, were associated with new depression diagnosis in residents 65 and older without a recorded depression diagnosis. Of 127,587 potential participants, 14,371 met inclusion criteria and were not depressed at baseline (Time 0). At the next quarterly assessment (Time 1), 1,342 (9.3%) had acquired a new diagnosis of depression. Residents with new depression were significantly younger and less cognitively impaired. Nearly 30% had a decline in activities of daily living (ADL) performance. The multivariate model predicting depression showed that increased verbal aggression, urinary incontinence, increased pain, weight loss, change in care needs, cognitive decline, and ADL decline significantly increased the likelihood of new depression diagnosis. The pattern of decline identified here may provide additional clues to the presence of underlying depression.

  15. [A motivational approach of cognitive efficiency in nursing home residents].

    Science.gov (United States)

    Clément, Evelyne; Vivicorsi, Bruno; Altintas, Emin; Guerrien, Alain

    2014-06-01

    Despite a widespread concern with self-determined motivation (behavior is engaged in "out of pleasure" or "out of choice and valued as being important") and psychological adjustment in later life (well-being, satisfaction in life, meaning of life, or self-esteem), very little is known about the existence and nature of the links between self-determined motivation and cognitive efficiency. The aim of the present study was to investigate theses links in nursing home residents in the framework of the Self-determination theory (SDT) (Deci & Ryan, 2002), in which motivational profile of a person is determined by the combination of different kinds of motivation. We hypothesized that self-determined motivation would lead to higher cognitive efficiency. Participants. 39 (32 women and 7 men) elderly nursing home residents (m= 83.6 ± 9.3 year old) without any neurological or psychiatric disorders (DSM IV) or depression or anxiety (Hamilton depression rating scales) were included in the study. Methods. Cognitive efficiency was evaluated by two brief neuropsychological tests, the Mini mental state examination (MMSE) and the Frontal assessment battery (FAB). The motivational profile was assessed by the Elderly motivation scale (Vallerand & 0'Connor, 1991) which includes four subscales assessing self- and non-self determined motivation to engage oneself in different domains of daily life activity. Results. The neuropsychological scores were positively and significantly correlated to self-determined extrinsic motivation (behavior is engaged in "out of choice" and valued as being important), and the global self-determination index (self-determined motivational profile) was the best predictor of the cognitive efficiency. Conclusion. The results support the SDT interest for a qualitative assessment of the motivation of the elderly people and suggest that a motivational approach of cognitive efficiency could help to interpret cognitive performances exhibited during neuropsychological

  16. Standardised electronic information exchange between nurses in home care and GPs - the medication information processes.

    Science.gov (United States)

    Lyngstad, Merete; Melby, Line; Hellesø, Ragnhild

    2012-01-01

    Improving the transfer of medication information between home care nurses and patient's general practitioners (GP) is assessed as essential for ensuring safe care. In this paper, we report on a Norwegian study in which we investigated how home care nurses experienced using standardised electronic messages in their communication with the GPs. Standardised electronic solutions were developed and implemented to resolve gaps in the medication information processes when patients received nursing care in their homes. Data was collected combining focus group interviews and individual interviews with nurses from home care in two municipalities in Norway. The data was analysed using systematic text condensation. We found that the nurses reported mostly advantages, but also some disadvantages regarding accuracy, consistency, availability and efficiency in the medication information process when they used standardised electronic messages. Efforts to refine the electronic messages to achieve better work processes and patient safety should be addressed.

  17. State of the science: relationship-oriented management practices in nursing homes.

    Science.gov (United States)

    Toles, Mark; Anderson, Ruth A

    2011-01-01

    Effective staff interdependence is needed to improve care of older adults in nursing homes. We synthesized research about nursing management practices that help nursing home staff members manage their relationships for better care. We searched PubMed for studies of relationship-oriented management in nursing homes, published in English between 2000 and 2010. We evaluated and synthesized findings from the literature. Thirty-three articles met the inclusion criteria. Analyzing these studies, we identified 3 themes: (a) managing relationships between managers and staff, (b) staff participation in decision-making, and (c) work designs that foster staff interactions. Most studies were descriptive and suggested that relationship-oriented management practices will promote better outcomes. Future intervention research that combines relationship-oriented management and evidenced-based clinical practices will help staff to skillfully manage problems in nursing home care, including complex geriatric syndromes.

  18. How to avoid and prevent coercion in nursing homes: a qualitative study.

    Science.gov (United States)

    Gjerberg, Elisabeth; Hem, Marit Helene; Førde, Reidun; Pedersen, Reidar

    2013-09-01

    In many Western countries, studies have demonstrated extensive use of coercion in nursing homes, especially towards patients suffering from dementia. This article examines what kinds of strategies or alternative interventions nursing staff in Norway used when patients resist care and treatment and what conditions the staff considered as necessary to succeed in avoiding the use of coercion. The data are based on interdisciplinary focus group interviews with nursing home staff. The study revealed that the nursing home staff usually spent a lot of time trying a wide range of approaches to avoid the use of coercion. The most common strategies were deflecting and persuasive strategies, limiting choices by conscious use of language, different kinds of flexibility and one-to-one care. According to the staff, their opportunities to use alternative strategies effectively are greatly affected by the nursing home's resources, by the organization of care and by the staff's competence.

  19. The experiences on dignity from the perspective of the elderly in nursing homes

    DEFF Research Database (Denmark)

    Høy, Bente

    2012-01-01

    The aim of the study was to explore nursing home residents’ practice experiences on dignity in caring situations and everyday life in order to illuminate the significance for a life in dignity. Elderly living in nursing homes are vulnerable which appeal to nursing care ethics and emphasise....... From the literature we have knowledge of how dignity is violated among persons who are sick, weak and helpless; however, the knowledge is limited on how dignity is maintained among vulnerable elderly in nursing homes. A hermeneutic approach was used to interpret the material, which was gathered during...... semi-structured interviews with elderly living in six nursing homes in Scandinavian. A total of 28 interviews were transcribed. The findings will be presented at the conference....

  20. Changes in clinical and hotel expenditures following publication of the nursing home compare report card.

    Science.gov (United States)

    Mukamel, Dana B; Spector, William D; Zinn, Jacqueline; Weimer, David L; Ahn, Richard

    2010-10-01

    Nursing Home Compare first published clinical quality measures at the end of 2002. It is a quality report card that for the first time offers consumers easily accessible information about the clinical quality of nursing homes. It led to changes in consumers' demand, increasing the relative importance of clinical versus hotel aspects of quality in their search and choice of a nursing home. To examine the hypothesis that nursing homes responding to these changes in demand shifted the balance of resources from hotel to clinical activities. The study included 10,022 free-standing nursing homes nationwide during 2001 to 2006. RESEARCH DESIGN AND DATA: A retrospective multivariate statistical analysis of trends in the ratio of clinical to hotel expenditures, using Medicare cost reports, Minimum Data Set and Online Survey, Certification and Reporting data, controlling for changes in residents' acuity and facility fixed effects. Inference is based on robust standard errors. The ratio of clinical to hotel expenditures averaged 1.78. It increased significantly (P hotel expenditures following publication of the report card suggests that nursing homes responded as expected to the changes in the elasticity of demand with respect to clinical quality brought about by the public reporting of clinical quality measures. The response was stronger among nursing homes facing stronger incentives.

  1. Acute hospital admissions among nursing home residents: a population-based observational study

    Directory of Open Access Journals (Sweden)

    Jamtvedt Gro

    2011-05-01

    Full Text Available Abstract Background Nursing home residents are prone to acute illness due to their high age, underlying illnesses and immobility. We examined the incidence of acute hospital admissions among nursing home residents versus the age-matched community dwelling population in a geographically defined area during a two years period. The hospital stays of the nursing home population are described according to diagnosis, length of stay and mortality. Similar studies have previously not been reported in Scandinavia. Methods The acute hospitalisations of the nursing home residents were identified through ambulance records. These were linked to hospital patient records for inclusion of demographics, diagnosis at discharge, length of stay and mortality. Incidence of hospitalisation was calculated based on patient-time at risk. Results The annual hospital admission incidence was 0.62 admissions per person-year among the nursing home residents and 0.26 among the community dwellers. In the nursing home population we found that dominant diagnoses were respiratory diseases, falls-related and circulatory diseases, accounting for 55% of the cases. The median length of stay was 3 days (interquartile range = 4. The in-hospital mortality rate was 16% and 30 day mortality after discharge 30%. Conclusion Acute hospital admission rate among nursing home residents was high in this Scandinavian setting. The pattern of diagnoses causing the admissions appears to be consistent with previous research. The in-hospital and 30 day mortality rates are high.

  2. Current Dermatologic Care in Dutch Nursing Homes and Possible Improvements: A Nationwide Survey.

    Science.gov (United States)

    Lubeek, Satish F K; van der Geer, Eric R; van Gelder, Marleen M H J; Koopmans, Raymond T C M; van de Kerkhof, Peter C M; Gerritsen, Marie-Jeanne P

    2015-08-01

    To assess the provision and need of dermatologic care among Dutch nursing home patients and to obtain recommendations for improvement. Cross-sectional nationwide survey. All 173 nursing home organizations in the Netherlands. Physicians working in nursing homes. Web-based questionnaire concerning the burden of skin diseases in nursing home patients, diagnostic procedures and therapy, collaboration with dermatologists, physicians' level of education, and suggestions for improvement. A total of 126 (72.8%) nursing home organizations, with 1133 associated physicians participated in our study and received the questionnaire. A total of 347 physicians (30.6%) completed the questionnaire. Almost all respondents (99.4%) were recently confronted with skin diseases, mostly (pressure) ulcers, eczema, and fungal infections. Diagnostic and treatment options were limited because of a lack of availability and experience of the physicians. More live consultation of dermatologists was suggested as being important to improve dermatologic care. Other suggestions were better education, more usage of telemedicine applications, and better availability of diagnostic and/or treatment procedures like cryotherapy. Physicians in nursing homes are frequently confronted with skin diseases. Several changes in organization of care and education are expected to improve dermatologic care in nursing home patients. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  3. Residents' Positive and Negative Relationship Networks in a Nursing Home.

    Science.gov (United States)

    Casey, Anne-Nicole S; Low, Lee-Fay; Jeon, Yun-Hee; Brodaty, Henry

    2016-11-01

    Person-centered care involves consideration of long-term care residents' lived experience, including social relationships. The current cross-sectional study investigated co-resident social networks in three units of a 94-bed Australian nursing home, including an 18-bed dementia-specific unit (DSU). Six care staff were interviewed. Chart, self-reported social isolation, and staff-reported social engagement data were collected for 36 residents ages 63 to 94 who consented to full participation. Fifty-five additional residents were included in observations. Median positive-to-negative network size ratios within units were 1.5:1 (Unit 1), 0.7:1 (Unit 3), and 0:1 (DSU). Moderate positive correlations existed between: perceived social support and total positive relationships [ρ(25) = 0.44, p = 0.03]; social withdrawal and total negative relationships [ρ(36) = 0.51, p = 0.002]; and objective social isolation and total negative relationships [ρ(22) = -0.44, p = 0.042]. Number and quality of relationships were associated with resident social withdrawal, perceived support, and isolation. High prevalence of isolation and negative relationships demonstrate the need for interventions. [Journal of Gerontological Nursing, 42(11), 9-13.].

  4. Applying the Advancing Excellence in America's Nursing Homes Circle of Success to improving and sustaining quality.

    Science.gov (United States)

    Bakerjian, Debra; Zisberg, Anna

    2013-01-01

    Looking forward to the Quality Assurance Performance Improvement (QAPI) program to be implemented and required in 2014, and as nursing home staff provide care for residents with increasingly complex health issues, knowledge of how to implement quality improvement (QI) is imperative. The nursing home administrator and director of nursing (DON) provide overall leadership, but it is the primary responsibility of the DON and other registered nurse staff to implement and manage the day to day QI process. This article describes potential roles of nursing leaders and key components of a QI project using a pressure ulcer case study exemplar to illustrate a quality improvement process. The authors suggest specific methods that RN leaders can employ using the Advancing Excellence Campaign Circle of Success as an organizing framework along with evidence-based resources. Nursing home leaders could use this article as a guideline for implementing any clinical quality improvement process. Copyright © 2013 Mosby, Inc. All rights reserved.

  5. Medical Foster Homes: Can the Adult Foster Care Model Substitute for Nursing Home Care?

    Science.gov (United States)

    Levy, Cari; Whitfield, Emily A

    2016-12-01

    To compare characteristics, healthcare use, and costs of care of veterans in the rapidly expanding Veterans Health Administration (VHA) medical foster home (MFH) with those of three other VHA long-term care (LTC) programs. Descriptive, unmatched study. VHA MFHs, home-based primary care (HBPC), community living centers (CLCs), and community nursing homes (CNHs). Veterans newly enrolled in one of the four LTC settings in calendar years 2010 or 2011. Using VA and Medicare data from fiscal years 2010 and 2011, demographic characteristics, healthcare use, and costs of 388 veterans in MFHs were compared with 26,037 of those in HBPC, 5,355 in CLCs, and 5,517 in CNHs in the year before and the year after enrollment. Veterans enrolled in the MFH program were more likely to be unmarried than those in other LTC programs and had higher levels of comorbidity and frailty than veterans receiving HBPC but had similar levels of comorbidity, frailty, and healthcare use as those in CLCs and CNHs. MFH veterans incurred lower costs than those in CNHs and CLCs. MFHs served a distinct subset of veterans with levels of comorbidity and frailty similar to those of veterans cared for in CLCs and CNHs at costs that were comparable to or lower than those of the VHA. Propensity-matched comparisons will be necessary to confirm these findings. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  6. Predictors of nursing home admission of individuals without a dementia diagnosis before admission - results from the Leipzig Longitudinal Study of the Aged (LEILA 75+

    Directory of Open Access Journals (Sweden)

    Matschinger Herbert

    2010-06-01

    Full Text Available Abstract Background In previous decades a substantial number of community-based studies mostly including dementia cases examined predictors of nursing home admission (NHA among elderly people. However, no one study has analysed predictors of NHA for individuals without developing dementia before NHA. Methods Data were derived from the Leipzig Longitudinal Study of the Aged, a population-based study of individuals aged 75 years and older. 1,024 dementia-free older adults were interviewed six times on average every 1.4 years. Socio-demographic, clinical, and psychometric variables were obtained. Kaplan-Meier estimates were used to determine mean time to NHA. Cox proportional hazards regression was used to examine predictors of long-term NHA. Results Of the overall sample, 7.8 percent of the non-demented elderly (n = 59 were admitted to nursing home (NH during the study period. The mean time to NHA in the dementia-free sample was 7.6 years. Characteristics associated with a shorter time to NHA were increased age, living alone, functional and cognitive impairment, major depression, stroke, myocardial infarction, a low number of specialist visits and paid home helper use. Conclusions Severe physical or psychiatric diseases and living alone have a significant effect on NHA for dementia-free individuals. The findings offer potentialities of secondary prevention to avoid or delay NHA for these elderly individuals. Further investigation of predictors of institutionalization is warranted to advance understanding of the process leading to NHA for this important group.

  7. Home-based nursing interventions improve knowledge of disease and management in patients with heart failure

    Directory of Open Access Journals (Sweden)

    Karina de Oliveira Azzolin

    2015-02-01

    Full Text Available OBJECTIVE: to assess patient knowledge of heart failure by home-based measurement of two NOC Nursing Outcomes over a six-month period and correlate mean outcome indicator scores with mean scores of a heart failure Knowledge Questionnaire.METHODS: in this before-and-after study, patients with heart failure received four home visits over a six-month period after hospital discharge. At each home visit, nursing interventions were implemented, NOC outcomes were assessed, and the Knowledge Questionnaire was administered.RESULTS: overall, 23 patients received home visits. Mean indicator scores for the outcome Knowledge: Medication were 2.27±0.14 at home visit 1 and 3.55±0.16 at home visit 4 (P<0.001; and, for the outcome Knowledge: Treatment Regimen, 2.33±0.13 at home visit 1 and 3.59±0.14 at home visit 4 (P<0.001. The correlation between the Knowledge Questionnaire and the Nursing Outcomes Classification scores was strong at home visit 1 (r=0.7, P<0.01, but weak and non significant at visit 4.CONCLUSION: the results show improved patient knowledge of heart failure and a strong correlation between Nursing Outcomes Classification indicator scores and Knowledge Questionnaire scores. The NOC Nursing Outcomes proved effective as knowledge assessment measures when compared with the validated instrument.

  8. Assessment of dementia in nursing home residents by nurses and assistants

    DEFF Research Database (Denmark)

    Sørensen, Lisbeth Uhrskov; Foldspang, Anders; Gulmann, Nils Christian

    2001-01-01

    Objectives To describe the criterion validity of nursing home staff's assessment of organic disorder compared with ICD-10 criteria, and to identify determinants of staff assessment of organic disorder. Method Two hundred and eighty-eight residents were diagnosed using the GMS-AGECAT. Nursing staff...... members were interviewed about the residents' activities of Daily Living, behavioural problems, orientation in surroundings and communication skills, and asked if the resident had an organic disorder. Multiple logistic regression was used to select the items that most strongly determined staff assessment...... of organic disorder. Results Sixty-two per cent of the residents were diagnosed by GMS-AGECAT as having organic disorder, 78% of these were correctly identified by the staff. Whether analysed among residents with or without organic disorder, or in the total group of residents, the staff assessment...

  9. NURSING HOME PRACTICES FOLLOWING RESIDENT DEATH: THE EXPERIENCE OF CERTIFIED NURSING ASSISTANTS

    Science.gov (United States)

    Barooah, Adrita; Boerner, Kathrin; van Riesenbeck, Isabelle; Burack, Orah R.

    2015-01-01

    This study examined certified nursing assistants’ (CNAs) experiences of nursing home practices following resident death. Participants were 140 CNAs who had experienced recent resident death. In semi-structured, in-person interviews, CNAs were asked about their experiences with the removal of the resident's body, filling the bed with a new resident, and how they were notified about the death. The facilities’ practice of filling the bed quickly was most often experienced as negative. Responses to body removal and staff notification varied, but negative experiences were reported by a substantial minority. Being notified prior to returning to work was associated with a more positive experience. Learning about the death by walking into a room to find the bed empty or already filled was the most negative experience. Study findings suggest that more mindful approaches to the transitions related to resident deaths would be valued by CNAs and could improve their work experience. PMID:25554351

  10. Association between subjective memory complaints and nursing home placement: a four-year follow-up

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Siersma, Volkert; Waldemar, Gunhild

    2009-01-01

    OBJECTIVE: In order to evaluate whether elderly persons with subjective memory complaints may be regarded as a group of potentially vulnerable patients who need close follow-up, we investigated the risk of nursing home placement during a 4-year follow-up period. METHODS: Prospective cohort survey...... with 4-year follow-up in general practice. Cox proportional hazard models were used to examine the influence of risk factors on nursing home placement. RESULTS: A total 758 non-nursing home residents aged 65 years and older consulted the General Practitioners in October and November 2002 of whom 50...

  11. Challenges in making a business case for effective pain management in nursing homes.

    Science.gov (United States)

    Bakerjian, Debra; Prevost, Suzanne S; Herr, Keela; Swafford, Kristen; Ersek, Mary

    2012-02-01

    The lack of a systematic and comprehensive pain management program is a common quality problem in nursing homes. The purpose of this article is to address the business case for effective pain management in this setting, including the conceptual domains and processes that should be considered in improving quality and reducing costs. Unfortunately, the literature contains very little to inform those working to implement effective and efficient pain management programs in nursing homes. This article suggests several strategies for establishing an internal business case to support the implementation of a comprehensive pain management program in a nursing home setting.

  12. Retrospective review of selective serotonin reuptake inhibitors and falling in older nursing home residents.

    Science.gov (United States)

    Arfken, C L; Wilson, J G; Aronson, S M

    2001-03-01

    We compared the rate of falling in older nursing home residents who had been prescribed selective serotonin reuptake inhibitors (SSRIs), other classes of antidepressants, and no antidepressants. Data were obtained from pharmacy records, medical records, fall logs, and incidence reports for one nursing home (1995 data). Older adults on SSRIs were more likely to fall than older adults not on antidepressants (p = .003) and were more likely to have an injurious fall (p = .03). The association with falling remained significant even when including potential confounders (p = .007). Older nursing home residents should be treated for depression. However, SSRIs may also carry an increased risk for falling.

  13. Dementia-friendly architecture: environments that facilitate wayfinding in nursing homes.

    Science.gov (United States)

    Marquardt, Gesine; Schmieg, Peter

    2009-01-01

    Spatial disorientation is a prime reason for institutionalization. The autonomy of the residents and their quality of life, however, is strongly linked with their ability to reach certain places within their nursing home. The physical environment has a great potential for supporting a resident's wayfinding abilities. For this study, data were collected from 30 German nursing homes. Skilled nurses rated the resident's ability to perform 5 wayfinding tasks. The architectural characteristics of the homes were analyzed and their impact on the resulting scores was tested for statistical significance using the Mann-Whitney U test (P architectural guidelines.

  14. Physical restraint use among nursing home residents: A comparison of two data collection methods

    Directory of Open Access Journals (Sweden)

    Voyer Philippe

    2004-10-01

    Full Text Available Abstract Background In view of the issues surrounding physical restraint use, it is important to have a method of measurement as valid and reliable as possible. We determined the sensitivity and specificity of physical restraint use a reported by nursing staff and b reviewed from medical and nursing records in nursing home settings, by comparing these methods with direct observation. Methods We sampled eight care units in skilled nursing homes, seven care units in nursing homes and one long-term care unit in a hospital, from eight facilities which included 28 nurses and 377 residents. Physical restraint use was assessed the day following three periods of direct observation by two different means: interview with one or several members of the regular nursing staff, and review of medical and nursing records. Sensitivity and specificity values were calculated according to 2-by-2 contingency tables. Differences between the methods were assessed using the phi coefficient. Other information collected included: demographic characteristics, disruptive behaviors, body alignment problems, cognitive and functional skills. Results Compared to direct observation (gold standard, reported restraint use by nursing staff yielded a sensitivity of 87.4% at a specificity of 93.7% (phi = 0.84. When data was reviewed from subjects' medical and nursing records, sensitivity was reduced to 74.8%, and specificity to 86.3% (phi = 0.54. Justifications for restraint use including risk for falls, agitation, body alignment problems and aggressiveness were associated with the use of physical restraints. Conclusions The interview of nursing staff and the review of medical and nursing records are both valid and reliable techniques for measuring physical restraint use among nursing home residents. Higher sensitivity and specificity values were achieved when nursing staff was interviewed as compared to reviewing medical records. This study suggests that the interview of nursing

  15. Physical restraint use among nursing home residents: A comparison of two data collection methods

    Science.gov (United States)

    Laurin, Danielle; Voyer, Philippe; Verreault, René; Durand, Pierre J

    2004-01-01

    Background In view of the issues surrounding physical restraint use, it is important to have a method of measurement as valid and reliable as possible. We determined the sensitivity and specificity of physical restraint use a) reported by nursing staff and b) reviewed from medical and nursing records in nursing home settings, by comparing these methods with direct observation. Methods We sampled eight care units in skilled nursing homes, seven care units in nursing homes and one long-term care unit in a hospital, from eight facilities which included 28 nurses and 377 residents. Physical restraint use was assessed the day following three periods of direct observation by two different means: interview with one or several members of the regular nursing staff, and review of medical and nursing records. Sensitivity and specificity values were calculated according to 2-by-2 contingency tables. Differences between the methods were assessed using the phi coefficient. Other information collected included: demographic characteristics, disruptive behaviors, body alignment problems, cognitive and functional skills. Results Compared to direct observation (gold standard), reported restraint use by nursing staff yielded a sensitivity of 87.4% at a specificity of 93.7% (phi = 0.84). When data was reviewed from subjects' medical and nursing records, sensitivity was reduced to 74.8%, and specificity to 86.3% (phi = 0.54). Justifications for restraint use including risk for falls, agitation, body alignment problems and aggressiveness were associated with the use of physical restraints. Conclusions The interview of nursing staff and the review of medical and nursing records are both valid and reliable techniques for measuring physical restraint use among nursing home residents. Higher sensitivity and specificity values were achieved when nursing staff was interviewed as compared to reviewing medical records. This study suggests that the interview of nursing staff is a more reliable

  16. Director of Nursing Current Job Tenure and Past Experience and Quality of Care in Nursing Homes

    Science.gov (United States)

    Krause, Melanie R.

    2011-01-01

    Background Directors of nursing (DON) are central to quality of care in nursing homes (NH) because of their role in coordinating and overseeing nursing care. Research is needed to test the association between DON characteristics and quality using large, representative samples of NHs and global measures of quality. One such measure is the quality measure (QM) rating from the Centers for Medicare & Medicaid Services’ Five-Star Quality Rating, which aggregates 10 individual QMs into a single rating. Purpose This study examined whether DON current job tenure or past experience (1) differed across levels of the QM rating, (2) was associated with QM ratings, and (3) was associated with any of the individual 10 QM scores that comprise QM ratings. Methodology Data for a nationally representative sample of 1,174 NHs were obtained from the 2004 National Nursing Home Survey, publicly-reported QMs, and an Area Resource File. Wald tests were used to test differences in mean DON current job tenure and past experience across levels of the QM rating. Multinomial logistic and Poisson regression analyses were used to examine the association between DON current job tenure and past experience and QM ratings and QM scores, respectively, controlling for selected market and organizational characteristics. Findings NHs with longer DON current job tenure tended to have higher QM ratings. Longer DON current job tenure was associated with higher QM ratings and lower QM scores for several individual QMs, suggesting higher quality. DON past experience did not differ across levels of the QM rating and was neither associated with QM ratings or QM scores. Practice Implications This study highlights the need for owners and administrators to support DONs as they either transition into the role of the DON for the first time or learn to effectively fulfill their role in a new NH. PMID:21712721

  17. [Consensus on nursing diagnoses, interventions and outcomes for home care of patients with heart failure].

    Science.gov (United States)

    Azzolin, Karina; de Souza, Emiliane Nogueira; Ruschel, Karen Brasil; Mussi, Cláudia Motta; de Lucena, Amália Fátima; Rabelo, Eneida Rejane

    2012-12-01

    This was a consensus study with six cardiology nurses with the objective of selecting nursing diagnoses, outcomes and interventions described by NANDA International (NANDA-I), Nursing Outcomes Classification (NOC), Nursing Intervention Classification (NIC), for home care of patients with heart failure (HF). Eight nursing diagnoses (NDs) were pre-selected and a consensus was achieved in three stages, during which interventions/activities and outcomes/indicators of each NDs were validated and those considered valid obtained 70% to 100% consensus. From the eight pre-selected NDs, two were excluded due to the lack of consensus on appropriate interventions for the clinical home care scenario. Eleven interventions were selected from a total of 96 pre-selected ones and seven outcomes were validated out of 71. The practice of consensus among expert nurses provides assistance to the qualifications of the care process and deepens the knowledge about the use of tazonomies in nursing clinical practice.

  18. Residents' experiences of interpersonal factors in nursing home care: a qualitative study.

    Science.gov (United States)

    Nakrem, Sigrid; Vinsnes, Anne Guttormsen; Seim, Arnfinn

    2011-11-01

    With life expectancy lengthening, the number of those who will require care in a nursing home will increase dramatically in the next 20 years. Nursing home residents are frail older adults with complex needs, dependent on advanced nursing care. Long-term residents in nursing homes have long-term relationships with the nurses, which require a unique approach to the interpersonal aspects of nursing care. Understanding what is experienced as care quality, including quality of interpersonal processes, requires insight into the residents' perspectives for best value in care to be realized. Main objective was to describe the nursing home residents' experience with direct nursing care, related to the interpersonal aspects of quality of care. A descriptive, exploratory design was used. Four public municipal nursing homes in Norway with long-term residents were purposely selected for the study. Fifteen mentally lucid residents were included. The inclusion criteria were aged 65 and over, being a resident of the nursing home for one month or longer, and physical and mental capacity to participate in the interview. In-depth interviews with the residents were performed. The transcribed interviews were analyzed using meaning categorizing. The residents emphasized the importance of nurses acknowledging their individual needs, which included need for general and specialized care, health promotion and prevention of complications, and prioritizing the individuals. The challenging balance between self-determination and dependency, the altered role from homeowner to resident, and feelings of indignity and depreciation of social status were key issues in which the residents perceived that their integrity was at risk in the patient-nurse interaction and care. Psychosocial well-being was a major issue, and the residents expressed an important role of the nursing staff helping them to balance the need for social contact and to be alone, and preserving a social network. Quality nursing

  19. Improvements in the quality of co-ordination of nursing care following implementation of the Resident Assessment Instrument in Dutch nursing homes.

    NARCIS (Netherlands)

    Achterberg, W.P.; Holtkamp, C.C.M.; Kerkstra, A.; Pot, A.M.; Ooms, M.E.; Ribbe, M.W.

    2001-01-01

    Aim: To study the effect of implementation of the Resident Assessment Instrument (RAI) on the quality of co-ordination of nursing care in Dutch nursing homes. Background: The Resident Assessment Instrument (RAI) was designed to improve the quality of care and quality of life in nursing homes. Until

  20. Improvements in the quality of co-ordination of nursing care following implementation of the Resident Assessment Instrument in Dutch nursing homes.

    NARCIS (Netherlands)

    Achterberg, W.P.; Holtkamp, C.C.M.; Kerkstra, A.; Pot, A.M.; Ooms, M.E.; Ribbe, M.W.

    2001-01-01

    Aim: To study the effect of implementation of the Resident Assessment Instrument (RAI) on the quality of co-ordination of nursing care in Dutch nursing homes. Background: The Resident Assessment Instrument (RAI) was designed to improve the quality of care and quality of life in nursing homes. Until

  1. Doctors' learning experiences in end-of-life care - a focus group study from nursing homes.

    Science.gov (United States)

    Fosse, Anette; Ruths, Sabine; Malterud, Kirsti; Schaufel, Margrethe Aase

    2017-01-31

    Doctors often find dialogues about death difficult. In Norway, 45% of deaths take place in nursing homes. Newly qualified medical doctors serve as house officers in nursing homes during internship. Little is known about how nursing homes can become useful sites for learning about end-of-life care. The aim of this study was to explore newly qualified doctors' learning experiences with end-of-life care in nursing homes, especially focusing on dialogues about death. House officers in nursing homes (n = 16) participated in three focus group interviews. Interviews were audiotaped and transcribed verbatim. Data were analysed with systematic text condensation. Lave & Wenger's theory about situated learning was used to support interpretations, focusing on how the newly qualified doctors gained knowledge of end-of-life care through participation in the nursing home's community of practice. Newly qualified doctors explained how nursing home staff's attitudes taught them how calmness and acceptance could be more appropriate than heroic action when death was imminent. Shifting focus from disease treatment to symptom relief was demanding, yet participants comprehended situations where death could even be welcomed. Through challenging dialogues dealing with family members' hope and trust, they learnt how to adjust words and decisions according to family and patient's life story. Interdisciplinary role models helped them balance uncertainty and competence in the intermediate position of being in charge while also needing surveillance. There is a considerable potential for training doctors in EOL care in nursing homes, which can be developed and integrated in medical education. This practice based learning arena offers newly qualified doctors close interaction with patients, relatives and nurses, teaching them to perform difficult dialogues, individualize medical decisions and balance their professional role in an interdisciplinary setting.

  2. Use of primary care teams by HMOS for care of long-stay nursing home residents.

    Science.gov (United States)

    Farley, D O; Zellman, G; Ouslander, J G; Reuben, D B

    1999-02-01

    To characterize the use of formal primary care programs by health maintenance organizations (HMOs) for their members who are long-stay residents of nursing homes. Using mail survey techniques, 34 Medicare risk-contracting HMOs with the largest Medicare beneficiary enrollments were asked to complete a written questionnaire. HMOs were asked how they evaluate care in nursing home settings and whether they operate a formal primary care program for members who are long-stay nursing home residents. Those reporting they had programs were asked about the program features, participation in the program, roles performed by clinical practitioners, and clinical caseloads. Surveys were completed by 21 (61.8%) of the HMOs. HMO management personnel who know the primary care programs the HMOs operate in affiliated nursing homes. Descriptive summaries of the HMOs' responses to the survey questions were generated. For HMOs with primary care programs, caseloads of physicians and nurse practitioners were estimated using survey data reported by the HMOs. Eight (38.1%) of the responding HMOs operate formal primary care programs in affiliated nursing homes. HMOs with programs consider more factors than non-program HMOs in evaluating care for nursing home residents. Reasons cited most frequently for not having a program are costs and too few nursing home residents. The most common primary care program features are designated physicians and use of physician extenders. Survey findings point to the potential importance of formal HMO primary care programs for long-term nursing home residents, which may expand with growth in the older population and Medicare-managed care. Program adoption, however, may depend on sufficient resident participation to be financially feasible.

  3. The impact of work culture on quality of care in nursing homes--a review study.

    Science.gov (United States)

    André, Beate; Sjøvold, Endre; Rannestad, Toril; Ringdal, Gerd I

    2014-09-01

    The main aim of this review study was to identify which factors that characterise the relationship between work culture and quality of care in nursing homes. This review study was structured through systematic search methods to identify articles that describe the relationship between work culture and quality of care in nursing homes. The database search yielded 14510 hits. Closer examination showed that 10401 of these hits were duplicates. Of the remaining 4109 articles, only 10 were related to our aim for the study. A qualitative method were used to explain and understand phenomena of work culture and quality if care in nursing homes. Nine out of 10 articles in this review study emphasise the importance of leadership style and supportive management to increase quality of care in nursing homes. Increased empowerment, participation and influence were important factors for improving quality of care. Significant associations between work culture and quality of care and between empowerment and quality of care were reported. Nursing management and leaders must take in consideration that work culture is crucial for improving quality of care in nursing homes, and this study can be used to increase the focus on the work culture among healthcare personnel in nursing homes. Changes are necessary to increase healthcare personnel's job satisfaction, empowerment, autonomy and influence in nursing homes. Giving empowerment to the healthcare personnel working in nursing homes is both an organisational and an interpersonal issue. Being given empowerment and influence over their own work situation, the healthcare workers can be more committed and involved in the goal of obtaining best possible care to the residents. © 2013 Nordic College of Caring Science.

  4. Cost control in nursing homes by means of economies of scale and care profile optimization.

    Science.gov (United States)

    Hoess, Victoria; Bachler, Adi; Ostermann, Herwig; Staudinger, Roland

    2009-01-01

    The call to enlarge or merge nursing homes in order to lower costs rests on the assumption that economies of scale exist within the cost structure of these homes. Economies of scale means that an increasing number of residents will reduce the costs per person needing care. However, the existence and the extent of economies of scale as such in nursing homes are the subject of controversy because studies of this issue performed in nursing homes up to now have yielded contradictory results. In this study, researchers demonstrated economies of scale in Tyrolean, Austria, nursing homes and showed that the composition of the nursing home residents in respect to their care needs influences the development of the average costs. Changing the size of the facility and/or influencing the average care level can have a considerable influence on the progression of average costs in nursing homes. Cost reductions can be achieved by increasing the size of the facility or by improved distribution of the care levels of the persons in need of care.

  5. Restraint use in home care: a qualitative study from a nursing perspective

    Science.gov (United States)

    2014-01-01

    Background Despite the growing demand for home care and preliminary evidence suggesting that the use of restraint is common practice in home care, research about restraint use in this setting is scarce. Methods To gain insight into the use of restraints in home care from the perspective of nurses, we conducted a qualitative explorative study. We conducted semi-structured face-to-face interviews of 14 nurses from Wit-Gele Kruis, a home-care organization in Flanders, Belgium. Interview transcripts were analyzed using the Qualitative Analysis Guide of Leuven. Results Our findings revealed a lack of clarity among nurses about the concept of restraint in home care. Nurses reported that cognitively impaired older persons, who sometimes lived alone, were restrained or locked up without continuous follow-up. The interviews indicated that the patient’s family played a dominant role in the decision to use restraints. Reasons for using restraints included “providing relief to the family” and “keeping the patient at home as long as possible to avoid admission to a nursing home.” The nurses stated that general practitioners had no clear role in deciding whether to use restraints. Conclusions These findings suggest that the issue of restraint use in home care is even more complex than in long-term residential care settings and acute hospital settings. They raise questions about the ethical and legal responsibilities of home-care providers, nurses, and general practitioners. There is an urgent need for further research to carefully document the use of restraints in home care and to better understand it so that appropriate guidance can be provided to healthcare workers. PMID:24498859

  6. Efficiency and quality of care in nursing homes: an Italian case study.

    Science.gov (United States)

    Garavaglia, Giulia; Lettieri, Emanuele; Agasisti, Tommaso; Lopez, Silvano

    2011-03-01

    This study investigates efficiency and quality of care in nursing homes. By means of Data Envelopment Analysis (DEA), the efficiency of 40 nursing homes that deliver their services in the north-western area of the Lombardy Region was assessed over a 3-year period (2005-2007). Lombardy is a very peculiar setting, since it is the only Region in Italy where the healthcare industry is organised as a quasi-market, in which the public authority buys health and nursing services from independent providers-establishing a reimbursement system for this purpose. The analysis is conducted by generating bootstrapped DEA efficiency scores for each nursing home (stage one), then regressing those scores on explanatory variables (stage two). Our DEA model employed two input (i.e. costs for health and nursing services and costs for residential services) and three output variables (case mix, extra nursing hours and residential charges). In the second-stage analysis, Tobit regressions and the Kruskall-Wallis tests of hypothesis to the efficiency scores were applied to define what are the factors that affect efficiency: (a) the ownership (private nursing houses outperform their public counterparts); and (b) the capability to implement strategies for labour cost and nursing costs containment, since the efficiency heavily depends upon the alignment of the costs to the public reimbursement system. Lastly, even though the public institutions are less efficient than the private ones, the results suggest that public nursing homes are moving towards their private counterparts, and thus competition is benefiting efficiency.

  7. Nurse's Aid And Housekeeping Mobile Robot For Use In The Nursing Home Workplace

    Science.gov (United States)

    Sines, John A.

    1987-01-01

    The large nursing home market has several natural characteristics which make it a good applications area for robotics. The environment is already robot accessible and the work functions require large quantities of low skilled services on a daily basis. In the near future, a commercial opportunity for the practical application of robots is emerging in the delivery of housekeeping services in the nursing home environment. The robot systems will assist in food tray delivery, material handling, and security, and will perform activities such as changing a resident's table side drinking water twice a day, and taking out the trash. The housekeeping work functions will generate cost savings of approximately 22,000 per year, at a cost of 6,000 per year. Technical system challenges center around the artificial intelligence required for the robot to map its own location within the facility, to find objects, and to avoid obstacles, and the development of an energy efficient mechanical lifting system. The long engineering and licensing cycles (7 to 12 years) required to bring this type of product to market make it difficult to raise capital for such a venture.

  8. MDS 3.0 for Nursing Homes and Swing Bed Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The MDS is a powerful tool for implementing standardized assessment and for facilitating care management in nursing homes (NHs) and non-critical access hospital...

  9. The experiences of family members in the nursing home to hospital transfer decision.

    Science.gov (United States)

    Abrahamson, Kathleen; Bernard, Brittany; Magnabosco, Lara; Nazir, Arif; Unroe, Kathleen T

    2016-11-15

    The objective of this study was to better understand the experiences of family members in the nursing home to hospital transfer decision making process. Semi-structured interviews were conducted with 20 family members who had recently been involved in a nursing home to hospital transfer decision. Family members perceived themselves to play an advocacy role in their resident's care and interview themes clustered within three over-arching categories: Family perception of the nursing home's capacity to provide medical care: Resident and family choices; and issues at 'hand-off' and the hospital. Multiple sub-themes were also identified. Findings from this study contribute to knowledge surrounding the nursing home transfer decision by illuminating the experiences of family members in the transfer decision process.

  10. High-Dose Flu Shot May Help Nursing Home Residents Avoid Hospital

    Science.gov (United States)

    ... Flu Shot May Help Nursing Home Residents Avoid Hospital Rates of all-cause admission were significantly lower ... moved out of their comfortable environment to a hospital," noted Dr. Theodore Strange. "This [new vaccine] is ...

  11. Indoor air quality, ventilation and respiratory health in elderly residents living in nursing homes in Europe

    DEFF Research Database (Denmark)

    Bentayeb, Malek; Norback, Dan; Bednarek, Micha

    2015-01-01

    European countries. 600 elderly people from 50 nursing homes underwent a medical examination and completed a standardised questionnaire. Air quality and comfort parameters were objectively assessed in situ in the nursing home. Mean concentrations of air pollutants did not exceed the existing standards...... cough. Elderly subjects aged ≥80 years were at higher risk. Pollutant effects were more pronounced in the case of poor ventilation. Even at low levels, indoor air quality affected respiratory health in elderly people permanently living in nursing homes, with frailty increasing with age. The effects were......Few data exist on respiratory effects of indoor air quality and comfort parameters in the elderly. In the context of the GERIE study, we investigated for the first time the relationships of these factors to respiratory morbidity among elderly people permanently living in nursing homes in seven...

  12. Gender Regimes in Ontario Nursing Homes: Organization, Daily Work, and Bodies.

    Science.gov (United States)

    Storm, Palle; Braedley, Susan; Chivers, Sally

    2017-06-01

    Today more men work in the long-term care sector, but men are still in the minority. Little is known about men's experiences in care work, and the dilemmas and opportunities they face because of their gender. This article focuses on men care workers' integration into the organization and flow of nursing home work as perceived by these workers and staff members. Using a rapid ethnography method in two Ontario nursing homes, we found work organization affected interpretations of gender and race, and that workers' scope for discretion affected the integration and acceptance of men as care workers. In a nursing home with a rigid work organization and little worker discretion, women workers perceived men workers as a problem, whereas at a nursing home with a more flexible work organization that stressed relational care, both women and men workers perceived men workers as a resource in the organization.

  13. 1 in 4 Nursing Home Residents Has Antibiotic-Resistant Bacteria

    Science.gov (United States)

    ... in 4 Nursing Home Residents Has Antibiotic-Resistant Bacteria More infection-prevention education and policies are needed, ... TUESDAY, May 30, 2017 (HealthDay News) -- Multidrug-resistant bacteria, such as E. coli , can be found in ...

  14. Comorbid depression in dementia on psychogeriatric nursing home wards: which symptoms are prominent?

    NARCIS (Netherlands)

    Verkaik, R.; Francke, A.L.; Meijel, B. van; Ribbe, M.W.; Bensing, J.M.

    2009-01-01

    OBJECTIVE: To provide insight into the prevalence and clinically relevant symptoms of comorbid depression among dementia patients in psychogeriatric nursing home wards, to enhance depression recognition. DESIGN: Cross-sectional analyses of multicenter diagnostic data. SETTING: Psychogeriatric wards

  15. The Effect of Depression on Social Engagement in Newly Admitted Dutch Nursing Home Residents.

    Science.gov (United States)

    Achterberg, Wilco; Pot, Anne Margriet; Kerkstra, Ada; Ooms, Marcel; Muller, Martien; Ribbe, Miel

    2003-01-01

    Studies the effect of depression on social engagement among newly admitted nursing home residents. Results reveal that residents with depression were significantly more often found to have low social engagement. (Contains 26 references and 3 tables.) (GCP)

  16. Aspects of indignity in nursing home residences as experienced by family caregivers

    DEFF Research Database (Denmark)

    Nåden, Dagfinn; Høy, Bente; Lohne, Vibeke

    2013-01-01

    The overall purpose of this cross-country Nordic study was to gain further knowledge about maintaining and promoting dignity in nursing home residents. The purpose of this article is to present results pertaining to the following question: How is nursing home residents' dignity maintained, promoted...... or deprived from the perspective of family caregivers? In this article, we focus only on indignity in care. This study took place at six different nursing home residences in Sweden, Denmark and Norway. Data collection methods in this part of this study consisted of individual research interviews. Altogether......, the sample consisted of 28 family caregivers of nursing home residents. The empirical material was interpreted using a hermeneutical approach. The overall theme that emerged was as follows: 'A feeling of being abandoned'. The sub-themes are designated as follows: deprived of the feeling of belonging...

  17. Indoor air quality, ventilation and respiratory health in elderly residents living in nursing homes in Europe.

    Science.gov (United States)

    Bentayeb, Malek; Norback, Dan; Bednarek, Micha; Bernard, Alfred; Cai, Guihong; Cerrai, Sonia; Eleftheriou, Konstantinos Kostas; Gratziou, Christina; Holst, Gitte Juel; Lavaud, François; Nasilowski, Jacek; Sestini, Piersante; Sarno, Giuseppe; Sigsgaard, Torben; Wieslander, Gunilla; Zielinski, Jan; Viegi, Giovanni; Annesi-Maesano, Isabella

    2015-05-01

    Few data exist on respiratory effects of indoor air quality and comfort parameters in the elderly. In the context of the GERIE study, we investigated for the first time the relationships of these factors to respiratory morbidity among elderly people permanently living in nursing homes in seven European countries. 600 elderly people from 50 nursing homes underwent a medical examination and completed a standardised questionnaire. Air quality and comfort parameters were objectively assessed in situ in the nursing home. Mean concentrations of air pollutants did not exceed the existing standards. Forced expiratory volume in 1 s/forced vital capacity ratio was highly significantly related to elevated levels of particles with a 50% cut-off aerodynamic diameter of indoor air quality affected respiratory health in elderly people permanently living in nursing homes, with frailty increasing with age. The effects were modulated by ventilation. Copyright ©ERS 2015.

  18. Back Facts: A Training Workbook to Prevent Back Injuries in Nursing Homes

    Science.gov (United States)

    ... to prevent back injuries in nursing homes Back Facts - A training workbook to prevent back injuries in ... past 10 years? List three or four responses. Fact Sheet 1 Good news, bad news and back ...

  19. Optimizing Antibiotic Stewardship in Nursing Homes: A Narrative Review and Recommendations for Improvement.

    Science.gov (United States)

    Crnich, Christopher J; Jump, Robin; Trautner, Barbara; Sloane, Philip D; Mody, Lona

    2015-09-01

    The emerging crisis in antibiotic resistance and concern that we now sit on the precipice of a post-antibiotic era have given rise to advocacy at the highest levels for widespread adoption of programmes that promote judicious use of antibiotics. These antibiotic stewardship programmes, which seek to optimize antibiotic choice when clinically indicated and discourage antibiotic use when clinically unnecessary, are being implemented in an increasing number of acute care facilities, but their adoption has been slower in nursing homes. The antibiotic prescribing process in nursing homes is fundamentally different from that observed in hospital and clinic settings, with formidable challenges to implementation of effective antibiotic stewardship. Nevertheless, an emerging body of research points towards ways to improve antibiotic prescribing practices in nursing homes. This review summarizes the findings of this research and presents ways in which antibiotic stewardship can be implemented and optimized in the nursing home setting.

  20. The Effect of Depression on Social Engagement in Newly Admitted Dutch Nursing Home Residents.

    Science.gov (United States)

    Achterberg, Wilco; Pot, Anne Margriet; Kerkstra, Ada; Ooms, Marcel; Muller, Martien; Ribbe, Miel

    2003-01-01

    Studies the effect of depression on social engagement among newly admitted nursing home residents. Results reveal that residents with depression were significantly more often found to have low social engagement. (Contains 26 references and 3 tables.) (GCP)