WorldWideScience

Sample records for home health nursing

  1. Health Information Technology and Nursing Homes

    Science.gov (United States)

    Liu, Darren

    2009-01-01

    Nursing homes are considered lagging behind in adopting health information technology (HIT). Many studies have highlighted the use of HIT as a means of improving health care quality. However, these studies overwhelmingly do not provide empirical information proving that HIT can actually achieve these improvements. The main research goal of this…

  2. Use of Clinical Health Information Technology in Nursing Homes: Nursing Home Characteristics and Quality Measures

    Science.gov (United States)

    Spinelli-Moraski, Carla

    2014-01-01

    This study compares quality measures among nursing homes that have adopted different levels of clinical health information technology (HIT) and examines the perceived barriers and benefits of the adoption of electronic health records as reported by Nursing Home Administrators and Directors of Nursing. A cross-sectional survey distributed online to…

  3. Mental health consultation in a nursing home.

    Science.gov (United States)

    Kennedy, B; Covington, K; Evans, T; Williams, C A

    2000-11-01

    As the world's population ages, increasing numbers of people can anticipate spending their latter years in long-term care settings. Many of these nursing home residents will also present psychiatric illnesses as primary or secondary diagnoses. The resulting behavioral problems may present challenges to nursing staff that they are ill-prepared to meet. This article illustrates the application of the Blake and Mouton consultation model to a Veterans Administration (VA) nursing home situation by a team of psychiatric mental health nurse specialists. The consultation is described and interpreted in terms of the Blake and Mouton model. The focal conflicts addressed in the consultation included issues of morale/cohesion, power/authority, and norms/standards. Interventions used were acceptant, prescriptive, confrontation, and theories/principles. The model provided a useful structure for conceptualizing and organizing assessment and intervention in the consultation situation.

  4. Oral health in Florida nursing homes.

    Science.gov (United States)

    Murray, P E; Ede-Nichols, D; Garcia-Godoy, F

    2006-11-01

    The purpose of this study was to measure the oral health and hygiene status among 265 South Florida nursing home residents aged between 45 and 98 years. The oral health and hygiene status of the residents were assessed by noting the presence of calculus, caries, gingivitis, cheilitis, apthous ulcer, dry mouth and red or white lesions. The incidence of nursing home residents with calculus was 79.6% and the remaining 20.4% were edentulous. More than half of residents had oral problems (50.6%) the commonest was gingivitis (36.6%), followed by caries (26%) and tooth fracture (15.9%). Almost half the residents wore dentures (47.2%). Statistical analysis was conducted using analysis of variance (P-values). Ageing of the residents was statistically correlated to a worsening of oral hygiene status (Pneglect affects almost all of the nursing home residents. Care providers should receive education and training from dental hygienists to improve the standard of oral hygiene and health of the elderly.

  5. 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.

  6. 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)

  7. Medicare home health utilization as a function of nursing home market factors.

    OpenAIRE

    Swan, J H; Benjamin, A E

    1990-01-01

    Rapid increases in the size and costs of the home health market, unknown impacts of Medicare's DRG hospital reimbursement on the posthospital market, and general lack of knowledge about factors that explain interstate variation in home health utilization all suggest the importance of developing and testing models of Medicare home health use. This article proposes and tests a model of state home health utilization as a function of the nursing home market. This model proposes that home health u...

  8. Evaluating home health care nursing outcomes with OASIS and NOC.

    Science.gov (United States)

    Schneider, Julia Stocker; Barkauskas, Violet; Keenan, Gail

    2008-01-01

    To determine the sensitivity and responsiveness of the Outcome and Assessment Information Set (OASIS) and the Nursing Outcomes Classification (NOC) to the effects of home healthcare nursing interventions. A quasi-experimental before-after study was conducted using a sample of 106 home healthcare participants referred to one of seven participating Midwest home healthcare agencies for treatment of a cardiac condition. Patient outcomes data were collected at home healthcare admission and discharge using OASIS and NOC. Nursing intervention data were collected at each visit using the Nursing Interventions Classification (NIC). Intervention intensity was calculated by totaling the number of NIC interventions provided over the episode of care. Neither OASIS nor NOC were sensitive to the effects of home healthcare nursing as measured by intervention intensity. The OASIS was not responsive to clinically discernable changes in patient outcomes; while the NOC was responsive to patient status change in the outcome categories including activities of daily living, cardiopulmonary status, coping, and illness management behavior. Outcome measures that are more condition-specific and discipline-specific are more responsive to the effects of home healthcare nursing. Further research is needed to identify and refine outcome measures that are sensitive and responsive to the effects of nursing care in home health and other nursing settings. The use of outcome measures that are more sensitive and responsive to nursing are more effective in guiding nursing practice.

  9. A nurse owned and managed home health agency.

    Science.gov (United States)

    Mariott, J

    1996-01-01

    The downsizing epidemic that has swept across the country's acute care facilities has forced many nurses to reassess their goals and explore different career options. Home care has become an important alternative to hospital nursing for many nurses. During a management reorganization of a major medical center in Oakland, California, in early 1993, several middle managers in the nursing department were laid off. What started as informal, support group meetings to help one another face the transition and explore new career alternatives led to the formation of Professional Health Care at Home (PHCH). PHCH is a nurse owned and operated home care agency serving homebound patients in the San Francisco Bay Area. In these initial meetings, many nurses expressed an interest in home care and discovered the talent in their group that enabled them to start their own company.

  10. Complexity of occupational exposures for home health-care workers: nurses vs. home health aides.

    Science.gov (United States)

    Hittle, Beverly; Agbonifo, Noma; Suarez, Rassull; Davis, Kermit G; Ballard, Tangela

    2016-11-01

    To identify occupational exposures for home health-care nurses and aides. Home health-care workers' occupational injury rates in the USA are higher than the national average, yet research on causative exposures and hazards is limited. Participants were interviewed about annual frequency of occupational exposures and hazards. Exposure and hazard means were compared between home health-care nurses and aides using a Wilcoxon two-sample test. A majority of the sample was over 40 years old and obese, potentially increasing injury risks. Home health-care nurses performed more clinical tasks, increasing exposure to blood-borne pathogens. Home health-care aides performed more physical tasks with risk for occupational musculoskeletal injuries. They also dispensed oral medications and anti-cancer medications, and were exposed to drug residue at a frequency comparable to home health-care nurses. Both groups were exposed to occupational second-hand smoke. Establishing employee safety-related policies, promoting healthy lifestyle among staff, and making engineered tools readily available to staff can assist in decreasing exposures and hazards. Implications for nursing management include implementation of health-promotion programmes, strategies to reduce exposure to second-hand smoke, ensuring access to and education on assistive and safety devices, and education for all staff on protection against drug residue. © 2016 John Wiley & Sons Ltd.

  11. Examining pediatric emergency home ventilation practices in home health nurses: Opportunities for improved care.

    Science.gov (United States)

    Kun, Sheila S; Beas, Virginia N; Keens, Thomas G; Ward, Sally S L; Gold, Jeffrey I

    2015-07-01

    To assess the pediatric home health nurses' knowledge in tracheostomy and ventilator emergency care on home mechanical ventilation (HMV). Emergencies are frightening experiences for solo home health nurses and require advanced skills in emergency response and care, especially in pediatric patients who pose unique challenges. Nurses with greater years of nursing experience would perform better on emergency HMV case-based scenarios than nurses with less years of experience. An exploratory online survey was used to evaluate emergency case-based pediatric scenarios. Demographic and professional experiences were profiled. Seventy-nine nurses had an average of 6.73 (SD = 1.41) years in pediatric nursing. Over 70% received their HMV training in their agency, 41% had less than 4 years of experience, and 30.4% had encountered at least one emergency situation at home. The online survey was distributed by managers of 22 home health agencies to nurses providing pediatric HMV care. Nurses scored an average of 4.87 out of 10 possible points. There were no significant differences between nurses with nurses favored more training in HMV from a variety of settings (e.g., agency, on-line training). Nurses did not perform well in case-based ventilator alarm scenarios. Length of nursing experience did not differentiate greater knowledge. It is clear that nurses require and want more training in emergency-based HMV. Recommendations for an enhanced curriculum are suggested. © 2014 Wiley Periodicals, Inc.

  12. Nursing Homes

    Science.gov (United States)

    ... homes have nursing aides and skilled nurses on hand 24 hours a day. Some nursing homes are set up like a hospital. The staff provides medical care, as well as physical, speech and occupational therapy. There might be a nurses' station on each ...

  13. 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…

  14. Visiting nurses' posthospital medication management in home health care

    DEFF Research Database (Denmark)

    Kollerup, Mette Geil; Curtis, Tine; Schantz Laursen, Birgitte

    2017-01-01

    . Thus, many patients are discharged with complex medication regimen instructions, accentuating the risk of medication errors that may cause readmission, adverse drug events and a need for further health care. AIM: The aim of this study was to explore visiting nurses' medication management in home health...... care after hospital discharge and to identify key elements in patient medication for improved patient safety. METHOD: Inspired by the ethnographic research cycle, participant observations and informal interviews were conducted at 12 initial visits by a nurse in a patient's home after hospital discharge...

  15. 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...

  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 quality...

  17. Mental health service use by the elderly in nursing homes.

    Science.gov (United States)

    Burns, B J; Wagner, H R; Taube, J E; Magaziner, J; Permutt, T; Landerman, L R

    1993-03-01

    Because current Omnibus Budget Reconciliation Act regulations influence the disposition of US nursing home residents who have mental illness, National Nursing Home Survey (1985) data are analyzed for predictors of mental health service use. Elderly residents' rates of mental health service use are presented. Logistic regression yielded odds ratios for treatment by both mental health specialists and general practitioners for client and service system variables. Among the two thirds of elderly residents with a mental disorder (including dementia), only 4.5% receive any mental health treatment in a 1-month period. The ratio of specialist to general practitioner care is approximately 1:1. Patients seen by a specialist are likely to be younger (aged 65 to 74); live in the Northeast; and have a diagnosis of schizophrenia (13:1), dementia (3:1), or other mental disorders (5:1). Prior residence in a psychiatric hospital predicts care by both health professional types. Rural location, nonproprietary ownership of the nursing home, and aggressive behavior point to general physician care. Our findings indicate significant neglect of the mental health needs of older nursing home residents and underscore the importance of monitoring the regulations for screening and treatment of mental disorders under the Omnibus Budget Reconciliation Act.

  18. Development of the International Guidelines for Home Health Nursing.

    Science.gov (United States)

    Narayan, Mary; Farris, Cindy; Harris, Marilyn D; Hiong, Fong Yoke

    2017-10-01

    Throughout the world, healthcare is increasingly being provided in home and community-based settings. There is a growing awareness that the most effective, least costly, patient-preferred setting is patients' home. Thus, home healthcare nursing is a growing nursing specialty, requiring a unique set of nursing knowledge and skills. Unlike many other nursing specialties, home healthcare nursing has few professional organizations to develop or support its practice. This article describes how an international network of home healthcare nurses developed international guidelines for home healthcare nurses throughout the world. It outlines how the guidelines for home healthcare nursing practice were developed, how an international panel of reviewers was recruited, and the process they used for reaching a consensus. It also describes the plan for nurses to contribute to future updates to the guidelines.

  19. Nursing Homes

    Science.gov (United States)

    ... to time. At least one-third of nursing home residents have problematic behaviors. These behaviors may include verbal and physical abuse, ... accessible are they? How close is the nursing home to family members? How close is it to the ... is the food like? How much do basic services cost? What ...

  20. Comparing Sleep Quality and General Health Among the Elderly Living at Home and at Nursing Home

    Directory of Open Access Journals (Sweden)

    Mansour Beyrami

    2014-01-01

    Full Text Available Objectives: Survey about the issues and problems related to elderly in order to improve their quality of life of this increasing population has become a universal concern.This study was performed by the purpose of comparing the sleep quality and general health among the Elderly Residing at Home and Old People's Homes. Methods & Materials: This study is descriptive-analytic type. Population of this investigation consisted of elderly men and women (upper than 60 years old living at personal home and at nursing home in Tabriz. Sample group composed of 100 elderly (50 men and 50 women 50 living at home and 50 living at nursing home who were selected through available sampling method. For collecting data, Goldberg General Health Questionnaire and Pittsburgh Sleep Quality Index were used. Data were analyzed by Multivariate analysis of variance (MANOVA. Results: Findings showed that In terms of general health and its components (Physical symptoms, anxiety, social dysfunction and depression and Sleep quality and its components (Subjective quality of sleep, time for sleep, total sleep time, sleep efficiency, routine, sleep disorders, sleep medications and daily dysfunction there were significant differences between nursing home residents and elderly residents in nursing homes (P=0.001. Conclusion: Findings indicated that elderly residents in nursing home are experiencing more symptoms of anxiety, depression, physical symptoms and social dysfunction Compared with the elderly whom resident at home. Also the results showed that the elderly residents of nursing homes have poor sleep quality than ones whom residents at home. On the other hand Future development of elderly care institution is inevitable. Therefore, more attention to the living conditions of elderly residents of institutions seems necessary.

  1. 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

  2. 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…

  3. 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…

  4. 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...

  5. Oral health educational interventions for nursing home staff and residents.

    Science.gov (United States)

    Albrecht, Martina; Kupfer, Ramona; Reissmann, Daniel R; Mühlhauser, Ingrid; Köpke, Sascha

    2016-09-30

    Associations between nursing home residents' oral health status and quality of life, respiratory tract infections, and nutritional status have been reported. Educational interventions for nurses or residents, or both, focusing on knowledge and skills related to oral health management may have the potential to improve residents' oral health. To assess the effects of oral health educational interventions for nursing home staff or residents, or both, to maintain or improve the oral health of nursing home residents. We searched the Cochrane Oral Health Trials Register (to 18 January 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2015, Issue 12), MEDLINE Ovid (1946 to 18 January 2016), Embase Ovid (1980 to 18 January 2016), CINAHL EBSCO (1937 to 18 January 2016), and Web of Science Conference Proceedings (1990 to 18 January 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 18 January 2016. In addition, we searched reference lists of identified articles and contacted experts in the field. We placed no restrictions on language or date of publication when searching the electronic databases. Randomised controlled trials (RCTs) and cluster-RCTs comparing oral health educational programmes for nursing staff or residents, or both with usual care or any other oral healthcare intervention. Two review authors independently screened articles retrieved from the searches for relevance, extracted data from included studies, assessed risk of bias for each included study, and evaluated the overall quality of the evidence. We retrieved data about the development and evaluation processes of complex interventions on the basis of the Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare: revised guideline (CReDECI 2). We contacted authors of relevant studies for additional information. We included nine RCTs involving

  6. Work-Family Conflict, Sleep, and Mental Health of Nursing Assistants Working in Nursing Homes.

    Science.gov (United States)

    Zhang, Yuan; Punnett, Laura; Nannini, Angela

    2017-07-01

    Work-family conflict is challenging for workers and may lead to depression, anxiety, and overall poor health. Sleep plays an important role in the maintenance of mental health; however, the role of sleep in the association between work-family conflict and mental health is not well-studied. Questionnaires were collected from 650 nursing assistants in 15 nursing homes. Multivariate linear regression modeling demonstrated that increased work-family conflict was associated with lower mental health scores (β = -2.56, p nursing assistants' mental health should increase their control over work schedules and responsibilities, provide support to meet their work and family needs, and address healthy sleep practices.

  7. 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...

  8. 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.

  9. Ensuring Quality Nursing Home Care

    Science.gov (United States)

    ... leadership positions are very important to maintaining quality care in the nursing home. Here are some things to look for ... symptoms, and health problems. May 2013 Ensuring Quality Nursing Home Care Expert information from Healthcare Professionals Who Specialize in ...

  10. 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...

  11. 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...

  12. 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.

  13. [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.

  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. Quality of Mental Health Care for Nursing Home Residents: A Literature Review

    Science.gov (United States)

    Grabowski, David C.; Aschbrenner, Kelly A.; Rome, Vincent F.; Bartels, Stephen J.

    2010-01-01

    Because of the high proportion of nursing home residents with a mental illness other than dementia, the quality of mental health care in nursing homes is a major clinical and policy issue. The authors apply Donabedian's framework for assessing quality of care based on the triad of structure, process, and outcome-based measures in reviewing the literature on the quality of mental health care in nursing homes. Quality measures used within the literature include mental health consultations and hospitalizations, inappropriate use of medications, and mental health survey deficiencies. Factors related to the resident's welfare (nurse staffing), provider norms (locality), and financial factors (payer mix) were associated with the quality of mental health care. Although future research is necessary, the extant literature suggests that persons with mental illness are frequently admitted to nursing homes and their care is often of poor quality and related to a series of resident and facility factors. PMID:20223943

  16. FastStats: Nursing Home Care

    Science.gov (United States)

    ... Adult Day Services Centers Home Health Care Hospice Care Nursing Home Care Residential Care Communities Screenings Mammography Pap ... this? Submit What's this? Submit Button NCHS Home Nursing Home Care Recommend on Facebook Tweet Share Compartir Data are ...

  17. Health of health care workers in Canadian nursing homes and pediatric hospitals: a cross-sectional study.

    Science.gov (United States)

    Hoben, Matthias; Knopp-Sihota, Jennifer A; Nesari, Maryam; Chamberlain, Stephanie A; Squires, Janet E; Norton, Peter G; Cummings, Greta G; Stevens, Bonnie J; Estabrooks, Carole A

    2017-11-21

    Poor health of health care workers affects quality of care, but research and health data for health care workers are scarce. Our aim was to compare physical/mental health among health care worker groups 1) within nursing homes and pediatric hospitals, 2) between the 2 settings and 3) with the physical/mental health of the Canadian population. Using cross-sectional data collected as part of the Translating Research in Elder Care program and the Translating Research on Pain in Children program, we examined the health of health care workers. In nursing homes, 169 registered nurses, 139 licensed practical nurses, 1506 care aides, 145 allied health care providers and 69 managers were surveyed. In pediatric hospitals, 63 physicians, 747 registered nurses, 155 allied health care providers, 49 nurse educators and 22 managers were surveyed. After standardization of the data for age and sex, we applied analyses of variance and general linear models, adjusted for multiple testing. Nursing home workers and registered nurses in pediatric hospitals had poorer mental health than the Canadian population. Scores were lowest for registered nurses in nursing homes (mean difference -4.4 [95% confidence interval -6.6 to -2.6]). Physicians in pediatric hospitals and allied health care providers in nursing homes had better physical health than the general population. We also found important differences in physical/mental health for care provider groups within and between care settings. Mental health is especially poor among nursing home workers, who care for a highly vulnerable and medically complex population of older adults. Strategies including optimized work environments are needed to improve the physical and mental health of health care workers to ameliorate quality of patient care. Copyright 2017, Joule Inc. or its licensors.

  18. Burnout in the nursing home health care aide: A systematic review

    OpenAIRE

    Cooper, Sarah L.; Carleton, Heather L.; Chamberlain, Stephanie A.; Cummings, Greta G; Bambrick, William; Estabrooks, Carole A

    2016-01-01

    Objective: To systematically review the evidence on factors that influence burnout in health care aides working in nursing homes. Design: Systematic literature review. Data sources: Two search engines (Google and EBSCO Discovery Service) and five databases (MEDLINE, Scopus, CINAHL, PsycINFO and Proquest Dissertations & Theses) through to August 2013. Keywords: nursing home, health care aide and burnout (all synonyms were included). Methods: Two authors independently assessed methodol...

  19. Oral health problems and needs of nursing home residents.

    Science.gov (United States)

    Kiyak, H A; Grayston, M N; Crinean, C L

    1993-02-01

    The problem of dental neglect and high levels of unmet dental needs among elderly residents of long term care facilities has been widely documented in literature. A survey was conducted of 1063 residents in 31 nursing homes throughout Washington (representing 11% of all facilities in the state). The greatest single need among dentate elderly was for routine oral hygiene (72%), while for denture wearers adjustment of loose dentures was the primary need (46.4%). Periodontal problems were slightly more prevalent than root caries (43% and 36% respectively) among dentate elderly. Dry mouth was found in 10% of residents. Oral conditions were worse in larger facilities located in rural and moderate size communities, and those under a proprietary corporation. These results suggest that daily oral hygiene and regular check-ups by a dental professional are most needed by frail elderly, especially in large, proprietary homes in rural and moderate size communities. Education of nursing home staff and the elderly themselves in the importance and methods of home care are also critical needs.

  20. Multilevel examination of facility characteristics, social integration, and health for older adults living in nursing homes.

    Science.gov (United States)

    Leedahl, Skye N; Chapin, Rosemary K; Little, Todd D

    2015-01-01

    Testing a model based on past research and theory, this study assessed relationships between facility characteristics (i.e., culture change efforts, social workers) and residents' social networks and social support across nursing homes; and examined relationships between multiple aspects of social integration (i.e., social networks, social capital, social engagement, social support) and mental and functional health for older adults in nursing homes. Data were collected at nursing homes using a planned missing data design with random sampling techniques. Data collection occurred at the individual-level through in-person structured interviews with older adult nursing home residents (N = 140) and at the facility-level (N = 30) with nursing home staff. The best fitting multilevel structural equation model indicated that the culture change subscale for relationships significantly predicted differences in residents' social networks. Additionally, social networks had a positive indirect relationship with mental and functional health among residents primarily via social engagement. Social capital had a positive direct relationship with both health outcomes. To predict better social integration and mental and functional health outcomes for nursing homes residents, study findings support prioritizing that close relationships exist among staff, residents, and the community as well as increased resident social engagement and social trust. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Meals in nursing homes

    DEFF Research Database (Denmark)

    Kofod, Jens Erik; Birkemose, A.

    2004-01-01

    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....... 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...

  2. Home health agency preferences for staff nurse qualifications, and practices in hiring and orientation.

    Science.gov (United States)

    Kalnins, I

    1989-06-01

    The purpose of this study was to describe home health agency preferences with respect to staff nurse qualifications, and practices in hiring and orienting new staff. An 85-item home health staff nurse selection and orientation questionnaire was used to collect data from a random sample of 287 midwestern home health agencies in 12 states. Qualifications rated most highly were medical-surgical experience, venipuncture skills, completion of a physical assessment course, intravenous therapy skills, and patient-teaching skills. With agency sponsorship (traditional, proprietary, and hospital-based) as the independent variable, the three types of agencies were significantly different on ratings of six qualifications and six orientation topics. None of the agencies rated a BSN degree as very important or required, and the same was true for completion of a student experience in community health nursing. Preference for qualifications in this study is consistent with increasing acuteness of patients' illness and technologic complexity of home care.

  3. Multilevel Examination of Facility Characteristics, Social Integration, and Health for Older Adults Living in Nursing Homes

    OpenAIRE

    Skye N. Leedahl; Rosemary K. Chapin; Little, Todd D.

    2015-01-01

    Objectives. Testing a model based on past research and theory, this study assessed relationships between facility characteristics (i.e., culture change efforts, social workers) and residents’ social networks and social support across nursing homes; and examined relationships between multiple aspects of social integration (i.e., social networks, social capital, social engagement, social support) and mental and functional health for older adults in nursing homes.

  4. The caring behaviors of the home health nurse and influence on medication adherence.

    Science.gov (United States)

    Owens, Rhoda A

    2006-09-01

    The purpose of this study was to determine if the caring behaviors of the home health nurse toward the patient influence the patient's medication adherence. The study focused on what effects the verbal and nonverbal caring behaviors of the nurse toward the patient have on the patient's medication adherence. How is the patient's perception of caring by the nurse related to his or her medication adherence? The study was conducted in a Midwestern home health agency over a 4-week period. Findings indicated an improvement in the use of verbal and nonverbal caring behaviors by the nurses with their patients. The patients perceived an increased use of these caring behaviors by the nurses with them. The patients' medication adherence and barriers to adherence improved. Other significant findings indicated that the verbal and nonverbal caring behaviors of the nurses and the patients' perception of the caring behaviors influenced and improved the patients' medication adherence by week 4.

  5. 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

    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...... 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...

  6. Home health nurses: stress, self-esteem, social intimacy, and job satisfaction.

    Science.gov (United States)

    Moore, S; Lindquist, S; Katz, B

    1997-06-01

    A survey of 253 home health care nurses' perceptions of work-related stress, self-esteem, social intimacy, and job satisfaction found that stress has a negative correlation with self-esteem, social intimacy, and job satisfaction. A positive correlation, however, was found between self-esteem and social intimacy and job satisfaction. Health system administrators, owners, and directors had significantly higher levels of self-esteem, nurses with 5 years or more in their home health nursing position had significantly higher levels of self-esteem. The survey found that nurses with less than a baccalaureate degree possessed significantly lower levels of sociability than those with a graduate or baccalaureate degree. Administrators and managers scored significantly higher on sociability than head nurses.

  7. Testing an app for reporting health concerns-Experiences from older people and home care nurses.

    Science.gov (United States)

    Göransson, Carina; Eriksson, Irene; Ziegert, Kristina; Wengström, Yvonne; Langius-Eklöf, Ann; Brovall, Maria; Kihlgren, Annica; Blomberg, Karin

    2017-12-05

    To explore the experiences of using an app among older people with home-based health care and their nurses. Few information and communication technology innovations have been developed and tested for older people with chronic conditions living at home with home-based health care support. Innovative ways to support older people's health and self-care are needed. Explorative qualitative design. For 3 months to report health concerns, older people receiving home-based health care used an interactive app, which included direct access to self-care advice, graphs and a risk assessment model that sends alerts to nurses for rapid management. Interviews with older people (n = 17) and focus group discussions with home care nurses (n = 12) were conducted and analysed using thematic analysis. The findings reveal that a process occurs. Using the app, the older people participated in their care, and the app enabled learning and a new way of communication. The interaction gave a sense of security and increased self-confidence among older people. The home care nurses viewed the alerts as appropriate for the management of health concerns. However, all participants experienced challenges in using new technology and had suggestions for improvement. The use of an app appears to increase the older people's participation in their health care and offers them an opportunity to be an active partner in their care. The app as a new way to interact with home care nurses increased the feeling of security. The older people were motivated to learn to use the app and described potential use for it in the future. The use of an app should be considered as a useful information and communication technology innovation that can improve communication and accessibility for older people with home-based health care. © 2017 John Wiley & Sons Ltd.

  8. 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.

  9. The integration of oral health care into day-to-day care in nursing homes: a qualitative study.

    NARCIS (Netherlands)

    Visschere, L. De; Baat, C. de; Meyer, L.; Putten, G.J. van der; Peeters, B.; Soderfelt, B.; Vanobbergen, J.

    2015-01-01

    OBJECTIVE: This qualitative study explored barriers and enabling factors to the implementation of an oral hygiene protocol in nursing homes. BACKGROUND: Oral health care in nursing homes in Flanders (Belgium) is inadequate. MATERIALS AND METHODS: Qualitative data were obtained from nurses employed

  10. Community Level Association between Home Health and Nursing Home Performance on Quality and Hospital 30-day Readmissions for Medicare Patients

    Science.gov (United States)

    Wang, Yun; Pandolfi, Michelle M.; Fine, Jonathan; Metersky, Mark L.; Wang, Changqin; Ho, Shih-Yieh; Galusha, Deron; Nuti, Sudhakar V.; Murugiah, Karthik; Spenard, Ann; Elwell, Timothy; Krumholz, Harlan M.

    2016-01-01

    We evaluated whether community-level home health agencies and nursing home performance is associated with community-level hospital 30-day all-cause risk-standardized readmission rates for Medicare patients used data from the Centers for Medicare & Medicaid Service from 2010 to 2012. Our final sample included 2,855 communities that covered 4,140 hospitals with 6,751,713 patients, 13,060 nursing homes with 1,250,648 residents, and 7,613 home health agencies providing services to 35,660 zipcodes. Based on a mixed effect model, we found that increasing nursing home performance by one star for all of its 4 measures and home health performance by 10 points for all of its 6 measures is associated with decreases of 0.25% (95% CI 0.17–0.34) and 0.60% (95% CI 0.33–0.83), respectively, in community-level risk-standardized readmission rates. PMID:27974869

  11. Safety Risks Among Home Infusion Nurses and Other Home Health Care Providers

    Science.gov (United States)

    Galligan, Catherine; Quinn, Margaret

    2017-01-01

    In the United States, home health care (HHC) is a rapidly growing industry and home infusion therapy is a rapidly growing market. HHC can present substantial occupational safety and health (OSH) risks. This article summarizes major OSH risks relevant to home infusion therapy by illustrating them through real-life scenarios collected systematically using qualitative research methods by the National Institute for Occupational Safety and Health-funded research projects at the University of Massachusetts Lowell. The need for home infusion therapy will continue to grow in the future, and safety interventions to prevent or minimize OSH risks are essential. PMID:28683000

  12. Visiting nurses' posthospital medication management in home health care: an ethnographic study.

    Science.gov (United States)

    Kollerup, Mette Geil; Curtis, Tine; Schantz Laursen, Birgitte

    2017-08-03

    Medication management is the most challenging component of a successful transition from hospital to home, a challenge of growing complexity as the number of older persons living with chronic conditions grows, along with increasingly specialised and accelerated hospital treatment plans. Thus, many patients are discharged with complex medication regimen instructions, accentuating the risk of medication errors that may cause readmission, adverse drug events and a need for further health care. The aim of this study was to explore visiting nurses' medication management in home health care after hospital discharge and to identify key elements in patient medication for improved patient safety. Inspired by the ethnographic research cycle, participant observations and informal interviews were conducted at 12 initial visits by a nurse in a patient's home after hospital discharge. Data consisted of field notes and photographs from the patients' homes, medication lists and medical records. Field notes were analysed in four steps. The analysis showed 12 stages in medication management in which nurses strove to adjust medication management to the patients' actual health status by mediating on knowledge of the patient, information to the patient and on rules and regulations and by establishing order in medication lists and medications in the home. The nurse-patient relationship, the integration of care and the context of care challenged patient safety in visiting nurses' medication management in patients' homes after hospital discharge. The implications for practice were the following: to ensure nurses' opportunities to continuously evolve their observation skills and skills in making sound clinical judgements; to establish interprofessional working processes which support the continuous assessment of patients' needs and the adjustment of care and treatment; to clarify expectations to nurses' responsibility and patients' privacy. © 2017 Nordic College of Caring Science.

  13. The Natural History of Nursing Home Patients.

    Science.gov (United States)

    Lewis, Mary Ann; And Others

    1985-01-01

    Former nursing home residents (N=197) were followed for 2 years after discharge. Four subgroups of patients were identified on the basis of different patterns of survival and use of health care resources: those who returned home, died in nursing homes, transferred to hospitals, or transferred to other nursing homes. (NRB)

  14. Sharps injuries and other blood and body fluid exposures among home health care nurses and aides.

    Science.gov (United States)

    Quinn, Margaret M; Markkanen, Pia K; Galligan, Catherine J; Kriebel, David; Chalupka, Stephanie M; Kim, Hyun; Gore, Rebecca J; Sama, Susan R; Laramie, Angela K; Davis, Letitia

    2009-11-01

    We quantified risks of sharp medical device (sharps) injuries and other blood and body fluid exposures among home health care nurses and aides, identified risk factors, assessed the use of sharps with safety features, and evaluated underreporting in workplace-based surveillance. We conducted a questionnaire survey and workplace-based surveillance, collaborating with 9 home health care agencies and 2 labor unions from 2006 to 2007. Approximately 35% of nurses and 6.4% of aides had experienced at least 1 sharps injury during their home health care career; corresponding figures for other blood and body fluid exposures were 15.1% and 6.7%, respectively. Annual sharps injuries incidence rates were 5.1 per 100 full-time equivalent (FTE) nurses and 1.0 per 100 FTE aides. Medical procedures contributing to sharps injuries were injecting medications, administering fingersticks and heelsticks, and drawing blood. Other contributing factors were sharps disposal, contact with waste, and patient handling. Sharps with safety features frequently were not used. Underreporting of sharps injuries to the workplace-based surveillance system was estimated to be about 50%. Sharps injuries and other blood and body fluid exposures are serious hazards for home health care nurses and aides. Improvements in hazard intervention are needed.

  15. Work-home interference among nurses: reciprocal relationships with job demands and health

    NARCIS (Netherlands)

    van der Heijden, Beatrice; Demerouti, Evangelia; Bakker, Arnold B.; Hasselhorn, Hans Martin

    2008-01-01

    Aims: This paper is a report of a study with three aims: (i) to investigate whether emotional, quantitative and physical demands have a causal, negative impact on nurses' health; (ii) to examine whether work-home interference can explain this effect, by playing a mediating role; and (iii) to test

  16. 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...

  17. Sharps Injuries and Other Blood and Body Fluid Exposures Among Home Health Care Nurses and Aides

    Science.gov (United States)

    Markkanen, Pia K.; Galligan, Catherine J.; Kriebel, David; Chalupka, Stephanie M.; Kim, Hyun; Gore, Rebecca J.; Sama, Susan R.; Laramie, Angela K.; Davis, Letitia

    2009-01-01

    Objectives. We quantified risks of sharp medical device (sharps) injuries and other blood and body fluid exposures among home health care nurses and aides, identified risk factors, assessed the use of sharps with safety features, and evaluated underreporting in workplace-based surveillance. Methods. We conducted a questionnaire survey and workplace-based surveillance, collaborating with 9 home health care agencies and 2 labor unions from 2006 to 2007. Results. Approximately 35% of nurses and 6.4% of aides had experienced at least 1 sharps injury during their home health care career; corresponding figures for other blood and body fluid exposures were 15.1% and 6.7%, respectively. Annual sharps injuries incidence rates were 5.1 per 100 full-time equivalent (FTE) nurses and 1.0 per 100 FTE aides. Medical procedures contributing to sharps injuries were injecting medications, administering fingersticks and heelsticks, and drawing blood. Other contributing factors were sharps disposal, contact with waste, and patient handling. Sharps with safety features frequently were not used. Underreporting of sharps injuries to the workplace-based surveillance system was estimated to be about 50%. Conclusions. Sharps injuries and other blood and body fluid exposures are serious hazards for home health care nurses and aides. Improvements in hazard intervention are needed. PMID:19890177

  18. [Training for nurse coordinators in nursing homes].

    Science.gov (United States)

    Martin, Jean-René

    2016-01-01

    For the last three years, the Poitou-Charentes regional health agency has organised and funded training for nurse coordinators in nursing homes. The training programme, created in partnership with the Poitiers healthcare manager training institute, enables professionals with multiple responsibilities and missions, who deserve greater recognition, to acquire the necessary skills. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. Burnout in the nursing home health care aide: A systematic review

    Directory of Open Access Journals (Sweden)

    Sarah L. Cooper

    2016-09-01

    Conclusion: Factors associated with burnout in health care aides are similar to those reported among nurses, although the level of evidence and low methodological rigor of these studies suggest more robust study designs are warranted. Our findings suggest research focused on this important but largely invisible group of care providers could yield important advances in understanding burnout in this group and yield potential interventions to buffer burnout and its consequences. Without mitigating the effects of burnout on nursing home health care aides, vulnerable older adults in residential care are at risk.

  20. Discharge planning in nursing homes.

    OpenAIRE

    Murtaugh, C M

    1994-01-01

    OBJECTIVE. The purpose of this study is to identify nursing home residents who vary in their discharge planning needs. DATA SOURCES AND STUDY SETTING. Administrative records from a database maintained by the National Health Corporation were the primary data source. The 3,883 persons studied were admitted in 1982 to one of 48 nursing homes located in Tennessee, other southern states, and Missouri. STUDY DESIGN. Residents were followed until discharge or for one year, whichever occurred first. ...

  1. Frailty decreases physical health domain of quality of life in nursing home elderly

    Directory of Open Access Journals (Sweden)

    Yvonne Suzy Handajani

    2016-04-01

    The percentages of respondents with pre-frail, frail, and non-frail status were 30.4%, 52.2%, and 17.4%, respectively. A decline in QOL scores of pre-frail and frail respondents was found for almost all QOL domains (physical, psychological and environment domains, except social relationships. The subdomains most influenced were “energy and fatigue” in the physical health domain, “thinking, learning, memory and concentration” in psychological health, and “opportunities for acquiring new information and skills” in the environment domain. CONCLUSIONS More than half of the nursing home elderly were frail and one-third were pre-frail. The main factor of frailty was weakness. The frailty syndrome in the elderly has a negative impact on QOL, especially in the physical health, psychological and environment domains in nursing home elderly.

  2. The Relationship between Health Promoting Behaviors and Quality of Life in Nursing Home Residents in Kayseri

    Directory of Open Access Journals (Sweden)

    Vesile Şenol

    2014-01-01

    Full Text Available Background and Aims. Healthy lifestyle behaviors are the major determinant of both prevention health and health related quality of life. The aim of this study was to examine the relationship between health-promoting behaviors and quality of life of elderly individuals living in nursing homes. Methods. The study was performed between October 2008 and 2009, in the city of Kayseri in Turkey, upon 136 individuals, aged 65 and above, living in the Gazioglu Nursing Home. A sociodemographic questionnaire, Standardized Mini Mental Test, Health Promoting Lifestyle Behaviors Profile (HPLP, and WHOQOL-OLD module were used for the gathering of data. Results. The overall HPLP and quality of life (QoL scores were 118.06±20.54 and 43.45±10.30, respectively. More than half of the participants have higher points than the mean QoL scores. The HPLP scores of these subjects were significantly higher compared to those with lower points than mean QoL scores. There was a positive relationship between the overall HPLP and WHOQOL-OLD mean scores, except for the autonomy and sensorial function domains. Conclusions. The study result showed that health-promoting behaviors are positively associated with better quality of life scores in the elderly subjects living in a nursing home.

  3. Health Monitoring System for Nursing Homes with Lightweight Security and Privacy Protection

    Directory of Open Access Journals (Sweden)

    Yu’e Jiang

    2017-01-01

    Full Text Available With the rapid growth of aged population in China, it is urgent to design a safe and effective monitoring system for the nursing homes. An optimized scheme and high performance security and privacy protection for monitoring system have already become the focus studied especially. So this paper proposed a health monitoring system with lightweight security and privacy protection for nursing homes. Dual-band RFID, virtual routing location algorithm, and diet and exercise data collection based on RFID were adopted to obtain the location and health information. And that fused a mobile authentication protocol based on Hash function to realize security access and privacy protection, which can improve security and reduce the complexity of calculation and the implementation cost compared with the typical authentication protocols. The experiment results show that the ratio of relative network delay is below 35%. The system has strong real-time, high security, more comprehensive data, and lower cost of computation and communication. It can satisfy the requirements of health monitoring for nursing homes.

  4. 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.

  5. Useful tool for general practitioners, home health care nurses and social workers in assessing determinants of the health status and treatment of patients visited in their homes

    Directory of Open Access Journals (Sweden)

    Andrzej Brodziak

    2012-09-01

    Full Text Available The necessity is emphasized to distinguish between the traditional model of data acquisition reported by a patient in doctor’s office and the more valuable and desired model to become acquainted with the core of the problem by going to a patient’s domicile. In the desired model it is possible to come across various determinants of health during home visits. Family members can be approached and there is a possibility to evaluate the relationships between the patient and his loved ones. One can visually assess one’s living conditions and predictable environmental hazard. For several years, the desired model has been put into practice by general practitioners and home health care nurses. Recently this model is also promoted by “health care therapists” who are members of “teams of home health care”. The authors, being convinced of the merits of “home and environmental model” of practical medicine, have developed a method of recording and illustrating data collected during visits in patient’s home. The elaborated tool helps to communicate and exchange information among general practitioners, home health care nurses, social workers of primary health care centers and specialists. The method improves the formulation of the plan of further therapeutic steps and remedial interventions in psycho-social relations and living conditions of patients.

  6. Health-related quality of life, rehabilitation and mortality in a nursing home population.

    Science.gov (United States)

    Hartog, L C; Landman, G W D; Cimzar-Sweelssen, M; Knipscheer, A; Groenier, K H; Kleefstra, N; Bilo, H J G; van Hateren, K J J

    2016-07-01

    Health-related quality of life (HRQOL) in nursing home residents is generally low. The purpose of this study was to investigate the associations between HRQOL and two clinically relevant outcome measures, all-cause mortality and successful rehabilitation, in a nursing home population. In an observational prospective cohort study in a nursing home population, HRQOL was assessed with the RAND-36. A total of 184 patients were included, 159 (86%) completed the RAND-36 and were included in the study. A Cox proportional hazard model was used to investigate the independent association between HRQOL, rehabilitation and mortality with adjustment for confounders. Risk prediction capabilities were assessed with Harrell's C statistics and the proportion of explained variance (R2). The median age (interquartile range) was 79 (75-85) years. The health dimensions vitality (HR 0.88 (95% CI 0.77-0.99)) and mental health (HR 0.86 (95% CI 0.75-0.98)) were inversely associated and role functioningphysical (HR 1.08 (95%CI 1.02-1.15)) was positively associated with mortality. The Harrell's C value and the R2 were ≤ 0.02 and ≤ 0.03 higher in the adjusted models with the dimensions role functioning- physical, mental health or vitality compared with the models without these dimensions. None of the health dimensions or summary scales were related to successful rehabilitation. HRQOL was significantly associated with mortality for three dimensions, but partly in opposite directions. Additional value of HRQOL in mortality prediction is very limited. There were no independent associations between HRQOL and successful rehabilitation. Although HRQOL is an important outcome, this study did not provide evidence for an association between HRQOL and successful rehabilitation.

  7. Tailored mental health care after nursing home admission: improving transfers of people with dementia with behavioral problems. An explorative study

    NARCIS (Netherlands)

    van Mierlo, L.D.; van der Wiel, A.; Meiland, F.J.M.; van Hout, H.P.J.; Stek, M.L.; Dröes, R.M.

    2015-01-01

    Objectives: In the Netherlands, many community-dwelling people with dementia and behavioral disturbances and their family caregivers receive mental health care from a community psychiatric nurse (CPN). To promote continuity of care for these persons after moving to a nursing home, a transfer

  8. Oral health status and physical, mental and cognitive disabilities among nursing home residents in Jordan.

    Science.gov (United States)

    Almomani, Fidaa; Hamasha, Abed Al-Hadi; Williams, Karen B; Almomani, Murad

    2015-06-01

    The purpose of this study is to describe physical, mental and cognitive disabilities and periodontal status as indicated by periodontal health, edentulism and use of dentures among nursing home residents in Jordan. A sample of 221 subjects with a mean age of 62.4 years (121 males and 100 females) from nursing home residents in Jordan were recruited to participate in this study. Oral health status, mini mental state examination (MMSE), Geriatric Depression Scale (GDS), Tinetti Assessment Battery for gait and balance (TAB) and disability of arm, shoulder and hand test (DASH) were assessed for all subjects. The response rate was about 88%. The multivariate analysis showed that the degree of upper limb disabilities, as measured by DASH, and reporting not brushing of teeth were the main risk indicators for severity of periodontal disease. Residents with dentures were found to have significantly higher cognitive abilities scores (MMSE), better upper arm abilities (DASH) and gait and balance score (TAB) in comparison with edentulous adults without dentures. Edentulous residents were found to suffer more from cognitive impairment (MMSE) than dentate residents. There was no predilection of upper limb (DASH) and lower limb (TAB) disabilities or depressive symptoms (GDS) for edentulous over dentate subjects. Results suggest that nursing home residents with a variety of physical, cognitive and psychological disabilities are at increased risk of deterioration of their oral health. All those associated with the health of residents need to be aware of this issue and take preventive and therapeutic measures as needed. © 2013 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

  9. Emancipatory practices of nurses in primary health care: the home visit as an instrument of health needs assessment

    Directory of Open Access Journals (Sweden)

    Celia Maria Sivalli Campos

    2014-08-01

    Full Text Available Objective Identify nurses’ emancipatory practices in primary care, to contribute to the improvement of health care. Method A case study type social research of qualitative nature, in which nurses of a primary health care service unit in São Paulo were interviewed. Results The home visit was identified as a nursing practice possible to be expanded in order to identify social determinants of health, triggering emancipatory practices in the service. This expansion occurred because the design of health care labour intended by the service team changed its focus from the traditional object of health services, the disease. Conclusion First, it is advocated that social policies lead projects with the purpose of improving health needs. On the other hand, the daily labour needs to provide opportunities for reflection and discussion of healthcare projects, leading workers to propose labour-processes targeted to both the social determinants of health and people’s illness.

  10. Effectiveness of wound, ostomy and continence-certified nurses on individual patient outcomes in home health care.

    Science.gov (United States)

    Bliss, Donna Z; Westra, Bonnie L; Savik, Kay; Hou, Yuefeng

    2014-01-01

    To assess whether there was a significant improvement and stabilization (not worse at discharge) in pressure ulcers, lower extremity venous ulcers, surgical wounds, urinary incontinence, bowel incontinence, and urinary tract infections in home health care (HHC) patients cared for by a certified WOC nurse. There were 449,170 episodes of care from a national convenience sample of 785 HHC agencies with 447,309 nonmaternity, adult patients between October 1, 2008, and December 31, 2009. Descriptive and comparative. Data from the Outcome and Assessment Information Set documented by HHC clinicians were analyzed using mixed-effects logistic regression, propensity score analysis, and appropriate parametric and nonparametric tests. An Internet survey identified whether WOC nurses provided care to patients in an HHC agency. Home health care agencies identified records of patients receiving WOC nurse visits/consults. An HHC patient assigned to a WOC nurse had surgical wounds, pressure ulcers, and incontinence problems that were significantly worse than HHC patients not assigned to a WOC nurse. Patients cared for by a WOC nurse showed significant improvement and stabilization of the number of pressure ulcers and surgical wounds and the frequency of urinary and bowel incontinence, despite having problems that were more severe than other patients. Home health care patients not cared for by WOC nurses, with less-severe wound and incontinence problems, also got better. WOC nurses are effective in achieving positive health outcomes for pressure ulcers, surgical wounds, and incontinence in HHC patients with severe health problems.

  11. Hospitalization Risk and Potentially Inappropriate Medications among Medicare Home Health Nursing Patients.

    Science.gov (United States)

    Lohman, Matthew C; Cotton, Brandi P; Zagaria, Alexandra B; Bao, Yuhua; Greenberg, Rebecca L; Fortuna, Karen L; Bruce, Martha L

    2017-08-28

    Hospitalizations and potentially inappropriate medication (PIM) use are significant and costly issues among older home health patients, yet little is known about the prevalence of PIM use in home health or the relationship between PIM use and hospitalization risk in this population. To describe the prevalence of PIM use and association with hospitalization among Medicare home health patients. Cross-sectional analysis using data from 132 home health agencies in the US. Medicare beneficiaries starting home health nursing services between 2013 and 2014 (n = 87,780). Prevalence of individual and aggregate PIM use at start of care, measured using the 2012 Beers criteria. Relative risk (RR) of 30-day hospitalization or re-hospitalization associated with individual and aggregate PIM use, compared to no PIM use. In total, 30,168 (34.4%) patients were using at least one PIM, with 5969 (6.8%) taking at least two PIMs according to the Beers list. The most common types of PIMs were those affecting the brain or spinal cord, analgesics, and medications with anticholinergic properties. With the exception of nonsteroidal anti-inflammatory drugs (NSAIDs), PIM use across all classes was associated with elevated risk (10-33%) of hospitalization compared to non-use. Adjusting for demographic and clinical characteristics, patients using at least one PIM (excluding NSAIDs) had a 13% greater risk (RR = 1.13, 95% CI: 1.09, 1.17) of being hospitalized than patients using no PIMs, while patients using at least two PIMs had 21% greater risk (RR = 1.21, 95% CI: 1.12, 1.30). Similar associations were found between PIMs and re-hospitalization risk among patients referred to home health from a hospital. Given the high prevalence of PIM use and the association between PIMs and hospitalization risk, home health episodes represent opportunities to substantially reduce PIM use among older adults and prevent adverse outcomes. Efforts to address medication use during home health episodes

  12. The integration of oral health care into day-to-day care in nursing homes: a qualitative study.

    Science.gov (United States)

    De Visschere, Luc; de Baat, Cees; De Meyer, Lize; van der Putten, Gert-Jan; Peeters, Bart; Söderfelt, Bjorn; Vanobbergen, Jacques

    2015-06-01

    This qualitative study explored barriers and enabling factors to the implementation of an oral hygiene protocol in nursing homes. Oral health care in nursing homes in Flanders (Belgium) is inadequate. Qualitative data were obtained from nurses employed in 13 nursing homes involved in two randomised controlled trials in Flanders-Belgium. Data were collected by focus group and face-to-face interviews during April 2005 and December 2009. All transcripts were analysed with support of NVivo 8 (Version 2008). Transcripts were intuitively analysed in a two-step method. Most revealed barriers were consistent with previous findings in the literature. Newly reported barriers were respect for residents' self-determination, experience based oral health care by nurses, residents' oral health status and nurses' inability to notice residents' oral health status. Demand-driven oral health care was found to be a strong enabling factor. The integration of oral health care into day-to-day care seems to be a major problem due to a multitude of barriers. In future implementation innovations in oral health care an a priori assessment of influencing factors is recommended. © 2013 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

  13. Health economic analyses of domiciliary dental care and care at fixed clinics for elderly nursing home residents in Sweden.

    Science.gov (United States)

    Lundqvist, M; Davidson, T; Ordell, S; Sjöström, O; Zimmerman, M; Sjögren, P

    2015-03-01

    Dental care for elderly nursing home residents is traditionally provided at fixed dental clinics, but domiciliary dental care is an emerging alternative. Longer life expectancy accompanied with increased morbidity, and hospitalisation or dependence on the care of others will contribute to a risk for rapid deterioration of oral health so alternative methods for delivering oral health care to vulnerable individuals for whom access to fixed dental clinics is an obstacle should be considered. The aim was to analyse health economic consequences of domiciliary dental care for elderly nursing home residents in Sweden, compared to dentistry at a fixed clinic. A review of relevant literature was undertaken complemented by interviews with nursing home staff, officials at county councils, and academic experts in geriatric dentistry. Domiciliary dental care and fixed clinic care were compared in cost analyses and cost-effectiveness analyses. The mean societal cost of domiciliary dental care for elderly nursing home residents was lower than dental care at a fixed clinic, and it was also considered cost-effective. Lower cost of dental care at a fixed dental clinic was only achieved in a scenario where dental care could not be completed in a domiciliary setting. Domiciliary dental care for elderly nursing home residents has a lower societal cost and is cost-effective compared to dental care at fixed clinics. To meet current and predicted need for oral health care in the ageing population alternative methods to deliver dental care should be available.

  14. FastStats: Home Health Care

    Science.gov (United States)

    ... Adult Day Services Centers Home Health Care Hospice Care Nursing Home Care Residential Care Communities Screenings Mammography Pap ... Centers Hospice Care National Study of Long-Term Care Providers Nursing Home Care Residential Care Communities Centers for Medicare ...

  15. Depression in nursing homes.

    Science.gov (United States)

    Snowdon, John

    2010-11-01

    Although studies have shown the prevalence of depression in nursing homes to be high, under-recognition of depression in these facilities is widespread. Use of screening tests to enhance detection of depressive symptoms has been recommended. This paper aims to provoke discussion about optimal management of depression in nursing homes. The utility of the Cornell Scale for Depression in Dementia (CSDD) is considered. CSDD data relating to residents assessed in 2008-2009 were collected from three Sydney nursing homes. CSDD scores were available from 162 residents, though raters stated they were unable to score participants on at least one item in 47 cases. Scores of 13 or more were recorded for 23% of residents in these facilities, but in most of these cases little was documented in case files to show that the results had been discussed by staff, or that they led to interventions, or that follow-up testing was arranged. Results of CSDD testing should prompt care staff (including doctors) to consider causation of depression in cases where residents are identified as possibly depressed. In particular, there needs to be discussion of how to help residents to cope with disability, losses, and feelings of powerlessness. Research is needed, examining factors that might predict response to antidepressants, and what else helps. Accreditation of nursing homes could be made to depend partly on evidence that staff regularly search for, and (if found) ensure appropriate responses to, depression.

  16. Nursing staff intentions towards managing deteriorating health in nursing homes: a convergent parallel mixed methods study using the Theory of Planned Behaviour.

    Science.gov (United States)

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

    2017-10-20

    To predict the factors that are most important in explaining nursing staff intentions towards early detection of the deteriorating health of a resident and providing subacute care in the nursing home setting. Nursing staff play a pivotal role in managing the deteriorating resident and determining whether the resident needs to be transferred to hospital or remain in the nursing home; however, there is a dearth of literature that explains the factors that influence their intentions. This information is needed to underpin hospital avoidance programs that aim to enhance nursing confidence and skills in this area. A convergent parallel mixed methods study, using the Theory of Planned Behaviour as a framework. Surveys and focus groups were conducted with nursing staff (n = 75) at a 94-bed nursing home at two points in time, prior to and following the implementation of a hospital avoidance program. The quantitative and qualitative data was analyzed separately and merged during final analysis. Nursing staff had strong intentions, a positive attitude that became significantly more positive with the hospital avoidance program in place, and a reasonable sense of control; however, the influence of important referents was the strongest predictor of intention towards managing residents with deteriorating health. Support from a hospital avoidance program empowered staff and increased confidence to intervene. The Theory of Planned Behaviour served as an effective framework for identifying the strong influence referents had on nursing staff intentions around managing residents with deteriorating health. Although nursing staff had a reasonable sense of control over this area of their work, they believed they benefitted from a hospital avoidance program initiated by the nursing home. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. [Fundamentals of hygiene in old-age and nursing homes. Recommendations for nursing personnel and for hygiene control by German public health offices].

    Science.gov (United States)

    Martin, U; Behler, R; Bock-Hensley, O; Boschek, H J; Fobbe, E; Gardemann, J; Groschopp, C; Hingmann, G; Istas, H; Weber, D; Wegerhof, P

    2001-10-01

    New German legislative ordinances prescribe hygiene control in nursing homes and homes for the aged, e. g. the Law for Protection against Infectious Diseases and in North-Rhine Westphalia the Public Health Law. However, there are as yet no clearly defined standards of hygiene because the special features of nursing homes must be considered when applying the "Guidelines for Hospital Hygiene and Prevention of Infections" issued by the Robert Koch Institute. Hence, specific recommendations are given for hygiene of the hands, disinfection, hygienic treatment care, protective and professional clothing, washing of textiles, central kitchen, disposal of waste, house cleaning and handling of drugs and medicines.

  18. Internet-based learning programme to increase nurses' knowledge level about venous leg ulcer care in home health care.

    Science.gov (United States)

    Ylönen, Minna; Viljamaa, Jaakko; Isoaho, Hannu; Junttila, Kristiina; Leino-Kilpi, Helena; Suhonen, Riitta

    2017-11-01

    To test the effectiveness of an Internet-based education programme about venous leg ulcer nursing care on perceived and theoretical knowledge levels and attitudes among nurses working in home health care. Nurses have been shown to have knowledge gaps in venous leg ulcer nursing care. Internet-based learning could offer a means for flexible continuing education for home healthcare environment. Quasi-experimental study with pre- and postmeasurements and nonequivalent intervention and comparison groups. Nurses (n = 946) in home health care in two Finnish municipalities were invited to participate in the study and divided into intervention and comparison groups. The intervention group received education programme about venous leg ulcer nursing care, while the comparison group did not. Data were collected at baseline, at six weeks and at 10 weeks to test the hypotheses: nurses using education programme about venous leg ulcer nursing care will have higher level of knowledge and more positive attitudes than those not using education programme about venous leg ulcer nursing care. An analysis of variance and mixed models with repeated measures were used to test differences in knowledge and attitudes between and within the groups. There were statistically significant increases in knowledge levels in the intervention group from baseline to the first and second follow-up measurements. In the comparison group, the knowledge levels remained unchanged during the study. Attitude levels remained unchanged in both groups. Nurses' perceived and theoretical knowledge levels of venous leg ulcer nursing care can be increased with Internet-based education. However, this increase in knowledge levels is short-lived, which emphasises the need for continuous education. Internet-based education about venous leg ulcer nursing care is recommended for home healthcare nurses. Education programme about venous leg ulcer nursing care provides flexible method for nurses' learning with feasible

  19. Individual and collective considerations in public health: influenza vaccination in nursing homes.

    Science.gov (United States)

    Verweij, M

    2001-10-01

    Many nursing homes have an influenza vaccination policy in which it is assumed that express (proxy) consent is not necessary. Tacit consent procedures are more efficient if one aims at high vaccination rates. In this paper I focus on incompetent residents and proxy consent. Tacit proxy consent for vaccination implies a deviance of standard proxy consent requirements. I analyse several arguments that may possibly support such a deviance. The primary reason to offer influenza vaccination is that vaccinated persons have a significantly reduced risk of getting the flu. This reason however cannot support the assumption that each nursing home resident is 'better off' if she is vaccinated. Neither can it support tacit proxy consent policies. More promising are arguments that take the collective nature of infectious diseases into account. A potentially strong, but ultimately insufficient, argument for non-express consent is that vaccination contributes to prevention of harm to others. Other arguments emphasize the importance of group protection: herd immunity. I discuss three collective reasons for aiming at herd immunity: solidarity, a common interest in reducing the risk of illness, and a common interest in the prevention of an influenza outbreak. The latter argument appears to be most important. An outbreak is not just detrimental to the health of residents; it is detrimental to their everyday social life as well. Outbreaks can be seen as collective evil. My analysis shows that there are valid (though not necessarily sufficient) moral arguments for a tacit proxy consent policy.

  20. [The effect of a health maintenance program on physical function and mental health of the elderly in nursing homes].

    Science.gov (United States)

    Sung, Ki Wol

    2007-06-01

    The purpose of this study was to determine the effects of a Health Maintenance Program on physical functions and mental health of the elderly in nursing homes. Sixty elderly(over 65 years old) in a randomized control study participated in a 16-week group-based intervention including functional exercises and health education. The participants were divided into 3 groups(Health Maintenance Program Group, Supportive Music Exercise Group, and Control Group) of 20 elderly each. Data was collected from Dec. 1st, 2005 to Mar. 30th, 2006. Physical function of lower body strength was assessed using a 30-second chair test, flexibility was assessed using a sit-and-reach test, and static balance was assessed by the ability to balance on one leg with open and closed eyes. Depression was assessed using the Korean Form of the Geriatric Depression Scale and self esteem was assessed using Rosenberg's Self Esteem Questionnaire. Data was analyzed by Chi-square test, One-way ANOVA, and Repeated measure two factor analysis. A Health Maintenance Program significantly increased muscle strength, flexibility and static balance, but depression and self-esteem scores were not significantly changed. Findings demonstrated that a Health Maintenance Program was more effective on physical function than mental health of the elderly in nursing homes.

  1. The use of the Nursing Interventions Classification (NIC) with cardiac patients receiving home health care.

    Science.gov (United States)

    Schneider, Julia Stocker; Slowik, Linda Haynes

    2009-01-01

    To identify Nursing Interventions Classification interventions (NICs) commonly provided to cardiac home care patients and to explore differences among patients with coronary artery disease, congestive heart failure, and patients with other cardiac disorders. The NICs provided to cardiac home care patients were recorded and analyzed to determine differences in frequencies across cardiac diagnoses. Frequent NICs provided in cardiac home care are similar across diagnoses, and include tissue perfusion management and patient education NICs. Variations can be detected and involve fluid monitoring/management, exercise promotion/teaching, and cardiac care NICs. Differences in nursing care among patients with similar medical diagnoses can be detected using NIC. Relevant knowledge of nursing care can be gleaned from analyzing NIC data generated in practice and can be used to plan, evaluate, and determine the effectiveness of nursing care.

  2. [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. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  3. Incorporating INTERACT II Clinical Decision Support Tools into Nursing Home Health Information Technology

    Science.gov (United States)

    Handler, Steven M.; Sharkey, Siobhan S.; Hudak, Sandra; Ouslander, Joseph G.

    2012-01-01

    A substantial reduction in hospitalization rates has been associated with the implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) quality improvement intervention using the accompanying paper-based clinical practice tools (INTERACT II). There is significant potential to further increase the impact of INTERACT by integrating INTERACT II tools into nursing home (NH) health information technology (HIT) via standalone or integrated clinical decision support (CDS) systems. This article highlights the process of translating INTERACT II tools from paper to NH HIT. The authors believe that widespread dissemination and integration of INTERACT II CDS tools into various NH HIT products could lead to sustainable improvement in resident and clinician process and outcome measures, including enhanced interclinician communication and a reduction in potentially avoidable hospitalizations. PMID:22267955

  4. [The "Duisgurg model" of intensified control of nursing homes and homes for the aged by the Duisberg public health services in cooperation with the Duisburg social welfare offices].

    Science.gov (United States)

    Martin, U; Behler, R

    1999-07-01

    This is a report on the joint cooperative control of nursing and old-age homes by the Public Health and Social Welfare Offices in Duisburg, Germany. A total of 40 of such homes were inspected and checked jointly by the physician and pharmacist of the local Public Health Office within a one-year period while collecting data on the intensity and quality of care in these homes. A total of 3883 inmates were covered. These data included, inter alia, information on the intensity of care, prevalence of urinary and fecal incontinence, feeding by means of percutaneous endoscopic gastrostomy, prevalence of bedridden patients and of cases of pressure sores. The data conveyed information on the overall situation (frequencies for all the Duisburg nursing and old-age homes) on the one hand, and for each individual home on the basis of its particular data on the other hand. It became evident that two-thirds of all the inmates of nursing homes were classified as belonging to nursing stages II and III. Urinary incontinence was present in 63 per cent of the cases, fecal incontinence in 43 per cent, whereas 32 per cent were severely confused. Of a total of 447 permanently bedridden patients (11.5 per cent of all the inmates) 131 had pressure sores or necroses of the heels (3.37 per cent of the total population). More than one-half of the pressure sores had been acquired by the patients during their hospital stay, i.e. before their referral to a home, whereas 56 inmates developed their pressure sores in the homes concerned.

  5. Care workers health in Swiss nursing homes and its association with psychosocial work environment: A cross-sectional study.

    Science.gov (United States)

    Dhaini, Suzanne R; Zúñiga, Franziska; Ausserhofer, Dietmar; Simon, Michael; Kunz, Regina; De Geest, Sabina; Schwendimann, Rene

    2016-01-01

    Previous studies have demonstrated poor health of care workers in nursing homes. Yet, little is known about the prevalence of physical and mental health outcomes, and their associations with the psychosocial work environment in nursing homes. (1) To explore the prevalence of physical and mental health outcomes of care workers in Swiss nursing homes, (2) their association with psychosocial work environment. This is a secondary data analysis of the cross-sectional Swiss Nursing Home Human Resources Project (SHURP). We used survey data on socio-demographic characteristics and work environment factors from care workers (N=3471) working in Swiss nursing homes (N=155), collected between May 2012 and April 2013. GEE logistic regression models were used to estimate the relationship between psychosocial work environment and physical and mental health outcomes, taking into account care workers' age. Back pain (19.0%) and emotional exhaustion (24.2%) were the most frequent self-reported physical and mental health. Back pain was associated with increased workload (odds ratios (OR) 1.52, confidence interval (CI) 1.29-1.79), conflict with other health professionals and lack of recognition (OR 1.72, CI 1.40-2.11), and frequent verbal aggression by residents (OR 1.36, CI 1.06-1.74), and inversely associated with staffing adequacy (OR 0.69, CI 0.56-0.84); emotional exhaustion was associated with increased workload (OR 1.96, CI 1.65-2.34), lack of job preparation (OR 1.41, CI 1.14-1.73), and conflict with other health professionals and lack of recognition (OR 1.68, CI 1.37-2.06), and inversely associated with leadership (OR 0.70, CI 0.56-0.87). Physical and mental health among care workers in Swiss nursing homes is of concern. Modifying psychosocial work environment factors offer promising strategies to improve health. Longitudinal studies are needed to conduct targeted assessments of care workers health status, taking into account their age, along with the exposure to all four

  6. Effectiveness of an Internet-based learning program on venous leg ulcer nursing care in home health care--study protocol.

    Science.gov (United States)

    Ylönen, Minna; Viljamaa, Jaakko; Isoaho, Hannu; Junttila, Kristiina; Leino-Kilpi, Helena; Suhonen, Riitta

    2015-10-01

    To describe the study protocol for a study of the effectiveness of an internet-based learning program on venous leg ulcer nursing care (eVLU) in home health care. The prevalence of venous leg ulcers is increasing as population age. The majority of these patients are treated in a municipal home healthcare setting. However, studies show nurses' lack of knowledge of ulcer nursing care. Quasi-experimental study with pre- and postmeasurements and non-equivalent intervention and comparison groups. During the study, nurses taking care of patients with a chronic leg ulcer in home health care in one Finnish municipality will use the eVLU. Nurses working in home health care in another Finnish municipality will not use it providing standard care. Nurses will complete three questionnaires during the study and they will also be observed three times at patients' homes. Nurses' perceived and theoretical knowledge is the primary outcome of the study. Funding for this study was received from the Finnish Foundation for Nursing Education in 2014. Data from this study will provide information about the effectiveness of an internet-based educational program. After completing the program nurses will be accustomed to using internet-based resources that can aid them in the nursing care of patients with a VLU. Nurses will also have better knowledge of VLU nursing care. This study is registered with the International Clinical Trials Registry, identifier NCT02224300. © 2015 John Wiley & Sons Ltd.

  7. Substitution of Formal and Informal Home Care Service Use and Nursing Home Service Use: Health Outcomes, Decision-Making Preferences, and Implications for a Public Health Policy.

    Science.gov (United States)

    Chen, Chia-Ching; Yamada, Tetsuji; Nakashima, Taeko; Chiu, I-Ming

    2017-01-01

    The purposes of this study are: (1) to empirically identify decision-making preferences of long-term health-care use, especially informal and formal home care (FHC) service use; (2) to evaluate outcomes vs. costs based on substitutability of informal and FHC service use; and (3) to investigate health outcome disparity based on substitutability. The methods of ordinary least squares, a logit model, and a bivariate probit model are used by controlling for socioeconomic, demographic, and physical/mental health factors to investigate outcomes and costs based substitutability of informal and formal health-care use. The data come from the 2013 Japanese Study of Aging and Retirement (JSTAR), which is designed by Keizai-Sangyo Kenkyu-jo, Hitotsubashi University, and the University of Tokyo. The JSTAR is a globally comparable data survey of the elderly. There exists a complement relationship between the informal home care (IHC) and community-based FHC services, and the elasticity's ranges from 0.18 to 0.22. These are reasonable results, which show that unobservable factors are positively related to IHC and community-based FHC, but negatively related to nursing home (NH) services based on our bivariate probit model. Regarding health-care outcome efficiency issue, the IHC is the best one among three types of elderly care: IHC, community-based FHC, and NH services. Health improvement/outcome of elderly with the IHC is heavier concentrated on IHC services than the elderly care services by community-based FHC and NH care services. Policy makers need to address a diversity of health outcomes and efficiency of services based on providing services to elderly through resource allocation to the different types of long-term care. A provision of partial or full compensation for elderly care at home is recommendable and a viable option to improve their quality of lives.

  8. Substitution of Formal and Informal Home Care Service Use and Nursing Home Service Use: Health Outcomes, Decision-Making Preferences, and Implications for a Public Health Policy

    Directory of Open Access Journals (Sweden)

    Chia-Ching Chen

    2017-11-01

    Full Text Available ObjectivesThe purposes of this study are: (1 to empirically identify decision-making preferences of long-term health-care use, especially informal and formal home care (FHC service use; (2 to evaluate outcomes vs. costs based on substitutability of informal and FHC service use; and (3 to investigate health outcome disparity based on substitutability.Methodology and dataThe methods of ordinary least squares, a logit model, and a bivariate probit model are used by controlling for socioeconomic, demographic, and physical/mental health factors to investigate outcomes and costs based substitutability of informal and formal health-care use. The data come from the 2013 Japanese Study of Aging and Retirement (JSTAR, which is designed by Keizai-Sangyo Kenkyu-jo, Hitotsubashi University, and the University of Tokyo. The JSTAR is a globally comparable data survey of the elderly.ResultsThere exists a complement relationship between the informal home care (IHC and community-based FHC services, and the elasticity’s ranges from 0.18 to 0.22. These are reasonable results, which show that unobservable factors are positively related to IHC and community-based FHC, but negatively related to nursing home (NH services based on our bivariate probit model. Regarding health-care outcome efficiency issue, the IHC is the best one among three types of elderly care: IHC, community-based FHC, and NH services. Health improvement/outcome of elderly with the IHC is heavier concentrated on IHC services than the elderly care services by community-based FHC and NH care services.ConclusionPolicy makers need to address a diversity of health outcomes and efficiency of services based on providing services to elderly through resource allocation to the different types of long-term care. A provision of partial or full compensation for elderly care at home is recommendable and a viable option to improve their quality of lives.

  9. Eldercare at Home: Choosing a Nursing Home

    Science.gov (United States)

    ... a regular basis? Residents can give you valuable insights. Talk with nursing assistants and observe them with ... a pleasant manner? Can residents bring furniture and personal items from home? Are there pet animals in ...

  10. 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

  11. Nursing Home Response to Nursing Home Compare: The Provider Perspective.

    Science.gov (United States)

    Perraillon, Marcelo Coca; Brauner, Daniel J; Konetzka, R Tamara

    2017-08-01

    Nursing Home Compare (NHC) publishes composite quality ratings of nursing homes based on a five-star rating system, a system that has been subject to controversy about its validity. Using in-depth interviews, we assess the views of nursing home administrators and staff on NHC and unearth strategies used to improve ratings. Respondents revealed conflicting goals and strategies. Although nursing home managers monitor the ratings and expend effort to improve scores, competing goals of revenue maximization and avoidance of litigation often overshadow desire to score well on NHC. Some of the improvement strategies simply involve coding changes that have no effect on resident outcomes. Many respondents doubted the validity of the self-reported staffing data and stated that lack of risk adjustment biases ratings. Policy makers should consider nursing home incentives when refining the system, aiming to improve the validity of the self-reported domains to provide incentives for broader quality improvement.

  12. The effect of group integrative reminiscence therapy on mental health among older women living in Iranian nursing homes.

    Science.gov (United States)

    Musavi, Motahareh; Mohammadian, Sara; Mohammadinezhad, Bahar

    2017-10-01

    The present study aimed to determine the impact of group integrative reminiscence therapy on mental health of older women living in Iranian nursing home in 2016. A quasi-experimental design pre- and post-test was used in the present study. Purposive sampling was used to recruit participants who met the study criteria. The statistical population included 60 older women living in nursing home, among whom 46 having the inclusion criteria were selected as the sample. After completing the Goldberg's General Health Questionnaire, the older people were divided into intervention (N = 23) and control (N = 23) group by using block randomization method. The intervention groups were trained by integrative reminiscence therapy for 60-90 min 10 sessions, twice a week. Descriptive statistics and ANOVA were used for data analysis by SPSS software. The results indicated that group integrative reminiscence therapy significantly affected general mental health and physical dimensions, anxiety and insomnia, social functions and depression.

  13. Radiography on wheels arrives to nursing homes - an economic assessment of a new health care technology in southern Sweden.

    Science.gov (United States)

    Dozet, Alexander; Ivarsson, Bodil; Eklund, Karin; Klefsgård, Rosemarie; Geijer, Mats

    2016-12-01

    The process of transferring older, vulnerable adults from an elder care facility to the hospital for medical care can be an emotionally and physically stressful experience. The recent development of modern mobile radiography may help to ease this anxiety by allowing for evaluation in the nursing home itself. Up until this point, no health economic evaluation of the technology has been attempted in a Swedish setting. The objective of this study was to determine whether examinations of patients in elder care facilities with mobile radiography were cost-effective from a societal perspective compared with hospital-based radiological examinations. This prospective study included two groups of nursing home residents in two different areas in southern Sweden. All residents in the nursing homes were targeted for the study. Seventy-one patients were examined with hospital-based radiography at two hospitals, and 312 patients were examined using mobile radiography in nursing homes. Given that the diagnostic effects are regarded as equivalent, a cost minimization method was applied. Direct costs were estimated using prices from the county council, Region Skåne, Sweden. From a societal perspective, mobile radiography was shown to have significantly lower costs per examination compared with hospital-based radiography. The difference in health care-related costs was also significant in favour of mobile radiography. Mobile radiography can be used to examine patients in nursing homes at a lower cost than hospital-based radiography. Patients benefit from not having to transfer to a hospital for radiography, resulting in reduced anxiety for patients. © 2016 John Wiley & Sons, Ltd.

  14. Improving the Quality of Nursing Documentation in Home Health Care Setting

    Science.gov (United States)

    Obioma, Chidiadi

    2017-01-01

    Poor nursing documentation of patient care was identified in daily nurse visit notes in a health care setting. This problem affects effective communication of patient status with other clinicians, thereby jeopardizing clinical decision-making. The purpose of this evidence-based project was to determine the impact of a retraining program on the…

  15. The satisfaction with the quality of dementia care and the health, burnout and work ability of nurses: a longitudinal analysis of 50 German nursing homes.

    Science.gov (United States)

    Schmidt, Sascha G; Dichter, Martin N; Bartholomeyczik, Sabine; Hasselhorn, Hans Martin

    2014-01-01

    The increasing prevalence of residents with dementia in Nursing Homes (NH) leads to a demanding work with high physical and psychological workloads. This study focuses on NH nurses and their satisfaction with quality of care for residents with dementia (SQCD) and its impact on nurses' general health, burnout and work ability. Two-wave (2007/2009) self-report questionnaire data of 305 nurses (RNs and nurses' aides) from 50 German NHs. 58.6% (2007) and 64.9% (2009) of the respondents reported satisfaction with the quality of care of the dementia residents. However, when dissatisfied, this was perceived as substantial work stressor and was adversely associated with nurses' individual resource outcomes. Those nurses who between 2007 and 2009 had become dissatisfied or were dissatisfied at both measurements showed the most adverse scorings for burnout, general health and work ability. The findings imply that in NHs, SQCD may be a relevant work factor with substantial impact on nurses' core resources. Copyright © 2014 Mosby, Inc. All rights reserved.

  16. Effectiveness of the teach-back method for improving the health literacy of senior citizens in nursing homes.

    Science.gov (United States)

    Liu, Yong-Bing; Li, Yan-Fei; Liu, Liu; Chen, Yan-Li

    2017-11-20

    To explore the effectiveness of the teach-back method for improving the health literacy of older adults in nursing homes in Ürümqi, the capital of Xinjiang, China. Among the 27 registered nursing homes, 10 were selected randomly by size and divided into the intervention and control groups. A total of 127 older adults in the intervention group and 136 in the control group met the inclusion criteria. The intervention and control groups were educated by using the teach-back and traditional methods, respectively, in this 6 month study. The Chinese Citizen Health Literacy Questionnaire was used to evaluate the effects of the interventions. Pre-intervention, the health literacy level of the cohorts was relatively low. Postintervention, the total health literacy score of the intervention group increased, while the total health literacy score of the control group had increased to a lesser extent. The total and four-dimension scores of the two groups were statistically significant. The intergroup difference in the two groups, and the intervention group's total health literacy score and each dimension score were higher than in the control group; these differences were statistically significant . The teach-back method can improve the health literacy level of older adults through short-term educational intervention. The teach-back method should be adopted by more healthcare providers and applied to improve the health literacy education of older adults. © 2017 Japan Academy of Nursing Science.

  17. Nursing staff in hospitals and nursing homes: is it adequate?

    National Research Council Canada - National Science Library

    Wunderlich, Gooloo S; Sloan, Frank A; Davis, Carolyne K

    1996-01-01

    ..., Editors Committee on the Adequacy of Nurse Staffing in Hospitals and Nursing Homes Division of Health Care Services INSTITUTE OF MEDICINE NATIONAL ACADEMY PRESS Washington, D.C. 1996 Copyrightthe cannot be not from book, paper however, version for formatting, original authoritative the typesetting-specific the as from created pub...

  18. Staff Perceptions of Key Factors Guiding Nursing Home Search and Selection Within the Veterans Health Administration.

    Science.gov (United States)

    Miller, Edward Alan; Gidmark, Stefanie; Gadbois, Emily; Rudolph, James L; Intrator, Orna

    2017-06-21

    Veterans enter nursing homes (NHs) for short-term postacute, rehabilitation, respite, or end-of-life care. They also enter NHs on a long-term basis due to frailty, disability, functional deficits, and cognitive impairment. Little is known about how a particular NH is chosen once the decision to enter a NH has been made. This study identified VA staff perceptions of the key factors influencing the search and selection of NHs within the Veterans Health Administration (VHA). Data derived from 35 semistructured interviews with discharge planning and contracting staff from 12 Veterans Affairs Medical Centers (VAMCs). VA staff placed a premium on Veteran and family preferences in the NH selection process, though VA staff knowledge and familiarity with placement options established the general parameters within which NH placement decisions were made. Geographic proximity to Veterans' homes and families was a major factor in NH choice. Other key considerations included Veterans' specialty care needs (psychiatric, postacute, ventilator) and Veteran/facility demographics (age, race/ethnicity, Veteran status). VA staff tried to remain neutral in NH selection, thus instructing families to visit facilities and review publicly available quality data. VA staff report that amenities (private rooms, activities, smoking) and aesthetics (cleanliness, smell, layout, décor) often outweighed objective quality indicators in Veteran and family decision making. Findings suggest that VAMCs facilitate Veteran and family decision making around NH selection. They also suggest that VAMCs endeavor to identify and recruit a broader array of higher quality NHs to better match the specific needs of Veterans and families to the choice set available.

  19. [How effective is the quality assurance as a result of external checking of nursing homes by the public health services].

    Science.gov (United States)

    Martin, U; Behler, R

    2001-12-01

    This is a report on the external checking of nursing homes by the Public Health Services in Duisburg, Germany, focussing on hygienic problems. For a second time in the last three-and-a-half years a total of 41 such homes were inspected and a total of 4150 residents were covered. Data on the intensity of care and on the hygienic standards were evaluated and compared with the results of 1998. 70.73 % of the homes inspected employed a nurse specifically trained in hygiene-management (1998 15 %), 53.66 % used disinfectant textile cleaning and 34.39 % possessed written standards for management of infections relevant for nursing homes. 1.45 % of all residents had pressure sores III degrees and IV degrees classified according to Shea (1998: 3.37 %). In spite of significant improvements, deficits were still registered. To achieve further improvement attention should be focussed on the effectiveness of Public Health Services' activities. Increased co-operation with other institutions engaged in the external checkings as well as a closer focus on specific subjects in hygiene could be appropriate.

  20. 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,…

  1. Suicide Mortality Following Nursing Home Discharge in the Department of Veterans Affairs Health System

    Science.gov (United States)

    Szymanski, Benjamin R.; Karlin, Bradley E.; Katz, Ira R.

    2013-01-01

    Objectives. We assessed suicide rates up to 6 months following discharge from US Department of Veterans Affairs (VA) nursing homes. Methods. In VA Minimum Data Set (MDS) records, we identified 281 066 live discharges from the 137 VA nursing homes during fiscal years 2002 to 2008. We used MDS and administrative data to assess resident age, gender, behaviors, pain, and indications of psychoses, bipolar disorder, dementia, and depression. We identified vital status and suicide mortality within 6 months of discharge through National Death Index searches. Results. Suicide rates within 6 months of discharge were 88.0 per 100 000 person-years for men and 89.4 overall. Standardized mortality ratios relative to age- and gender-matched individuals in the VA patient population were 2.3 for men (95% confidence interval [CI] = 1.9, 2.8) and 2.4 overall (95% CI = 2.0, 2.9). In multivariable proportional hazards regression analyses, resident characteristics, diagnoses, behaviors, and pain were not significantly associated with suicide risk. Conclusions. Suicide risk was elevated following nursing home discharge. This underscores the importance of ongoing VA efforts to enhance discharge planning and timely postdischarge follow-up. PMID:24134359

  2. An educational intervention on drug use in nursing homes improves health outcomes resource utilization and reduces inappropriate drug prescription.

    Science.gov (United States)

    García-Gollarte, Fermín; Baleriola-Júlvez, José; Ferrero-López, Isabel; Cuenllas-Díaz, Álvaro; Cruz-Jentoft, Alfonso J

    2014-12-01

    Inappropriate drug prescription is a common problem in people living in nursing homes and is linked to adverse health outcomes. This study assessed the effect of an educational intervention directed to nursing home physicians in reducing inappropriate prescription and improving health outcomes and resource utilization. Prospective, randomized, multicenter study. A private organization of nursing homes in Spain. Sixty nursing home physicians caring for approximately 3900 nursing home residents in 37 centers were randomized to receive an educational intervention (30) or as a control group (30). 10 hours educational program, followed by on demand support by phone. Outcomes were assessed in 1018 randomly selected nursing home residents. Appropriateness of drug use [measured by the Screening Tool of Older Persons Prescriptions (STOPP) and Screening Tool to Alert Doctors to Right Treatment (START) criteria], incidence of selected geriatric syndromes (falls, delirium) and health resource utilization (visits to physicians and nursing homes, visits to the emergency room, days of hospitalization) were recorded for 3 months before the intervention started and 3 months after the intervention finished. O total of 716 residents finished the study (344 cared for by the intervention group physicians, 372 cared for by control physicians). Mean age was 84.4 ± 12.7 years; 73% were women. The mean number of inappropriate drugs (STOPP criteria) was higher at the end of the study in the control than in the intervention group (1.29 ± 1.56 vs 0.81 ± 1.13), as was the number of residents on 6 or more drugs (76.5% vs.67.0%), using antipsychotics (9.1% vs 3.2%) or duplicate medications (32.5% vs 9.2%). The number of fallers increased in the control group (from 19.3% to 28%) and did not significantly change in the intervention group (from 25.3% to 23.9%); the number of residents with delirium increased in the control group (from 3.8% to 9.1%) and decreased in the intervention group (from 6

  3. 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.

  4. Effect of a health coaching self-management program for older adults with multimorbidity in nursing homes

    Directory of Open Access Journals (Sweden)

    Park YH

    2014-07-01

    Full Text Available Yeon-Hwan Park,1,2 HeeKyung Chang31College of Nursing, 2The Research Institute of Nursing Science, Seoul National University, Seoul, South Korea; 3Seoul Women’s College of Nursing, Seoul, South KoreaBackground and aims: Although a growing number of older people are suffering from multimorbidity, most of the health problems related to multimorbidity can be improved by self-management. The aim of this study was to examine the effectiveness of a health coaching self-management program for older adults with multimorbidity in nursing homes. Methods: Older adults with multimorbidity from one nursing home in Korea were randomly allocated to either an intervention group (n=22 or conventional group (n=21. Participants in the intervention group met face to face with the researchers twice a week for 8 weeks, during which time the researchers engaged them in goal setting and goal performance using the strategies in the health coaching self-management program. Regular care was provided to the other participants in the conventional group. Results: Participants in the intervention group had significantly better outcomes in exercise behaviors (P=0.015, cognitive symptom management (P=0.004, mental stress management/relaxation (P=0.023, self-rated health (P=0.002, reduced illness intrusiveness (P<0.001, depression (P<0.001, and social/role activities limitations (P<0.001. In addition, there was a significant time-by-group interaction in self-efficacy (P=0.036. According to the goal attainment scales, their individual goals of oral health and stress reduction were achieved.Conclusion: The health coaching self-management program was successfully implemented in older adults with multimorbidity in a nursing home. Further research is needed to develop and evaluate the long-term effects of an intervention to enhance adherence to self-management and quality of life for older adults with multimorbidity.Keywords: chronic diseases, nursing intervention, older adults

  5. An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms.

    Science.gov (United States)

    Markle-Reid, Maureen; McAiney, Carrie; Forbes, Dorothy; Thabane, Lehana; Gibson, Maggie; Browne, Gina; Hoch, Jeffrey S; Peirce, Thomas; Busing, Barbara

    2014-05-10

    Depressive symptoms in older home care clients are common but poorly recognized and treated, resulting in adverse health outcomes, premature institutionalization, and costly use of health services. The objectives of this study were to examine the feasibility and acceptability of a new six-month interprofessional (IP) nurse-led mental health promotion intervention, and to explore its effects on reducing depressive symptoms in older home care clients (≥ 70 years) using personal support services. A prospective one-group pre-test/post-test study design was used. The intervention was a six-month evidence-based depression care management strategy led by a registered nurse that used an IP approach. Of 142 eligible consenting participants, 98 (69%) completed the six-month and 87 (61%) completed the one-year follow-up. Outcomes included depressive symptoms, anxiety, health-related quality of life (HRQoL), and the costs of use of all types of health services at baseline and six-month and one-year follow-up. An interpretive descriptive design was used to explore clients', nurses', and personal support workers' perceptions about the intervention's appropriateness, benefits, and barriers and facilitators to implementation. Of the 142 participants, 56% had clinically significant depressive symptoms, with 38% having moderate to severe symptoms. The intervention was feasible and acceptable to older home care clients with depressive symptoms. It was effective in reducing depressive symptoms and improving HRQoL at six-month follow-up, with small additional improvements six months after the intervention. The intervention also reduced anxiety at one year follow-up. Significant reductions were observed in the use of hospitalization, ambulance services, and emergency room visits over the study period. Our findings provide initial evidence for the feasibility, acceptability, and sustained effects of the nurse-led mental health promotion intervention in improving client outcomes

  6. Fall prevention in nursing homes

    DEFF Research Database (Denmark)

    Andresen, Mette; Hauge, Johnny

    2014-01-01

    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...

  7. Alzheimer's Disease And Nursing Homes

    National Research Council Canada - National Science Library

    Gaugler, Joseph E; Yu, Fang; Davila, Heather W; Shippee, Tetyana

    2014-01-01

    Close to two-thirds of all US nursing home residents have some type of cognitive impairment such as Alzheimer's disease, and the quality of care and quality of life of these people has long been called into question...

  8. 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...... of interventions to improve the implementation of guidelines in nursing homes. METHODS: A systematic literature search was conducted in the Cochrane Library, CINAHL, Embase, MEDLINE, DARE, HTA, CENTRAL, SveMed + and ISI Web of Science from their inception until August 2015. Reference screening and a citation...... search were performed. Studies were eligible if they evaluated any type of guideline implementation strategy in a nursing home setting. Eligible study designs were systematic reviews, randomised controlled trials, non-randomised controlled trials, controlled before-after studies and interrupted...

  9. Green House Adoption and Nursing Home Quality.

    Science.gov (United States)

    Afendulis, Christopher C; Caudry, Daryl J; O'Malley, A James; Kemper, Peter; Grabowski, David C

    2016-02-01

    To evaluate the impact of the Green House (GH) model on nursing home resident-level quality of care measures. Resident-level minimum data set (MDS) assessments merged with Medicare inpatient claims for the period 2005 through 2010. Using a difference-in-differences framework, we compared changes in care quality and outcomes in 15 nursing homes that adopted the GH model relative to changes over the same time period in 223 matched nursing homes that had not adopted the GH model. For individuals residing in GH homes, adoption of the model lowered readmissions and several MDS measures of poor quality, including bedfast residents, catheter use, and pressure ulcers, but these results were not present across the entire GH organization, suggesting possible offsetting effects for residents of non-GH "legacy" units within the GH organization. GH adoption led to improvement in rehospitalizations and certain nursing home quality measures for individuals residing in a GH home. The absence of evidence of a decline in other clinical quality measures in GH nursing homes should reassure anyone concerned that GH might have sacrificed clinical quality for improved quality of life. © Health Research and Educational Trust.

  10. The Changing Role of Health Care Professionals in Nursing Homes: A Systematic Literature Review of a Decade of Change

    Directory of Open Access Journals (Sweden)

    Arend R. van Stenis

    2017-11-01

    Full Text Available Although the role of health care professionals is known to have changed over the last years, few formal efforts have been made to examine this change through means of a scientific review. Therefore, the goal of this paper was to investigate the changing role of health care professionals in nursing homes, as well as the conditions that make this change possible. A systematic review of health care literature published in the last decade (2007–2017 was utilized to address these goals. Our findings suggest that although health care in nursing homes is shifting from task-oriented care to relation-oriented care (e.g., through an increased focus on patient dignity, various obstacles (e.g., negative self-image, work pressure, and a lack of developmental opportunities, needs (e.g., shared values, personal development, personal empowerment, team development, and demonstrating expertise, and competences (e.g., communication skills, attentiveness, negotiation skills, flexibility, teamwork, expertise, and coaching and leadership skills still need to be addressed in order to successfully facilitate this change. As such, this paper provides various implications for health care research, health care institutions, practitioners, HR professionals and managers, and occupational health research.

  11. The Changing Role of Health Care Professionals in Nursing Homes: A Systematic Literature Review of a Decade of Change.

    Science.gov (United States)

    van Stenis, Arend R; van Wingerden, Jessica; Kolkhuis Tanke, Isolde

    2017-01-01

    Although the role of health care professionals is known to have changed over the last years, few formal efforts have been made to examine this change through means of a scientific review. Therefore, the goal of this paper was to investigate the changing role of health care professionals in nursing homes, as well as the conditions that make this change possible. A systematic review of health care literature published in the last decade (2007-2017) was utilized to address these goals. Our findings suggest that although health care in nursing homes is shifting from task-oriented care to relation-oriented care (e.g., through an increased focus on patient dignity), various obstacles (e.g., negative self-image, work pressure, and a lack of developmental opportunities), needs (e.g., shared values, personal development, personal empowerment, team development, and demonstrating expertise), and competences (e.g., communication skills, attentiveness, negotiation skills, flexibility, teamwork, expertise, and coaching and leadership skills) still need to be addressed in order to successfully facilitate this change. As such, this paper provides various implications for health care research, health care institutions, practitioners, HR professionals and managers, and occupational health research.

  12. 77 FR 45719 - Proposed Information Collection (Per Diem for Nursing Home Care of Veterans in State Homes; Per...

    Science.gov (United States)

    2012-08-01

    ... Information Collection (Per Diem for Nursing Home Care of Veterans in State Homes; Per Diem for Adult Day Care... solicits comments on information needed to ensure that nursing home and adult day health care facilities... services care to Veterans. VA requires facilities providing nursing home and adult day health care to...

  13. A systematic review of the effectiveness of in-home community nurse led interventions for the mental health of older persons.

    Science.gov (United States)

    Thompson, Penelope; Lang, Lyn; Annells, Merilyn

    2008-06-01

    The aim was to systematically review evidence about the effectiveness of in-home community nurse-led interventions for older persons with, or at risk of, mental health disorders, to inform best practice nursing care with this focus. The primary review question was 'How effective are in-home community nurse-led interventions for older persons with or at risk of mental health disorders for improving mental health?' The outcome indices of interest were nursing actions to determine incidence or prevalence of mental health disorders, any change in a patient's attitude towards their mental health condition, any change in objective measurement of mental health, or a change in diagnostic status. The rising incidence of mental health disorders in older persons is a major concern for community nurses in developed countries. Effectively facilitating improved mental health for older persons is necessary in this era of ageing populations with increased demands on health funding. Disseminating systematically reviewed evidence for in-home community nursing that positively impacts on the mental health of older persons is crucial to ensure effective care is provided to this vulnerable patient group. This review reveals that there is evidence to support the superiority of applying validated screening tools for mental health disorders over relying on community nurses' opinions and non-validated tools about this matter. Systematic review. Search of electronic databases. A clear need for replication and multi-centre trials of reviewed pertinent studies is identified. Relevance to clinical practice. Community nurses should consider using validated screening tools for this focus. Until such time as higher quality evidence is available about other nursing interventions, the reviewers suggest that the prime nursing action should be the identification of whether older persons receiving community nursing care might have a mental health disorder and, if so, then collaborative referral is made

  14. 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…

  15. Differences in the health care needs and service utilization of women in nursing homes: comparison by race/ethnicity.

    Science.gov (United States)

    Davis, Jullet A

    2005-01-01

    The purpose of this study is to describe health care needs and service utilization among institutionalized women of color. The sample was dichotomized by length of stay to determine how African American, Native American, Asian/Pacific Islander, and Hispanic/Latino women differed at two points in time. Data for this study came from the Current Resident Survey of the 1999 National Nursing Home Survey. The data were analyzed using GLM. The findings suggest that Native American women are the most impaired and Asian/Pacific Islander women are the least impaired. Additionally, very few women received mental health services despite their extensive need.

  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. The effects of influenza vaccination of health care workers in nursing homes: insights from a mathematical model.

    Directory of Open Access Journals (Sweden)

    Carline van den Dool

    2008-10-01

    Full Text Available BACKGROUND: Annual influenza vaccination of institutional health care workers (HCWs is advised in most Western countries, but adherence to this recommendation is generally low. Although protective effects of this intervention for nursing home patients have been demonstrated in some clinical trials, the exact relationship between increased vaccine uptake among HCWs and protection of patients remains unknown owing to variations between study designs, settings, intensity of influenza seasons, and failure to control all effect modifiers. Therefore, we use a mathematical model to estimate the effects of HCW vaccination in different scenarios and to identify a herd immunity threshold in a nursing home department. METHODS AND FINDINGS: We use a stochastic individual-based model with discrete time intervals to simulate influenza virus transmission in a 30-bed long-term care nursing home department. We simulate different levels of HCW vaccine uptake and study the effect on influenza virus attack rates among patients for different institutional and seasonal scenarios. Our model reveals a robust linear relationship between the number of HCWs vaccinated and the expected number of influenza virus infections among patients. In a realistic scenario, approximately 60% of influenza virus infections among patients can be prevented when the HCW vaccination rate increases from 0 to 1. A threshold for herd immunity is not detected. Due to stochastic variations, the differences in patient attack rates between departments are high and large outbreaks can occur for every level of HCW vaccine uptake. CONCLUSIONS: The absence of herd immunity in nursing homes implies that vaccination of every additional HCW protects an additional fraction of patients. Because of large stochastic variations, results of small-sized clinical trials on the effects of HCW vaccination should be interpreted with great care. Moreover, the large variations in attack rates should be taken into

  18. Medication Use and Its Potential Impact on the Oral Health Status of Nursing Home Residents in Flanders (Belgium).

    Science.gov (United States)

    Janssens, Barbara; Petrovic, Mirko; Jacquet, Wolfgang; Schols, Jos M G A; Vanobbergen, Jacques; De Visschere, Luc

    2017-09-01

    Polypharmacy is considered the most important etiologic factor of hyposalivation, which in turn can initiate oral health problems. To describe the medication use of nursing home residents, to identify the medications related to hyposalivation and to find possible associations between the different classes of medication, the number of medications, and the oral health status of the residents. A cross-sectional study. The study population consisted of the residents of a nonrandom sample of 23 nursing homes from 2 Belgian provinces, belonging to the oral health care network Gerodent. All residents of the sample visited the Gerodent mobile dental clinic between October 2010 and April 2012. For each resident, oral health data, demographic data, and an overview of the total medication intake were collected. The study sample consisted of 1226 nursing home residents with a mean age of 83.9 years [standard deviation (SD) 8.5]. The mean number of medications per person was 9.0 (SD 3.6, range 0-23, median 9.0). Of all prescribed medication, 49.6% had a potential hyposalivatory effect with a mean number per person of 4.5 (SD 2.2, range 0-15, median 4.0). In the bivariate analyses, associations were found between medication use and oral health of residents with natural teeth: the higher the number of medications (with risk of dry mouth) and the overall risk of medication-related dry mouth, the lower the number of natural teeth (P = .022, P = .005, and P = .017, respectively). In contrast, the total treatment need tended to decrease with rising medication intake, resulting in a clear increase of the treatment index with rising medication intake (P = .003, P oral status of the residents. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  19. "I'm not sure I'm a nurse": A hermeneutic phenomenological study of nursing home nurses' work identity.

    Science.gov (United States)

    Thompson, Juliana; Cook, Glenda; Duschinsky, Robbie

    2017-10-20

    To explore nursing home nurses' experiences and views of work identity. Nursing home nurses are in a unique position as they work at the interface of health and social care. Little is known about nursing home nurses' perceptions and experiences of working within this context. Evidence suggests that using the concept of work identity can support understanding of how workers make sense of their work. Hermeneutic phenomenological study. The study was carried out in seven nursing homes in North East England. Findings are based upon literary analysis of multiple episodic interviews with 13 nursing home nurses. Participants' responses suggested that nursing "residents" is different to nursing "patients," and nursing home nurses are required to modify their care activities to account for these differences. Participants also proposed that they are isolated and excluded from the rest of the healthcare workforce group. These issues led participants to feel uncertain about work identity. Many participants attempted to strengthen their work identity by aligning their role with what they perceived the "nurse identity" to be. Nurses' work activities and professional group identity influence their work identity. When work activities and professional group identity do not align with role expectations, as can be the case for nursing home nurses, work identity may be compromised. These nurses may attempt to change work practices to strengthen their work identity. Health- and social care providers need to account for work identity factors in the organisation of care, and planning and implementation of integrated health- and social care initiatives. © 2017 John Wiley & Sons Ltd.

  20. Assessing Health Practitioner Knowledge of Appropriate Psychotropic Medication Use in Nursing Homes: Validation of the Older Age Psychotropic Quiz.

    Science.gov (United States)

    Brown, Donnamay Tegan; Westbury, Juanita Louise

    2016-07-05

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS XX 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, "Assessing Health Practitioner Knowledge of Appropriate Psychotropic Medication Use in Nursing Homes: Validation of the Older Age Psychotropic Quiz" found on pages XX-XX, 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 MONTH XX, 20XX. 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. XXX 2. XXX DISCLOSURE STATEMENT

  1. Nursing Home Social Workers and Allied Professionals: Enhancing Geriatric Mental Health Knowledge

    Science.gov (United States)

    Bonifas, Robin P.

    2011-01-01

    Research has highlighted the challenges social services professionals face in providing quality psychosocial care to persons living in skilled nursing facilities (SNFs). A primary area of difficulty is addressing the needs of persons with mental health conditions, including problematic behaviors associated with dementia. This study evaluated the…

  2. An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms

    Science.gov (United States)

    2014-01-01

    Background Depressive symptoms in older home care clients are common but poorly recognized and treated, resulting in adverse health outcomes, premature institutionalization, and costly use of health services. The objectives of this study were to examine the feasibility and acceptability of a new six-month interprofessional (IP) nurse-led mental health promotion intervention, and to explore its effects on reducing depressive symptoms in older home care clients (≥ 70 years) using personal support services. Methods A prospective one-group pre-test/post-test study design was used. The intervention was a six-month evidence-based depression care management strategy led by a registered nurse that used an IP approach. Of 142 eligible consenting participants, 98 (69%) completed the six-month and 87 (61%) completed the one-year follow-up. Outcomes included depressive symptoms, anxiety, health-related quality of life (HRQoL), and the costs of use of all types of health services at baseline and six-month and one-year follow-up. An interpretive descriptive design was used to explore clients’, nurses’, and personal support workers’ perceptions about the intervention’s appropriateness, benefits, and barriers and facilitators to implementation. Results Of the 142 participants, 56% had clinically significant depressive symptoms, with 38% having moderate to severe symptoms. The intervention was feasible and acceptable to older home care clients with depressive symptoms. It was effective in reducing depressive symptoms and improving HRQoL at six-month follow-up, with small additional improvements six months after the intervention. The intervention also reduced anxiety at one year follow-up. Significant reductions were observed in the use of hospitalization, ambulance services, and emergency room visits over the study period. Conclusions Our findings provide initial evidence for the feasibility, acceptability, and sustained effects of the nurse-led mental health promotion

  3. Health-related quality of life and physical, mental, and cognitive disabilities among nursing home residents in Jordan.

    Science.gov (United States)

    Almomani, Fidaa Mohammad; McDowd, Joan M; Bani-Issa, Wegdan; Almomani, Murad

    2014-02-01

    To describe the physical, cognitive, psychological, and medical status of nursing home residents in Jordan. We also investigated the perceived health-related quality of life of this population. A sample of 221 nursing home residents in Jordan was recruited to participate in this study. Demographic variables and medical history were collected. In addition, all participants were assessed using health-related quality of life items (HRQOL), mini-mental state examination (MMSE), Geriatric Depression Scale (GDS), Tinetti assessment battery for gait and balance (TAB), and disability of arm, shoulder, and hand assessment (DASH). TAB and DASH scores were related to the following HRQOL items: self-reported general health status, the need for personal care, the need for help from others in handling routine needs, the number of days of pain, feeling sad, depressed, worried, and not getting enough sleep, and the number of days feeling very healthy and full of energy. MMSE scores were related to self-reported need for personal care, the need for help from others in handling daily routine needs, and the number of days feeling pain, sad, worried, and depressed. GDS scores were related to self-reported general health status, the need for personal care, the need for help from others for handling daily routine needs, the number of pain, sad, worried, and not getting enough sleep days, and the number of days feeling healthy and full of energy. This study revealed a substantial impact of physical, cognitive, and psychological disabilities on HRQOL of nursing home residents in Jordan.

  4. 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...

  5. 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... home and adult day health services care to Veterans. VA requires facilities providing nursing home and...

  6. [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.

  7. Involved accounting and control in health care : Different perceptions of management accounting and control systems in the Dutch branch of nursing homes, homes for the elderly and homecare

    NARCIS (Netherlands)

    Wil van Erp

    2014-01-01

    The purpose of this study is to explore why and how Management Accounting and Control Systems (MACS) enact and are enacted upon in the Dutch branch of nursing homes, homes for the elderly and home care. In search for answers, this study chooses an actor-network theory (ANT) perspective combined with

  8. [Subjective theories on quality of life and health in old age : An explorative study with nursing home residents and their nursing personnel].

    Science.gov (United States)

    Kada, Olivia; Hedenik, Marina; Griesser, Anna; Mark, Anna-Theresa; Trost, Julia

    2017-01-25

    The terms "quality of life" and "health" are often used interchangeably even though there are indications to suggest that they are distinct constructs. Nevertheless, studies which would help to understand the difference between these constructs on the level of subjective theories of nursing home residents are lacking. Because nursing personnel can essentially contribute to the quality of life of residents, the comparison of subjective theories from residents and from nursing personnel can help to detect and understand potential discrepancies. Semi-structured interviews were conducted with 31 pairs of residents and their nursing personnel. Based on the approach of Fliege and Filipp (2000) one half of the respondents answered the questions using the term "quality of life" and the other half using the term "health". In addition, quality of life and health had to be rated on a visual analogue scale (VAS), whereby residents rated themselves and nurses rated the corresponding resident. Data were analyzed using qualitative content analysis in a team-based approach. Following a mixed methods approach the deductively developed main categories and the inductively developed subcategories were quantified and statistically analyzed together with the VAS ratings. Quality of life was more strongly associated with psychological, social and environmental aspects, whereas health more strongly evoked thoughts on physical functioning. This effect was stronger in nursing personnel, which can be explained by their role concept. In future scientific studies the terms should be used accurately, as they elicit different associations. The term "quality of life" seems to be more suitable to adequately reflect the adaptability of elderly people.

  9. The moderating effect of social support on the relationship between physical health and suicidal thoughts among Chinese rural elderly: A nursing home sample.

    Science.gov (United States)

    Zhang, Dan; Yang, Yang; Wu, Menglian; Zhao, Xia; Sun, Yaoyao; Xie, Hui; Li, Hongkai; Li, Yuqin; Wang, Kefang; Zhang, Jie; Jia, Jihui; Su, Yonggang

    2018-01-23

    Suicide rate is relatively high among Chinese rural elderly. While there has been some exciting work on reporting and preventing suicide among community-dwelling elderly, only a few published studies have addressed the issues of rural nursing homes in China. This study aimed to investigate the relationship among perceived social support, physical health, and suicidal thoughts of the elderly living in Chinese rural nursing homes. It also examined the moderating effects of social support on the path from physical health to suicidal thoughts of the rural institutional elderly in China. This study investigated 205 participants aged 60 years and above in Chinese rural nursing homes. Participants' suicidal thoughts, perceived social support, and physical health were assessed. This study conducted descriptive analysis, Student's t-test, and Pearson's chi-square test to test how physical health and social support predicted suicidal thoughts, as well as the moderating effects of family's, friends', and others' social support on physical health and suicidal thoughts. Both physical health and perceived social support were significantly related to suicidal thoughts. Perceived social support from family, friends, and significant others moderated the relationship between physical health and suicidal thoughts. Findings of this study suggested that increasing social support and improving physical health would be effective in both suicide prevention and intervention for the residents in Chinese rural nursing homes. © 2018 Australian College of Mental Health Nurses Inc.

  10. Oral health-related quality of life and prosthetic status of nursing home residents with or without dementia

    Directory of Open Access Journals (Sweden)

    Klotz AL

    2017-04-01

    Full Text Available Anna-Luisa Klotz,1 Alexander Jochen Hassel,1 Johannes Schröder,2,3 Peter Rammelsberg,1 Andreas Zenthöfer1 1Department of Prosthodontics, Dental School, 2Institute of Gerontology, 3Section of Geriatric Psychiatry, University of Heidelberg, Heidelberg, Germany Purpose: The objective of this cross-sectional study was to evaluate the effect of prosthetic status on the oral health-related quality of life (OHRQoL of nursing home residents with or without dementia.Methods: The study was performed in 14 nursing homes across the federal state of Baden-Württemberg, Germany. All eligible participants were included, and general and medical information and information about their dental and prosthetic statuses were collected. The Geriatric Oral Health Assessment Index (GOHAI was administered to evaluate OHRQoL. The Mini-Mental State Examination (MMSE served to classify participants into living or not living with dementia according to the established cutoff value for dementia (MMSE <24. Parametric bivariate statistics and logistic regression models were used to analyze data at P<0.05.Results: A total of 169 participants were included in this study. The mean age of the participants was 82.9 years. A total of some 70% of the sample was living with dementia. The mean GOHAI score along the sample was 49.1 (8.3, and 41% of the sample reported substantially compromised OHRQoL (GOHAI <50. OHRQoL was statistically similar for people with or without dementia (P=0.234; objective oral health was also similar in both groups (P>0.05. The number of teeth (odds ratio [OR]: 2.0, the type of prosthetic status (OR: 6.5, and denture-related treatment needs (OR: 2.4 were the major factors significantly affecting OHRQoL (P<0.05.Conclusion: The OHRQoL of elderly nursing home residents is substantially compromised. Several prosthetic treatment needs for residents living with or without dementia were identified. Edentulism without tooth replacement and having <5 teeth resulted

  11. Factors influencing home care nurse intention to remain employed.

    Science.gov (United States)

    Tourangeau, Ann; Patterson, Erin; Rowe, Alissa; Saari, Margaret; Thomson, Heather; MacDonald, Geraldine; Cranley, Lisa; Squires, Mae

    2014-11-01

    To identify factors affecting Canadian home care nurse intention to remain employed (ITR). In developed nations, healthcare continues to shift into community settings. Although considerable research exists on examining nurse ITR in hospitals, similar research related to nurses employed in home care is limited. In the face of a global nursing shortage, it is important to understand the factors influencing nurse ITR across healthcare sectors. A qualitative exploratory descriptive design was used. Focus groups were conducted with home care nurses. Data were analysed using qualitative content analysis. Six categories of influencing factors were identified by home care nurses as affecting ITR: job characteristics; work structures; relationships/communication; work environment; nurse responses to work; and employment conditions. Findings suggest the following factors influence home care nurse ITR: having autonomy; flexible scheduling; reasonable and varied workloads; supportive work relationships; and receiving adequate pay and benefits. Home care nurses did not identify job satisfaction as a single concept influencing ITR. Home care nursing management should support nurse autonomy, allow flexible scheduling, promote reasonable workloads and create opportunities for team building that strengthen supportive relationships among home care nurses and other health team members. © 2013 John Wiley & Sons Ltd.

  12. 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...

  13. Impact of health care worker policy awareness on hand hygiene and urinary catheter care in nursing homes: results of a self-reported survey.

    Science.gov (United States)

    Montoya, Ana; Chen, Shu; Galecki, Andrzej; McNamara, Sara; Lansing, Bonnie; Mody, Lona

    2013-06-01

    Utilizing a self-administered questionnaire in 440 health care workers (81% response rate), we evaluated the impact of health care workers policy awareness on hand hygiene and urinary catheter care in nursing homes. We show that health care workers aware of their nursing home policies are more likely to report wearing gloves and practicing hand hygiene as per evidence-based recommendations during urinary catheter care compared with those who are unaware of their facility policies. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  14. Predictors for assessing electronic messaging between nurses and general practitioners as a useful tool for communication in home health care services: a cross-sectional study.

    Science.gov (United States)

    Lyngstad, Merete; Hofoss, Dag; Grimsmo, Anders; Hellesø, Ragnhild

    2015-02-17

    Nurses providing home health care services are dependent on access to patient information and communicating with general practitioners (GPs) to deliver safe and effective health care to patients. Information and communication technology (ICT) systems are viewed as powerful tools for this purpose. In Norway, a standardized electronic messaging (e-messaging) system is currently being established in health care. The aim of this study was to explore home health care nurses' assessments of the utility of the e-messaging system for communicating with GPs and identify elements that influence the assessment of e-messaging as a useful communication tool. The data were collected using a self-developed questionnaire based on variables identified by focus group interviews with home health care nurses (n=425) who used e-messaging and existing research. Data were analyzed using logistic regression analyses. Over two-thirds (425/632, 67.2%) of the home health care nurses returned the questionnaire. A high proportion (388/399, 97.2%) of the home health care nurses who returned the questionnaire found the e-messaging system to be a useful tool for communication with GPs. The odds of reporting that e-messaging was a useful tool were over five times higher (OR 5.1, CI 2.489-10.631, Pnurses agreed or strongly agreed that e-messaging was easy to use. The odds of finding e-messaging easy to use were nearly seven times higher (OR 6.9, CI 1.713-27.899, P=.007) if the nurses did not consider the system functionality poor. If the nurses had received training in the use of e-messaging, the odds were over six times higher (OR 6.6, CI 2.515-17.437, Pcare nurse would experience e-messaging as easy to use increased as the full-time equivalent percentage of the nurses increased (OR 1.032, CI 1.001-1.064, P=.045). This study has shown that technical (ease of use and system functionality), organizational (training), and individual (full-time equivalent percentage) elements had an impact on home

  15. Psycho-social impact of visual impairment on health-related quality of life among nursing home residents.

    Science.gov (United States)

    Dev, Mahesh Kumar; Paudel, Nabin; Joshi, Niraj Dev; Shah, Dev Narayan; Subba, Shishir

    2014-08-15

    Visual impairment (VI) affects physical, psychological, and emotional well-being, and social life as well. The purpose of this exploratory study was to assess the psycho-social impact of VI on health-related quality of life (HRQoL) among nursing home residents. This cross-sectional study involved 272 residents of 60 years or older residing in seven nursing homes of the Kathmandu Valley, Nepal. Comprehensive ocular examinations, including near and distance vision assessment and refractions were carried out. VI was defined as visual acuity (VA) less than 6/18 in the better eye. Residents were divided into two groups: one group did not have VI (in whom VA was greater than or equal to 6/18 in the better eye), and the other had VI (in whom VA was worse than 6/18 in the better eye).Face-to-face interviews were conducted filling out a 36-item The Medical Outcomes Study Short-Form (SF-36) questionnaire. The SF-36 questionnaire was scored according to the scoring algorithm SF-36 subscales. The mean age of residents was 74.68 ± 8.19 years (range, 60-99 years) and the majority were female (78.68%). The mean composite score of SF-36 was 46.98 ± 13.08. VI detrimentally affected scores of both the physical and the mental components, but the impact of VI was slightly greater for the physical component than that for the mental component. There was a trend towards a lower composite score as well as each subscale score of the SF-36 in participants with VI than in those without VI. VI has a negative effect on HRQoL. HRQoL is reduced among nursing home residents and the reduction in the HRQoL bears a positive association with VI.

  16. Animal-Assisted Interventions in Dutch Nursing Homes: A Survey.

    Science.gov (United States)

    Schuurmans, Lonneke; Enders-Slegers, Marie-Jose; Verheggen, Theo; Schols, Jos

    2016-07-01

    Animal-assisted interventions (AAI) have become more and more popular in nursing homes in the past decade. Various initiatives for using animals in nursing homes have been developed over the years (eg, animal visiting programs, residential companion animals, petting zoos) and, on the whole, the number of nursing homes that refuse animals on their premises has declined. In this survey, we aimed to determine how many Dutch nursing homes offer AAIs, what type of interventions are used, and with what aim. We also focus on the use of underlying health, hygiene, and (animal) safety protocols. Using an online Dutch nursing home database, we invited all listed (457) nursing home organizations in the Netherlands (encompassing a total of 804 nursing home locations) to participate in our digital survey, powered by SurveyMonkey. The survey consisted of a total of 45 questions, divided into general questions about the use of animals in interventions; the targeted client population(s); and specific questions about goals, guidelines, and protocols. The results were analyzed with SPSS Statistics. In the end, 244 surveys, representing 165 organizations, were returned: 125 nursing homes used AAI in one way or another, 40 did not. Nursing homes that did not offer AAI cited allergy and hygiene concerns as the most important reasons. Most nursing homes offering AAI used visiting animals, mostly dogs (108) or rabbits (76). A smaller number of nursing homes had resident animals, either living on the ward or in a meadow outside. Almost all programs involved animal-assisted activities with a recreational purpose; none of the participating nursing homes provided animal assisted therapy with therapeutic goals. Psychogeriatric patients were most frequently invited to participate. A total of 88 nursing homes used alternatives when animals were not an option or not available. The most popular alternative was the use of stuffed animals (83) followed by FurReal Friends robotic toys (14). The

  17. 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. χ2 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.

  18. Nurse Physiotherapy in Medical Home Care

    OpenAIRE

    Truhlářová, Lenka

    2008-01-01

    Bachelor's thesis is centred on theme medical home care, importace of nurse physiotherapy and significance nurse physiotherapy by patiens in medical home care. It look on wide of use at illnies cerebral apoplexy, the theses of nurse physiotherapy and some suggestions and tips how the nurse physiotherapy instruments use for patients by cerebral apoplexy. Substance of the bachelor's thesis make research of use nurse physioterapy by medical workers and of knowledge how utilize in medical home ca...

  19. Advance directives in Japanese nursing homes.

    Science.gov (United States)

    Takezako, Yayoi; Ishikawa, Shizukiyo; Kajii, Eiji

    2013-01-01

    Advance directives are poorly understood in Japanese nursing homes. In April 2006, additional funding for end-of-life care became available as the first support for terminal care at Japanese nursing homes. The objectives of this study were to investigate the adoption of advance directives by Japanese nursing homes, the effect of additional funding for end-of-life care in nursing homes from long-term care insurance on the use of advance directives, and the types of directives used. A nationwide questionnaire survey of nursing homes was performed in Japan. The participants were 913 nursing homes. We investigated the prevalence of advance directives, details of the directives, and demographic data of the responders. Advance directives were used in 58.4% of nursing homes. The timing of introduction of the directives and the results of multivariate analysis at the facility level suggested a relation between the availability of additional funding for end-of-life care and the adoption of advance directives. Most nursing homes used instructional directives, especially directives providing an explanation and informed consent for end-of-life care in the nursing home. More than half of Japanese nursing homes have introduced advance directives, and additional funding for end-of-life care is related to their introduction. Most nursing homes have adopted instructional directives, especially those providing an explanation and informed consent regarding end-of-life care at the nursing home. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  20. Future Development of Nursing Home Quality Indicators

    Science.gov (United States)

    Arling, Greg; Kane, Robert L.; Lewis, Teresa; Mueller, Christine

    2005-01-01

    Nursing home quality indicators have been developed over the past 10 years to quantify nursing home quality and to draw systematic comparisons between facilities. Although these indicators have been applied widely for nursing home regulation, quality improvement, and public reporting, researchers and stakeholders have raised concerns about their…

  1. Action research in nursing homes

    DEFF Research Database (Denmark)

    Andersen, John; Bilfeldt, Anette

    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...

  2. Nursing home statutes: mistreatment definitions.

    Science.gov (United States)

    Daly, Jeanette M; Jogerst, Gerald J

    2006-01-01

    Forty-nine states and the District of Columbia have adult protective services (APS) related statutes that define adult/elder mistreatment found in domestic settings. Institutional adult/elder mistreatment laws are administered by the nursing home licensing agencies and may contain different or duplicate APS-related mistreatment definitions. The purposes of this paper are to describe and summarize the mistreatment definitions in the nursing home licensure statutes and compare those definitions with the definitions found in the APS-related statutes. Westlaw and Lexis-Nexis law database systems were used to retrieve all adult protective services statutes and institutional licensure statutes. Each statute's text was reviewed and coded by two researchers. Institutional mistreatment definitions are addressed in 14 of the states and District of Columbia's nursing home statutes. No one state has a list of the 27 different definitions of mistreatment identified in the literature search. The common types of mistreatment described were physical and emotional abuse, neglect, financial and property exploitation, and sexual abuse. Standardized definitions of resident-to-resident and institutional specific types of mistreatment need to be included in nursing home statutes.

  3. 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....

  4. Nursing home quality: a comparative analysis using CMS Nursing Home Compare data to examine differences between rural and nonrural facilities.

    Science.gov (United States)

    Lutfiyya, May Nawal; Gessert, Charles E; Lipsky, Martin S

    2013-08-01

    Advances in medicine and an aging US population suggest that there will be an increasing demand for nursing home services. Although nursing homes are highly regulated and scrutinized, their quality remains a concern and may be a greater issue to those living in rural communities. Despite this, few studies have investigated differences in the quality of nursing home care across the rural-urban continuum. The purpose of this study was to compare the quality of rural and nonrural nursing homes by using aggregated rankings on multiple quality measures calculated by the Centers for Medicare and Medicaid Services and reported on their Nursing Home Compare Web site. Independent-sample t tests were performed to compare the mean ratings on the reported quality measures of rural and nonrural nursing homes. A linear mixed binary logistic regression model controlling for state was performed to determine if the covariates of ownership, number of beds, and geographic locale were associated with a higher overall quality rating. Of the 15,177 nursing homes included in the study sample, 69.2% were located in nonrural areas and 30.8% in rural areas. The t test analysis comparing the overall, health inspection, staffing, and quality measure ratings of rural and nonrural nursing homes yielded statistically significant results for 3 measures, 2 of which (overall ratings and health inspections) favored rural nursing homes. Although a higher percentage of nursing homes (44.8%-42.2%) received a 4-star or higher rating, regression analysis using an overall rating of 4 stars or higher as the dependent variable revealed that when controlling for state and adjusting for size and ownership, rural nursing homes were less likely to have a 4-star or higher rating when compared with nonrural nursing homes (OR = .901, 95% CI 0.824-0.986). Mixed model logistic regression analysis suggested that rural nursing home quality was not comparable to that of nonrural nursing homes. When controlling for

  5. 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

  6. Nurse-led health promotion interventions improve quality of life in frail older home care clients: lessons learned from three randomized trials in Ontario, Canada.

    Science.gov (United States)

    Markle-Reid, Maureen; Browne, Gina; Gafni, Amiram

    2013-02-01

    This paper explores the lessons learned from a series of three randomized controlled trials that included 498 community-living frail older adults (≥65 years) using home care services in Southern Ontario, Canada. Each study was designed to evaluate the effectiveness of different multi-component nurse-led health promotion and disease prevention (HPDP) interventions. The nurse-led HPDP interventions were 6- or 12-month multi-component and evidence-based strategies targeting known risk factors for functional decline and frailty. Across the three studies, a common approach was used to measure the change in health-related quality of life (HRQOL) (SF-36) and the costs of use of health services (Health and Social Services Utilization Inventory) from baseline to the end of the intervention. The main lesson learned from the three studies is that nurse-led HPDP interventions for frail older home care clients provide greater improvements in HRQOL compared with usual home care. Such approaches are highly acceptable to this population and can be implemented using existing home care resources. Nurse-led HPDP interventions should include multiple home visits, multidimensional screening and assessment, multi-component evidence-based HPDP strategies, intensive case management, inter-professional collaboration, providers with geriatric training and experience, referral to and coordination of community services, and theory use. The results of the three trials underscore the need to reinvest in nurse-led HPDP interventions in home care to optimize HRQOL and promote ageing in place in the target population of frail older adults. More studies are needed to evaluate the effectiveness of additional nurse-led HPDP interventions in other contexts and settings. © 2011 Blackwell Publishing Ltd.

  7. MRSA Prevalence and Risk Factors among Health Personnel and Residents in Nursing Homes in Hamburg, Germany – A Cross-Sectional Study

    Science.gov (United States)

    Peters, Claudia; Dulon, Madeleine; Kleinmüller, Olaf; Nienhaus, Albert; Schablon, Anja

    2017-01-01

    Introduction The increase of multidrug-resistant organisms in hospitals causes problems in nursing homes. Staff in geriatric nursing homes are at greater risk of MRSA colonisation. The aim of the study was to describe the occupational exposure to MRSA among health personnel in geriatric nursing. Methods A point prevalence survey was conducted among health personnel and residents of geriatric nursing homes within the greater Hamburg district. Nasal swabs and, where relevant, wound swabs were collected for the screening survey. Risk factors for MRSA colonisation were identified by means of a questionnaire and using the files held on the residents. Where tests on nursing staff were positive, a control swab was taken; when the results were confirmed positive, decolonisation was performed. The responsible general practitioners were notified of positive MRSA findings among residents. A molecular biological examination of the MRSA samples was performed. Results A total of 19 institutions participated in the study. Nasal swabs were taken from 759 nursing staff and 422 residents. Prevalence of MRSA was 1.6% among staff and 5.5% among residents. MRSA colonisation among health personnel indicated a correlation with male gender (OR 4.5, 95% CI 1.4–14.1). Among the residents, chronic skin diseases (OR 3.2, 95% CI 1.0–10.3) and indwelling devices (OR 3.2, 95% CI 1.2–8.1) were identified as risk factors. No link between MRSA in residents and in health personnel could be established. Conclusion The number of MRSA colonisations among nursing staff and residents of geriatric nursing homes in Hamburg was rather low at 1.6% and 5.5% respectively and equates to the results of other surveys in non-outbreak scenarios. PMID:28068356

  8. MRSA Prevalence and Risk Factors among Health Personnel and Residents in Nursing Homes in Hamburg, Germany - A Cross-Sectional Study.

    Science.gov (United States)

    Peters, Claudia; Dulon, Madeleine; Kleinmüller, Olaf; Nienhaus, Albert; Schablon, Anja

    2017-01-01

    The increase of multidrug-resistant organisms in hospitals causes problems in nursing homes. Staff in geriatric nursing homes are at greater risk of MRSA colonisation. The aim of the study was to describe the occupational exposure to MRSA among health personnel in geriatric nursing. A point prevalence survey was conducted among health personnel and residents of geriatric nursing homes within the greater Hamburg district. Nasal swabs and, where relevant, wound swabs were collected for the screening survey. Risk factors for MRSA colonisation were identified by means of a questionnaire and using the files held on the residents. Where tests on nursing staff were positive, a control swab was taken; when the results were confirmed positive, decolonisation was performed. The responsible general practitioners were notified of positive MRSA findings among residents. A molecular biological examination of the MRSA samples was performed. A total of 19 institutions participated in the study. Nasal swabs were taken from 759 nursing staff and 422 residents. Prevalence of MRSA was 1.6% among staff and 5.5% among residents. MRSA colonisation among health personnel indicated a correlation with male gender (OR 4.5, 95% CI 1.4-14.1). Among the residents, chronic skin diseases (OR 3.2, 95% CI 1.0-10.3) and indwelling devices (OR 3.2, 95% CI 1.2-8.1) were identified as risk factors. No link between MRSA in residents and in health personnel could be established. The number of MRSA colonisations among nursing staff and residents of geriatric nursing homes in Hamburg was rather low at 1.6% and 5.5% respectively and equates to the results of other surveys in non-outbreak scenarios.

  9. Self-reported competence of home nursing staff in Finland.

    Science.gov (United States)

    Grönroos, Eija; Perälä, Marja-Leena

    2008-10-01

    This paper is a report of a study to investigate the self-reported competence of home nursing staff and whether this is associated with their education, job descriptions, access to help and support and with factors in their psychosocial work environment, such as opportunities for personal growth and development at work. Home nursing staff face increasing demands on their competence. Advances in information technology and working methods have increased the need for education. Thus, information on the factors associated with the competence of home nursing staff help us to support them in a way that improves the quality of care. The data were gathered via a questionnaire completed in 2003 by the home nursing staff of 24 municipalities in different regions of Finland. A total of 2366 home care staff (response rate 63%), of whom 790 were home nursing staff (response rate 65%), were sent questionnaires. Univariate and multivariate logistic regression were used as main statistical methods. The best predictors for self-reported competence of home nursing staff were their reading scientific or professional journals, opportunities for skill development, decision-making latitude and work demands. Simple and practical ways for updating the competence of home nursing staff should be created. These staff are a very important source of information for home care clients. Supporting the knowledge of home nursing staff is also an efficient way of keeping clients and their informal caregivers informed about care guidelines, health and social services and social benefits.

  10. The predictive value of self-rated health in the presence of subjective memory complaints on permanent nursing home placement in elderly primary care patients over 4-year follow-up

    DEFF Research Database (Denmark)

    Nielsen, Anni Brit Sternhagen; Siersma, Volkert Dirk; Waldemar, Gunhild

    2013-01-01

    self-rated health (SRH) predicts nursing home (NH) placement; subjective memory complaints (SMC) too. However, the predictive value of SRH in the presence of SMC is unclear.......self-rated health (SRH) predicts nursing home (NH) placement; subjective memory complaints (SMC) too. However, the predictive value of SRH in the presence of SMC is unclear....

  11. New Opportunities for Cancer Health Services Research: Linking the SEER-Medicare Data to the Nursing Home Minimum Data Set.

    Science.gov (United States)

    Thomas, Kali S; Boyd, Eric; Mariotto, Angela B; Penn, Dolly C; Barrett, Michael J; Warren, Joan L

    2018-02-02

    The Surveillance, Epidemiology and End Results (SEER)-Medicare data combine clinical information from population-based cancer registries with Medicare claims. These data have been used in many studies to understand cancer screening, treatment, outcomes, and costs. However, until recently, these data included limited information related to the characteristics and outcomes of cancer patients residing in or admitted to nursing homes. To provide an overview of the new linkage between SEER-Medicare data and the Minimum Data Set (MDS), a nursing home resident assessment instrument detailing residents' physical, psychological, and psychosocial functioning as well as any therapies or treatments received. This is a descriptive, retrospective cohort study. Persons in SEER-Medicare diagnosed with cancer from 2004 to 2013 were linked to the 2011-2014 MDS, with 17% of SEER-Medicare patients linked to the MDS data. During 2011-2014, we identified 318,617 cancer patients receiving care in a nursing home and 256,947 cancer patients newly admitted to a total of 10,953 nursing homes. Of these patients, approximately two thirds were Medicare fee-for-service beneficiaries. The timing from cancer diagnoses to nursing home admission varied by cancer. In total, 93% of all patients were admitted directly to a nursing home from an acute care hospital. The majority of patients were cognitively intact, 21% reported some level of depression, and 9% had severe functional limitations. The new SEER-Medicare-MDS dataset provides a valuable resource for understanding the postacute and long-term care experiences of cancer patients receiving care in United States' nursing homes.

  12. Feeling safe and motivated to achieve better health: Experiences with a partnership-based nursing practice programme for in-home patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Leine, Marit; Wahl, Astrid Klopstad; Borge, Christine Råheim; Hustavenes, Magne; Bondevik, Hilde

    2017-09-01

    To explore chronic obstructive pulmonary disease patients' experiences with a partnership-based nursing practice programme in the home setting. Patients with chronic obstructive pulmonary disease suffer from psychological and physiological problems, especially when they return home after hospitalisation from exacerbation. Many express a need for information and knowledge about chronic obstructive pulmonary disease. Partnership as practice is a patient-centred framework providing an individualised practice for each patient. This study intends to achieve a nuanced and improved understanding of chronic obstructive pulmonary disease patients' experiences with a partnership-based nursing practice programme comprising home visits from a respiratory nurse after hospital discharge, alongside interdisciplinary collaboration. This study has a qualitative design with interviews. Six individual semi-structured interviews collected in 2012-2013 constitute the material. Interviews were recorded, transcribed to written text and analysed using systematic text condensation. Three key themes were identified: to be seen, talked with and understood; healthcare support at home-continuity, practical support and facilitation; and exchange of knowledge. However, there were two generic themes that permeated the material: feeling safe and comforted, and motivation to achieve better health. Patients with chronic obstructive pulmonary disease can experience feeling safe and comforted, and be motivated to make changes in order to achieve better health after participating in a partnership-based nursing practice programme that includes home visits from a respiratory nurse and interdisciplinary cooperation after hospital discharge. To feel safe is of great importance, and how this relates to the patient's ability to cope with illness should be explored in further research. The results suggest that the partnership-based nursing practice programme that includes home visits and interdisciplinary

  13. Organization aesthetics in nursing homes.

    Science.gov (United States)

    Hujala, Anneli; Rissanen, Sari

    2011-05-01

    The aim of this study was to make visible the material dimensions of nursing management.   Management theories have mainly ignored the material dimensions, namely the physical spaces in which management actually takes place as well as the physical bodies of organization members. The perspective of organization aesthetics enhances our understanding of the role of materiality in nursing management. The data were collected in 2009 using observation and interviews in eight nursing homes. Qualitative content analysis with critical interpretations was used. Three main issues of organizational aesthetics related to nursing management were identified: (1) the functionality of working spaces and equipment; (2) the relevance of 'organizational' space; and (3) the emotional-aesthetic dimension of daily work. Materiality is closely related to management topics, such as decision-making, values and identity formation of organizational members. Aesthetic dimensions of care are constructed by management practices which, in their turn, influence the nature of management. Implications for nursing management  Nurse managers need to be aware of the unintended and unnoticed consequences of materiality and aesthetics. Space and body issues may have considerable effects, for example, on the identity of care workers and on the attractiveness of the care branch. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

  14. Home Health Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Home Health Compare has information about the quality of care provided by Medicare-certified home health agencies throughout the nation. Medicare-certified means the...

  15. Reducing depression in older home care clients: design of a prospective study of a nurse-led interprofessional mental health promotion intervention.

    Science.gov (United States)

    Markle-Reid, Maureen F; McAiney, Carrie; Forbes, Dorothy; Thabane, Lehana; Gibson, Maggie; Hoch, Jeffrey S; Browne, Gina; Peirce, Thomas; Busing, Barbara

    2011-08-25

    Very little research has been conducted in the area of depression among older home care clients using personal support services. These older adults are particularly vulnerable to depression because of decreased cognition, comorbid chronic conditions, functional limitations, lack of social support, and reduced access to health services. To date, research has focused on collaborative, nurse-led depression care programs among older adults in primary care settings. Optimal management of depression among older home care clients is not currently known. The objective of this study is to evaluate the feasibility, acceptability and effectiveness of a 6-month nurse-led, interprofessional mental health promotion intervention aimed at older home care clients with depressive symptoms using personal support services. This one-group pre-test post-test study aims to recruit a total of 250 long-stay (> 60 days) home care clients, 70 years or older, with depressive symptoms who are receiving personal support services through a home care program in Ontario, Canada. The nurse-led intervention is a multi-faceted 6-month program led by a Registered Nurse that involves regular home visits, monthly case conferences, and evidence-based assessment and management of depression using an interprofessional approach. The primary outcome is the change in severity of depressive symptoms from baseline to 6 months using the Centre for Epidemiological Studies in Depression Scale. Secondary outcomes include changes in the prevalence of depressive symptoms and anxiety, health-related quality of life, cognitive function, and the rate and appropriateness of depression treatment from baseline to 12 months. Changes in the costs of use of health services will be assessed from a societal perspective. Descriptive and qualitative data will be collected to examine the feasibility and acceptability of the intervention and identify barriers and facilitators to implementation. Data collection began in May 2010 and

  16. 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...

  17. 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...

  18. Home Health Aides

    Science.gov (United States)

    ... State & Area Data Explore resources for employment and wages by state and area for home health aides and personal care aides. Similar Occupations Compare the job duties, education, job growth, and pay of home health aides ...

  19. Beliefs on Mandatory Influenza Vaccination of Health Care Workers in Nursing Homes : A Questionnaire Study from the Netherlands

    NARCIS (Netherlands)

    Looijmans-van den Akker, Ingrid; Marsaoui, Badyr; Hak, Eelko; van Delden, Johannes J. M.

    2009-01-01

    OBJECTIVES: To assess whether nursing homes (NHs) made organizational improvements to increase influenza vaccination rates in healthcare workers (HCWs) and to quantify the beliefs of NH administrators on the arguments used in favor of implementation of mandatory influenza vaccination of HCWs.

  20. Rurality and Nursing Home Quality: Evidence from the 2004 National Nursing Home Survey

    Science.gov (United States)

    Kang, Yu; Meng, Hongdao; Miller, Nancy A.

    2011-01-01

    Purpose of the Study: To evaluate the impact of rural geographic location on nursing home quality of care in the United States. Design and Methods: The study used cross-sectional observational design. We obtained resident- and facility-level data from 12,507 residents in 1,174 nursing homes from the 2004 National Nursing Home Survey. We used…

  1. Effects of Physical Exercise on Health and Well-Being of Individuals Living With a Dementia in Nursing Homes: A Systematic Review.

    Science.gov (United States)

    Brett, Lindsey; Traynor, Victoria; Stapley, Paul

    2016-02-01

    Physical exercise interventions have benefits for older individuals and improve the health and well-being of individuals living with a dementia, specifically those living in nursing homes. Report evidence from randomized controlled trials and cluster randomized control trials that evaluated the effects of physical exercise interventions on individuals living with a dementia in nursing homes. Web of Science, Scopus, Science Direct, Academic Search Complete, Proquest Central, British Medical Journal Database, PubMed, Cochrane Library, PEDro, Informit, Informa, and Nursing Consult were searched for relevant clinical trials and snowballing of recommended studies. One reviewer screened articles on inclusion criteria and identified relevant studies. Data extraction was performed by 1 reviewer and checked by second and third reviewers. Two authors assessed the methodological quality and risk of bias of the relevant studies. Twelve study populations consisting of individuals living with a dementia in nursing homes were included (n = 901). Different types of physical exercises were undertaken: multimodal (n = 6), walking (n = 5), music and movement (n = 2), and hand exercises (n = 1). The parameters of the interventions varied across the studies. Most of the studies reported significant positive effects of physical exercise on cognition, agitation, mood, mobility, and functional ability for individuals living with dementia in nursing homes. The main limitations were the heterogeneity of design, small samples, and short interventions. There is emerging evidence that physical exercise significantly benefits individuals living with a dementia in nursing homes. Higher quality research is required adopting more rigorous methods, including longer interventions and larger samples to determine optimum parameters of the physical exercise interventions evaluated. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc

  2. 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.

  3. 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,…

  4. 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 any...

  5. 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…

  6. Are the barriers to good oral hygiene in nursing homes within the nurses or the patients?

    Science.gov (United States)

    Willumsen, Tril; Karlsen, Line; Naess, Richard; Bjørntvedt, Sissel

    2012-06-01

    To explore nursing home patients' oral hygiene and their nurses' assessments of barriers to improvement. In nursing homes, nurses are responsible for patients' oral hygiene. This study assessed the oral hygiene of 358 patients in 11 Norwegian nursing homes. 494 nurses in the same nursing homes participated in a questionnaire study. More than 40% of patients had unacceptable oral hygiene. 'More than 10 teeth' gave OR = 2, 1 (p = 0.013) and 'resist being helped' OR = 2.5 (p = 0.018) for unacceptable oral hygiene. Eighty percent of the nurses believed knowledge of oral health was important, and 9.1% often considered taking care of patients' teeth unpleasant. Half of the nurses reported lack of time to give regular oral care, and 97% experienced resistant behaviour in patients. Resistant behaviour often left oral care undone. Twenty-one percent of the nurses had considered making legal decisions about use of force or restraints to overcome resistance to teeth cleaning. Oral hygiene in the nursing homes needed to be improved. Resistant behaviour is a major barrier. To overcome this barrier nurses' education, organisational strategies to provide more time for oral care, and coping with resistant behaviour in patients are important factors. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

  7. Acceptability Among Community Healthcare Nurses of Intelligent Wireless Sensor-system Technology for the Rapid Detection of Health Issues in Home-dwelling Older Adults.

    Science.gov (United States)

    Cohen, Christine; Kampel, Thomas; Verloo, Henk

    2017-01-01

    The effective care and support of community healthcare nurses (CHNs) contribute greatly to the healthy aging of older adults living at home. Integrating innovative technologies into CHNs' daily practice offers new opportunities and perspectives for early detection of health issues and interventions among home-dwelling older adults. To explore the perception of acceptability among CHNs of an intelligent wireless sensor system (IWSS) for use in daily practice for the detection of health issues in home-dwelling older adults receiving home healthcare. Descriptive and qualitative data were sourced from a pilot randomized controlled trial involving 17 CHNs using an IWSS in their daily practice to rapidly detect falls and other health issues in patients' homes. IWSS alerts indicating behavior changes were sent to CHNs. Their perceived usefulness (PU) and perceived ease of use (PEOU) were assessed. The acceptability of IWSS technology was explored using a questionnaire and focus group discussions. The PU and PEOU of the IWSS technology were low to moderate. A majority of the CHNs were dissatisfied with its performance and intrusiveness; they reported multiple obstacles in the usefulness and ease of use of the IWSS technology in daily practice. To improve the IWSS technology's low to moderate acceptability among CHNs, we recommend a more user-centered implementation strategy and an embedded model of nursing care.

  8. Nursing Leadership in Home and Community Care: An Introduction.

    Science.gov (United States)

    Donner, Gail

    2017-01-01

    There is agreement across all provinces that there is transformation needed in the area of home and community care. Yet, where is the collective voice of nurse leaders in this transformation? The guest editor calls on nurses to respond to this unique opportunity to shape the transformation of our health system, and improve care for patients and their caregivers.

  9. 38 CFR 17.57 - Use of community nursing homes.

    Science.gov (United States)

    2010-07-01

    ... 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... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Use of community nursing...

  10. 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.

  11. 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.

  12. Mobile computing and the quality of home care nursing practice.

    Science.gov (United States)

    Paré, Guy; Sicotte, Claude; Moreault, Marie-Pierre; Poba-Nzaou, Placide; Nahas, Georgette; Templier, Mathieu

    2011-01-01

    We investigated the effects of the introduction of mobile computing on the quality of home care nursing practice in Québec. The software, which structured and organized the nursing activities in patients' homes, was installed sequentially in nine community health centres. The completeness of the nursing notes was compared in 77 paper records (pre-implementation) and 73 electronic records (post-implementation). Overall, the introduction of the software was associated with an improvement in the completeness of the nursing notes. All 137 nurse users were asked to complete a structured questionnaire. A total of 101 completed questionnaires were returned (74% response rate). Overall, the nurses reported a very high level of satisfaction with the quality of clinical information collected. A total of 57 semi-structured interviews were conducted and most nurses believed that the new software represented a user-friendly tool with a clear and understandable structure. A postal questionnaire was sent to approximately 1240 patients. A total of 223 patients returned the questionnaire (approximately 18% response rate). Overall, patients felt that the use of mobile computing during home visits allowed nurses to manage their health condition better and, hence, provide superior care services. The use of mobile computing had positive and significant effects on the quality of care provided by home nurses.

  13. ‘Knowing the places of care’: How nurses facilitate transition of children with complex health care needs from hospital to home

    OpenAIRE

    Carter, Bernie; Bray, Lucy; Sanders, Caroline Diane; Van Miert, Clare; Hunt, Anne; Moore, Andrew

    2016-01-01

    The number of children with complex health care needs continues to rise and they often have prolonged hospital stays with their discharge home being delayed by a range of factors, despite the fact that, except in extraordinary circumstances, a child’s home is the most appropriate place for them to receive long-term care. The aim of this appreciative, qualitative interview-based study was to explore the work of nurses whose main role is supporting children and families move from an institution...

  14. Evaluation of dental hygiene education for nursing home staff.

    Science.gov (United States)

    Sjögren, Petteri; Kullberg, Erika; Hoogstraate, Janet; Johansson, Olle; Herbst, Bertil; Forsell, Marianne

    2010-02-01

    This paper is a report of a study evaluating the long-term effects on the oral hygiene status of older nursing home residents one and a half years after dental hygiene education was given to the staff. A strong relationship exists between oral infections and general health complications (especially aspiration pneumonia) among nursing home residents and hospitalized older people. It is therefore important to educate nursing home staff in oral hygiene measures and to follow up the effects of the education over time. Dental plaque measurements were conducted at a Swedish nursing home in 2006-2008. Forty-one residents (12 men, 31 women, aged 69-99 years) fulfilled the inclusion criteria and participated in a dental hygiene evaluation 1.5 years after dental hygiene education was given to the staff at the nursing home. Plaque index scores (year 2008) were compared to those soon after the education (year 2006). After the dental hygiene education in 2006, 60 nursing home residents (14 men, 46 women) were available for plaque index measurements, whereas 41 residents (12 men, 29 women) were available 1.5 years later. The median plaque index scores were 17.0 (n = 60) in 2006, and 18.0 (n = 41) in 2008 (Mann-Whitney U-test, P > 0.05). Dental hygiene education for nursing home staff is important to maintain an adequate level of oral hygiene among older nursing home residents over time. Follow-up of dental hygiene education for nursing home staff is recommended to maintain a sufficient level of oral hygiene among the residents.

  15. Home Health PPS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Under prospective payment, Medicare pays home health agencies (HHAs) a predetermined base payment. The payment is adjusted for the health condition and care needs of...

  16. PNEUMONIA IN NURSING HOME RESIDENTS

    Directory of Open Access Journals (Sweden)

    Renato Eržen

    2002-10-01

    Full Text Available Background. Pneumonia remains one of the leading causes of morbidity and mortality worldwide, especially in advanced age. Prognosis of the disease depends on premorbid condition and immune competence of the patient, severity of the disease and causative microorganism. In our analysis we wanted to establish clinical, x-ray and microbiological characteristics of pneumonia in nursing home residents, estimate suitability of therapeutic measures and find out risk factors for adverse outcome in this group of patients.Material and methods. This retrospective study includes all nursing home residents hospitalised due to CAP in Hospital Golnik in 2000. Clinical data was/were evaluated according to case history. Microbiological data and laboratory results were gathered from the patients files. Chi-square test was used for statistical analysis.Results. 30 patients, 17 women were included, aged 82.5 ± 11.7 years. 60% of patients had at least 2 accompanying diseases, most frequently cardiovascular and neurologic diseases. At admittance 83% of patients presented with severe form of the disease. Dispnea (93%, tachypnea, cough (67% and confusion (47% dominate clinical picture. Patients rarely expectorate, are frequently hypoxemic (93%, have leucocytosis (63%, electrolyte disturbances and elevated urea (67%. According to the microbiologic results most frequent causative agents are Enterobacteriae, S. pneumoniae, H. influenzae and also some multiresistant bacteria. Amoxycillin with clavulanic acid was the most frequently used antibiotic, followed by macrolides and 3rd generation cephalosporines.9 patients died, mortality rate was 30%. Their average age was 83,4 years, 67% of them had more than 2 accompanying diseases, all of them severe form of the disease, 89% severe respiratory insufficiency and 22% positive hemoculture.Conclusions. Patients are characterised with numerous comorbidities and advanced age. Clinical presentation is unspecific. Mortality is high

  17. A home-based, nurse-led health program for postoperative patients with early-stage cervical cancer: A randomized controlled trial.

    Science.gov (United States)

    Li, Jue; Huang, Jiliang; Zhang, Jun; Li, Yajie

    2016-04-01

    To investigate the effect of a home-based, nurse-led health program on quality of life and family function for postoperative patients with early-stage cervical cancer. 226 cervical cancer patients, from two hospitals between December 2012 and April 2014, were randomly divided into intervention and control groups. Patients in the intervention group received an individual home-based, nurse-led health program (family-care team provision, physiological rehabilitation, emotion-release management, informal social support system, and follow-up monitoring), in addition to conventional nursing education. Patients in the control group only received conventional nursing education. The Functional Assessment Cancer Therapy-Cervix, Female Sexual Function Index, and the Family Adaptability and Cohesion Scale were used for assessment before and after the intervention. After the intervention, significant improvements were found for the quality of life total scores (t=-7.650, p=0.000), sexual function scores (t=-6.465, p=0.000), cohesion scores (t=-8.417, p=0.001) and adaptability scores (t=-10.735, p=0.000) in the intervention group. Moreover, proportions of family types were also improved (χ2 = 17.77, p=0.000). However, for the control group, no significant differences were found except for a decrease in sexual function scores (t = -4.035, p=0.000). Significant differences in change scores between groups were also found for quality of life (F=41.980, p=0.000), Sexual function (F=37.380, p=0.000), cohesion (F=15.268, p=0.000) and adaptability (F=16.998, p=0.000). A home-based, nurse-led health promotion program improves the quality of life, sexual function and family function in postoperative patients with early-stage cervical cancer. Copyright © 2015. Published by Elsevier Ltd.

  18. Perspectives and expectations for telemedicine opportunities from families of nursing home residents and caregivers in nursing homes.

    Science.gov (United States)

    Chang, Jun-Yih; Chen, Liang-Kung; Chang, Chia-Ching

    2009-07-01

    This study assessed current perspectives and expectations for telemedicine by nursing home caregivers and families of nursing home patients in Taipei, Taiwan. A total of 116 interviews were conducted with family members (n=37) and caregivers (n=79) using an original, four-part questionnaire devised to assess the expectations and concerns related to prospective telemedicine opportunities, including consumer attitude, knowledge of and interest in medicine, concerns and worries about telemedicine, and anticipated benefits of telemedicine. Statistical significance between the two groups was observed in sex, age, and educational level (all ppatients, notifications of health abnormalities, teleconferencing between physicians and family members, obtaining test/exam results and face-to-face consultation through telenetworks. Both groups hoped for information and education through telemedicine. More caregivers were concerned about increased costs (p=0.020), poor hardware quality (psecurity, confidentiality, and reliability (p=0.036), inconvenience to patients (p=0.006), associated moral and ethical issues (p=0.006), and uncertainty about responsibility (p=0.022). The two groups did not differ in expectations concerning benefits of telemedicine. More than 60% of family members or caregivers expected improved efficiency and quality of hospital and nursing home health care, greater rapport between nursing homes and either staff or patients, reduced overall medical costs of caregiving, and reduced staff/caregiver working hours. The acceptable cost was anything up to $15.30 USD per month. Nursing home caregivers and families of nursing home patients are highly interested in telemedicine; however, they are only willing to pay a slightly higher cost of nursing care for this service. The challenge for the future in this industry is to balance peoples' demands and telemedicine's associated costs. Results of this study suggest that caregivers and families of nursing home residents

  19. Family Caregivers Define and Manage the Nursing Home Placement Process.

    Science.gov (United States)

    Koplow, Sarah M; Gallo, Agatha M; Knafl, Kathleen A; Vincent, Catherine; Paun, Olimpia; Gruss, Valerie

    2015-08-01

    The nursing home placement process is complex and difficult for family caregivers. This qualitative descriptive study examines the experiences of caregivers involved in the management of care and placement of an older family member using the Family Management Style Framework. Ten caregivers were recruited from four nursing homes in the Midwest. The caregivers were interviewed shortly after placement and again 3 months post-placement. Results provide a unique understanding of care management and the nursing home placement process from the perspective of the primary family caregiver. Overall, there were similarities across the same types of caregiving dyads, for example, spousal and adult-children caregivers. Caregivers expressed the need to maintain the identity of their older family member, a familial responsibility for caregiving, and change in their family relationship over time. Appreciating caregivers' challenges and needs gives health care professionals a better understanding for how to provide assistance for a smoother nursing home transition. © The Author(s) 2015.

  20. Older Adult Residents' Perceptions of Daily Lives in Nursing Homes.

    Science.gov (United States)

    Cho, Eunhee; Kim, Hyejin; Kim, Jeongah; Lee, Kyongeun; Meghani, Salimah H; Chang, Soo Jung

    2017-09-01

    This study aimed to explore older adults' perceptions of their daily lives in South Korean nursing homes. We employed a qualitative descriptive study using semistructured interviews. We conducted individual, semistructured interviews with 21 older adult residents from five nursing homes in South Korea and analyzed the data using thematic analysis. Five themes related to older adults' perceptions of their daily lives in nursing homes emerged: enhanced comfort, aspiring to maintain physical and cognitive functions as human beings, desire for meaningful interpersonal relationships, feelings of confinement and limited autonomy, and acceptance of and adaptation to life in a facility. These themes indicated the positive and negative aspects of nursing home residence, and facilitators and challenges to enhancing older adult residents' quality of life (QOL). Policy, practice, and research endeavors are required to improve older adult residents' QOL, such as adequate professional nursing care for physical and psychological comfort and residents' health and functional status, sufficient activity programs and meaningful relationships, person-centered care to enhance residents' autonomy, and homelike environments. This study demonstrates that healthcare providers, researchers, and policymakers should consider nursing home residents' QOL to examine the quality of care within the setting and facilitate the development of appropriate strategies to improve QOL among this population. © 2017 The Authors. Journal of Nursing Scholarship published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.

  1. Enhancing three bliss concepts among nursing home elders in Taiwan.

    Science.gov (United States)

    Chang, Su-Hsien; Fang, Mao-Chun; Chang, Hsiang-Yu

    2010-03-01

    The purpose was to examine the effectiveness of the self-care self-efficacy enhancement programme (SCSEEP) to improve the three bliss concepts, life satisfaction, self-esteem and motivation in health behaviours, among Taiwanese nursing home elders. Promoting self-care is the most effective means for Chinese elders to achieve happiness and bliss. No studies have examined how to enhance bliss by improving self-care ability in older nursing home residents in Taiwan. This study used an experimental, longitudinal research design. The 101 subjects were recruited and randomly assigned to an experimental group (n = 55) and a comparison group (n = 46). Subjects in the experimental group received the SCSEEP. Programme from nursing home staff. Subjects in the comparison group received care as usual. The programme was implemented immediately after staff received a SCSEEP. The training programme was based partly on the SCSEEP developed by the principal investigator. Activities used in the SCSEEP included performance accomplishment, vicarious experiences and verbal persuasion. Results found that there was a significant positive correlation between life satisfaction and ADL performance (p = 0.019), self-esteem and ADL performance (p self-esteem (p self-esteem and motivation in health behaviours among Taiwanese nursing home elders. The SCSEEP provides nursing home staff a series of interventions to improve self-care ability of Chinese nursing home which in turn enhances the three bliss concept.

  2. The relationship between advertising, price, and nursing home quality.

    Science.gov (United States)

    Kash, Bita A; Miller, Thomas R

    2009-01-01

    Theoretically, nursing homes should engage in advertising for the following two reasons: (a) to improve awareness of the services offered in a particular market and (b) to signal high-quality services. In this study, we build upon results from prior studies of nursing home advertising activity, market competition, and quality. The purpose of this study was to examine the association between advertising expenses, price, and quality. We focused on answering the question: Do nursing homes use advertising and price to signal superior quality? The Texas Nursing Facilities Medicaid Cost Report, the Texas Quality Reporting System, and the Area Resource File were merged for the year 2003. We used three alternative measures of quality to improve the robustness of this exploratory analysis. Quality measures were examined using Bonferroni correlation coefficient analysis. Associations between advertising expenses and quality were evaluated using three regression models predicting quality. We also examined the association of the price of a private bed per day with quality. Advertising expenses were not associated with better nursing home quality as measured by three quality scales. The average price customers pay for one private bed per day was associated with better quality only in one of the three quality regression models. The price of nursing home care might be a better indicator of quality and necessary to increase as quality of care is improved in the nursing homes sector. Because more advertising expenditures are not necessarily associated with better quality, consumers could be mislead by advertisements and choose poor quality nursing homes. Nursing home administrators should focus on customer relationship management tools instead of expensive advertising. Relationship management tools are proven marketing techniques for the health services sector, usually less expensive than advertising, and help with staff retention and quality outcomes.

  3. Association between social support and health-related quality of life among Chinese rural elders in nursing homes: the mediating role of resilience.

    Science.gov (United States)

    Wu, Menglian; Yang, Yang; Zhang, Dan; Zhao, Xia; Sun, Yaoyao; Xie, Hui; Jia, Jihui; Su, Yonggang; Li, Yuqin

    2017-11-09

    This study aims to confirm the relationship between social support and health-related quality of life (HRQOL) among rural Chinese elders in nursing homes, and to examine the mediating role of resilience in the impact of social support on HRQOL. A cross-sectional survey of 205 elders aged 60 and above was conducted in five rural public nursing homes. Sociodemographic characteristics, the SF-36 questionnaire, and information about social support and resilience were collected. The researchers administered the questionnaires to the participants in a face-to-face setting. Descriptive analysis and a correlation matrix were used to indicate characteristics of the participants and bivariate correlations, respectively. The mediation analyses, composed of regression analysis and PROCESS analysis, were preformed to test both direct and indirect effects of social support on HRQOL, namely the mediating role of resilience. Social support was positively related to HRQOL (β = 0.303, p social support and HRQOL was confirmed (a*b bootstrapped 95% confidence interval = [0.098, 0.257]), which revealed that social support had an indirect effect on HRQOL through resilience. Resilience partially mediates the relationship between social support and HRQOL. The mediation model provides a better understanding of how social support and resilience work together to affect HRQOL, and it could guide the interventions in health care for promoting HRQOL among Chinese rural elders in nursing homes.

  4. Does the care dependency of nursing home residents influence their health-related quality of life?-A cross-sectional study.

    Science.gov (United States)

    Tabali, Manuela; Ostermann, Thomas; Jeschke, Elke; Dassen, Theo; Heinze, Cornelia

    2013-03-11

    Studies on health-related quality of life (HRQOL) are missing for nursing home residents independent from their health conditions or interventions after admission. Our aim was to analyse if the care dependency of nursing home residents influence their HRQOL and to describe HRQOL of nursing home residents at the time of admission. Eleven German nursing homes were randomly selected for a cross-sectional multicentre study from April 2008 until December 2009. HRQOL was measured with the Nottingham Health Profile (NHP) in the six domains "Physical Mobility", "Energy", "Pain", "Social Isolation", "Emotional Reaction" and "Sleep". Domain scores range from zero (good subjective health status) to 100 (poor subjective health status). Care dependency was evaluated using the Care Dependency Scale, age, sex, cognitive status and diseases were documented by the research assistants. Multivariate regression analysis was performed to quantify the influence of care dependency on HRQOL. 120 residents were included in total. HRQOL was mostly reduced in the domains "Physical Mobility" and "Energy" (mean scores >43.0), while impairment differences in the domains "Pain", "Social Isolation", "Emotional Reaction" and "Sleep" were only moderate (≤25.0). HRQOL was not influenced by the age. Women (n = 85) had a significantly poorer HRQOL in the domain "Pain" than men (mean score women: 29.5 ± 31.5; males: 14.9 ± 17.2; p = 0.011). Care dependency had an influence on the domain "Sleep" (ß = -0.195, p = 0.031), while the other domains were not influenced by care dependency. Residents with a low care dependency scored significantly lower (better HRQOL) in the domain "Sleep" than residents with a high care dependency (mean score 15.3; SD ± 19.0 versus mean score 32.8 SD ± 33.2; p dependency has no influence on the HRQOL from the nursing home residents' perspective apart from the domain "Sleep". High care dependency residents have a lower HRQOL in the

  5. Dental hygiene education for nursing staff in a nursing home for older people.

    Science.gov (United States)

    Kullberg, Erika; Sjögren, Petteri; Forsell, Marianne; Hoogstraate, Janet; Herbst, Bertil; Johansson, Olle

    2010-06-01

    This paper is a report of a study evaluating the effect of a repeated education programme for nursing staff in a home for older people. A strong relationship exists between oral infections and general health complications (especially aspiration pneumonia) among nursing home residents and hospitalized older people. Thus, nursing staff need to be educated in oral hygiene measures. Forty-three nursing home resident older people (12 men, 31 women, age range 69-99 years) were included in a dental hygiene and gingivitis evaluation using gingival bleeding scores and modified plaque scores. Evaluation was conducted before and 3 weeks after a repeated dental hygiene education for nursing staff at a nursing home in Sweden in 2008. Dental hygiene education had been given 1.5 years previously. Forty-one residents (12 men and 29 women) were available for evaluation after the repeated dental hygiene education (one died, one had had teeth extracted). There was a reduction in gingival bleeding scores (P hygiene education improves the dental hygiene among nursing home resident older people. In order to succeed it may be necessary to address attitudes and perceptions towards oral care in such a dental hygiene education programme for nursing staff. Improved oral hygiene contributes to reducing the incidence of healthcare-associated pneumonia among nursing home resident older people, and thus to reduced healthcare costs.

  6. 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)

  7. Deprivation of Dignity in Nursing Home Residents

    DEFF Research Database (Denmark)

    Høy, Bente

    2016-01-01

    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...

  8. Barriers and facilitators in providing oral health care to nursing home residents, from the perspective of care aides-a systematic review protocol.

    Science.gov (United States)

    Hoben, Matthias; Hu, Huimin; Xiong, Tianyuan; Kent, Angelle; Kobagi, Nadia; Yoon, Minn N

    2016-04-07

    Unregulated care aides provide up to 80 % of direct resident care in nursing homes. They have little formal training, manage high workloads, frequently experience responsive behaviours from residents, and are at high risk for burnout. This affects quality of resident care, including quality of oral health care. Poor quality of oral health care in nursing homes has severe consequences for residents and the health care system. Improving quality of oral health care requires tailoring interventions to identified barriers and facilitators if these interventions are to be effective. Identifying barriers and facilitators from the care aide's perspective is crucial. We will systematically search the databases MEDLINE, Embase, Evidence Based Reviews-Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science. We will include qualitative and quantitative research studies and systematic reviews published in English that assess barriers and facilitators, as perceived by care aides, to providing oral health care to nursing home residents. Two reviewers will independently screen studies for eligibility. We will also search by hand the contents of key journals, publications of key authors, and reference lists of all the studies included. Two reviewers will independently assess the methodological quality of the studies included using four validated checklists appropriate for different research designs. Discrepancies at any stage of review will be resolved by consensus. We will conduct a thematic analysis of barriers and facilitators using all studies included. If quantitative studies are sufficiently homogeneous, we will conduct random-effects meta-analyses of the associations of barriers and facilitators with each other, with care aide practices in resident oral health care, and with residents' oral health. If quantitative study results cannot be pooled, we will present a narrative synthesis of the results. Finally, we will compare quantitative findings to

  9. Health Begins at Home

    Centers for Disease Control (CDC) Podcasts

    2009-03-30

    Clean and well-maintained homes can prevent many illnesses and injuries. This podcast discusses how good health begins at home.  Created: 3/30/2009 by Coordinating Center for Environmental Health and Injury Prevention (CCEHIP).   Date Released: 3/30/2009.

  10. Funding a Health Disparities Research Agenda: The Case of Medicare Home Health Care

    Science.gov (United States)

    Davitt, Joan K.

    2014-01-01

    Medicare home health care provides critical skilled nursing and therapy services to patients in their homes, generally after a period in an inpatient facility or nursing home. Disparities in access to, or outcomes of, home health care can result in patient deterioration and increased cost to the Medicare program if patient care needs intensify.…

  11. Factors contributing to serious adverse events in nursing homes.

    Science.gov (United States)

    Andersson, Åsa; Frank, Catharina; Willman, Ania Ml; Sandman, Per-Olof; Hansebo, Görel

    2018-01-01

    To identify the most common serious adverse events that occurred in nursing homes and their most frequent contributing factors to the improvement of safe nursing care. There is a need to improve safe nursing care in nursing homes. Residents are often frail and vulnerable with extensive needs for nursing care. A relatively minor adverse event in nursing care can cause serious injury that could have been preventable. This was a retrospective study, with a total sample of data regarding adverse events (n = 173) in nursing homes, concerning nursing care reported by healthcare providers in Sweden to the Health and Social Care Inspectorate. The reports were analysed with content analysis, and the frequencies of the adverse events, and their contributing factors, were described with descriptive statistics. Medication errors, falls, delayed or inappropriate intervention and missed nursing care contributed to the vast majority (89%) of the serious adverse events. A total of 693 possible contributing factors were identified. The most common contributing factors were (i) lack of competence, (ii) incomplete or lack of documentation, (iii) teamwork failure and (iv) inadequate communication. The contributing factors frequently interacted yet they varied between different groups of serious adverse events. The resident's safety depends on the availability of staff's competence as well as adequate documentation about the resident's condition. Lack of competence was underestimated by healthcare providers. Registered nurses and assistant nurses need to have awareness of contributing factors to adverse events in nursing care. A holistic approach to improve patient safety in nursing homes requires competence of the staff, safe environments as well as resident's and relative's participation. © 2017 John Wiley & Sons Ltd.

  12. 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

  13. Sexual Abuse of Older Residents in Nursing Homes: A Focus Group Interview of Nursing Home Staff

    Directory of Open Access Journals (Sweden)

    Maria Helen Iversen

    2015-01-01

    Full Text Available The objective of this study was to increase knowledge of sexual abuse against older residents in nursing homes. A qualitative approach was used. Through a focus group interview with staff in nursing homes, the aim was to reveal employees’ thoughts, experiences, and attitudes. Findings from the focus group interview show that sexual abuse of older residents is a taboo topic among health professionals. Acts of sexual abuse are difficult to imagine; it is hard to believe that it occurs. The fact that staff are not aware that it could happen, or have a hard time believing that it actually happens, can amplify the residents’ vulnerable position as potential victims of abuse, and it makes it even more challenging to report or uncover such acts. The study highlights the need for education of all health care workers in Norway as well as more research on sexual abuse against older residents in nursing homes. Furthermore, there is a need for good policies and reporting systems, as an important step towards addressing sexual abuse of the aged in a more appropriate way. Further research must aim to reveal more about this taboo area.

  14. Home Health Compare Data

    Data.gov (United States)

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

  15. Home Health PPS - Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — Abt Associates July 21, 2010 Analysis of 2000-2008 Home Health Case-mix Change Report estimates the extent to which the observed increases in average case-mix were...

  16. Home Health Quality Initiative

    Data.gov (United States)

    U.S. Department of Health & Human Services — The instrument-data collection tool used to collect and report performance data by home health agencies is called the Outcome and Assessment Information Set (OASIS)....

  17. Home Health Care Agencies

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of all Home Health Agencies that have been registered with Medicare. The list includes addresses, phone numbers, and quality measure ratings for each agency.

  18. 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…

  19. 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.

  20. Nursing Home Regulations Redefined: Implications for Providers.

    Science.gov (United States)

    Unroe, Kathleen T; Ouslander, Joseph G; Saliba, Debra

    2018-01-01

    The Centers for Medicare and Medicaid Services (CMS) finalized a comprehensive update to nursing home requirements of participation in October 2016. Nearly 10,000 public comments were received regarding the proposed rule, and CMS made multiple modifications based on comments from providers, advocacy organizations, and others before issuing the final rule. The final rule describing nursing home requirements of participation modernizes nursing home regulation. It is being implemented in three phases-beginning in November 2016, November 2017, and November 2019. There are multiple provisions that have implications for clinicians caring for nursing home residents, particularly in terms of management of infections, medication prescribing and monitoring, and delegation of medical orders. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  1. The clinical effectiveness and cost-effectiveness of home-based, nurse-led health promotion for older people: a systematic review.

    Science.gov (United States)

    Tappenden, P; Campbell, F; Rawdin, A; Wong, R; Kalita, N

    2012-01-01

    In older age, reduction in physical function can lead to loss of independence, the need for hospital and long-term nursing or residential home care, and premature death. Home-visiting programmes for older people, carried out by nurses and other health-care professionals (e.g. occupational therapists and physiotherapists), aim to positively affect health and functional status, and may promote independent functioning of older people. The main research question addressed by this assessment is 'What is the clinical effectiveness and cost-effectiveness of home-based, nurse-led health promotion intervention for older people in the UK?' A comprehensive literature search was undertaken across 12 different databases and research registries from the year 2001 onwards (including MEDLINE, MEDLINE in Process & Other Non-Indexed Citations, EMBASE, Science Citation Index Expanded, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, NHS Health Economic Evaluation Database, Health Technology Assessment Database, Database of Abstracts of Reviews of Effects, Cumulative Index to Nursing and Allied Health Literature). Published systematic reviews were also hand searched to identify other trials previously published. Potentially relevant studies were sifted by one reviewer, and inclusion decisions were agreed among the broader research team. The methodological quality of included studies was assessed using the Cochrane Risk of Bias tool. The results of included studies were synthesised using narrative and statistical methods. A separate systematic search was undertaken to identify existing health economic analyses of home-based, nurse-led health promotion programmes. Included studies were critically appraised using a published checklist. Owing to resource constraints, a de novo health economic model was not developed. Eleven studies were included in the systematic review of clinical effectiveness. There was considerable heterogeneity among the

  2. Patient safety in nursing homes in Sweden: nurses' views on safety and their role.

    Science.gov (United States)

    Andersson, Frieda; Hjelm, Katarina

    2017-01-01

    Objective Knowledge about patient safety in nursing homes is limited. The aim of this study was to describe what patient safety means to nurses working in nursing homes for the elderly and how these nurses address patient safety. Method Qualitative study of semi-structured interviews with 15 nurses aged 27-62 years. Qualitative content analysis was applied. Results Nurses describe the meaning of patient safety in terms of proper care and treatment, and a sense of security. Based on nurses' description of patient safety, several factors were identified as prerequisites to achieve safe health care: competence; clear information transfer between health care organizations; continuity of care and appropriate environment. Barriers to patient safety were described as lack of sufficient resources; lack of communication and negative attitudes to incident reporting. To a great extent, nurses' work for patient safety consists of efforts to compensate for defects and ensure good health care in their daily work, since work with patient safety is not a management priority. Conclusion Patient safety needs to be clarified and prioritized in nursing homes, and there is a need to understand nurses' role among other care givers and the need for shared routines among care givers.

  3. 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 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 assessment may help nursing home leaders to initiate targeted quality improvement interventions. Further research should investigate associations between patient safety culture and the

  4. Nursing home-acquired pneumonia, dysphagia and associated diseases in nursing home residents: A retrospective, cross-sectional study

    NARCIS (Netherlands)

    Hollaar, V.R.Y.; Putten, G.J. van der; Maarel-Wierink, C.D. van der; Bronkhorst, E.M.; Swart, B.J.M. de; Baat, C. de; Creugers, N.H.J.

    2017-01-01

    BACKGROUND: Nursing home-acquired pneumonia (NHAP) is a common infection among nursing home residents. There is also a high prevalence of dysphagia in nursing home residents and they suffer more often from comorbidity and multimorbidity. This puts nursing home residents at higher risk of (mortality

  5. The Nursing Home Compare Report Card: Perceptions of Residents and Caregivers Regarding Quality Ratings and Nursing Home Choice.

    Science.gov (United States)

    Schapira, Marilyn M; Shea, Judy A; Duey, Katia A; Kleiman, Carly; Werner, Rachel M

    2016-06-01

    To evaluate the perceived usefulness of publicly reported nursing home quality indicators. Primary data were collected from October 2013 to August 2014 among a convenience sample of persons (or family member) recently admitted or anticipating admission to a nursing home within 75 miles of the city of Philadelphia. Structured interviews were conducted to assess the salience of data on the Medicare Nursing Home Compare website, including star ratings, clinical quality measures, and benchmarking of individual nursing home quality with state and national data. Interviews were transcribed verbatim, independently coded by two reviewers, and agreement determined. A thematic analysis of transcripts was undertaken. Thirty-five interviews were completed. Eighty-three percent (n = 29) were caregivers and 17 percent (n = 6) were residents. Star ratings, clinical quality measures, and benchmarking information were salient to decision making, with preferred formats varying across participants. Participants desired additional information on the source of quality data. Confusion was evident regarding the relationship between domain-specific and overall star quality ratings. The Nursing Home Compare website provides salient content and formats for consumers. Increased awareness of this resource and clarity regarding the definition of measures could further support informed decision making regarding nursing home choice. © Health Research and Educational Trust.

  6. A Survey of Educational Programs for Provisionally Licensed Nursing Home Administrators.

    Science.gov (United States)

    Mowrer, John L.

    Continuing education for health service professionals operating nursing homes is the subject of this report. Reasons for the growth and development of nursing homes are discussed, and licensure is defined. Methodologies and techniques employed in Missouri and other states are identified, after a background report on the Missouri Nursing Home…

  7. [Planning and controlling care services for elderly migrants--an analysis of health-care reporting in nursing homes and at home].

    Science.gov (United States)

    Habermann, M; Schenk, L; Albrecht, N-J; Gavranidou, M; Lindert, J; Butler, J

    2009-06-01

    Elderly migrants are a rapidly growing group in Germany. Well-grounded health and nursing care reports which deal with the situation of migrants are therefore necessary to secure an appropriate local and national planning of care for elderly migrants. Also quality control and development need substantiated data in order to ensure proper nursing care services for this segment of the population. This contribution explores whether and to what extent data sources provide information about access, quality and use of care services by migrants. The result: the major data sources for regional and national care planning and quality control render no specific information about migrants. This is problematic since several studies indicate severe deficits in nursing care services for this group.

  8. 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

  9. Job Openings Projected in Nursing Home Industry

    Science.gov (United States)

    Maust, Ann Parker

    1977-01-01

    Most nurses employed in nursing homes today have little or no training in geriatrics and the special needs of the chronically ill patient. Community colleges can play a vital role in upgrading presently employed personnel and in producing a supply of trained manpower to meet the future projected demand. (DC)

  10. From health organization-centred standardization work process to a personhood-centred care process in an Italian nursing home: effectiveness on bowel elimination model.

    Science.gov (United States)

    Palese, Alvisa; Granzotto, Debora; Broll, Maria Grazia; Carlesso, Nathalie

    2010-06-01

    An Italian nursing home's standardized work process redesign towards a personhood-centred nursing care is the focus of this study. The aim was to develop and implement a multi-method, personhood-centred, bowel elimination programme, to reduce the number of patients suffering from constipation and lessen the use of the invasive practises routinely adopted in nursing home (laxatives, enemas, rectal exploration). Although the importance of the application of personhood-centred care concepts in gerontology nursing has been widely recognized, the actual tendency of the Italian National Health System, which has few nursing resources for to the care of the older persons, is standardization. Standardization is enacted mainly by a functional pattern and carries the risk of using the same nursing answer to patient's different needs, priorities, preferences and histories. Constipation in older people living in nursing homes is one of the effects of extreme standardization. A case-crossover study design was adopted from 2006 to 2007. Twenty persons were enrolled in the programme. The multi-method programme included three phases: assessment (first phase), development/implementation (second) and evaluation (third phase). In the first phase, nine (45%) persons were constipated; in the third phase, only two (10%) were constipated (χ(2) 6.14, P = 0.013). The relative risk of being a constipated person in the first phase compared with the third phase was 4.5 (confidence interval 95%: 1.11-18.27). During the first phase 562 invasive procedures were observed (± 25.5, range: 2-85) for bowel elimination whereas during the third phase 120 were observed (± 12, range: 0-58). After the personhood-centred multi-method programme, seven persons have modified their bowel elimination pattern, and they were no longer constipated. The programme has also reduced the use of invasive procedures. The reduction of invasive practises might have affected positively the persons' quality of life, their

  11. A Survey of Nursing Home Organizational Characteristics Associated with Potentially Avoidable Hospital Transfers and Care Quality in One Large British Columbia Health Region

    Science.gov (United States)

    McGregor, Margaret J.; Baumbusch, Jennifer; Abu-Laban, Riyad B.; McGrail, Kimberlyn M.; Andrusiek, Dug; Globerman, Judith; Berg, Shannon; Cox, Michelle B.; Salomons, Kia; Volker, Jan; Ronald, Lisa

    2011-01-01

    Hospitalization of nursing home residents can be futile as well as costly, and now evidence indicates that treating nursing home residents in place produces better outcomes for some conditions. We examined facility organizational characteristics that previous research showed are associated with potentially avoidable hospital transfers and with…

  12. Impact of Dual Sensory Impairment on Onset of Behavioral Symptoms in European Nursing Homes: Results From the Services and Health for Elderly in Long-Term Care Study

    NARCIS (Netherlands)

    Yamada, Y.; Denkinger, M.D.; Onder, G.; Finne-Soveri, H.; van der Roest, H.G.; Vlachova, M.; Richter, T.; Gindin, J.; Bernabei, R.; Topinkova, E.

    2015-01-01

    Objectives: To investigate if dual sensory impairment (DSI) in the form of a combined visual and hearing impairment is associated with the onset of behavioral symptoms in nursing homes. Methods: A total of 1524 nursing home residents without behavioral symptoms at baseline followed for 12months in

  13. Adjustment of nursing home quality indicators

    Directory of Open Access Journals (Sweden)

    Hirdes John P

    2010-04-01

    Full Text Available Abstract Background This manuscript describes a method for adjustment of nursing home quality indicators (QIs defined using the Center for Medicaid & Medicare Services (CMS nursing home resident assessment system, the Minimum Data Set (MDS. QIs are intended to characterize quality of care delivered in a facility. Threats to the validity of the measurement of presumed quality of care include baseline resident health and functional status, pattern of comorbidities, and facility case mix. The goal of obtaining a valid facility-level estimate of true quality of care should include adjustment for resident- and facility-level sources of variability. Methods We present a practical and efficient method to achieve risk adjustment using restriction and indirect and direct standardization. We present information on validity by comparing QIs estimated with the new algorithm to one currently used by CMS. Results More than half of the new QIs achieved a "Moderate" validation level. Conclusions Given the comprehensive approach and the positive findings to date, research using the new quality indicators is warranted to provide further evidence of their validity and utility and to encourage their use in quality improvement activities.

  14. Female labour supply and nursing home prices.

    Science.gov (United States)

    Bauer, Thomas K; Stroka, Magdalena A

    2013-09-01

    Long term care in Germany is provided in nursing homes, by professional ambulatory services and by the patient's relatives at home, with the latter being predominantly provided by women. Given an increasing labour market participation of women, long term care at home by female relatives might become less frequent in the future which in turn may result in rising demand for and hence rising prices for long term care services. This paper builds upon the existing literature on the determinants of nursing home prices and investigates whether the labour market participation and the education level of women are correlated with the prices of nursing homes. To the best of our knowledge, this is the first study using panel data approaches in this field of research. Based on a full sample of nursing homes in Germany for the years 2001, 2003, 2005 and 2007, our empirical results suggest that a high share of full-time employed women aged 50-65 at the district level is not associated with higher prices of nursing homes. Furthermore, we find only weak evidence for a positive correlation of prices with the local average of women's educational level and a negative correlation with part-time employment indicating that price levels are lower in regions with higher shares of part-time employed women.

  15. The effect of community health nurse home visit on self-care self-efficacy of the elderly living in selected Falavarjan villages in Iran in 2010.

    Science.gov (United States)

    Hosseini, Habibollah; Torkani, Sara; Tavakol, Khosrow

    2013-01-01

    Perceived self-efficacy is a strong predictor for behavior. Considering the importance of health-promoting self-care behaviors in increasing quality of life in the elderly, this study was aimed at defining the effect of nurse home visits on self-care self-efficacy of the elderly in rural areas. This is a pre and post quasi-experimental study conducted on 33 older adults randomly selected from five villages in Falavarjan province in Iran. Intervention program was in the direction of self-care self-efficacy in four domains including nutrition, health practice, physical activity, and well-being in the form of five home visit programs and one group session by a nurse during 6 weeks, and included two different sections of education and nursing interventions administered based on needs assessment and determination of the tasks for the clients and their families. Theoretical framework of this study was supported by Bandura's self-efficacy, Orem's self-care theory, and Pender's revised health promotion model. The data were collected by self-care self-efficacy and demographic information questionnaire before and after the intervention. Data were analyzed by descriptive statistics and paired t-test. The mean elderly score in the four aforementioned domains increased after the home visit program. A significant difference was seen in the mean total scores of self-care self-efficacy and its subscales by paired t-test before and after intervention (P theories, had a positive influence on improving self-care self-efficacy of the elderly, and was supported by Bandura's theory of self-efficacy suggesting four sources of performance accomplishment, vicarious experience, verbal persuasion, and emotional arousal. With regard to the importance of self-care behavior in health promotion of the elderly, multifaceted low-cost interventions with the highest effect seem essential.

  16. 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.   

  17. The effect of nurse-patient interaction on anxiety and depression in cognitively intact nursing home patients.

    Science.gov (United States)

    Haugan, Gørill; Innstrand, Siw T; Moksnes, Unni K

    2013-08-01

    To test the effects of nurse-patient interaction on anxiety and depression among cognitively intact nursing home patients. Depression is considered the most frequent mental disorder among the older population. Specifically, the depression rate among nursing home patients is three to four times higher than among community-dwelling older people, and a large overlap of anxiety is found. Therefore, identifying nursing strategies to prevent and decrease anxiety and depression is of great importance for nursing home patients' well-being. Nurse-patient interaction is described as a fundamental resource for meaning in life, dignity and thriving among nursing home patients. The study employed a cross-sectional design. The data were collected in 2008 and 2009 in 44 different nursing homes from 250 nursing home patients who met the inclusion criteria. A sample of 202 cognitively intact nursing home patients responded to the Nurse-Patient Interaction Scale and the Hospital Anxiety and Depression Scale. A structural equation model of the hypothesised relationships was tested by means of Lisrel 8.8 (Scientific Software International Inc., Lincolnwood, IL, USA). The SEM model tested demonstrated significant direct relationships and total effects of nurse-patient interaction on depression and a mediated influence on anxiety. Nurse-patient interaction influences depression, as well as anxiety, mediated by depression. Hence, nurse-patient interaction might be an important resource in relation to patients' mental health. Nurse-patient interaction is an essential factor of quality of care, perceived by long-term nursing home patients. Facilitating nurses' communicating and interactive skills and competence might prevent and decrease depression and anxiety among cognitively intact nursing home patients. © 2013 Blackwell Publishing Ltd.

  18. Rethinking Teaching Nursing Homes: Potential for Improving Long-Term Care

    Science.gov (United States)

    Mezey, Mathy D.; Mitty, Ethel L.; Burger, Sarah Green

    2008-01-01

    To meet the special needs of and provide quality health care to nursing home residents, the health care workforce must be knowledgeable about the aging process. Health professionals are minimally prepared in their academic programs to care for older adults, and few programs have required rotations in geriatrics. Teaching nursing homes (TNHs) have…

  19. Nursing Effort and Quality of Care for Nursing Home Residents

    Science.gov (United States)

    Arling, Greg; Kane, Robert L.; Mueller, Christine; Bershadsky, Julie; Degenholtz, Howard B.

    2007-01-01

    Purpose: The purpose of this study was to determine the relationship between nursing home staffing level, care received by individual residents, and resident quality-related care processes and functional outcomes. Design and Methods: Nurses recorded resident care time for 5,314 residents on 156 units in 105 facilities in four states (Colorado,…

  20. Older Adult Residents' Perceptions of Daily Lives in Nursing Homes

    Science.gov (United States)

    Cho, Eunhee; Kim, Hyejin; Kim, Jeongah; Lee, Kyongeun; Meghani, Salimah H.

    2017-01-01

    Abstract Purpose This study aimed to explore older adults’ perceptions of their daily lives in South Korean nursing homes. Design We employed a qualitative descriptive study using semistructured interviews. Methods We conducted individual, semistructured interviews with 21 older adult residents from five nursing homes in South Korea and analyzed the data using thematic analysis. Findings Five themes related to older adults’ perceptions of their daily lives in nursing homes emerged: enhanced comfort, aspiring to maintain physical and cognitive functions as human beings, desire for meaningful interpersonal relationships, feelings of confinement and limited autonomy, and acceptance of and adaptation to life in a facility. These themes indicated the positive and negative aspects of nursing home residence, and facilitators and challenges to enhancing older adult residents’ quality of life (QOL). Conclusions Policy, practice, and research endeavors are required to improve older adult residents’ QOL, such as adequate professional nursing care for physical and psychological comfort and residents’ health and functional status, sufficient activity programs and meaningful relationships, person‐centered care to enhance residents’ autonomy, and homelike environments. Clinical Relevance This study demonstrates that healthcare providers, researchers, and policymakers should consider nursing home residents’ QOL to examine the quality of care within the setting and facilitate the development of appropriate strategies to improve QOL among this population. PMID:28605167

  1. Enabling at-homeness for residents living in a nursing home: Reflected experience of nursing home staff.

    Science.gov (United States)

    Saarnio, Lotta; Boström, Anne-Marie; Hedman, Ragnhild; Gustavsson, Petter; Öhlén, Joakim

    2017-12-01

    Older people are often living the last period of their lives in institutions such as nursing homes. Knowledge of this period, specifically related to at-homeness which can be described as wellbeing in spite of illness and has been regarded as one of the goals in palliative care, has been very little researched in the context of nursing homes and the experience of nursing home staff. The aim of this study was to explore the experiences of nursing home staff of how to enable at-homeness for residents. Qualitative interpretive description methodology guided the design. The data generation was conducted in winter 2014-2015, when seven repetitive reflective group discussions with staff in a nursing home were held. The results show five patterns for how healthcare staff enabled at-homeness for the residents: Striving to know the resident, Showing respect for the resident's integrity, Creating and working in family-like relationships, Helping to find a new ordinariness and Preparing and making plans to ensure continuity. Nursing home staff seem to have collegial knowledge of how to enable at-homeness for the residents in a nursing home. Close relationships with respect for the resident's integrity stand out as enabling at-homeness. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. 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...... treat others in ways that one would like others to treat oneself” and “Uneasiness due to indignity”. The main reason for dignity was experiences as respect, confidence, security and charity. The uneasiness occurred when indignity aroused. The voices of the family caregivers are usually taciturn...

  3. Effect of an oral healthcare protocol in nursing homes on care staffs' knowledge and attitude towards oral health care: a cluster-randomised controlled trial.

    Science.gov (United States)

    Janssens, Barbara; De Visschere, Luc; van der Putten, Gert-Jan; de Lugt-Lustig, Kersti; Schols, Jos M G A; Vanobbergen, Jacques

    2016-06-01

    To explore the impact of a supervised implementation of an oral healthcare protocol, in addition to education, on nurses' and nurses' aides' oral health-related knowledge and attitude. A random sample of 12 nursing homes, accommodating a total of 120-150 residents, was obtained using stratified cluster sampling with replacement. The intervention included the implementation of an oral healthcare protocol and three different educational stages. One of the investigators supervised the implementation process, supported by a dental hygienist. A 34-item questionnaire was developed and validated to evaluate the knowledge and attitude of nurses and nurses' aides at baseline and 6 months after the start of the intervention. Linear mixed-model analyses were performed to explore differences in knowledge and attitude at 6 months after implementation. At baseline, no significant differences were observed between the intervention and the control group for both knowledge (p = 0.42) and attitude (p = 0.37). Six months after the start of the intervention, significant differences were found between the intervention and the control group for the variable knowledge in favour of the intervention group (p attitude (p = 0.78). Out of the mixed model with attitude as the dependent variable, it can be concluded that age (p = 0.031), educational level (p = 0.009) and ward type (p = 0.014) have a significant effect. The mixed model with knowledge as the dependent variable resulted in a significant effect of the intervention (p = 0.001) and the educational level (p = 0.009). The supervised implementation of an oral healthcare protocol significantly increased the knowledge of nurses and nurses' aides. In contrast, no significant improvements could be demonstrated in attitude. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  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 day...

  5. 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.

  6. Nursing home culture change: what does it mean to nurses?

    Science.gov (United States)

    Bellot, Jennifer

    2012-10-01

    The purpose of this study was to explore, from the perspectives of licensed nurses, the organizational culture, work environment, and factors influencing culture change in two nursing homes participating in the Wellspring Program. All licensed nurses ≥ 0.25 full-time equivalent from two nursing homes were invited to complete the Organizational Culture Inventory and the Work Environment Scale. A subset of respondents was invited to participate in subsequent interviews. Data indicated unresolved conflict, low employee satisfaction, high work demands, and managerial control in the workplace. Qualitatively, three categories emerged: Confusion over culture change, role, and documentation; Conflict over the integration of traditional care with a resident-centered model; and Commitment to providing quality nursing care to the resident. To ensure the successful implementation of culture change, consideration must be given to clarity of communication, anticipation of role conflict, and building on the underlying strength of job commitment. Copyright 2012, SLACK Incorporated.

  7. A facilitated approach to family case conferencing for people with advanced dementia living in nursing homes: perceptions of palliative care planning coordinators and other health professionals in the IDEAL study.

    Science.gov (United States)

    Luckett, Tim; Chenoweth, Lynnette; Phillips, Jane; Brooks, Deborah; Cook, Janet; Mitchell, Geoffrey; Pond, Dimity; Davidson, Patricia M; Beattie, Elizabeth; Luscombe, Georgina; Goodall, Stephen; Fischer, Thomas; Agar, Meera

    2017-10-01

    Palliative care for nursing home residents with advanced dementia is often sub-optimal due to poor communication and limited care planning. In a cluster randomized controlled trial, registered nurses (RNs) from 10 nursing homes were trained and funded to work as Palliative Care Planning Coordinators (PCPCs) to organize family case conferences and mentor staff. This qualitative sub-study aimed to explore PCPC and health professional perceptions of the benefits of facilitated case conferencing and identify factors influencing implementation. Semi-structured interviews were conducted with the RNs in the PCPC role, other members of nursing home staff, and physicians who participated in case conferences. Analysis was conducted by two researchers using a thematic framework approach. Interviews were conducted with 11 PCPCs, 18 other nurses, eight allied health workers, and three physicians. Perceived benefits of facilitated case conferencing included better communication between staff and families, greater multi-disciplinary involvement in case conferences and care planning, and improved staff attitudes and capabilities for dementia palliative care. Key factors influencing implementation included: staffing levels and time; support from management, staff and physicians; and positive family feedback. The facilitated approach explored in this study addressed known barriers to case conferencing. However, current business models in the sector make it difficult for case conferencing to receive the required levels of nursing qualification, training, and time. A collaborative nursing home culture and ongoing relationships with health professionals are also prerequisites for success. Further studies should document resident and family perceptions to harness consumer advocacy.

  8. 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

  9. Is higher nursing home quality more costly?

    Science.gov (United States)

    Giorgio, L Di; Filippini, M; Masiero, G

    2016-11-01

    Widespread issues regarding quality in nursing homes call for an improved understanding of the relationship with costs. This relationship may differ in European countries, where care is mainly delivered by nonprofit providers. In accordance with the economic theory of production, we estimate a total cost function for nursing home services using data from 45 nursing homes in Switzerland between 2006 and 2010. Quality is measured by means of clinical indicators regarding process and outcome derived from the minimum data set. We consider both composite and single quality indicators. Contrary to most previous studies, we use panel data and control for omitted variables bias. This allows us to capture features specific to nursing homes that may explain differences in structural quality or cost levels. Additional analysis is provided to address simultaneity bias using an instrumental variable approach. We find evidence that poor levels of quality regarding outcome, as measured by the prevalence of severe pain and weight loss, lead to higher costs. This may have important implications for the design of payment schemes for nursing homes.

  10. Activities in nursing homes: A descriptive study in Southern Austria

    OpenAIRE

    Jenull-Schiefer, Brigitte; Janig, Herbert

    2005-01-01

    This study aimed at (1) assessing activities and services offered by nursing homes, (2) estimating the residents' and the nurses' contentedness about the residents’ activities, and (3) finding out the residents' and nurses' wishes for alterations in the home routine. Based on the information of 255 residents and 171 nurses in eleven Austrian nursing homes our results showed that there was a great discrepancy of the values between the residents' and the nurses' view of an active daily life in ...

  11. A haven of last resort: the consequences of evacuating Florida nursing home residents to nonclinical buildings.

    Science.gov (United States)

    Christensen, Janelle J; Brown, Lisa M; Hyer, Kathryn

    2012-01-01

    Nursing home administrators (n = 15) and directors of nursing (n = 15) who worked in nursing homes during the 2004-2005 Florida hurricane season participated in a series of 6 focus groups. The purpose of the focus groups was to explore issues faced by nursing home administrators, nurses, and residents during hurricane evacuations. A primary finding was that evacuating nursing home residents to buildings that are not designed to support nursing activities (e.g., a school gymnasium or church) adversely affected resident feeding, sleeping, movement, and security. These nonclinical buildings also presented serious occupational health concerns for nursing staff members who provided care during emergencies. Recommendations for reducing patient and nursing staff injuries for those forced to evacuate to a nonclinical building as the result of an emergency event are provided. Copyright © 2012 Mosby, Inc. All rights reserved.

  12. The effect of laughter therapy on the quality of life of nursing home residents.

    Science.gov (United States)

    Kuru, Nilgun; Kublay, Gulumser

    2017-11-01

    To evaluate the effect of Laughter therapy on the quality of life of nursing home residents. By improving the quality of life of residents living in nursing homes and allowing them to have a healthier existence, their lives can be extended. Therefore, interventions impacting the quality of life of older adults are of critical importance. Quasi-experimental design. The study was conducted between 2 March - 25 May 2015. The experimental group was composed of 32 nursing home residents from one nursing home, while the control group consisted of 33 nursing home residents from another nursing home in the capital city of Turkey. Laughter therapy was applied with nursing home residents of the experimental group two days per week (21 sessions in total). A socio-demographic form and the Short-Form Health Survey (SF-36) were used for data collection. After the laughter therapy intervention, general and subscales (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional and spiritual health) quality-of-life scores of residents in the experimental group significantly increased in comparison with the pretest. Laughter therapy improved the quality of life of nursing home residents. Therefore, nursing home management should integrate laughter therapy into health care and laughter therapy should be provided as a routine nursing intervention. The results indicated that the laughter therapy programme had a positive effect on the quality of life of nursing home residents. Nurses can use laughter therapy as an intervention to improve quality of life of nursing home residents. © 2016 John Wiley & Sons Ltd.

  13. 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

  14. Infections in Nursing Homes: Epidemiology and Prevention Programs.

    Science.gov (United States)

    Montoya, Ana; Cassone, Marco; Mody, Lona

    2016-08-01

    This review summarizes current literature pertaining to infection prevention in nursing home population including post-acute care patients and long-term care residents. Approximately 2 million infections occur each year and more than one-third of older adults harbor multidrug-resistant organisms in this setting. Surveillance, hand hygiene, isolation precautions, resident and employee health programs, education, and antibiotic stewardship are essential elements of infection prevention and control programs in nursing homes. This article discusses emerging evidence suggesting the usefulness of interactive multimodal bundles in reducing infections and antimicrobial resistance, thereby enhancing safety and quality of care for older adults in nursing homes. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. A study of balance, gait and psychotropic drug use in relation to fall risk in nursing home residents with dementia

    NARCIS (Netherlands)

    C.S. Sterke (Carolyn)

    2011-01-01

    textabstractFalls are a major health problem in nursing home residents with dementia. In nursing homes one-third of all falls results in an injury. In order to take tailor-made preventive measures in time, the fall risk profile of each individual nursing home resident should be periodically

  16. 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.

  17. Sexuality in nursing homes: practice and policy.

    Science.gov (United States)

    Doll, Gayle M

    2013-07-01

    Older adults' sexuality and sexual expression are often overlooked in nursing home and residential care settings. Despite cultural beliefs that this population is asexual, sexual activity occurs frequently among residents in long-term care. This study, using written survey instrumentation, examines the scope of resident sexuality, staff reactions to sexual behavior, and the policies and guidelines used in 91 nursing homes to address residents' sexual activity. Eighty-five percent of respondents reported that sexual activity had occurred in their homes, and staff reactions to sexual activity were based on general guidelines. Many responses indicated that sexual expression of residents was considered non-normative. Issues of consent, especially concerning residents with dementia, and residents' right to privacy were addressed using existing general policies. Survey results demonstrate a need for specific policies and staff training regarding sexual expression to be developed with the input of nurses, family members, and residents. Copyright 2013, SLACK Incorporated.

  18. [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.

  19. Nursing Home Aides Experience Increase in Serious Injuries.

    Science.gov (United States)

    Personick, Martin E.

    1990-01-01

    Bureau of Labor Statistics' data show that the incidence rate of 15 workplace injuries and illnesses per 100 full-time nursing home workers is well above that for private industry as a whole. Back injuries are most frequently reported. Short tenure and high turnover are correlated with health and safety problems. (SK)

  20. Restorative Virtual Environment Design for Augmenting Nursing Home Rehabilitation

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...

  1. [Psychology of nursing personnel in home care nursing].

    Science.gov (United States)

    Bergler, R

    1995-04-01

    In a random survey questions were put to 100 employees of home care centers (51 qualified nursing staff, 28 assistants and/or trainees, 21 young people doing community service as an alternative to military service). (1) The job motivation is primarily of a private nature: social commitment, achievement motivation, being responsible for solving diverse human problems are at the centre of job orientation. (2) Huge disappointments (neglect of patients, stress, arrangement of working hours, bureaucracy, lack of self-responsibility) are in 62% of the cases the reasons for changing from a clinic to the home care centre. (3) The psychological results of home care nursing are only positive in 62% of the cases; 26% have thought of giving notice, 37% would not choose their job again. (4) The training qualification for home care nursing is only adequate for 60% of those questioned; deficiencies are experienced with regard to consulting competence, gerontopsychiatry, specific knowledge about illnesses, legal questions. Essential further training is neglected. Also initial instruction in the home care service is to a great extent unsatisfactory. (5) For economic reasons it is frequently necessary to limit daily care to basic nursing; the patients' communicative needs have to ignored. One's occupational self-importance dwindles away; the job increasingly becomes an everyday stress factor. (6) The high risk of infection in the case of home-care patients is considered to be above-average (bedsores, infection risks with regard to changing bandages/catheters, anuspraeter aids, incontinence, fungal diseases, food risks: not keeping to diets, food not suitable for the elderly, lack of appropriate storage for leftovers. (7) Nursing staff, as well as patients, regard soap, cleansing lotion, shampoo, tooth brushes and toothpaste as the main items for personal hygiene, for the prevention and treatment of bedsores. Beyond that, compared with nursing staff, patients have a greater need for

  2. Job strain in nursing homes - Exploring the impact of leadership.

    Science.gov (United States)

    Backman, Annica; Sjögren, Karin; Lövheim, Hugo; Edvardsson, David

    2017-11-17

    This study aimed to explore the association between leadership behaviours, job strain and social support as perceived by direct care staff in nursing homes. It is well known that aged care staff experience high levels of job strain, and that aged care staff experiencing job strain are exposed to increased risk for adverse health effects. Managerial leadership styles have been associated to job strain in the literature, however, the impact of perceived leadership behaviors' on staff job strain and social support has not been clarified within this context. This study had a cross-sectional design. Participating staff (n=3605) completed surveys which included questions about staff characteristics, valid and reliable measures of managerial leadership behaviors, perceived job strain and social support. Statistical analyses of correlations and multiple regression analysis with interaction terms were conducted. Highly rated leadership behaviors' were significantly associated to lower lever of job strain and higher level of social support. Higher levels of leadership behaviors' also moderated the impact of social support on job strain. Highly rated leadership behaviours in nursing home managers seems to buffer staff job strain and potentiate social support within nursing homes. Thus, nursing home managers' leadership behaviors seem beneficial for the working situation and strain of staff. Promoting a supporting work environment through a positive leadership seems to be an important implication for middle managers in nursing home care as it can influence staff perception of job strain and social support within the unit. By providing leadership, offering support and strategies towards a healthy work environment, nursing home managers may through their leadership, prevent adverse health effects among staff. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  3. 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.

  4. Voicing Ageism in Nursing Home Dementia Care.

    Science.gov (United States)

    Williams, Kristine; Shaw, Clarissa; Lee, Alexandria; Kim, Sohyun; Dinneen, Emma; Turk, Margaret; Jao, Ying-Ling; Liu, Wen

    2017-09-01

    Elderspeak (i.e., infantilizing communication) is a common form of ageism that has been linked to resistiveness to care in nursing home residents with dementia. Nursing home staff use elderspeak by modifying speech with older residents based on negative stereotypes, which results in patronizing communication that provides a message of incompetence. The purpose of the current secondary analysis was to describe communication practices used by nursing home staff that reflect ageism. Transcripts of 80 video recordings of staff-resident communication collected during nursing home care activities were re-analyzed to identify specific elderspeak patterns, including diminutives, collective pronouns, tag questions, and reflectives. Elderspeak was used in 84% of transcripts, and specifically during bathing, dressing, oral care, and other activities. Collective pronoun substitution occurred most frequently-in 69% of recorded conversations. Subgroup analysis of the inappropriate terms of endearment found that "honey"/"hon" and "sweetheart"/"sweetie" were most commonly used. [Journal of Gerontological Nursing, 43(9), 16-20.]. Copyright 2017, SLACK Incorporated.

  5. Assisted Living Facilities - CARE_LONG_TERM_FACILITIES_ISDH_IN: Residential Care Facilities, Nursing Homes, and Hospices in Indiana in 2007 (Indiana State Department of Health, Point Shapefile)

    Data.gov (United States)

    NSGIC State | GIS Inventory — CARE_LONG_TERM_FACILITIES_ISDH_IN is a point shapefile showing the locations of 86 residential care facilities, 525 long-term care facilities (nursing homes), and 81...

  6. Monitoring pressure ulcers in nursing homes.

    Science.gov (United States)

    Madsen, W; Leonard, M

    1997-12-01

    Clinical indicators may be used to monitor the quality of care delivery. Unfortunately, they are often viewed by nursing staff as unnecessary paper work. This study used Waterlow's Pressure Sore Risk Assessment Tool as the basis of a clinical indicator to monitor pressure ulcers within a nursing home. It was found that by closely monitoring the skin status of residents, preventative actions could be implemented, thereby minimizing the risk of pressure ulcer development. The advantage of utilizing such a tool is that it is seen to be clinically relevant for nursing staff while providing a bank of data for quality management.

  7. Rheumatologic care of nursing home residents with rheumatoid arthritis: a comparison of the year before and after nursing home admission.

    Science.gov (United States)

    Luque Ramos, Andres; Albrecht, Katinka; Zink, Angela; Hoffmann, Falk

    2017-12-01

    The purpose of this study was to investigate health care for patients with rheumatoid arthritis (RA) before and after admission to nursing homes. Data of a German health insurance fund from persons with diagnostic codes of RA, aged ≥65 years, admitted to a nursing home between 2010 and 2014 and continuously insured 1 year before and after admission were used. The proportion of patients with ≥1 rheumatologist visit and ≥1 prescription of biologic or conventional synthetic disease-modifying antirheumatic drugs (bDMARDs or csDMARDs), glucocorticoids and non-steroidal anti-inflammatory drugs (NSAIDs) in the year before and after admission were calculated. Predictors of rheumatologic care after admission were analyzed by multivariable logistic regression. Of 75,697 nursing home residents, 2485 (3.3%) had RA (90.5% female, mean age 83.8). Treatment by rheumatologists and prescription of antirheumatic drugs decreased significantly in the year after admission (rheumatologic visits: 17.6 to 9.1%, bDMARDs: 2.1 to 1.5%, csDMARDs: 22.5 to 16.5%, glucocorticoids: 46.5 to 43.1%, NSAIDs: 47.4 to 38.5%). 60.2% of patients in rheumatologic care received csDMARDs compared with 14.5% without rheumatologic care. Rheumatologic care before admission to a nursing home strongly predicted rheumatologic care thereafter (OR 33.8, 95%-CI 23.2-49.2). Younger age and lower care level (reflecting need of help) were also associated with a higher chance of rheumatologic care. Rheumatologic care is already infrequent in old patients with RA and further decreases after admission to a nursing home. Patients without rheumatologic care are at high risk of insufficient treatment for their RA. Admission to a nursing home further increases this risk.

  8. Depressive symptoms in newly admitted nursing home residents.

    Science.gov (United States)

    Achterberg, Wilco; Pot, Anne Margriet; Kerkstra, Ada; Ribbe, Miel

    2006-12-01

    To study the relationship between the prevalence of depressive symptoms in newly admitted nursing home residents and their previous place of residence. In 65 nursing homes in the Netherlands trained physicians assessed 562 residents (mean age 78.5, range 28-101, 64.6% female) within 10 days after admission. Depressive symptoms were assessed with the Minimum Data Set (MDS) Depression Rating Scale (DRS), and the MDS items: 'diagnosis of major or minor depression', 'change in depression' and 'indicators of persistent depressed, sad or anxious mood disorder present'. Previous place of residence was categorized as 'own home', 'hospital' or 'sheltered living facility'. Adjustments were performed for demographic and health related factors measured with the MDS. The prevalence of depressive symptoms (DRS > or = 3) for all 562 residents was 26.9%; it was higher in residents admitted from their own home (34.3%) than in residents admitted from the hospital (19.7%) (p = 0.002). Residents who were admitted from the hospital have an adjusted Odds Ratio for having many depressive symptoms of 0.54 (95% CI 0.31-0.94) compared to residents admitted from their own home. There is, after adjustment, no statistical significant difference between residents admitted from their own home, or residents admitted from a sheltered living facility. Depressive symptoms are very prevalent in nursing homes. Residents who are admitted from their own home, or from a residential facility, have more depressive symptoms than residents admitted from the hospital. This may reflect different conceptualizations or different adjustment patterns for those groups. For a better understanding of the factors associated with nursing home depression, future studies in detection, prevention and management of depressive symptoms should start prior to or directly after admission, especially for those who have no prior institutional history.

  9. Greater Independence in Activities of Daily Living is Associated with Higher Health-Related Quality of Life Scores in Nursing Home Residents with Dementia

    Directory of Open Access Journals (Sweden)

    Charice S. Chan

    2015-06-01

    Full Text Available Health-related quality of life (HRQL for nursing home residents is important, however, the concept of quality of life is broad, encompasses many domains and is difficult to assess in people with dementia. Basic activities of daily living (ADL are measured routinely in nursing homes using the Resident Assessment Instrument-Minimum Data Set Version 2.0 (RAI-MDS and Functional Independence Measure (FIM instrument. We examined the relationship between HRQL and ADL to assess the future possibility of ADL dependency level serving as a surrogate measure of HRQL in residents with dementia. To assess ADL, measures derived from the RAI-MDS and FIM data were gathered for 111 residents at the beginning of our study and at 6-month follow-up. Higher scores for independence in ADL were correlated with higher scores for a disease-specific HRQL measure, the Quality of Life—Alzheimer’s Disease Scale. Preliminary evidence suggests that FIM-assessed ADL is associated with HRQL for these residents. The associations of the dressing and toileting items with HRQL were particularly strong. This finding suggests the importance of ADL function in HRQL. The RAI-MDS ADL scales should be used with caution to evaluate HRQL.

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

    Science.gov (United States)

    Kandelman, Nadia; Mazars, Thierry; Levy, Antonin

    2018-01-01

    (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.

  11. 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

  12. What Is Nursing Home Quality and How Is It Measured?

    Science.gov (United States)

    Castle, Nicholas G.; Ferguson, Jamie C.

    2010-01-01

    Purpose: In this commentary, we examine nursing home quality and indicators that have been used to measure nursing home quality. Design and Methods: A brief review of the history of nursing home quality is presented that provides some context and insight into currently used quality indicators. Donabedian's structure, process, and outcome (SPO)…

  13. 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 =

  14. 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=

  15. International survey of nursing home research priorities

    NARCIS (Netherlands)

    Morley, J.E.; Caplan, G.; Cesari, M.; Dong, B.; Flaherty, J.H.; Grossberg, G.T.; Holmerova, I.; Katz, P.R.; Koopmans, R.T.C.M.; Little, M.O.; Martin, F.; Orrell, M.; Ouslander, J.; Rantz, M.; Resnick, B.; Rolland, Y.; Tolson, D.; Woo, J.; Vellas, B.

    2014-01-01

    This article reports the findings of a policy survey designed to establish research priorities to inform future research strategy and advance nursing home practice. The survey was administered in 2 rounds during 2013, and involved a combination of open questions and ranking exercises to move toward

  16. Light conditions in the nursing home.

    NARCIS (Netherlands)

    Joost van Hoof; M. Sinoo; H.S.M. Kort

    2012-01-01

    Purpose In the Netherlands, the prevalence of visual impairments is the highest among the subgroup of nursing home residents. Over 40 percent are estimated to have visual impairments1. Older adults experience visual problems due to biological aging or eye disease2. These problems can affect several

  17. Clinical competencies for community health nursing.

    Science.gov (United States)

    Kenyon, V; Smith, E; Hefty, L V; Bell, M L; McNeil, J; Martaus, T

    1990-03-01

    Cost-containment strategies initiated in the early 1980s caused a major shift in site of care delivery for persons needing nursing care. Where once the majority of clients were cared for in the acute-care setting until they were self-sufficient, now most are discharged to the home environment still requiring acute-care nursing interventions as well as community health nursing skills. This rapid shift in practice sites has placed severe strain on community health nursing agencies. Not only are more nurses required to fill the increased demand for services, but the demand comes at a time when we are experiencing a severe nursing shortage. This has forced many agencies to hire acute care nurses who have little or no community health nursing experience. These nurses come to community health nursing expecting to use the same set of skills and knowledge base used in their acute-care practice; however, the skill levels and concepts required for community health nursing are quite different from the acute care setting. Educational preparation has not kept pace with this shift in practice. Consequently, many nurses are not adequately prepared to enter community health nursing. Preparation must include theoretical and experiential components that focus on assessment skills (of the community and individual), decision making, case management, health systems management, teaching, and leadership. Collaborative efforts between community health organizations and educational institutions would seem to be one solution that would ensure adequately prepared nurses for community health nursing. The establishment and maintenance of strong staff-development programs within community health nursing agencies are also required.

  18. Home health care

    Science.gov (United States)

    ... Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Related MedlinePlus Health Topics Home Care Services Browse the Encyclopedia A.D.A.M., ...

  19. Nurse Staffing and Quality of Care of Nursing Home Residents in Korea.

    Science.gov (United States)

    Shin, Juh Hyun; Hyun, Ta Kyung

    2015-11-01

    To investigate the relationship between nurse staffing and quality of care in nursing homes in Korea. This study used a cross-sectional design to describe the relationship between nurse staffing and 15 quality-of-care outcomes. Independent variables were hours per resident day (HPRD), skill mix, and turnover of each nursing staff, developed with the definitions of the Centers for Medicare & Medicaid Services and the American Health Care Association. Dependent variables were prevalence of residents who experienced more than one fall in the recent 3 months, aggressive behaviors, depression, cognitive decline, pressure sores, incontinence, prescribed antibiotics because of urinary tract infection, weight loss, dehydration, tube feeding, bed rest, increased activities of daily living, decreased range of motion, use of antidepressants, and use of restraints. Outcome variables were quality indicators from the U.S. Centers for Medicare & Medicaid and 2013 nursing home evaluation manual by the Korean National Health Insurance Service. The effects of registered nurse (RN) HPRD was supported in fall prevention, decreased tube feeding, decreased numbers of residents with deteriorated range of motion, and decreased aggressive behavior. Higher turnover of RNs related to more residents with dehydration, bed rest, and use of antipsychotic medication. Study results supported RNs' unique contribution to resident outcomes in comparison to alternative nurse staffing in fall prevention, decreased use of tube feeding, better range of motion for residents, and decreased aggressive behaviors in nursing homes in Korea. More research is required to confirm the effects of nurse staffing on residents' outcomes in Korea. We found consistency in the effects of RN staffing on resident outcomes acceptable. By assessing nurse staffing levels and compositions of nursing staffs, this study contributes to more effective long-term care insurance by reflecting on appropriate policies, and ultimately

  20. 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…

  1. Transmission of methicillin-resistant Staphylococcus aureus to health care worker gowns and gloves during care of residents in Veterans Affairs nursing homes.

    Science.gov (United States)

    Pineles, Lisa; Morgan, Daniel J; Lydecker, Alison; Johnson, J Kristie; Sorkin, John D; Langenberg, Patricia; Blanco, Natalia; Lesse, Alan; Sellick, John; Gupta, Kalpana; Leykum, Luci; Cadena, Jose; Lepcha, Nickie; Roghmann, Mary-Claire

    2017-09-01

    This was an observational study designed to estimate the frequency of methicillin-resistant Staphylococcus aureus (MRSA) transmission to gowns and gloves worn by health care workers (HCWs) interacting with Veterans Affairs Community Living Center (VA nursing home) residents to inform MRSA prevention policies. Participants included residents and HCWs from 7 VA nursing homes in 4 states and Washington, DC. Residents were cultured for MRSA at the anterior nares, perianal skin, and wound (if present). HCWs wore gowns and gloves during usual care activities. After each activity, a research coordinator swabbed the HCW's gown and gloves. Swabs were cultured for MRSA. There were 200 residents enrolled; 94 (46%) were MRSA colonized. Glove contamination was higher than gown contamination (20% vs 11%, respectively; P  1.0, P < .05) for gown contamination included changing dressings (eg, wound), dressing, providing hygiene (eg, brushing teeth), and bathing. Low-risk care activities (OR < 1.0, P < .05 or no transmission) for gown contamination included glucose monitoring, giving medications, and feeding. MRSA transmission from colonized residents to gloves was higher than transmission to gowns. Transmission to gloves varies by type of care, but all care had a risk of contamination, demonstrating the importance of hand hygiene after all care. Transmission to gowns was significantly higher with certain types of care. Optimizing gown and glove use by targeting high-risk care activities could improve resident-centered care for MRSA-colonized residents by promoting a home-like environment. Published by Elsevier Inc.

  2. [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.

  3. 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

    '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......Purpose To characterise the prescription pattern of psychotropics in Danish nursing homes and to identify diagnostic, behavioural, cognitive and performance characteristics associated with prevalent psychotropic drug use. Methods Prescribed daily medication was recorded from nurses' files. Based...... 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...

  4. The nursing home as a learning environment: dealing with less is learning more.

    Science.gov (United States)

    Molema, Frederique; Koopmans, Raymond; Helmich, Esther

    2014-03-01

    Despite the imperative to develop adequate competence in caring for the growing demographic of elderly patients with complex health care problems, nursing homes are underused as learning environments for the education of future doctors; thus, the authors aimed to gain more insight into the characteristics of the nursing home as a learning environment. Approaching the nursing home as a learning environment from a predominantly sociocultural perspective, the authors carried out five focus group interviews (December 2011 through February 2012) with 36 family medicine and elderly care medicine residents during their nursing home placements. Data analysis was an iterative process following a grounded theory approach. The software ATLAS.ti supported data analysis. The authors identified 23 themes in five categories regarding the nursing home as a learning environment: organization, medical opportunities, communication, teamwork, and supervision. Working and learning in a nursing home was characterized by "dealing with less" (i.e., fewer resources), yet the residents reported that dealing with less resulted in "learning more." Family medicine and elderly care residents from different backgrounds differed in their perceptions and specific learning needs. To the authors' knowledge, this study is one of the first to identify characteristics of the nursing home as a learning environment. The main challenge in the nursing home is dealing with less, which, according to the residents in the present study, often leads to learning more. To ensure that learning really happens, the authors call for high-quality supervision to support learners in the nursing home environment.

  5. Nurse Bullying: Impact on Nurses' Health.

    Science.gov (United States)

    Sauer, Penny A; McCoy, Thomas P

    2017-12-01

    Workplace bullying has been experienced by 27% to 80% of nurses who have participated in studies. Bullying behaviors negatively impact the health of nurses. This study examined whether nurses' resilience had an impact on the effects of bullying on the nurse's health. This cross-sectional descriptive study surveyed licensed registered nurses in one state. The sample ( N = 345) was predominately female (89%) and Caucasian (84%), with an average age of 46.6 years. In this sample, 40% of nurses were bullied. Higher incidence of bullying was associated with lower physical health scores ( p = .002) and lower mental health scores ( p = .036). Nurses who are bullied at work experience lower physical and mental health, which can decrease the nurses' quality of life and impede their ability to deliver safe, effective patient care.

  6. 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

  7. Hand hygiene practices of home visiting community nurses: perceptions, compliance, techniques, and contextual factors of practice using the World Health Organization's "five moments for hand hygiene".

    Science.gov (United States)

    Felembam, Ohood; John, Winsome St; Shaban, Ramon Z

    2012-03-01

    In this observational study, the perceptions, compliance, techniques, and contextual issues of hand hygiene practices among community clinicians (nurses) during 103 hand hygiene opportunities (based on the World Health Organization "Five Moments for Hand Hygiene") in 40 patient care episodes were examined. Compliance with standard hand hygiene practices was generally poor, with many contextual influences making compliance difficult. Clinician preferences and convenience are important considerations in hand hygiene compliance. Improving home-visiting community clinicians' hand hygiene practices requires addressing contextual issues related to the availability of hand hygiene equipment, such as alcohol-based hand rubs, as well as hand hygiene in-service education to update knowledge on hand hygiene for everyday practice in community settings.

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

    DEFF Research Database (Denmark)

    Andresen, Mette; Puggaard, Lis

    2008-01-01

    information about the effectiveness of individually tailored programmes according to perceptions of autonomy registered in institutionalised physically frail older people. This will add knowledge to assist response to present and future challenges in relation to health promotion initiatives for this group.......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...... themselves perceive autonomy in daily life. Further, there are no studies on the extent to which this perception can be influenced positively by participating in an individually tailored programme based on residents' own wishes for daily activities. METHODS AND DESIGN: A total of 9 nursing homes and 55...

  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. End-of-life care in U.S. nursing homes: nursing homes with special programs and trained staff for hospice or palliative/end-of-life care.

    Science.gov (United States)

    Miller, Susan C; Han, Beth

    2008-07-01

    The degree to which nursing homes have internal programs for hospice and palliative care is unknown. We used self-reported data from the 2004 National Nursing Home Survey (NNHS) to estimate the prevalence of special programs and (specially) trained staff (SPTS) for hospice or palliative/end-of-life care in U.S. nursing homes. Factors associated with the presence of SPTS for hospice or palliative/end-of-life care were identified. We merged 2004 NNHS data for 1174 nursing homes to county-level data from the 2004 Area Resource File and to Nursing Home 2004 Online Survey, Certification, and Reporting data. chi(2) tests and logistic regression models were applied. Twenty-seven percent of U.S. nursing homes reported (internal) SPTS for hospice or palliative/end-of-life care. After controlling for covariates, we found nonprofit status, being in the southern region of the United States, having an administrator certified by the American College of Health Care Administrators, contracting with an outside hospice provider, and having other specialty programs to be associated with a greater likelihood of nursing homes having SPTS for hospice or palliative/end-of-life care. The largest effects were observed for nursing homes with programs for behavioral problems (adjusted odds ratio [AOR] 3.59; 95% confidence interval [CI] 2.40, 5.37) and for pain management (AOR 5.92; 95% CI 4.09, 8.57). The presence of internal SPTS for hospice or palliative/end-of-life care is prevalent in U.S. nursing homes, and may be preceded by hospice contracting and/or the implementation of specialty programs that assist nursing homes in developing the expertise needed to establish their own palliative care programs.

  11. [Infection control and hand hygiene in nursing homes in Oslo].

    Science.gov (United States)

    Sie, Ingrid; Thorstad, Margrete; Andersen, Bjørg Marit

    2008-06-26

    Nosocomial infections and transmission can be substantially reduced by good infection control. The laws and regulations for infection control in heath care institutions emphasize establishment of infection control programs and improved hand hygiene. Our study reviews some factors that are important for practicing adequate hand hygiene (knowledge about infection control and hand-washing facilities). Health care workers (HCW) in nursing homes in Oslo participated in this study in 2006-2007. A questionnaire was made and SPSS was used to analyse the data . 70.7% of 324 HCW (in 42 nursing homes) answered the questionnaires. Nearly all of the respondents (95.6%) knew about the written procedures for hygiene and infection control; 88.5% knew that an infection control program was in place and about 50% had received information through internal education. Three of four had read the National guidelines for hand hygiene, 77.5% thought that hand disinfection was more effective than hand washing, and 97% reported hand hygiene after contact with a patient having an infection. Dispensers for hand disinfection were situated at central work places. At the same time, 17.9% informed that they worked in more than one place at the same time. This study confirms that most nursing homes in Oslo have an infection control program and training that improves the knowledge and awareness of hand hygiene among HCWs. However, the fact that nursing homes in Oslo have the resources, knowledge and education, is not the same as compliance.

  12. Measures of emergency preparedness contributing to nursing home resilience.

    Science.gov (United States)

    Lane, Sandi J; McGrady, Elizabeth

    2017-12-13

    Resilience approaches have been successfully applied in crisis management, disaster response, and high reliability organizations and have the potential to enhance existing systems of nursing home disaster preparedness. This study's purpose was to determine how the Center for Medicare and Medicaid Services (CMS) "Emergency Preparedness Checklist Recommended Tool for Effective Health Care Facility Planning" contributes to organizational resilience by identifying the benchmark resilience items addressed by the CMS Emergency Preparedness Checklist and items not addressed by the CMS Emergency Preparedness Checklist, and to recommend tools and processes to improve resilience for nursing homes. The CMS Emergency Preparedness Checklist items were compared to the Resilience Benchmark Tool items; similar items were considered matches. Resilience Benchmark Tool items with no CMS Emergency Preparedness Checklist item matches were considered breaches in nursing home resilience. The findings suggest that the CMS Emergency Preparedness Checklist can be used to measure some aspects of resilience, however, there were many resilience factors not addressed. For nursing homes to prepare and respond to crisis situations, organizations need to embrace a culture that promotes individual resilience-related competencies that when aggregated enable the organization to improve its resiliency. Social workers have the skills and experience to facilitate this change.

  13. Hospitals will send an integrated nurse home with each discharge.

    Science.gov (United States)

    Morrow, Thomas

    2015-01-01

    Hospitals must adapt to the rapidly changing environment of risk by changing the health behavior of their population. There is only one way to do this efficiently and at scale; send a nurse home with every patient at the time of discharge. That nurse can ensure adherence to medication and slowly, over time, transform personal behavior to evidence based levels ... basically taking their medication as prescribed, changing eating habits, increasing exercise, getting people to throw away their cigarettes, teaching them how to cope, improving their sleep and reducing their stress. But, this approach will require a nurse to basically "live" with the patient for prolonged periods of time, as bad health behaviors are quick to start but slow to change or end. The rapid developments in artificial intelligence and natural language understanding paired with cloud based computing and integrated with a variety of data sources has led to a new marketplace comprised of cognitive technologies that can emulate even the most creative, knowledgeable and effective nurse. Termed the Virtual Health Assistant, your patients can literally talk to these agents using normal conversational language. The possibility to send a nurse home with each patient to maintain adherence and prevent readmissions has arrived. The technology is available. Who will step forward to reap the rewards first?

  14. 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

  15. 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.

  16. Patient safety in nursing homes in Sweden: nurses´views on safety and their role

    OpenAIRE

    Andersson, Frieda; Hjelm, Katarina

    2017-01-01

    Objective: Knowledge about patient safety in nursing homes is limited. The aim of this study was to describe what patient safety means to nurses working in nursing homes for the elderly and how these nurses address patient safety. Method: Qualitative study of semi-structured interviews with 15 nurses aged 27-62 years. Qualitative content analysis was applied. Results: Nurses describe the meaning of patient safety in terms of proper care and treatment, and a sense of security. Based on nurses'...

  17. Managing the deteriorating nursing home resident after the introduction of a hospital avoidance programme: a nursing perspective.

    Science.gov (United States)

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

    2017-06-01

    Hospital avoidance programmes aim to reduce the number of emergency transfers from nursing homes to hospitals and facilitate early discharge for hospitalised residents. Nursing staff are at the forefront of these efforts, yet little is known about how the programmes affect them and their management of the deteriorating resident. This information is needed to inform hospital avoidance programmes and better understand their work. To examine nursing home nursing staff perceptions regarding their management of the deteriorating resident after the introduction of a hospital avoidance programme. A thematic analysis was conducted of focus group data collected from nursing staff 14 to 15 months after the introduction of a pilot hospital avoidance programme at an Australian nursing home. The programme was well received and filled a gap in nursing staff management of residents with deteriorating health by providing structure and support. Staff were more confident and focused on this area of their work. Nursing assistants felt more integrated into the system and were supported and learning from nurses. Workload remained heavy and there was a shift in how time was allocated, but nursing staff preferred to keep residents at the facility. Nursing staff welcomed the programme and benefitted from its implementation. However, strategies must be explored to accommodate the staffing needs associated with providing emergency and subacute care in the nursing home setting. © 2016 Nordic College of Caring Science.

  18. The relationship between nurse-patient interaction and meaning-in-life in cognitively intact nursing home patients.

    Science.gov (United States)

    Haugan, Gørill

    2014-01-01

    To investigate the associations between nurse-patient interaction and meaning-in-life in a nursing home population. Meaning has been found to be a strong individual predictor of successful ageing and life satisfaction as well as an important psychological variable that promotes well-being. Meaning seems to serve as a mediating variable in both psychological and physical health. Connecting and communicating with others have been seen to facilitate meaning-in-life among older individuals. Cross-sectional descriptive study. The data were collected in 2008-2009 using the Nurse-Patient Interaction Scale and the Purpose-in-Life test. A total of 250 cognitively intact nursing home patients met the inclusion criteria and 202 (81%) participated. A structural equation model of the hypothesized relationship between nurse-patient interaction and meaning was tested by means of LISREL 8.8. The structural equation model fit well with the data. A significant direct relationship between nurse-patient interaction and meaning-in-life in cognitively intact nursing home patients was displayed. Nurse-patient interaction significantly relates to meaning and purpose-in-life among cognitively intact nursing home patients and might be an important resource in relation to the patient's mental health and global well-being. High-quality nurse-patient interaction and in-house activities aiming to increase patients' meaning might increase psychological and physical health, well-being and psycho-spiritual functioning in this vulnerable population. © 2013 John Wiley & Sons Ltd.

  19. How well trained are nursing home administrators?

    Science.gov (United States)

    Singh, D A; Shi, L; Samuels, M E; Amidon, R L

    1997-01-01

    Nursing home administrators represent wide variations in academic training. General education levels do not seem to affect administrative preparation in key domains of practice--specific academic fields of study are more relevant. Hence, sole emphasis on higher educational requirements for licensure appears to be a misdirected strategy for improving quality of care and enhancing management efficiencies in nursing homes. Educational paradigms studied have strengths and weakness in furnishing various job skills. These results are helpful in defining strategic actions for addressing both current deficiencies and future training needs. A specialized long-term care model that incorporates appropriate clinical and business skills is recommended. The roles of continuing education and executive educational offerings also need streamlining. These initiatives would require a joint effort from policymakers, academicians, and practitioners.

  20. Development and testing of a scale for assessing the quality of home nursing.

    Science.gov (United States)

    Chiou, Chii-Jun; Wang, Hsiu-Hung; Chang, Hsing-Yi

    2016-03-01

    To develop a home nursing quality scale and to evaluate its psychometric properties. This was a 3-year study. In the first year, 19 focus group interviews with caregivers of people using home nursing services were carried out in northern, central and southern Taiwan. Content analysis was carried out and a pool of questionnaire items compiled. In the second year (2007), study was carried out on a stratified random sample selected from home nursing organizations covered by the national health insurance scheme in southern Taiwan. The study population was the co-resident primary caregivers of home care nursing service users. Item analysis and exploratory factor analysis were carried out on data from 365 self-administered questionnaires collected from 13 selected home care organizations. In the third year (2008), a random sample of participants was selected from 206 hospital-based home care nursing organizations throughout Taiwan, resulting in completion of 294 questionnaires from 27 organizations. Confirmatory factor analysis was then carried out on the scale, and the validity and reliability of the scale assessed. The present study developed a reliable and valid home nursing quality scale from the perspective of users of home nursing services. The scale comprised three factors: dependability, communication skills and service usefulness. This scale is of practical value for the promotion of long-term community care aging in local policies. The scale is ready to be used to assess the quality of services provided by home care nursing organizations. © 2015 Japan Geriatrics Society.

  1. Integrating Advanced Practice Nurses in Home Care. Recommendations for a Teaching Home Care Program.

    Science.gov (United States)

    Mitty, Ethel; Mezey, Mathy

    1998-01-01

    A telephone survey of home care agencies and providers revealed a need for the following: evidence of the effectiveness of nurse practitioners in home care, regulatory and financial support for nurse practitioner home care, and development of home care agencies as clinical sites for training. (SK)

  2. Regulation and mindful resident care in nursing homes.

    Science.gov (United States)

    Colón-Emeric, Cathleen S; Plowman, Donde; Bailey, Donald; Corazzini, Kirsten; Utley-Smith, Queen; Ammarell, Natalie; Toles, Mark; Anderson, Ruth

    2010-09-01

    Regulatory oversight is intended to improve the health outcomes of nursing home residents, yet evidence suggests that regulations can inhibit mindful staff behaviors that are associated with effective care. We explored the influence of regulations on mindful staff behavior as it relates to resident health outcomes, and offer a theoretical explanation of why regulations sometimes enhance mindfulness and other times inhibit it. We analyzed data from an in-depth, multiple-case study including field notes, interviews, and documents collected in eight nursing homes. We completed a conceptual/thematic description using the concept of mindfulness to reframe the observations. Shared facility mission strongly impacted staff perceptions of the purpose and utility of regulations. In facilities with a resident-centered culture, regulations increased mindful behavior, whereas in facilities with a cost-focused culture, regulations reduced mindful care practices. When managers emphasized the punitive aspects of regulation we observed a decrease in mindful practices in all facilities.

  3. 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.

  4. Self-care management practices for the home health nurse: staying hale and hearty through enhanced self-care and ergonomics--with a case study.

    Science.gov (United States)

    Hitt, Jennifer M; Tatum, Eva; McNair, Mary; Harrington, Marilyn; Stanton, Sandra D; Askew, Rebecca; Lofton, Susan; Walker, Jean T; Robertson, Amy

    2012-05-01

    Ergonomics provides a broad framework for home healthcare nurses to improve their individual physical, psychological, cognitive, and spiritual well-being through application of models for self-care planning. As the individual becomes stronger, more resilient and work hardy, the benefits to the individual, along with the work organization and ultimately the clients, grow exponentially. This article seeks to explore the relevant ergonomic domains and assist home healthcare nurses to develop self-care planning practices that lead to healthy lifestyles and improved quality of life.

  5. 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.…

  6. Predictive Factors associated with Death of Elderly in Nursing Homes

    Directory of Open Access Journals (Sweden)

    Kiwol Sung, PhD, RN

    2014-06-01

    Conclusion: Dyspnea, problematic behaviors, and ADL data were identified as the key factors associated with death among nursing home residents. Future plans for the prediction of death among nursing home residents can be made by nursing staff, factoring in these identified variables, to ensure more comfortable conditions and more responsive care.

  7. Guidelines for audiology service delivery in nursing homes. Ad Hoc Committee on Audiology Service Delivery in Home Care and Institutional Settings. American Speech-Language-Hearing Association.

    Science.gov (United States)

    1997-01-01

    The increasing number of older adults in society as well as changing consumer preference and health care delivery systems have led to more frequent activity of audiologists in the delivery of services in nursing homes. The nursing home setting presents a number of challenges for the audiologist. It is anticipated that this document will provide audiologists with a comprehensive hearing management protocol and facilitate audiologists to confront the numerous challenges of the nursing home setting and provide quality audiology services.

  8. Why Do They Stay? Job Tenure among Certified Nursing Assistants in Nursing Homes

    Science.gov (United States)

    Wiener, Joshua M.; Squillace, Marie R.; Anderson, Wayne L.; Khatutsky, Galina

    2009-01-01

    Purpose: This study identifies factors related to job tenure among certified nursing assistants (CNAs) working in nursing homes. Design and Methods: The study uses 2004 data from the National Nursing Home Survey, the National Nursing Assistant Survey, and the Area Resource File. Ordinary least squares regression analyses were conducted with length…

  9. Evaluation of a Nurse-Led Fall Prevention Education Program in Turkish Nursing Home Residents

    Science.gov (United States)

    Uymaz, Pelin E.; Nahcivan, Nursen O.

    2016-01-01

    Falls are a major cause of morbidity and mortality among the elderly living in nursing homes. There is a need to implement and evaluate fall prevention programs in nursing homes to reduce the number of falls. The purpose of this research was to examine the effect of a nurse-led fall prevention education program in a sample of nursing home…

  10. 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.

  11. Psychometric properties of the Nursing Home Survey on Patient Safety Culture in Norwegian nursing homes.

    Science.gov (United States)

    Cappelen, Kathrine; Aase, Karina; Storm, Marianne; Hetland, Jørn; Harris, Anette

    2016-08-27

    Developing a culture where staff are actively aware of how to prevent adverse events is a challenge. The use of survey tools to assess the status of patient safety culture seems to be acceptable as an early step in improving patient safety. The Nursing Home Survey on Patient Safety Culture (NHSOPSC) includes 12 dimensions and is specifically developed for nursing homes. In this study, we describe a Norwegian version of the NHSOPSC and assess its psychometric properties when tested on a sample of healthcare staff in nursing homes. The NHSOPSC was translated into Norwegian and pilot tested before being distributed to 12 nursing homes in Norway. Of the 671 healthcare staff invited, 466 (69 %) answered the questionnaire. SPSS 23.0 was used for descriptive data analysis and estimating internal consistency (Cronbach's alpha). The dimensional structure of the questionnaire was tested by confirmatory factor analysis (CFA) using Mplus (version 7.2). The CFA testing of the original 12-factor solution suggested that some modifications were needed because of the high correlations between three of the latent factors. A subsequent analysis resulted in a final ten-factor solution. The final model showed acceptable fit to the data (root mean square error of approximation = 0.060, 90 % confidence interval: 0.057-0.063, comparative fit index = 0.934, Tucker-Lewis index = 0.926, χ (2) = 2058.33, df = 765, p safety in the nursing home. Factor analysis indicated that a modified ten-factor model fitted the data set in a Norwegian community healthcare context with acceptable goodness-of-fit values and could be recommended as a useful tool to assess staff perceptions of patient safety issues in Norwegian nursing homes.

  12. Are nursing home care workers' health and presenteeism associated with implicit rationing of care? A cross-sectional multi-site study.

    Science.gov (United States)

    Dhaini, Suzanne R; Zúñiga, Franziska; Ausserhofer, Dietmar; Simon, Michael; Kunz, Regina; De Geest, Sabina; Schwendimann, Rene

    To explore associations between care workers' health and implicit rationing of care. Diverse studies have linked impaired health to reduced work performance - a factor measured through omission of required tasks. This cross-sectional study gathered data from 3239 care workers in 162 Swiss nursing homes. Data were analyzed via a linear logistic regression model using general estimating equations. Overall, rationing of care occurred "never" to "seldom." Rationing of activities of daily living was positively associated with care workers' joint pain (β 0.04, CI 0.001-0.07), emotional exhaustion (β 0.11, CI 0.07-0.15), and presenteeism (β 0.05, CI 0.004-0.09). Rationing of caring, rehabilitation, and monitoring was positively associated with care workers' joint pain (β 0.05, CI 0.01-0.09) and emotional exhaustion (β 0.2, CI 1.16-0.24). Care workers health complaints are strongly associated with rationing of tasks directly related to resident care. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Spouse caregivers of people with advanced dementia in nursing homes: a longitudinal narrative study.

    Science.gov (United States)

    Hennings, Jean; Froggatt, Katherine; Payne, Sheila

    2013-07-01

    Dementia is a life limiting illness and is becoming a major cause of death in developed countries. Many people with dementia die in nursing homes or long-term residential care settings. Spouse caregivers of people with dementia living in nursing homes find themselves in a position which is difficult to understand and live with. To explore the caregiving experiences of spouse carers of people with advanced dementia living in nursing homes. Longitudinal narrative study using three sequential interviews and diary accounts. Spouse caregivers of people with dementia nearing the end of life were recruited from two nursing homes in Northern England. Twenty-seven interviews were conducted and seven diaries collected from 10 spouse caregivers (7 women and 3 men). We demonstrate that for this group the experience of caregiving is one of struggle to live in 'two worlds', the world of the nursing home and the world of wider society, where, in both settings, their role is often ambiguous and their position liminal. We also identify that feelings of guilt associated with nursing home placement of a spouse with dementia endure far beyond the time of the move. Nursing home staff need to acknowledge spouse carers in their own right, inviting them to tell their stories. We recommend that communication skills be included in educational programmes for nursing home staff. Further research is needed to determine the shape and context of carer needs assessment and support, as recommended in health policy.

  14. Efficacy of integrated interventions combining psychiatric care and nursing home care for nursing home residents: a review of the literature.

    Science.gov (United States)

    Collet, Janine; de Vugt, Marjolein E; Verhey, Frans R J; Schols, Jos M G A

    2010-01-01

    Nursing home residents needing both psychiatric care and nursing home care for either somatic illness or dementia combined with psychiatric disorders or severe behavioural problems are referred to as Double Care Demanding patients, or DCD patients. Integrated models of care seem to be necessary in order to improve the well-being of these residents. Two research questions were addressed. First, which integrated interventions combining both psychiatric care and nursing home care in DCD nursing home residents are described in the research literature? And second, which outcomes of integrated interventions combining both psychiatric care and nursing home care in DCD nursing home residents are reported in the literature? A critical review of studies was done that involved integrated interventions combining both psychiatric care and nursing home care on psychiatric disorders and severe behavioural problems in nursing home patients. A systematic literature search was performed in a number of international databases. Eight intervention trials, including four RCTs (2b level of evidence), were identified as relevant studies for the purpose of this review. Seven studies, three of which were RCTs, showed beneficial effects of a comprehensive, integrated multidisciplinary approach combining medical, psychiatric and nursing interventions on severe behavioural problems in DCD nursing home patients. Important elements of a successful treatment strategy for DCD nursing home patients include a thorough assessment of psychiatric, medical and environmental causes as well as programmes for teaching behavioural management skills to nurses. DCD nursing home patients were found to benefit from short-term mental hospital admission.This review underlines the need for more rigorously designed studies to assess the effects of a comprehensive, integrated multidisciplinary approach towards DCD nursing home residents. (c) 2009 John Wiley & Sons, Ltd.

  15. Predictors of Nursing Staff Voluntary Termination in Nursing Homes: A Case-Control Study.

    Science.gov (United States)

    Zhang, Yuan; Punnett, Laura; Gore, Rebecca

    2017-08-01

    Workforce instability in the long-term care sector has raised wide attention about nursing staff turnover. Most attention has been devoted to understanding the relationship between facility's characteristics and organizational turnover. This case-control study examined the contribution of work characteristics to individual staff turnover. Surveys were collected with nursing staff in 18 for-profit nursing homes on up to five occasions between 2006 and 2012. A list of nursing staff voluntarily terminating jobs was provided by the company. Cases and controls (628 of each) were selected from survey respondents by matching on age, job category, and survey occasion. Multiple predictor conditional logistic regression models showed that evening shift work (hazards ratio [HR] = 2.00, p 8 hr (HR = 1.42, p < .05) were contributing factors to voluntary termination. This study provides different perspectives of nursing staff voluntary termination in nursing homes. Future qualitative research would be valuable to explore and understand nursing staff turnover in the health care industry.

  16. 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

  17. 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

    Dysphagia (ENCAD) in long-term care settings. 2. Review the outcome of implementing the ENCAD for dysphagia management in a nursing home. DISCLOSURE STATEMENT Neither the planners nor the authors have any conflicts of interest to disclose. Standardized nursing care protocols for dysphagia management have not been established in nursing home settings in Korea. The purpose of the current study was to examine the effect of the Evidence-Based Nursing Care Algorithm of Dysphagia (ENCAD) on risk of dysphagia, oral health, and dysphagia-specific quality of life among nursing home residents. The ENCAD was administered to 40 residents in one nursing home in urban South Korea for 6 months. A control-intervention, time-series design was used, under which participants served as their own controls. Oral health, risk of aspiration, and dysphagia-specific quality of life were measured at baseline, post-control, and post-intervention. Findings showed that risk of aspiration (p < 0.01) and dysphagia-related quality of life (p < 0.001) improved significantly after the ENCAD was applied, whereas oral health status did not change over time (p = 0.06). Results suggest that implementing the ENCAD contributed to a reduction in the risk of aspiration and an improvement in the quality of life in nursing home residents. Copyright 2015, SLACK Incorporated.

  18. 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...

  19. High-Dose Flu Shot May Help Nursing Home Residents Avoid Hospital

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_167348.html High-Dose Flu Shot May Help Nursing Home Residents Avoid Hospital ... July 21, 2017 (HealthDay News) -- Nobody wants the flu, but it can prove deadly for frail residents ...

  20. 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 ...

  1. Return to nursing home investment: Issues for public policy

    Science.gov (United States)

    Baldwin, Carliss Y.; Bishop, Christine E.

    1984-01-01

    Because Government policy does much to determine the return available to nursing home investment, the profitability of the nursing home industry has been a subject of controversy since Government agencies began paying a large portion of the Nation's nursing home bill. Controversy appears at several levels. First is the rather narrow concern, often conceived in accounting terms, of the appropriate reimbursement of capital-related expense under Medicaid and Medicare. Second is the concern about how return to capital affects the flow of investment into nursing homes, leading either to inadequate access to care or to over-capacity. Third is the concern about how-sources of return to nursing home investment affect the pattern of nursing home ownership and the amount of equity held by owners since the pattern of ownership and amount of equity have been linked to quality of care. PMID:10310945

  2. Impact of nursing care services on self-efficacy perceptions and healthy lifestyle behaviors of nursing home residents.

    Science.gov (United States)

    Kulakçi, Hülya; Emiroğlu, Oya Nuran

    2013-10-01

    The purpose of this study was to evaluate the impact of tailored individualized nursing care services on the self-efficacy perceptions and healthy lifestyle behaviors of older adults living in a nursing home in Turkey. This outcomes evaluation research used a quasi-experimental study design in which outcomes evaluations were repeated within time intervals in a single group. The study sample included 30 older adults. Nursing diagnoses and interventions were identified using the Omaha System. The impact of implemented nursing care services was evaluated using the Self-Efficacy Scale and Healthy Life-Style Behaviours Scale II. A total of 3,024 nursing interventions were performed, and self-efficacy perceptions and healthy lifestyle behaviors of older nursing home residents were significantly increased in a positive manner (p healthy lifestyle behaviors of older adults and that nursing care services directed at health promotion of older adults should be maintained. Copyright 2013, SLACK Incorporated.

  3. Excess Demand and Cost Relationships Among Kentucky Nursing Homes

    OpenAIRE

    Davis, Mark A.; Freeman, James W.

    1994-01-01

    This article examines the influence of excess demand on nursing home costs. Previous work indicates that excess demand, reflected in a pervasive shortage of nursing home beds, constrains market competition and patient care expenditures. According to this view, nursing homes located in under-bedded markets can reduce costs and quality with impunity because there is no pressure to compete for residents. Predictions based on the excess demand argument were tested using 1989 data from a sample of...

  4. Setting a new standard of care in nursing homes.

    Science.gov (United States)

    Klaasen, Kathleen; Lamont, Lori; Krishnan, Preetha

    2009-11-01

    The Winnipeg Regional Health Authority's introduction of a full-time nurse practitioner in a 116-bed non-profit nursing home provided an opportunity to explore a collaborative relationship between an NP acting as the primary care provider and a single physician serving as the consultant for complex care and after-hours care. The outcomes were measured in terms of resident and family satisfaction, quality of care indicators and cost effectiveness. Data were collected from pre-existing quality indicators, including a resident/family satisfaction survey, transfers to acute care, and medication use statistics. Unstructured interviews were also conducted with nursing staff and members of the interdisciplinary team. Dramatic improvements in medication use were observed, including a 17 per cent reduction in overall drug costs, a 55 per cent decrease in polypharmacy rates and a 63 per cent reduction in antipsychotic drug use. Transfers to emergency decreased by 20 per cent. Family satisfaction with the quality of health care provided to residents increased by 24 per cent. The collaborative practice of an NP with physician consultation is an effective way of delivering quality care to nursing home residents.

  5. Hillcrest House Nursing Home, Long Lane, Letterkenny, Donegal.

    LENUS (Irish Health Repository)

    Hanan, Terry

    2014-08-01

    A community oncology nursing programme was developed in Ireland between the hospital and community health services for patients receiving systemic cancer therapy, in response to a service need. A robust evaluation of the pilot programme was undertaken, which found that defined clinical procedures traditionally undertaken in hospitals were safely undertaken in the patient\\'s home with no adverse effects. There was a dramatic decrease in hospital attendances for these defined clinical procedures, and hospital capacity was consequently freed up. Patients valued having aspects of their care delivered at home and reported that it improved their quality of life, including reduced hospital visits and travel time. Community nurses expanded their scope of practice and became partners with oncology day-ward nurses in caring for these patients. Community nurses developed the competence and confidence to safely deliver cancer care in the community. This initiative shows that defined elements of acute cancer care can be safely delivered in the community so long as the training and support are provided. The findings and recommendations of the evaluation resulted in university accreditation and approval for national roll-out of the programme. Integration of services between primary and secondary care is a key priority. This innovative programme is a good example of shared integrated care that benefits both patients and health-care providers.

  6. Effect of a high-intensity exercise program on physical function and mental health in nursing home residents with dementia: an assessor blinded randomized controlled trial.

    Science.gov (United States)

    Telenius, Elisabeth Wiken; Engedal, Knut; Bergland, Astrid

    2015-01-01

    Dementia is among the leading causes of functional loss and disability in older adults. Research has demonstrated that nursing home patients without dementia can improve their function in activities of daily living, strength, balance and mental well being by physical exercise. The evidence on effect of physical exercise among nursing home patients with dementia is scarce and ambiguous. Thus, the primary objective of this study was to investigate the effect of a high intensity functional exercise program on the performance of balance in nursing home residents with dementia. The secondary objective was to examine the effect of this exercise on muscle strength, mobility, activities of daily living, quality of life and neuropsychiatric symptoms. This single blinded randomized controlled trial was conducted among 170 persons with dementia living in nursing homes. Mean age was 86.7 years (SD = 7.4) and 74% were women. The participants were randomly allocated to an intervention (n = 87) or a control group (n = 83). The intervention consisted of intensive strengthening and balance exercises in small groups twice a week for 12 weeks. The control condition was leisure activities. The intervention group improved the score on Bergs Balance Scale by 2.9 points, which was significantly more than the control group who improved by 1.2 points (p = 0.02). Having exercised 12 times or more was significantly associated with improved strength after intervention (pexercise group after the intervention, compared to the control group (p = 0.048). The results from our study indicate that a high intensity functional exercise program improved balance and muscle strength as well as reduced apathy in nursing home patients with dementia. ClinicalTrials.gov NCT02262104.

  7. Effect of a high-intensity exercise program on physical function and mental health in nursing home residents with dementia: an assessor blinded randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Elisabeth Wiken Telenius

    Full Text Available Dementia is among the leading causes of functional loss and disability in older adults. Research has demonstrated that nursing home patients without dementia can improve their function in activities of daily living, strength, balance and mental well being by physical exercise. The evidence on effect of physical exercise among nursing home patients with dementia is scarce and ambiguous. Thus, the primary objective of this study was to investigate the effect of a high intensity functional exercise program on the performance of balance in nursing home residents with dementia. The secondary objective was to examine the effect of this exercise on muscle strength, mobility, activities of daily living, quality of life and neuropsychiatric symptoms.This single blinded randomized controlled trial was conducted among 170 persons with dementia living in nursing homes. Mean age was 86.7 years (SD = 7.4 and 74% were women. The participants were randomly allocated to an intervention (n = 87 or a control group (n = 83. The intervention consisted of intensive strengthening and balance exercises in small groups twice a week for 12 weeks. The control condition was leisure activities.The intervention group improved the score on Bergs Balance Scale by 2.9 points, which was significantly more than the control group who improved by 1.2 points (p = 0.02. Having exercised 12 times or more was significantly associated with improved strength after intervention (p<0.05. The level of apathy was lower in the exercise group after the intervention, compared to the control group (p = 0.048.The results from our study indicate that a high intensity functional exercise program improved balance and muscle strength as well as reduced apathy in nursing home patients with dementia.ClinicalTrials.gov NCT02262104.

  8. Nenagh Manor Nursing Home, Yewston, Nenagh, Tipperary.

    LENUS (Irish Health Repository)

    Day, Mary Rose

    2015-03-02

    Self-neglect is a worldwide and serious public health issue that can have serious adverse outcomes and is more common in older people. Cases can vary in presentation, but typically present as poor self-care, poor care of the environment and service refusal. Community nurses frequently encounter self-neglect cases and health and social care professionals play a key role in the identification, management and prevention of self-neglect. Self-neglect cases can give rise to ethical, personal and professional challenges. The aim of this article is to create a greater understanding of the concept of self-neglect among community nurses.

  9. [Psychological factors and sleep in the lifeworld nursing home from the nursing home residents' perspective. A qualitative study].

    Science.gov (United States)

    Herrmann, W J; Flick, U

    2014-04-01

    Sleep disorders are common among nursing home residents. However, the possible involvement of psychological factors has been given little attention up until now. We investigated nursing home residents' perspective on psychological factors and sleep disorders within the nursing home environment. We conducted a qualitative interview study comprising episodic interviews with 30 nursing home residents in five different nursing homes. The data was analysed by thematic coding. Nursing home residents require peace of mind in order to sleep well. Ruminations and thoughts disturb inner peace and are, in turn, caused by psychological factors. Of particular relevance is the end-of-life situation of the residents. Nursing home residents possess only limited strategies to relax and achieve inner peace. Psychosocial factors play a central role in sleep disturbances among nursing home residents. Nurses and physicians who treat nursing home residents with sleep disorders should consider the possible psychosocial causes. Counselling and treatment should be given on an individual basis, for example by educating in relaxation techniques.

  10. Work-related factors influencing home care nurse intent to remain employed.

    Science.gov (United States)

    Tourangeau, Ann E; Patterson, Erin; Saari, Margaret; Thomson, Heather; Cranley, Lisa

    Health care is shifting out of hospitals into community settings. In Ontario, Canada, home care organizations continue to experience challenges recruiting and retaining nurses. However, factors influencing home care nurse retention that can be modified remain largely unexplored. Several groups of factors have been identified as influencing home care nurse intent to remain employed including job characteristics, work structures, relationships and communication, work environment, responses to work, and conditions of employment. The aim of this study was to test and refine a model that identifies which factors are related to home care nurse intentions to remain employed for the next 5 years with their current home care employer organization. A cross-sectional survey design was implemented to test and refine a hypothesized model of home care nurse intent to remain employed. Logistic regression was used to determine which factors influence home care nurse intent to remain employed. Home care nurse intent to remain employed for the next 5 years was associated with increasing age, higher nurse-evaluated quality of care, having greater variety of patients, experiencing greater meaningfulness of work, having greater income stability, having greater continuity of client care, experiencing more positive relationships with supervisors, experiencing higher work-life balance, and being more satisfied with salary and benefits. Home care organizations can promote home care nurse intent to remain employed by (a) ensuring nurses have adequate training and resources to provide quality client care, (b) improving employment conditions to increase income stability and satisfaction with pay and benefits, (c) ensuring manageable workloads to facilitate improved work-life balance, and (d) ensuring leaders are accessible and competent.

  11. Improving the Quality of Home Health Care for Children With Medical Complexity.

    Science.gov (United States)

    Nageswaran, Savithri; Golden, Shannon L

    2017-08-01

    The objectives of this study are to describe the quality of home health care services for children with medical complexity, identify barriers to delivering optimal home health care, and discuss potential solutions to improve home health care delivery. In this qualitative study, we conducted 20 semistructured in-depth interviews with primary caregivers of children with medical complexity, and 4 focus groups with 18 home health nurses. During an iterative analysis process, we identified themes related to quality of home health care. There is substantial variability between home health nurses in the delivery of home health care to children. Lack of skills in nurses is common and has serious negative health consequences for children with medical complexity, including hospitalizations, emergency room visits, and need for medical procedures. Inadequate home health care also contributes to caregiver burden. A major barrier to delivering optimal home health care is the lack of training of home health nurses in pediatric care and technology use. Potential solutions for improving care include home health agencies training nurses in the care of children with medical complexity, support for nurses in clinical problem solving, and reimbursement for training nurses in pediatric home care. Caregiver-level interventions includes preparation of caregivers about: providing medical care for their children at home and addressing problems with home health care services. There are problems in the quality of home health care delivered to children with medical complexity. Training nurses in the care of children with medical complexity and preparing caregivers about home care could improve home health care quality. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  12. Reorganizing the nursing home industry: a proposal.

    Science.gov (United States)

    Shulman, D; Galanter, R

    1976-01-01

    This paper proposes a reorganization of the nursing home industry with capital facilities owned by government, but with management conducted through a system of competitive contracts with the private sector. The paper explicity demonstrates in real estate finance terms how the present system of private ownership of capital facilities inherently impedes providing a high quality of care. The authors believe that in the proposed industry reorganization, market forces, instead of working against quality care, would be supportive of quality care in a framework that would involve generally less regulation than exists today.

  13. Nursing care community health

    Directory of Open Access Journals (Sweden)

    Diana Acosta-Salazar

    2016-07-01

    Full Text Available Process Nursing Care (PAE is a systematic tool that facilitates the scientificity of care in community practice nurse, the application of scientific method in community practice, allows nursing to provide care in logical, systematic and comprehensive reassessing interventions to achieve the proposed results. It began with the valuation of Marjory Gordon Functional Patterns and then at the stage of diagnosis and planning North American Nursing Diagnosis Association (NANDA, Nursing Interventions Classification (NIC and Nursing Outcomes Classification (NOC is interrelate. It is a descriptive and prospective study. Diagnosis was made by applying the instruments measuring scale of the socio-demographic characteristics, symptom questionnaire for early detection of mental disorders in the community and appreciation for functional patterns. The PAE includes more frequent diagnoses, criteria outcomes, indicators, interventions and activities to manage community issues. alteration was evidenced in patterns: Adaptation and Stress Tolerance, Self-perception-Self-concept-, Role-Relationships, sleep and rest and Perception and Health Management. A standardized NANDA-NIC-NOC can provide inter care holistic care from the perspective of community mental health with a degree of scientific nature that frames the professional work projecting the individual, family and community care.

  14. Changes in Consumer Demand Following Public Reporting of Summary Quality Ratings: An Evaluation in Nursing Homes.

    Science.gov (United States)

    Werner, Rachel M; Konetzka, R Tamara; Polsky, Daniel

    2016-06-01

    Limited consumer use of health care report cards may be due to the large amount of information presented in report cards, which can be difficult to understand. These limitations may be overcome with summary measures. Our objective was to evaluate consumer response to summary measures in the setting of nursing homes. 2005-2010 nursing home Minimum Data Set and Online Survey, Certification and Reporting (OSCAR) datasets. In December 2008, Medicare converted its nursing home report card to summary or star ratings. We test whether there was a change in consumer demand for nursing homes related to the nursing home's star rating after the information was released. The star rating system was associated with a significant change in consumer demand for low- and high-scoring facilities. After the star-based rating system was released, 1-star facilities typically lost 8 percent of their market share and 5-star facilities gained over 6 percent of their market share. The nursing home star rating system significantly affected consumer demand for high- and low-rated nursing homes. These results support the use of summary measures in report cards. © Health Research and Educational Trust.

  15. [Evaluating the quality of care in nursing homes: comparison of three International models].

    Science.gov (United States)

    Rubino, Alessandro; Leigheb, Fabrizio; Rinaldi, Carmela; Di Dio, Angelo; Knesse, Sanita; Donnarumma, Chiara; Panella, Massimiliano

    2016-01-01

    The aim of this observational descriptive study was to identify the main international models evaluating the quality of nursing homes for non self-sufficient elderly persons, and to apply them in the Italian health system. Firstly, a bibliographic search of institutional websites and Pubmed-Medline was performed to identify the main international models. Secondly, three variables were chosen to evaluate the level of implementability of the models: (1) frequency of use of quality indicators in the international models; (2) degree of constructability of the models in two Italian nursing homes; (3) perceived relevance of the indicators used by the chosen models, by nursing home workers. Thirdly, the chosen models were evaluated. Three international models were identified, respectively used in USA, Canada and Australia. About 80% of the indicators used by the three models were constructable in the two Italian nursing homes that were evaluated. The two nursing homes were "promoted" according to the Canadian model, "better than sufficient" according to the Australian model, but "failed" when US model indicators were applied. The poorest performances in the two Italian nursing homes, with respect to international quality standards, were related to indicators of incontinence, physical restraints (1,1% for USA and 13% for Canada and Australia, versus 55% in one of the nursing homes and 30% in the second home), diagnosis of depressive symptoms, and antipneumococcical vaccination (0% in the two nursing homes, in comparison with the 93,8% in the USA). A low level of performance in prevention and safety matters was identified, while performance was higher for aspects warranted by law. The survey also revealed thatnursing home workers' perceptions of the utility of specific indicators were often based on habit rather than on the actual relevance of care indicators. The development of a model of quality of care that offers a multidimensional evaluation of the level of performance

  16. 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.

  17. Rules of performance in the nursing home: A grounded theory of nurse-CNA communication.

    Science.gov (United States)

    Madden, Connie; Clayton, Margaret; Canary, Heather E; Towsley, Gail; Cloyes, Kristin; Lund, Dale

    This study offers an initial theoretical understanding of nurse-CNA communication processes from the perspectives of nurses and CNAs who are providing direct care to residents in nursing homes. A grounded theory approach provided an understanding of nurse-CNA communication process within the complexities of the nursing home setting. Four themes (maintaining information flow, following procedure, fostering collegiality, and showing respect) describe the "rules of performance" that intertwine in nuanced relationships to guide nurse-CNA communication processes. Understanding how these rules of performance guide nurse-CNA communication processes, and how they are positively and negatively influenced, suggests that nurse-CNA communication during direct care of nursing home residents could be improved through policy and education that is specifically designed to be relevant and applicable to direct care providers in the nursing home environment. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Attitudes and perceptions towards oral hygiene tasks among geriatric nursing home staff.

    Science.gov (United States)

    Forsell, M; Sjögren, P; Kullberg, E; Johansson, O; Wedel, P; Herbst, B; Hoogstraate, J

    2011-08-01

    To assess attitudes and perceptions towards oral hygiene tasks among geriatric nursing home staff, before and after a dental hygiene education. A survey questionnaire was distributed to the nursing staff (n = 105), at a geriatric nursing home in Stockholm, Sweden. The response rate to the questionnaire was 83%. A vast majority (87%) of the nursing staff considered oral hygiene tasks unpleasant. The main reason for considering oral care unpleasant was a perceived unwillingness from the residents. The perceived unwillingness from the residents among the nursing staff was reduced after the dental hygiene education (chi-square test, P = 0.02). A vast majority of the nursing staff experienced, always or sometimes, resistance from the residents towards oral care. Nursing home staff members consider oral care tasks unpleasant, and frequently experience resistance from the nursing home residents towards oral care. The perceived unwillingness from the residents is reduced after an advanced dental hygiene education. Further studies are needed to evaluate the effects of education on nursing staff's attitudes and perceptions towards oral care tasks, with the overall aim of improving the oral health among older people in hospitals and nursing homes. © 2010 John Wiley & Sons A/S.

  19. Racial and ethnic comparisons of nursing home residents at admission.

    Science.gov (United States)

    Buchanan, Robert J; Rosenthal, Mark; Graber, David R; Wang, Suojin; Kim, Myung Suk

    2008-10-01

    To present racial/ethnic comparisons of comprehensive profiles of nursing home residents at admission, including whites, African Americans, Hispanics, Asians/Pacific Islanders, and American Indians/Alaska Natives. More than 885,000 admission assessments recorded in the national Minimum Data Set (MDS) were analyzed. Racial and ethnic analyses of the MDS admission assessments were conducted using the software package SAS. There were significant racial/ethnic differences in gender and age, with minority residents more likely to be male and younger. African American, Hispanic, and Asian/Pacific Islanders were significantly more likely than white residents to exhibit total dependence in the self-performance of the ADLs and to have greater cognitive impairments, with Asian/Pacific Islanders the most physically dependent and cognitively impaired. The results illustrate significant and substantive differences among the racial/ethnic groups for many demographic characteristics, as well as health-related indicators and conditions. This analysis suggests that the general perspective that economically disadvantaged minorities enter nursing homes in worse condition than whites is too simplistic. More research, particularly qualitative studies of specific minority groups, will advance our understanding of why members of some racial/ethnic groups require nursing home placement sooner than other groups.

  20. Influence of staff infection control training on infection-related quality measures in US nursing homes.

    Science.gov (United States)

    Kaur, Jasjit; Stone, Patricia W; Travers, Jasmine L; Cohen, Catherine C; Herzig, Carolyn T A

    2017-09-01

    Health care-associated infections are a leading cause of morbidity and mortality in US nursing home residents. Ongoing training of nursing home staff is vital to the implementation of infection prevention and control processes. Our aim was to describe associations between methods, frequency, and timing of staff infection prevention and control training and infection-related quality measures. In this national survey of nursing homes, timing of staff infection prevention and control training was associated with reduced indwelling urinary catheter use. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  1. Consumers' use of internet-based nursing home report cards.

    Science.gov (United States)

    Castle, Nicholas G

    2009-06-01

    Few studies have addressed the extent to which consumers use nursing home report cards and how they use this information. These questions, which are significant because the nursing home market presents several challenges to the effectiveness of report cards, were pursued in a study. Data used in this investigation came from three mail surveys conducted in 2006 of family members of nursing home residents (N = 4,754), family members of assisted-living residents (N = 496), and elders living in high-rise buildings (N = 1,252). Some 31% of family members of nursing home residents, 53% of family members of assisted-living residents, and 23% of elders living in high-rise buildings used the Internet in looking for a nursing home. In general, these different types of consumers look for different types of nursing home information. According to the results, most consumers who used the Internet to look for a nursing home also used a report card. In addition, between 6% and 17% of consumers specifically identified using Nursing Home Compare when looking for a nursing home. The highest use of report cards was reported by family members of assisted-living residents, followed by family members of nursing home residents. Many consumers primarily used the report cards simply to find the location of nursing homes-a useful first step when examining the facility choices available. Yet relatively few consumers primarily used report cards for the arguably more important step of comparing quality information. Future research should investigate why the quality information is not used to a greater extent and what hinders consumers from using this information.

  2. A national view of workplace injuries in nursing homes.

    Science.gov (United States)

    Castle, Nicholas G; Engberg, John; Mendeloff, John; Burns, Rachel

    2009-01-01

    Data from a large sample of nursing homes were used to examine the cross-sectional association between workplace injuries and organizational factors, caregiver staffing levels, and quality. Three sources of data were used, the Occupational Safety and Health Administration data initiative for 2004, the Online Survey Certification and Recording system representing 2004, and the 2004 Area Resource File. For the organizational characteristics of interest, the results show that for-profit facilities were less likely to report high injury rates and that facilities with a higher average occupancy and belonging to a chain were more likely to report high injury rates. For the staffing characteristics of interest, facilities with high staffing levels of registered nurses were more likely to report high injury rates, whereas those with high staffing levels of nurse aides were less likely to report high injury rates. For the quality characteristic of interest, facilities of low quality (as measured by quality-of-care deficiency citations) were more likely to report high injury rates. Workplace injuries are associated with organizational, caregiver, and quality characteristics of nursing homes. This may present an opportunity to reduce high injury rates.

  3. 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.

  4. [Use of fluoroquinolones in nursing homes].

    Science.gov (United States)

    Fagan, Mark; Skotheim, Stian Bøe

    2010-10-21

    In Norway, a substantial increase in the use of fluoroquinolones (in the last years) has occurred in parallel with a disconcertering increase in ciprofloxacin resistant E. Coli bacteria. Elderly patients (over 70 years) use most antibiotics. The purpose of this study is to investigate prescribing of fluoroquinolone in nursing homes within a Norwegian municipality. Clinical information was recorded for nursing home patients treated with fluoroquinolone in Arendal municipality in the period 01.12.06-31.11.07. 94 courses of ciprofloxacin were prescribed for 78 patients. No patients were treated with ofloxacine. Urinary tract infection was the most common indication for patients both in long- term (78%) and short term (40%) wards. In short-term wards, respiratory tract infection was also a common indication for prescribing ciprofloxacin (37%), but not in long- term wards (4%). 44 infections (47%) were verified by microbiology culture. 12 infections were caused by a bacterium susceptible only to ciprofloxacin. Ciprofloxacin was used in a large proportion of the patients in cases when another antibiotic should have been the first choice according to Norwegian national guidelines. Results of microbiology culture showed that most pathogens were susceptible to antibiotics with a narrower spectrum than ciprofloxacin.

  5. 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.

    Science.gov (United States)

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

    2016-01-01

    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. The study included 127 nursing personnel (32 registered nurses, 69 nursing aides and 26 nursing assistants) at three nursing homes and one home-based care facility in Norway. We examined the reliability and content and construct validity of the Michigan Diabetes Knowledge Test. The items in both the general diabetes subscale and the insulin-use subscale were considered relevant and appropriate. The instrument showed satisfactory properties for distinguishing between groups. Item response theory-based measurements and item information curves indicate maximum information at average or lower knowledge scores. Internal consistency and the item-total correlations were quite weak, indicating that the Michigan Diabetes Knowledge Test measures a set of items related to various relevant knowledge topics but not necessarily related to each other. The Michigan Diabetes Knowledge Test measures a broad range of topics relevant to diabetes care. It is an appropriate instrument for identifying individual and distinct needs for diabetes education among nursing personnel. The knowledge gaps identified by the Michigan Diabetes Knowledge Test could also provide useful input for the content of educational activities. However, some revision of the test should be considered.

  6. 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......The number of older people from their own home into a nursing home is likely to increase. This study intends to examine important aspects in the transition process by applying ethnographic methods. Ten older people and their relatives were interviewed and observed. It was found...... and met. This left them barely able to maintain their homes and, as a consequence of this, their identity....

  7. [Urgency of GP Emergency Visits to Nursing Homes].

    Science.gov (United States)

    Bleckwenn, Markus; Ahrens, Sabrina; Schnakenberg, Rieke; Weckbecker, Klaus

    2017-10-01

     Until now there are no uniform criteria or standards for classification of emergency home visits. Due to demographic changes, especially urgent visits to patients in nursing homes will increase. In the URGENT study, physicians and nurses rated the urgency of emergency visits to nursing home patients before and after the visit. This should help to see how many emergency house calls had been classified as less urgent and how often the assessment of physicians and nurses were in agreement with each other. In a prospective observational study, home visits were analyzed, which were classified as urgent at request by the physicians. After performing home visits, the physicians and the responsible nurse classified again the urgency of the home visit from 0 (not urgent) to 10 (highly urgent). In addition, the times of the home visit requests and the time for carrying out the visits, as well the reasons for the home visits were documented. A total of 75 urgent home visits were documented. The patients were on average 82 years old (65% female). The home visits were done on average 2.5 h after request. In retrospect, the physicians evaluated emergency home visits on average less urgent (5.7±2.7) than the nurses (7.2±2.2). In 20% of emergency home visits (15 cases), physicians and nurses agreed as to their being less urgent (0-5). Our data show that in the absence of a standardized urgent assessment scheme, a significant proportion of home visits is misclassified. In further studies it has to be investigated if a uniform score for urgent assessment could reduce the proportion of incorrect medical response operations so that the efficiency of emergency care for nursing home patients can be improved. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Hospital in the Home nurses' recognition and response to clinical deterioration.

    Science.gov (United States)

    Gray, Erika; Currey, Judy; Considine, Julie

    2017-09-19

    To obtain an understanding of how Hospital in the Home (HITH) nurses recognise and respond to clinical deterioration in patients receiving care at home or in their usual place of residence. Recognising and responding to clinical deterioration is an international safety priority and a key nursing responsibility. Despite an increase in care delivery in home environments, how HITH nurses recognise and respond to clinical deterioration is not yet fully understood. A prospective, descriptive exploratory design was used. A survey containing questions related to participant characteristics and 10 patient scenarios was used to collect data from 47 nurses employed in the HITH units of three major health services in Melbourne, Australia. The 10 scenarios reflected typical HITH patients and included medical history and clinical assessment findings (respiratory rate, oxygen saturation, heart rate, blood pressure, temperature, conscious state and pain score). The three major findings from this study were that: (i) nurse and patient characteristics influenced HITH nurses' assessment decisions; (ii) the cues used by HITH nurses to recognise clinical deterioration varied according to the clinical context; and (iii) although HITH nurses work in an autonomous role, they engage in collaborative practice when responding to clinical deterioration. Hospital in the Home nurses play a fundamental role in patient assessment, and the context in which they recognise and respond to deterioration is markedly different to that of hospital nurses. The assessment, measurement and interpretation of clinical data are a nursing responsibility that is crucial to early recognition and response to clinical deterioration. The capacity of HITH services to care for increasing numbers of patients in their home environment, and to promptly recognise and respond to clinical deterioration should it occur, is fundamental to safety within the healthcare system. Hospital in the Home nurses are integral to a

  9. 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…

  10. Essential elements of the nursing practice environment in nursing homes: Psychometric evaluation

    NARCIS (Netherlands)

    Brouwer, B.J.M. de; Kaljouw, M.J.; Schoonhoven, L.; Achterberg, T. van

    2017-01-01

    AIMS AND OBJECTIVES: To develop and psychometrically test the Essentials of Magnetism II in nursing homes. BACKGROUND: Increasing numbers and complex needs of older people in nursing homes strain the nursing workforce. Fewer adequately trained staff and increased care complexity raise concerns about

  11. Survival to late dementia in Dutch nursing home patients.

    NARCIS (Netherlands)

    Koopmans, R.T.C.M.; Ekkerink, J.L.P.; Weel, C. van

    2003-01-01

    OBJECTIVES: To investigate the determinants of survival to late dementia in Dutch nursing home patients. DESIGN: Observational analysis of a cohort of patients with a prospective follow-up. SETTING: Psychogeriatric nursing home "Joachim en Anna" in Nijmegen, the Netherlands. PARTICIPANTS: Dementia

  12. Observational Learning among Older Adults Living in Nursing Homes

    Science.gov (United States)

    Story, Colleen D.

    2010-01-01

    The purpose of this study was to evaluate learning by older adults living in nursing homes through observational learning based on Bandura's (1977) social learning theory. This quantitative study investigated if older adults could learn through observation. The nursing homes in the study were located in the midwestern United States. The…

  13. 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,

  14. 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…

  15. Learning Opportunities for Nurses Working within Home Care

    Science.gov (United States)

    Lundgren, Solveig

    2011-01-01

    Purpose: The purpose of this study is to explore home care nurses' experience of learning in a multicultural environment. Design/methodology/approach: The study was based on qualitative research design. Data were collected through repeated interviews with registered home care nurses working in a multicultural area. The data were analyzed through a…

  16. 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…

  17. Medicare Home Visit Program Associated With Fewer Hospital And Nursing Home Admissions, Increased Office Visits.

    Science.gov (United States)

    Mattke, Soeren; Han, Dan; Wilks, Asa; Sloss, Elizabeth

    2015-12-01

    Clinical home visit programs for Medicare beneficiaries are a promising approach to supporting aging in place and avoiding high-cost institutional care. Such programs combine a comprehensive geriatric assessment by a clinician during a home visit with referrals to community providers and health plan resources to address uncovered issues. We evaluated UnitedHealth Group's HouseCalls program, which has been offered to Medicare Advantage plan members in Arkansas, Georgia, Missouri, South Carolina, and Texas since January 2008. We found that, compared to non-HouseCalls Medicare Advantage plan members and fee-for-service beneficiaries, HouseCalls participants had reductions in admissions to hospitals (1 percent and 14 percent, respectively) and lower risk of nursing home admission (0.67 percent and 1.3 percent, respectively). In addition, participants' numbers of office visits--chiefly to specialists--increased 2-6 percent (depending on the comparison group). The program's effects on emergency department use were mixed. These results indicate that a thorough home-based clinical assessment of a member's health and home environment combined with referral services can support aging in place, promote physician office visits, and preempt costly institutional care. Project HOPE—The People-to-People Health Foundation, Inc.

  18. Nursing interventions in crisis-oriented and long-term psychiatric home care

    NARCIS (Netherlands)

    Boomsma, J.; Dassen, T.WN; Dingemans, T.; van den Heuvel, W.J.A.

    1999-01-01

    Psychiatric nurses in The Netherlands are moving out of residential mental health institutions and are pioneering home care for the acutely and chronically mentally ill. The purpose of this study was to identify the interventions nurses currently use and to describe the differences between

  19. 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...... and municipalities. However, the migration populations in Denmark do not utilize public help and care in old age at any significant level.This is the reason why the municipality of Copenhagen is developing a specific ‘diversity profile’ in an existing public nursing home in Copenhagen; Peder Lykke Centeret...

  20. Neglect of older adults in Michigan nursing homes.

    Science.gov (United States)

    Zhang, Zhenmei; Schiamberg, Lawrence B; Oehmke, James; Barboza, Gia E; Griffore, Robert J; Post, Lori A; Weatherill, Robin P; Mastin, Teresa

    2011-01-01

    Although research on domestic elder abuse and neglect has grown over the past 20 years, there is limited research on elder neglect in nursing homes. The purpose of this study is to estimate the incidence of elder neglect in nursing homes and identify the individual and contextual risks associated with elder neglect. Data came from a 2005 random digit dial survey of individuals in Michigan who had relatives in long term care. Our analytic sample included 414 family members who had a relative aged 65 or older in nursing homes. Results showed that about 21% of nursing home residents were neglected on one or more occasion in the last 12 months. Two nursing home residents' characteristics reported by family members appear to significantly increase the odds of neglect: functional impairments in activities of daily living and previous resident-to-resident victimization. Behavior problems also are associated with higher odds of neglect (p = 0.078). Policy implications of these results are discussed.

  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. PMID:23894261

  2. Health Smart Homes: New Challenges.

    Science.gov (United States)

    Maeder, Anthony J; Williams, Patricia A H

    2017-01-01

    Health Smart Homes provide various forms of assisted living support, by monitoring the activities and health status of their occupants to generate flows of information and sometimes interventions involving the occupants and their careers. Technologies of varying complexity must be combined to produce the underlying Health Smart Home system, and processing of the resulting data may require methods of varying sophistication. These aspects have been well studied, but no widely-adopted approaches for practical implementation of systems or systematic processing of data have been developed. Also, the integration of Health Smart Home services with the overall health care system has not been regularized. This paper identifies and categorizes the emerging high-level challenges beyond those in the basic technical and algorithmic spaces. These challenges will influence future directions for Health Smart Homes and their wider adoption and integration with health systems.

  3. 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.

  4. The changing role of health care professionals in nursing homes: A systematic literature review of a decade of change

    NARCIS (Netherlands)

    van Stenis, A.R. (Arend R.); J. Van Wingerden (Jessica); Tanke, I.K. (Isolde Kolkhuis)

    2017-01-01

    textabstractAlthough, the role of health care professionals is known to have changed over the last years, few formal efforts have been made to examine this change through means of a scientific review. Therefore, the goal of this paper was to investigate the changing role of health care professionals

  5. Frailty and Potentially Inappropriate Medication Use at Nursing Home Transition.

    Science.gov (United States)

    Maclagan, Laura C; Maxwell, Colleen J; Gandhi, Sima; Guan, Jun; Bell, Chaim M; Hogan, David B; Daneman, Nick; Gill, Sudeep S; Morris, Andrew M; Jeffs, Lianne; Campitelli, Michael A; Seitz, Dallas P; Bronskill, Susan E

    2017-10-01

    To estimate the prevalence of potentially inappropriate medication (PIM) use among older adults with cognitive impairment or dementia prior to and following admission to nursing homes and in relation to frailty. Retrospective cohort study using health administrative databases. Ontario, Canada. 41,351 individuals with cognitive impairment or dementia, aged 66+ years newly admitted to nursing home between 2011 and 2014. PIMs were defined with 2015 Beers Criteria and included antipsychotics, H2 -receptor antagonists, benzodiazepines, and drugs with strong anticholinergic properties. Medication information was obtained at nursing home admission and in the subsequent 180 days. Multivariable Cox proportional-hazards models were used to assess the impact of frailty status (determined by a 72-item frailty index) on the hazard of starting and discontinuing PIMs. At admission, 44% of residents with cognitive impairment or dementia were on a PIM and prevalence varied by frailty (38.7% non-frail, 42.8% pre-frail, and 48.1% frail, P PIMs (23.5% for antipsychotics, 49.3% benzodiazepines, 32.2% anticholinergics, and 30.9% H2 -receptor antagonists). However, PIMs were also introduced with 10.9% newly started on antipsychotics, benzodiazepines (10.1%), anticholinergics (6.6%), and H2 -receptor antagonists (1.2%). After adjustment for other characteristics, frail residents had a similar risk of PIM discontinuation as non-frail residents except for anticholinergics (HR = 1.21, 95% CI 1.06-1.39) but were more likely to be newly prescribed benzodiazepines (HR = 1.32, 95% CI 1.20-1.44), antipsychotics (HR = 1.36, 1.23-1.49), and anticholinergics (HR = 1.34, 95% CI 1.20-1.50). Many residents with cognitive impairment or dementia enter nursing homes on PIMs. PIMs are more likely to be started in frail individuals following admission. Interventions to support deprescribing of PIMs should be implemented targeting frail individuals during the transition to nursing home. © 2017, Copyright

  6. Effect evaluation of a supervised versus non-supervised implementation of an oral health care guideline in nursing homes: a cluster randomised controlled clinical trial.

    NARCIS (Netherlands)

    Visschere, L. De; Schols, J.; Putten, G.J. van der; Baat, C. de; Vanobbergen, J.

    2012-01-01

    OBJECTIVE: To compare a supervised versus a non-supervised implementation of an oral health care guideline in Flanders (Belgium). BACKGROUND: The key factor in realising good oral health is daily oral hygiene care. In 2007, the Dutch guideline 'Oral health care in care homes for elderly people' was

  7. [Using interaction-intensive therapeutic nursing measures and "home remedies" in nursing care. An explorative study as a plea for integrated nursing practice].

    Science.gov (United States)

    Ulmer, E M; Höhmann, U; Linhart, M; Kohan, D; Saller, R

    2001-06-01

    Until today there existed no major studies about the wide range of currently utilized methods or potential sociodemographic and institutional influences on utilization despite an immense interest among nurses in alternative nursing methods (in this study referred to as home remedies). In this study, from standardized questionnaires with a convenience sample of three different settings of nursing practice, i.e. acute-care, nursing homes, and home health care were analyzed using the statistical program SPSS. Our analysis showed that a wide range of traditional home remedies is being utilized, e.g. application of heat and cold or herbal infusion (herbal teas). Furthermore, lay approaches such as aromatherapy were also commonly used. The statistical analysis revealed complex influences of age, duration of nursing practice and institutional setting in the utilization of home remedies. There is need for more systematic studies to further examine the alternative methods or home remedies so popular among nurses and their patients. Regarding a more consistent naming of the variety of different methods coming from naturopathy, folk and lay medicine, the authors suggest the term "integrative nursing care".

  8. Preparing tomorrow's nursing home nurses: the wisconsin long term care clinical scholars program.

    Science.gov (United States)

    Nolet, Kim; Roberts, Tonya; Gilmore-Bykovskyi, Andrea; Roiland, Rachel; Gullickson, Colleen; Ryther, Brenda; Bowers, Barbara J

    2015-01-01

    Preparing future nurses to care for the growing population of older adults has become a national priority. The demand for long term care services is expected to double between 2000 and 2040, yet the field remains stigmatized as an undesirable place for highly skilled nurses to work. Recent efforts to increase student preparation in geriatrics have been shown to improve student attitudes toward working with older adults and increase knowledge, but long term care settings remain unattractive to students. This article reports on the development, implementation, and evaluation of The Wisconsin Long Term Care Clinical Scholars Program, a nursing home internship for baccalaureate nursing students. The program couples a paid nursing home work experience with an evidence-based long term care nursing curriculum. The program increased student preparation and interest in working both with older adults and in nursing homes, while increasing the capacity of nursing homes to provide a positive student experience.

  9. Preparing Tomorrow’s Nursing Home Nurses: The Wisconsin-Long Term Care Clinical Scholars Program

    Science.gov (United States)

    Nolet, Kim; Roberts, Tonya; Gilmore-Bykovskyi, Andrea; Roiland, Rachel; Gullickson, Colleen; Ryther, Brenda; Bowers, Barbara J.

    2014-01-01

    Preparing future nurses to care for the growing population of older adults has become a national priority. The demand for long term care services is expected to double between 2000 and 2040, yet the field remains stigmatized as an undesirable place for highly-skilled nurses to work. Recent efforts to increase student preparation in geriatrics have been shown to improve student attitudes toward working with older adults and increase knowledge, but long term care settings remain unattractive to students. This paper reports on development, implementation and evaluation of The Wisconsin Long Term Care Clinical Scholars Program, a nursing home internship for baccalaureate nursing students. The program couples a paid nursing home work experience with an evidence-based long term care nursing curriculum. The program increased student preparation and interest in working with older adults and in nursing homes, while concurrently increasing the capacity of nursing homes to provide a positive student experience. PMID:25162659

  10. Family Satisfaction With Nursing Home Care.

    Science.gov (United States)

    Shippee, Tetyana P; Henning-Smith, Carrie; Gaugler, Joseph E; Held, Robert; Kane, Robert L

    2017-03-01

    This article explores the factor structure of a new family satisfaction with nursing home care instrument and determines the relationship of resident quality of life (QOL) and facility characteristics with family satisfaction. Data sources include (1) family satisfaction interviews ( n = 16,790 family members), (2) multidimensional survey of resident QOL ( n = 13,433 residents), and (3) facility characteristics ( n = 376 facilities). We used factor analysis to identify domains of family satisfaction and multivariate analyses to identify the role of facility-level characteristics and resident QOL on facility-mean values of family satisfaction. Four distinct domains were identified for family satisfaction: "care," "staff," "environment," and "food." Chain affiliation, higher resident acuity, more deficiencies, and large size were all associated with less family satisfaction, and resident QOL was a significant (albeit weak) predictor of family satisfaction. Results suggest that family member satisfaction is distinct from resident QOL but is associated with resident QOL and facility characteristics.

  11. 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.

  12. Identity-supportive nursing of patients with dementia in nursing homes

    OpenAIRE

    Drageset, Ingrid Marie Saga; Normann, Hans Ketil; Elstad, Ingunn

    2015-01-01

    This is the accepted manuscript version. Published version available at http://www.idunn.no/nsf This article aims to explore how nursing can support a sense of continuity and identity in patients with advanced dementia disease, living in nursing homes. Fourteen carers and managers in two nursing homes in northern Norway were interviewed. The analysis and discussion are based on the theoretical concepts of identity, continuity and person-centred nursing. This study concludes that a...

  13. Nursing home residents' views on dying and death: nursing home employee's perspective.

    Science.gov (United States)

    Dwyer, Lise-Lotte; Hansebo, Görel; Andershed, Birgitta; Ternestedt, Britt-Marie

    2011-12-01

    To reveal nursing home employees' views on dying and death among older people they cared for. Palliative care stakeholders recently included more groups in their definition of palliative care; older people constitute one such group. Consequently, palliative care systems, which will serve a large, aging cohort, will require new skills. The first stage in skills acquisition is to gather current views on dying and death. Qualitative descriptive study that uses focus group discussions for data collection; 20 employees in 4 Swedish nursing homes participated. Data were analysed using qualitative content analysis. The following categories were conceptualised: alleviating suffering and pain; finding meaning in everyday life; revealing thoughts and attitudes about death; taking care of the dead person's body; and coping with the gap between personal ideals and reality. A deeper understanding of the palliative care philosophy is needed to further develop and tailor care for the dying persons in nursing homes. To get public support for palliative care, the silence surrounding dying and death must be broken. Employees must receive education to prepare for all aspects of their work, and management must account for employees' situation when planning the care. © 2010 Blackwell Publishing Ltd.

  14. Determinants of financial performance of home-visit nursing agencies in Japan.

    Science.gov (United States)

    Fukui, Sakiko; Yoshiuchi, Kazuhiro; Fujita, Junko; Ikezaki, Sumie

    2014-01-09

    Japan has the highest aging population in the world and promotion of home health services is an urgent policy issue. As home-visit nursing plays a major role in home health services, the Japanese government began promotion of this activity in 1994. However, the scale of home-visit nursing agencies has remained small (the average numbers of nursing staff and other staff were 4.2 and 1.7, respectively, in 2011) and financial performance (profitability) is a concern in such small agencies. Additionally, the factors related to profitability in home-visit nursing agencies in Japan have not been examined multilaterally and in detail. Therefore, the purpose of the study was to examine the determinants of financial performance of home-visit nursing agencies. We performed a nationwide survey of 2,912 randomly selected home-visit nursing agencies in Japan. Multinomial logistic regression was used to clarify the determinants of profitability of the agency (profitable, stable or unprofitable) based on variables related to management of the agency (operating structure, management by a nurse manager, employment, patient utilization, quality control, regional cooperation, and financial condition). Among the selected home-visit nursing agencies, responses suitable for analysis were obtained from 1,340 (effective response rate, 46.0%). Multinomial logistic regression analysis showed that both profitability and unprofitability were related to multiple variables in management of the agency when compared to agencies with stable financial performance. These variables included the number of nursing staff/rehabilitation staff/patients, being owned by a hospital, the number of cooperative hospitals, home-death rate among terminal patients, controlling staff objectives by nurse managers, and income going to compensation. The results suggest that many variables in management of a home-visit nursing agency, including the operating structure of the agency, regional cooperation, staff

  15. Health status and drug use 1 year before and 1 year after skilled nursing home admission during the first quarter of 2013 in France: a study based on the French National Health Insurance Information System.

    Science.gov (United States)

    Atramont, Alice; Bonnet-Zamponi, Dominique; Bourdel-Marchasson, Isabelle; Tangre, Isabelle; Fagot-Campagna, Anne; Tuppin, Philippe

    2018-01-01

    Changes in prescribing practices following skilled nursing home (SNH) admission have not been clearly described in France. The study aimed to evaluate health status and drug use 1 year before and 1 year after admission to SNH. People ≥ 65 years old admitted to SNH in the first quarter of 2013, covered by the national health insurance general scheme (69% of the population of this age) and still alive 1 year after admission were identified in a specific database (Resid-ehpad). Linking with the National Health Insurance Information System (SNIIRAM) allowed analysis of their health status, identified by algorithms, and changes in their use of reimbursed drugs. In a population of 11,687 residents (mean age: 86 years, women: 76%), the most prevalent diseases were cardiovascular/neurovascular diseases (45%) and dementias (35%). The use of certain chronic treatments (≥ 3 reimbursements/year) increased significantly (p < 0.001) after nursing home admission: antidepressants: 34 to 46%, anxiolytics: 32 to 42%, hypnotics/sedatives: 18 to 24%, antipsychotics: 10 to 21% (14 to 30% in patients with dementia). The use of lipid-modifying agents and agents acting on the renin-angiotensin system decreased significantly (33 to 24% and 44 to 37%, respectively, p < 0.001). The use of antibacterials (≥ 1 reimbursement/year) increased also significantly (p < 0.001): 45 to 61%, including quinolones (13 to 20%) and third-generation cephalosporins (10 to 18%). These results reveal increased prescribing of psychotropic drugs and antibacterials in SNH, requiring the development or sustainability of actions designed to improve prescribing practices in older people targeted by these treatments.

  16. 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

  17. The inter-play between facilitation and context in the promoting action on research implementation in health services framework: A qualitative exploratory implementation study embedded in a cluster randomized controlled trial to reduce restraint in nursing homes.

    Science.gov (United States)

    Mekki, Tone Elin; Øye, Christine; Kristensen, Bodil; Dahl, Helen; Haaland, Astrid; Nordin, Kristin Aas; Strandos, Marta; Terum, Toril Marie; Ydstebø, Arnt Egil; McCormack, Brendan

    2017-11-01

    To explore the inter-play between external facilitation and nursing home contexts relative to intervention outcomes. The Promoting Action on Research Implementation in Health Services framework is frequently used to theoretically inform implementation and research in nursing and recent reviews indicate high face validity for health services. However, the inter-play and relationship between framework sub-elements of evidence, context and facilitation and the prospective utility in non-English speaking contexts warrant further illumination. In an overarching single-blind cluster-randomized controlled trial, we applied participatory action research and ethnography from August 2011-June 2015 to evaluate a standardized education intervention to reduce restraint and agitation in nursing home residents living with dementia. The trial results are published elsewhere. Prospectively informed by the PARIHS framework, a research team and eight facilitators participating in dual roles as action researchers designed, implemented, and evaluated the intervention. How contextual factors influenced the facilitation processes were explored in focus group interviews (1), reflection notes (84) written by the facilitators' after each education session, ethnographic field studies (6 homes), and co-analysis workshops (5). Directed content analysis was used to analyse data. Clinical leaders taking roles of internal facilitator influenced the success of implementation, while complex and fluctuating context elements determined whether restraint use was reduced- or not. The PARIHS framework was found to be relevant in a non-English nursing home setting, albeit some elements merit further conceptualization. Our findings confirm the prospective utility of the PARIHS framework for implementation in a non-English context, particularly the notion of implementation processes as dynamic and multifaceted. © 2017 John Wiley & Sons Ltd.

  18. The link between individual expectations and savings: Do nursing home expectations matter?

    DEFF Research Database (Denmark)

    Kleinjans, Kristin J.; Lee, Jinkook

    Preparing for the end of life, especially for the prospect of needing long-term care, is an important issue facing older Americans. Those who reach age 65 have a 40% chance of going into a nursing home in their remaining lifetime, and about 10% of those who do will stay there for at least five...... years. The costs of a stay are high with on average US$70,000 annually for a private room. Long-term stays in nursing homes are, therefore, not likely, but very expensive. In this paper, we examine individual expectations about future nursing home entry and study the relationship between...... these expectations and savings behavior, using data from the Health and Retirement Study. We find a clear relation between subjective expectations and probability of future nursing home entry, and a positive effect of these expectations on savings behavior. Surprisingly, we find no difference of this effect...

  19. Documentation and communication of nutritional care for elderly hospitalized patients: perspectives of nurses and undergraduate nurses in hospitals and nursing homes.

    Science.gov (United States)

    Halvorsen, Kristin; Eide, Helene Kjøllesdal; Sortland, Kjersti; Almendingen, Kari

    2016-01-01

    Nutritional care is a basic human right for all people. Nevertheless, undernourishment is known to be a frequent and serious health care problem among elderly hospitalized patients in Western Europe. Nutritional documentation contributes to ensuring proper nutritional treatment and care. Only a few studies have explored how nurses document nutritional care in hospitals, and between hospitals and nursing homes. Available research suggests that documentation practices are unsatisfactory. The aim of this study was to explore how nurses document nutritional treatment and care for elderly patients in hospitals and how nurses and undergraduate nurses communicate information about patients' nutritional status when elderly patients are transferred between hospital and nursing homes. A qualitative study was conducted using a phenomenological-hermeneutic approach. Data was collected in focus group interviews with 16 nurses in one large university hospital, and 11 nurses and 16 undergraduate nurses in five nursing homes associated with the university hospital. Participants from the university hospital represented a total of seven surgical and medical wards, all of which transferred patients to the associated nursing homes. The catchment area of the hospital and the nursing homes represented approximately 10% of the Norwegian population in heterogenic urban and rural municipalities. Data were coded and analysed thematically within the three contexts: self-understanding, critical common sense, and theoretical understanding. The results were summarized under three main themes 1) inadequate documentation of nutritional status on hospital admission, 2) inadequate and unsystematic documentation of nutritional information during hospital stay, 3) limited communication of nutritional information between hospital and nursing homes. The three main themes included seven sub-themes, which reflected the lack of nutritional screening and unsystematic documentation on admission and during

  20. Nurses and nurse assistants' experiences with using a design thinking approach to innovation in a nursing home.

    Science.gov (United States)

    Eines, Trude Fløystad; Vatne, Solfrid

    2017-10-23

    The aim of this study was to evaluate nurses' and nurse assistants' experiences with a design thinking approach to innovation used in a nursing home in Norway. A design thinking approach to innovation that focuses on users' needs can be employed to address many of the challenges facing health care providers in a field facing a growing ageing population, complex diseases and financial shortfalls. This study is based on a thematic analysis of four focus group interviews with nurses and nurse assistants (n = 23). In the initial phase of developing the new service model, which included defining staff roles and responsibilities, participating nurses and nurse assistants felt engaged and motivated by the designers' inclusive and creative methods. However, during the new model's testing phase, they were critical of management's lack of involvement in the model`s implementation and therefore became less motivated about the project. The findings of the study highlight the importance of the designers cooperating with management and staff for the duration of the innovation process. Challenging innovation processes require strong managers who engage with designers, patients, staff and volunteers throughout all phases of an innovation process using a design thinking approach. © 2017 John Wiley & Sons Ltd.

  1. Drumbear Lodge Nursing Home, Cootehill Road, Monaghan.

    LENUS (Irish Health Repository)

    Bennett, Annemarie E

    2014-08-06

    Adults with an intellectual disability have poorer diets than the general adult population. The Able 2 Cook 4 Health cookery course aims to improve the diets of adults with mild to moderate intellectual disability. This study aims to evaluate the course by obtaining the views of course participants and the views of managers hosting the course. Thirty course participants took part in focus groups. Five managers hosting the course participated in a semi-structured interview. Positive features of the course included the group cooking, social interaction and course instructors. Collaboration between centres hosting the course and participants\\' home environment is needed to help transfer the skills learned to all home settings. The Able 2 Cook 4 Health cookery course provided participants with an important social outlet to learn essential occupational skills. These findings could particularly influence the diets of adults with an intellectual disability moving into independent living.

  2. Comparative review of family-professional communication: what mental health care can learn from oncology and nursing home care

    NARCIS (Netherlands)

    van de Bovenkamp, H.M.; Trappenburg, M.J.

    2012-01-01

    Because family members take on caring tasks and also suffer as a consequence of the illness of the patient, communication between health-care professionals and family members of the patient is important. This review compares communication practices between these two parties in three different parts

  3. Guide Map for Preserving Remaining Ability of Nursing Home Residents With Physical-Cognitive Functional Decline.

    Science.gov (United States)

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

    2017-02-01

    As the population ages, preserving the remaining ability of residents is emphasized in nursing homes. Establishing the nursing knowledge of nursing home-specific practice should be included in the continuing education of new nursing home nurses. This study developed a practical guide map for preserving the remaining ability of nursing home residents by analyzing 144 residents' case data pertaining to the nursing care provided by 19 nurses skilled in nursing homes, as well as conducting a literature review. From the collected data, 236 nursing diagnoses were given to the 144 cases. As the residents' physical conditions and psychosocial characteristics were linked with the nursing process, various steps were needed to plan the nursing process of preserving the remaining ability of nursing home residents. This practical guide map will be useful for new nurses in nursing homes to improve the quality care of elderly residents. J Contin Educ Nurs. 2017;48(2):73-80. Copyright 2017, SLACK Incorporated.

  4. Technical efficiency of nursing homes: do five-star quality ratings matter?

    Science.gov (United States)

    Dulal, Rajendra

    2017-02-28

    This study investigates associations between five-star quality ratings and technical efficiency of nursing homes. The sample consists of a balanced panel of 338 nursing homes in California from 2009 through 2013 and uses two-stage data envelopment (DEA) analysis. The first-stage applies an input oriented variable returns to scale DEA analysis. The second-stage uses a left censored random-effect Tobit regression model. The five-star quality ratings i.e., health inspections, quality measures, staffing available on the Nursing Home Compare website are divided into two categories: outcome and structure form of quality. Results show that quality measures ratings and health inspection ratings, used as outcome form of quality, are not associated with mean technical efficiency. These quality ratings, however, do affect the technical efficiency of a particular nursing home and hence alter the ranking of nursing homes based on efficiency scores. Staffing rating, categorized as a structural form of quality, is negatively associated with mean technical efficiency. These findings show that quality dimensions are associated with technical efficiency in different ways, suggesting that multiple dimensions of quality should be included in the efficiency analysis of nursing homes. They also suggest that patient care can be enhanced through investing more in improving care delivery rather than simply raising the number of staff per resident.

  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. The economics of dementia-care mapping in nursing homes: a cluster-randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Geertje van de Ven

    Full Text Available BACKGROUND: Dementia-care mapping (DCM is a cyclic intervention aiming at reducing neuropsychiatric symptoms in people with dementia in nursing homes. Alongside an 18-month cluster-randomized controlled trial in which we studied the effectiveness of DCM on residents and staff outcomes, we investigated differences in costs of care between DCM and usual care in nursing homes. METHODS: Dementia special care units were randomly assigned to DCM or usual care. Nurses from the intervention care homes received DCM training, a DCM organizational briefing day and conducted the 4-months DCM-intervention twice during the study. A single DCM cycle consists of observation, feedback to the staff, and action plans for the residents. We measured costs related to health care consumption, falls and psychotropic drug use at the resident level and absenteeism at the staff level. Data were extracted from resident files and the nursing home records. Prizes were determined using the Dutch manual of health care cost and the cost prices delivered by a pharmacy and a nursing home. Total costs were evaluated by means of linear mixed-effect models for longitudinal data, with the unit as a random effect to correct for dependencies within units. RESULTS: 34 units from 11 nursing homes, including 318 residents and 376 nursing staff members participated in the cost analyses. Analyses showed no difference in total costs. However certain changes within costs could be noticed. The intervention group showed lower costs associated with outpatient hospital appointments over time (p = 0.05 than the control group. In both groups, the number of falls, costs associated with the elderly-care physician and nurse practitioner increased equally during the study (p<0.02. CONCLUSIONS: DCM is a cost-neutral intervention. It effectively reduces outpatient hospital appointments compared to usual care. Other considerations than costs, such as nursing homes' preferences, may determine whether they

  7. From hospital to home after cardiac surgery: evaluation of a community nursing care management model.

    Science.gov (United States)

    Morin, Diane; Aubin, Michele; Vezina, Lucie; Gagnon, Johanne; Racine, Sandra; Reinharz, Daniel; Paradis, Michele; Dallaire, Clemence; Aubin, Karine

    2009-01-01

    This quasi-experimental research aims to (1) evaluate the implementation process of a community nursing care management model and (2) assess the effects of this model on patients followed at home. Two community healthcare centers had introduced a community nursing care management model in their practice (experimental groups), whereas another health community care center with no experience with such a model served as a control group. The community nursing care management model included clinical pathways designed for a clientele who had been hospitalized for cardiac surgery. Even though the implementation process was challenging, the community nursing care management model was found useful enough to be integrated into routine nursing home care practice after cardiac surgery. Although the effects produced by this systematic home care program on the clientele did not differ significantly from those produced by usual nursing care, there was a positive effect for the clientele recorded on all measurement indicators used. The introduction of the nursing care management model enabled nurses to structure the care provided and reduced interindividual variation. The application of this program also proved to be an opportunity to initiate and assimilate new professional roles. Additional studies should be conducted to assess its effectiveness in home care for other health problems.

  8. Examining Racial and Ethnic Differences in Nursing Home Quality.

    Science.gov (United States)

    Hefele, Jennifer Gaudet; Ritter, Grant A; Bishop, Christine E; Acevedo, Andrea; Ramos, Candi; Nsiah-Jefferson, Laurie A; Katz, Gabrielle

    2017-11-01

    Identifying racial/ethnic differences in quality is central to identifying, monitoring, and reducing disparities. Although disparities across all individual nursing home residents and disparities associated with between-nursing home differences have been established, little is known about the degree to which quality of care varies by race//ethnicity within nursing homes. A study was conducted to measure within-facility differences for a range of publicly reported nursing home quality measures. Resident assessment data on approximately 15,000 nursing homes and approximately 3 million residents (2009) were used to assess eight commonly used and publicly reported long-stay quality measures: the proportion of residents with weight loss, with high-risk and low-risk pressure ulcers, with incontinence, with depressive symptoms, in restraints daily, and who experienced a urinary tract infection or functional decline. Each measure was stratified by resident race/ethnicity (non-Hispanic white, non-Hispanic black, and Hispanic), and within-facility differences were examined. Small but significant differences in care on average were found, often in an unexpected direction; in many cases, white residents were experiencing poorer outcomes than black and Hispanic residents in the same facility. However, a broad range of differences in care by race/ethnicity within nursing homes was also found. The results suggest that care is delivered equally across all racial/ethnic groups in the same nursing home, on average. The results support the call for publicly reporting stratified nursing home quality measures and suggest that nursing home providers should attempt to identify racial/ethnic within-facility differences in care. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  9. A measure of palliative care in nursing homes.

    Science.gov (United States)

    Thompson, Sarah; Bott, Marjorie; Boyle, Diane; Gajewski, Byron; Tilden, Virginia P

    2011-01-01

    Efforts to improve care for nursing home residents stand to be enhanced by measures to assess the degree to which staff provide palliative care. As the incidence of death in nursing homes increases with the aging population, the gap in measurement must be addressed. To that end, we report the development and psychometric testing of a nursing home palliative care survey. The purpose of this study was to evaluate the psychometric properties of the Palliative Care Survey (PCS) for use in nursing homes. Psychometric evaluation of the instrument was completed in two phases. Phase 1 focused on individual item analyses and subsequent revision or deletion of items, and Phase 2 evaluated evidence for reliability and validity. Phase 1 included 26 nursing homes and staff (n=717), and Phase 2 included 85 nursing homes and staff (n=2779). Data were analyzed using item-total correlations, Cronbach's alpha, confirmatory factor analysis, and analysis of variance. Support was obtained for a 51-item PCS made up of two constructs, Palliative Care Practice and Palliative Care Knowledge. The PCS measures the extent to which the nursing home staff engage in palliative care practices and have knowledge consistent with good end-of-life care. Both practice and knowledge are an essential foundation to providing good end-of-life care to nursing home residents. Efforts to improve care for the dying in nursing homes have been slowed by an absence of measurement tools that capture care processes, a gap that the PCS reported here helps fill. Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  10. 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

  11. 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.

  12. Home diuretic protocol for heart failure: partnering with home health to improve outcomes and reduce readmissions.

    Science.gov (United States)

    Veilleux, Richard P; Wight, Joseph N; Cannon, Ann; Whalen, Moira; Bachman, David

    2014-01-01

    The management of heart failure (HF) is challenging, with high rates of readmission and no single solution. MaineHealth, a health care system serving southern Maine, has shown initial success with home health nurses partnering with physicians in the management of complex patients with HF using the MaineHealth Home Diuretic Protocol (HDP). To demonstrate that augmented diuretic therapy, both oral and intravenous, an evidence-based treatment for care of patients with HF experiencing fluid retention, can be delivered safely in the home setting using the HDP and can improve outcomes for recently hospitalized patients with HF. In late 2011, the MaineHealth HDP was implemented in two hospitals and in the home health agency serving those hospitals. The patient population included recently hospitalized patients with a diagnosis of advanced HF, eligible for home health services and telemonitoring. Home health nurses reported data on the patients managed using the protocol, including interventions made, physical findings, lab values, and patient disposition after each episode of care. Questionnaires were used to determine patient and clinician satisfaction. Sixty patients meeting the criteria above were enrolled between November 2011 and January 2014. The protocol was initiated 84 times for 30 of these patients. Sixteen patients had multiple activations. The readmission rate was 10% and no adverse outcomes were observed. Clinician and patient satisfaction was 97% or greater. The MaineHealth HDP can be delivered effectively and safely to improve outcomes, reducing readmissions and allowing patients to remain at home.

  13. Elder mistreatment in the nursing home: a systematic review.

    Science.gov (United States)

    Lindbloom, Erik J; Brandt, Julie; Hough, Landon D; Meadows, Susan E

    2007-11-01

    Because of their significant dependence on others for their care, nursing home residents are potentially vulnerable to abuse and/or neglect. The topic of elder mistreatment, whether in the nursing home or other living environments, received little attention from clinicians and researchers until the past 2 decades. Original research is now emerging that sheds light on the scope of the problem and the challenges to timely prevention, identification, and management. Practitioners may use this information to recognize and change factors associated with a higher likelihood of nursing home mistreatment.

  14. Maintaining dignity. The perspective of nursing home residents

    DEFF Research Database (Denmark)

    Høy, Bente

    2014-01-01

    body image; feeling recognised and valued as a person of worth; Abilities and opportunities for changing of lifevalues; to exert control; to form and maintain meaningful relationships and to participation in meaningful activity. Conclusion. Although there is no one way to maintain dignity, the themes...... 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. [Experienced quality of life of somatic nursing home patients: a review of measuring instruments].

    Science.gov (United States)

    van Campen, C; Kerkstra, A

    1996-02-01

    Research into the quality of life of somatic patients in nursing home is scarce in the Netherlands. In this article, 33 quality of life instruments for somatic nursing home patients are reviewed with respect to content, psychometric characteristics and resident-friendliness. A combination of a health status instrument and a life satisfaction instrument seems most suitable for the assessment of somatic patients in nursing homes: Eight instruments, including six health status instruments (McMaster Health Index Questionnaire, MOS SF-36, Nottingham Health Profile, Sickness Impact Profile, Quality of Well-being scale and COOP/WONCA charts) and two life satisfaction instruments (Philadelphia Geriatric Center Morale Scale and Life Satisfaction Index Z) are qualified and should be further investigated.

  16. Evaluating the impact of palliative or hospice care provided in nursing homes.

    Science.gov (United States)

    Cimino, Nina M; McPherson, Mary Lynn

    2014-10-01

    Palliative and hospice care are increasingly being provided in nursing home settings. The current article reviews the existing evidence relevant to nursing homes to provide practitioners with a greater understanding of the impact of palliative and hospice care on clinical care outcomes (e.g., pain, symptom management), processes of care outcomes (e.g., hospitalizations, cost of care), and family member or health care proxy perceptions of care. Overall, the provision of hospice or palliative care in nursing facilities can improve the clinical care residents receive, reduce hospitalizations, and improve family members' perception of care. Copyright 2014, SLACK Incorporated.

  17. The Impact of Nursing Home Pay-for-Performance on Quality and Medicare Spending: Results from the Nursing Home Value-Based Purchasing Demonstration.

    Science.gov (United States)

    Grabowski, David C; Stevenson, David G; Caudry, Daryl J; O'Malley, A James; Green, Lisa H; Doherty, Julia A; Frank, Richard G

    2017-08-01

    To evaluate the impact of the Nursing Home Value-Based Purchasing demonstration on quality of care and Medicare spending. Administrative and qualitative data from Arizona, New York, and Wisconsin nursing homes over the base-year (2008-2009) and 3-year (2009-2012) demonstration period. Nursing homes were randomized to the intervention in New York, while the comparison facilities were constructed via propensity score matching in Arizona and Wisconsin. We used a difference-in-difference analysis to compare outcomes across the base-year relative to outcomes in each of the three demonstration years. To provide context and assist with interpretation of results, we also interviewed staff members at participating facilities. Medicare savings were observed in Arizona in the first year only and Wisconsin for the first 2 years; no savings were observed in New York. The demonstration did not systematically impact any of the quality measures. Discussions with nursing home administrators suggested that facilities made few, if any, changes in response to the demonstration, leading us to conclude that the observed savings likely reflected regression to the mean rather than true savings. The Federal nursing home pay-for-performance demonstration had little impact on quality or Medicare spending. © Health Research and Educational Trust.

  18. Competence for older people nursing in care and nursing homes: An integrative review.

    Science.gov (United States)

    Kiljunen, Outi; Välimäki, Tarja; Kankkunen, Päivi; Partanen, Pirjo

    2017-09-01

    People living in care and nursing homes are vulnerable individuals with complex needs; therefore, a wide array of nursing competence is needed to ensure their well-being. When developing the quality of care in these units, it is essential to know what type of competence is required for older people nursing. The aim of this integrative review was to identify the competence needed for older people nursing in licensed practical nurses' and registered nurses' work in care and nursing homes. Integrative literature review. We performed an integrative review using Whittemore and Knafl's method. The CINAHL, MEDLINE, PsycINFO, SocINDEX and Scopus databases were searched for studies published from 2006 to April 2016. We assessed the quality of the studies using Joanna Briggs Institute critical appraisal tools and analysed the data by applying qualitative content analysis. Ten articles were included in the review. Most of the studies focused on registered nurses' work. We identified five competence areas that are needed for older people nursing in registered nurses' work in care and nursing homes: attitudinal and ethical, interactional, evidence-based care, pedagogical, and leadership and development competence. Empirical evidence of competence requirements related to licensed practical nurses' work in these facilities was scarce. The competence required for registered nurses and licensed practical nurses should be clearly identified to support competence management in the care and nursing home context. Well-educated nursing staff are needed in care and nursing homes to provide high-quality care because comprehensive and advanced nurse competence is required to meet the needs of older people. © 2016 John Wiley & Sons Ltd.

  19. Maintaining dignity. The perspective of nursing home residents

    DEFF Research Database (Denmark)

    Høy, Bente

    2016-01-01

    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 dign...... may be used as a frame-work to understand what nursing home residents tend to value and support dignity in the context of vulnerable situations in eldercare.......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...

  20. Respiratory Home Health Care

    Science.gov (United States)

    ... Control Preventing infections can help the respiratory home care patient stay as healthy as possible. Hand-washing is the single most important thing for patients and caregivers to perform on a routine basis. Use a liquid soap and lots of warm running water. Work up a good lather and scrub for at ...

  1. [Factors associated with non-institutional abuse in nursing homes].

    Science.gov (United States)

    Gómez Martínez, Carmelo; Hernández Morante, Juan José; Carrasco Martínez, Elena; García Belzunce, Agustín; Nicolás Alarcón, Virginia

    Abuse in elderly has dimensions not yet sufficiently explored. Particularly, little is known about the abuse or mistreatment suffered by old people in nursing homes, but where the origin is not, at least initially, institutional, since is perpetrated by external social agents not related to the nursing home. The lack of data in this area has led us to conduct this exploratory study, with the aim of assessing the prevalence of this non-institutional abuse. The Elder Abuse Suspicion Index was administered to a total of 286 subjects belonging to the nursing homes from the «Mensajeros de la Paz» Association of Murcia. Cases of suspected abuse were referred to the social workers to confirm the diagnosis. Initially, 53 subjects (18.5%) suffered any kind of abuse, which was reduced to only 26 cases after one year. On the other hand, abuse appeared after admission in 20 subjects (7%). Precisely, this 7% might present what we called non-institutional abuse. Economic abuse was the most prevalent, followed by psychological, neglect, physical, and sexual abuse. The data showed a significant interaction between the different types of abuse. Our data provides evidence of a new scenario that must be addressed in a professional and social context, considering the environment where this mistreatment takes place. Health and social professionals must be sensitive to this reality, and should be informed and trained about the different ways to dignify the care of the elderly. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. State variations in nursing home social worker qualifications.

    Science.gov (United States)

    Bern-Klug, Mercedes

    2008-01-01

    This is the first published account of state administrative code variations in nursing home social worker qualifications. It is important to review state codes because the majority of nursing homes in the U.S. have fewer than 121 beds and therefore are not required by the federal government to employ at least one full-time qualified social worker. States have the option of extending the federal regulations to homes with 120 or fewer beds, or strengthening the federal requirements in other ways. Findings indicate enormous variation in state requirements for qualifications of nursing home social workers, and even when states define a qualified nursing home social worker (not all do), they often exempt facilities from employing one. Seven states were found to be out of federal compliance. Research describing the qualifications of people employed in nursing home social services is called for, as well as research documenting effective psychosocial interventions, especially as they relate to resident quality of life. Ten recommendations for enhancing nursing home social work services are included.

  3. Call to action: APRNs in U.S. Nursing homes to improve care and reduce costs.

    Science.gov (United States)

    Rantz, Marilyn J; Birtley, Nancy M; Flesner, Marcia; Crecelius, Charles; Murray, Cathy

    2017-09-21

    Centers for Medicare and Medicaid Innovation Center sponsored the initiative to reduce avoidable hospitalizations among nursing facility residents. Missouri Quality Initiative (MOQI) designed inter-professional model in nursing homes with advanced practice registered nurses (APRNs). MOQI APRN model was implemented for 4 years in 16 nursing homes in a metro area of the Midwest. Hospitalizations were reduced (40% all-cause, 58% potentially avoidable), emergency room visits (54% all-cause, 65% potentially avoidable), Medicare expenditures for hospitalizations (34% all-cause, 45% potentially avoidable), and Medicare expenditures for emergency room visits (50% all-cause, 60% potentially avoidable) for long-stay nursing home residents. Success of the MOQI model reinforces decades of research demonstrating that care provided by APRNs is cost-effective, safe, and associated with positive health outcomes and patient satisfaction. Nursing homes can implement and benefit by hiring APRNs. However, changes in the Code of Federal Regulation (CFR 483.40) are necessary to improve patient access to care and encourage hiring APRNs in US nursing homes. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Client-nurse relationships in home-based palliative care: a critical analysis of power relations.

    Science.gov (United States)

    Oudshoorn, Abram; Ward-Griffin, Catherine; McWilliam, Carol

    2007-08-01

    To elicit an in-depth understanding of the sources of power and how power is exercised within client-nurse relationships in home-based palliative care. As in all social relations, power is present within client-nurse relationships. Although much research has focused on interpersonal relationships in nursing, the concept of power within the client-nurse relationship in palliative care settings has not been extensively investigated. Applying a critical lens, secondary qualitative data analysis was conducted. Seventeen nurse and 16 client transcripts from a primary study were selected for secondary data analysis. These 33 transcripts afforded theme saturation, which allowed for both commonalities and differences to be identified. Data analysis involved analytic coding. Study findings help make explicit the underlying power present in the context of home-based palliative care and how this power is used and potentially abused. In analysing the sources and exercise of power, the linkage between macro and micro levels of power is made explicit, as nurses functioned within a hierarchy of power. The findings suggest that educational/occupational status continues to be a source of power for nurses within the relationship. However, nurses also experience powerlessness within the home care context. For clients, being able to control one's own life is a source of power, but this power is over-shadowed by the powerlessness experienced in relationships with nurses. The exercise of power by clients and nurses creates experiences of both liberation and domination. Nurses who are willing to reflect on and change those disempowering aspects of the client-nurse relationship, including a harmful hierarchy, will ultimately be successful in the health promotion of clients in home-based palliative care. Additionally, it should be recognized that nurses work within a specific health system context and, therefore, their practice is influenced by policies and funding models implemented at

  5. Incontinence care in nursing homes: a cross-sectional study.

    Science.gov (United States)

    Mandl, Manuela; Halfens, Ruud J G; Lohrmann, Christa

    2015-09-01

    To describe the quality of incontinence care in nursing homes. Main outcome measures were: (1) availability of structural quality indicators on ward and institutional levels; (2) use of nursing interventions as quality indicators on a process level; (3) prevalence of incontinence as an outcome indicator. Incontinence in older people is a major problem in nursing care that presents a high workload for nurses, increases costs and places a high burden on affected individuals. The availability of structural indicators, and the use of nursing interventions, is recommended to improve the quality of care. Only limited amounts of reliable and valid data are available regarding the quality of incontinence care in nursing homes. A cross-sectional multicentre study in 16 nursing homes (N = 1302) in 2013. A standardized and validated questionnaire was used for data collection. Each resident was assessed by two trained nurses. The primary outcome of the study indicated that structural indicators, such as the availability of information brochures, are limited in nursing homes. On a process level, the provision of body worn pads or underlay pads to protect beds or chairs were most frequently used and training interventions were only delivered to a small proportion of residents with incontinence. The prevalence of all types of incontinence, particularly double incontinence, was high (69·2%). Due to the high prevalence of double incontinence and low rate of training interventions regarding this type of incontinence, ongoing efforts to improve the quality of incontinence care are warranted. © 2015 John Wiley & Sons Ltd.

  6. Learning to care for older patients: hospitals and nursing homes as learning environments.

    Science.gov (United States)

    Huls, Marije; de Rooij, Sophia E; Diepstraten, Annemie; Koopmans, Raymond; Helmich, Esther

    2015-03-01

    A significant challenge facing health care is the ageing of the population, which calls for a major response in medical education. Most clinical learning takes place within hospitals, but nursing homes may also represent suitable learning environments in which students can gain competencies in geriatric medicine. This study explores what students perceive as the main learning outcomes of a geriatric medicine clerkship in a hospital or a nursing home, and explicitly addresses factors that may stimulate or hamper the learning process. This qualitative study falls within a constructivist paradigm: it draws on socio-cultural learning theory and is guided by the principles of constructivist grounded theory. There were two phases of data collection. Firstly, a maximum variation sample of 68 students completed a worksheet, giving brief written answers on questions regarding their geriatric medicine clerkships. Secondly, focus group discussions were conducted with 19 purposively sampled students. We used template analysis, iteratively cycling between data collection and analysis, using a constant comparative process. Students described a broad range of learning outcomes and formative experiences that were largely distinct from their learning in previous clerkships with regard to specific geriatric knowledge, deliberate decision making, end-of-life care, interprofessional collaboration and communication. According to students, the nursing home differed from the hospital in three aspects: interprofessional collaboration was more prominent; the lower resources available in nursing homes stimulated students to be creative, and students reported having greater autonomy in nursing homes compared with the more extensive educational guidance provided in hospitals. In both hospitals and nursing homes, students not only learn to care for older patients, but also describe various broader learning outcomes necessary to become good doctors. The results of our study, in particular the

  7. How individuals with dementia in nursing homes maintain their dignity through life storytelling - a case study.

    Science.gov (United States)

    Heggestad, Anne Kari Tolo; Slettebø, Åshild

    2015-08-01

    The aim of this article was to present and discuss findings on what individuals with dementia do by themselves to maintain or promote their dignity of identity when they live in a nursing home. The majority of residents living in Norwegian nursing homes suffer from dementia. Individuals who suffer from dementia are particularly vulnerable, and their dignity of identity is at risk. It is therefore of great importance to explore how we can maintain their dignity of identity. The study builds on a phenomenological and hermeneutic design. The article reports three cases or life stories based on participant observation in two different nursing homes and interviews with five residents with dementia living in these nursing homes. Fifteen residents with dementia from these nursing home wards were included in the overall study. Individuals with dementia living in nursing homes may use life storytelling or narratives to manage chaos and to find safety in their lives. Storytelling is also used as a way to present and maintain identity. We can see this as a way of maintaining dignity of identity or social dignity. Life storytelling can be seen as an important way of preserving dignity for people with dementia. It is of great importance that health care professionals are open to and listen to the life stories people with dementia tell. As nurses we have an obligation to ensure that dignity is enhanced in care for people with dementia. Knowledge about how residents with dementia use life storytelling as a way to maintain dignity is therefore of great importance to health care workers in nursing homes. © 2015 John Wiley & Sons Ltd.

  8. Pressure ulcer incidence in Dutch and German nursing homes: design of a prospective multicenter cohort study

    Directory of Open Access Journals (Sweden)

    Lohrmann Christa

    2011-04-01

    Full Text Available Abstract Background Pressure ulcers are a common and serious health care problem in all health care settings. Results from annual national pressure ulcer prevalence surveys in the Netherlands and Germany reveal large differences in prevalence rates between both countries over the past ten years, especially in nursing homes. When examining differences in prevalence and incidence rates, it is important to take into account all factors associated with the development of pressure ulcers. Numerous studies have identified patient related factors, as well as nursing related interventions as risk factors for the development of pressure ulcers. Next to these more process oriented factors, also structural factors such as staffing levels and staff quality play a role in the development of pressure ulcers. This study has been designed to investigate the incidence of pressure ulcers in nursing homes in the Netherlands and Germany and to identify patient related factors, nursing related factors and structural factors associated with pressure ulcer development. The present article describes the protocol for this study. Methods/design A prospective multicenter study is designed in which a cohort of newly admitted nursing home residents in 10 Dutch and 11 German nursing homes will be followed for a period of 12 weeks. Data will be collected by research assistants using questionnaires on four different levels: resident, staff, ward, and nursing home. Discussion The results of the study will provide information on the incidence of pressure ulcers in Dutch and German nursing homes. Furthermore, information will be gathered on the influence of patient related factors, nursing related factors and structural factors on the incidence of pressure ulcers. The present article describes the study design and addresses the study's strengths and weaknesses.

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

    NARCIS (Netherlands)

    Joost van Hoof; Janssen B.M.; H.R. Marston; Eveline Wouters; M.D. Rijnaard; M.M. Verhagen

    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

  10. A national report of nursing home information technology: year 1 results.

    Science.gov (United States)

    Alexander, Gregory L; Madsen, Richard W; Miller, Erin L; Schaumberg, Melissa K; Holm, Allison E; Alexander, Rachel L; Wise, Keely K; Dougherty, Michelle L; Gugerty, Brian

    2017-01-01

    To provide a report on year 1 results of a national study investigating nursing home information technology (IT) adoption, called IT sophistication. A reliable and valid survey was used to measure IT sophistication. The target goal was 10% from each state in the United States, 1570 nursing homes. A random sample of homes from each state was recruited from Nursing Home Compare. The team reached 2627 nursing home administrators, among whom 1799 administrators agreed to participate and were sent a survey. A total of 815 surveys were completed (45.3% response rate), which was below the goal. Facilities in the participating sample have similar demographic characteristics (ownership, total population in a location, and bed size) to the remaining homes not participating. There are greater IT capabilities in resident care and administrative activities, less in clinical support. The extent of use of these capabilities appears to be highest in administrative activities and lowest in clinical support. IT in resident care appears to be the most integrated with internal and external stakeholders. IT capabilities appear to be greater than IT extent of use in all health domains, with the greatest difference in resident care. National evaluations of nursing home IT are rare. Measuring trends in IT adoption in a nationally representative sample provides meaningful analytics that could be more useful for policy makers and nursing home leaders in the future. Discovering national baseline assessments is a first step toward recognizing nursing home trends in IT adoption. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Nursing home culture change: legal apprehensions and opportunities.

    Science.gov (United States)

    Kapp, Marshall B

    2013-10-01

    There continue to be serious deficiencies in the quality of life available to many nursing home residents in the United States. One significant response to this undesirable situation is the nursing home "Culture Change" movement, which attempts to improve the nursing home environment-and consequently residents' quality of life-by making facilities less institutional and more homelike. One of the impediments often interfering with the adoption and implementation of culture change in specific facilities is apprehension by staff, administrators, and governing boards about potential legal liability and regulatory exposure if residents suffer injuries that might arguably be attributed to facility conditions or policies that were inspired and encouraged by the culture change movement. This article addresses and responds to the provider liability and regulatory apprehensions that impede the progress of culture change in nursing homes, using proposed new dietary services standards as an example.

  12. Family members' reports of abuse in Michigan nursing homes.

    Science.gov (United States)

    Griffore, Robert J; Barboza, Gia E; Mastin, Teresa; Oehmke, James; Schiamberg, Lawrence B; Post, Lori Ann

    2009-04-01

    The objective of this article is to describe abuse and neglect of adults age 65 and older in Michigan nursing homes, as reported by members of their families. Using list-assisted random-digit dialing, data on abuse and neglect for a 12-month period were collected from individuals who had a relative age 65 or older in a Michigan nursing home. Of the nursing home residents represented in this analysis, the majority were female, Caucasian, and widowed. Neglect and caretaking mistreatment were the most frequent types of abuse reported. Comparison of these data with data from the National Ombudsman Reporting System suggests that family members constitute a sensitive source of data on abuse in nursing homes.

  13. Home care nursing orientation model. Justification and structure.

    Science.gov (United States)

    Humphrey, C J; Milone-Nuzzo, P

    1992-01-01

    An orientation program for new nurses in a home care agency can be an effective tool that increases job satisfaction, alleviates a potentially high employee attrition rate, boosts morale, and thereby improves overall quality of patient care.

  14. 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\

  15. Restorative Virtual Environment Design for Augmenting Nursing Home Rehabilitation

    DEFF Research Database (Denmark)

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

    2016-01-01

    With increasing age, muscle strength decreases excessively rapidly if physical activity is not maintained. However, physical activity is increasingly difficult with age, due to balance, strength or coordination difficulties, arthritis, etc. Moreover, many nursing home residents become unable...

  16. 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.

  17. 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.

  18. Nurse Delegation in Home Care: Research Guiding Policy Change.

    Science.gov (United States)

    Young, Heather M; Farnham, Jennifer; Reinhard, Susan C

    2016-09-01

    The current study evaluated nurse delegation in home care, a pilot program introduced in 2007 in New Jersey to promote home care options for consumers needing assistance with medical/nursing tasks. Findings on readiness for the program, barriers and facilitating factors, experience with the program, and recommendations are summarized and presented. Methods included surveys and interviews with participants in nurse delegation, observations of planning and implementation meetings, and review meeting minutes. Major findings were no negative outcomes for consumers, improvements in quality of life and quality of care for consumers, high readiness and increasing satisfaction with experience in delegation, perception of nurse delegation in home care as a valued option, and the challenges of ensuring adequate staffing. Subsequent changes in regulation in New Jersey are underway, translating this research into policy. [Journal of Gerontological Nursing, 42(9), 7-15.]. Copyright 2016, SLACK Incorporated.

  19. Crucial aspects promoting meaning and purpose in life: perceptions of nursing home residents

    National Research Council Canada - National Science Library

    Jorunn Drageset; Gorill Haugan; Oscar Tranvag

    2017-01-01

    Meaning and purpose in life among nursing home residents without dementia are significantly related to nurse-patient interaction or to family and friends outside the nursing home or other residents [15, 16...

  20. Economic impact analysis of an end-of-life programme for nursing home residents.

    Science.gov (United States)

    Teo, W-S Kelvin; Raj, Anusha Govinda; Tan, Woan Shin; Ng, Charis Wei Ling; Heng, Bee Hoon; Leong, Ian Yi-Onn

    2014-05-01

    Due to limited end-of-life discussions and the absence of palliative care, hospitalisations are frequent at the end of life among nursing home residents in Singapore, resulting in high health-care costs. Our objective was to evaluate the economic impact of Project Care at the End-of-Life for Residents in homes for the Elderly (CARE) programme on nursing home residents compared to usual end-of-life care. DESIGN AND SETTINGS/PARTICIPANTS: Project CARE was introduced in seven nursing homes to provide advance care planning and palliative care for residents identified to be at risk of dying within 1 year. The cases consisted of nursing home residents enrolled in the Project CARE programme for at least 3 months. A historical group of nursing home residents not in any end-of-life care programme was chosen as the matched controls. Cost differences between the two groups were analysed over the last 3 months and final month of life. The final sample comprised 48 Project CARE cases and 197 controls. Compared to the controls, the cases were older with more comorbidities and higher nursing needs. After risk adjustment, Project CARE cases demonstrated per-resident cost savings of SGD$7129 (confidence interval: SGD$4544-SGD$9714) over the last 3 months of life and SGD$3703 (confidence interval: SGD$1848-SGD$5557) over the last month of life (US$1 = SGD$1.3). This study demonstrated substantial savings associated with an end-of-life programme. With a significant proportion of the population in Singapore requiring nursing home care in the near future, these results could assist policymakers and health-care providers in decision-making on allocation of health-care resources.

  1. Baccalaureate education and American nursing homes: a survey of nursing schools.

    Science.gov (United States)

    Chen, Shu-li; Brown, Janet W; Groves, Marni L; Spezia, Alicia M

    2007-11-01

    Approximately one-third of the people in the United States will pass through a long-term care facility before they die. However, the learning opportunities in this unique setting for baccalaureate nursing education remain unclear. This regional survey examined the use of nursing homes within baccalaureate nursing programs in nine southeastern states of the United States of America. A descriptive exploratory method and mailed questionnaires were used for data collection. Fifty-three nursing schools were included in the study. According to the survey, 83% of the nursing schools have used nursing homes as clinical sites to teach fundamental psychomotor skills, communication skills and physical assessment. Identified advantages of using nursing homes in baccalaureate education include: learning basic nursing skills, working with willing and helpful nursing home residents and staff, and developing positive attitude toward aging. On the other hand, the major problem encountered was lack of appropriate role models in nursing home staff. As the world population continues to age rapidly, nurse educators need to consider the advantages of clinical experiences for students in long-term care facilities.

  2. Nursing people at home is a special skill that requires support.

    Science.gov (United States)

    Cook, Rosemary

    2012-02-01

    Nursing people at home has always been a special skill. It is very different from nursing people in hospital beds, or in clinical type settings outside of hospital, such as GP surgeries and health centres. The real point at which care changes fundamentally is when it crosses the patient's doorstep. To provide high quality nursing care to people in their own homes requires particular skills, knowledge and approaches - and the development of these has been seriously neglected in recent years. These are the basic tenets of the new report from the Queen's Nursing Institute (QNI) (2011), which was launched at the House of Lords in November 2011. The evidence for the report was gathered throughout the first year of the QNI's Right Nurse, Right Skills campaign, which was supported by BJCN. As part of the campaign, both nurses and members of the public were invited to leave stories and comments on a special webpage, and hundreds of people did so. The nurses talked about the replacement of registered nurses with health-care assistants, and the influx of inexperienced nurses who were not given the support they needed to develop community skills. Patients and carers spoke of their experiences of care - most of the time, these were good or excellent. However, too often, care was delivered by nurses or assistants who lacked the right skills to prevent harm or deliver care properly. The results were sometimes discomfort, sometimes unnecessary suffering, and occasionally very serious.

  3. Mobbing among care workers in nursing homes: A cross-sectional secondary analysis of the Swiss Nursing Homes Human Resources Project.

    Science.gov (United States)

    Tong, Myriam; Schwendimann, René; Zúñiga, Franziska

    2017-01-01

    As a category of bullying, mobbing is a form of violence in the workplace that damages the employing organization as well as the targeted employee. In Europe, the overall prevalence of mobbing in healthcare is estimated at 4%. However, few studies have explored mobbing among long-term care workers. This study aims to examine the frequency of mobbing in Swiss nursing homes and its relationships with care workers' (i.e. registered nurse, licensed practical nurse, assistant nurse, nurse aide) health status, job satisfaction, and intention to leave, and to explore the work environment as a contributing factor to mobbing. A cross-sectional, multi-center sub-study of the Swiss Nursing Homes Human Resource Project (SHURP). Nursing homes in Switzerland's three language regions. A total of 162 randomly selected nursing homes with 20 or more beds, including 5311 care workers with various educational levels. Controlling for facility and care worker characteristics, generalized estimation equations were used to assess the relationships between mobbing and care workers' health status, job satisfaction, and intention to leave as well as the association of work environment factors with mobbing. In Swiss nursing homes, 4.6% of surveyed care workers (n=242) reported mobbing experiences in the last 6 months. Compared to untargeted persons, those directly affected by mobbing had higher odds of health complaints (Odds Ratios (OR): 7.81, 95% CI 5.56-10.96) and intention to leave (OR: 5.12, 95% CI 3.81-6.88), and lower odds of high job satisfaction (OR: 0.19, 95% CI 0.14-0.26). Odds of mobbing occurrences increased with declining teamwork and safety climate (OR: 0.41, 95% CI 0.30-0.58), less supportive leadership (OR: 0.42, 95% CI 0.30-0.58), and higher perceived inadequacy of staffing resources (OR: 0.66, 95% CI 0.48-0.92). Mobbing experiences in Swiss nursing homes are relatively rare. Alongside teamwork and safety climate, risk factors are strongly associated with superiors

  4. "Aloha": an in-house nursing home vacation.

    Science.gov (United States)

    Gipner, D W

    1996-01-01

    This article describes a weeklong in-house "vacation" that was held at a Department of Veterans Affairs nursing home. The author provides the guidelines used to plan, implement, and evaluate the project. The in-house nursing home vacation was successful, as measured by the number of residents in attendance, their positive evaluations, and their desire to repeat the experience. The primary reason for the success of this program was the number and strength of the interactive partnerships.

  5. 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.

  6. Raising The Standard: Palliative Care In Nursing Homes

    National Research Council Canada - National Science Library

    Meier, Diane E; Lim, Betty; Carlson, Melissa D.A

    2010-01-01

    ... from palliative care. Indeed, we would argue that the growing acceptance of the culture-change movement centered on elder-directed goals in nursing homes is promising evidence of the goodness-of-fit of palliative care principles in the long-term care setting. More than 70 percent of long-stay residents in nursing homes are elderly and have moderate-t...

  7. Nursing care for patients on the edge of life in nursing homes: obstacles are overshadowing opportunities.

    Science.gov (United States)

    Hov, Reidun; Hedelin, Birgitta; Athlin, Elsy

    2013-03-01

    Patients in nursing homes have comprehensive needs for nursing care and medical treatment. Most patients benefit from the treatment, but some are 'on the edge of life'-in a borderland between living and dying with an unpredictable outcome, and questions are sometimes raised whether to withhold/withdraw curative treatment. The aim was to describe nurses' conceptions of good nursing care, and how this could be carried out for patients on the edge of life in nursing homes. In order to discover variations in the nurses' understandings a phenomenographic approach was chosen. Phenomenography is concerned with qualitatively different ways of conceiving a phenomenon. Methods.  Fourteen nurses from two nursing homes were individually interviewed twice. A phenomenographic analysis was used. The outcome-space included two main categories. The first, 'good nursing care is to meet patients' needs for dignity,' included three description-categories: needs for 'preparedness', 'human relationship' and 'bodily comfort and safety'. The second, 'opportunities were overshadowed by obstacles' in carrying out nursing care encompassed three description-categories: 'organisational factors,''relational factors' and 'personal factors'. This study shows nurses' conceptions of the importance of good nursing care for comforting patients on the edge of life. Several obstacles related to resources, communication, cooperation and nurses' professional strength and power need to be overcome if good nursing care can be performed. © 2012 Blackwell Publishing Ltd.

  8. How are nursing homes cleaned? Results of a survey of 6 nursing homes in Southeast Michigan.

    Science.gov (United States)

    Saeb, Aya; Mody, Lona; Gibson, Kristen

    2017-11-01

    This brief report details 2 surveys that were conducted to better understand current cleaning practices in 6 nursing home facilities in Southeast Michigan. Each facility's environmental services supervisor answered questions regarding cleaning policy and procedures, roles and responsibilities of the staff, and frequency of education and training; one environmental services employee from each facility answered questions addressing education and training, employer evaluation and feedback, and workload. We identify gaps in knowledge and behaviors and note substantial variations in cleaning practices. Published by Elsevier Inc.

  9. Malpractice Litigation and Nursing Home Quality of Care

    Science.gov (United States)

    Konetzka, R Tamara; Park, Jeongyoung; Ellis, Robert; Abbo, Elmer

    2013-01-01

    Objective. To assess the potential deterrent effect of nursing home litigation threat on nursing home quality. Data Sources/Study Setting. We use a panel dataset of litigation claims and Nursing Home Online Survey Certification and Reporting (OSCAR) data from 1995 to 2005 in six states: Florida, Illinois, Wisconsin, New Jersey, Missouri, and Delaware, for a total of 2,245 facilities. Claims data are from Westlaw's Adverse Filings database, a proprietary legal database, on all malpractice, negligence, and personal injury/wrongful death claims filed against nursing facilities. Study Design. A lagged 2-year moving average of the county-level number of malpractice claims is used to represent the threat of litigation. We use facility fixed-effects models to examine the relationship between the threat of litigation and nursing home quality. Principal Findings. We find significant increases in registered nurse-to-total staffing ratios in response to rising malpractice threat, and a reduction in pressure sores among highly staffed facilities. However, the magnitude of the deterrence effect is small. Conclusions. Deterrence in response to the threat of malpractice litigation is unlikely to lead to widespread improvements in nursing home quality. This should be weighed against other benefits and costs of litigation to assess the net benefit of tort reform. PMID:23741985

  10. 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.

  11. 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.

  12. The Influence of Nurse Staffing Levels on Quality of Care in Nursing Homes

    Science.gov (United States)

    Hyer, Kathryn; Thomas, Kali S.; Branch, Laurence G.; Harman, Jeffrey S.; Johnson, Christopher E.; Weech-Maldonado, Robert

    2011-01-01

    Objective: This study examines the relationship between increasing certified nursing assistants (CNAs) and licensed nurse staffing ratios and deficiencies in Florida nursing homes over a 4-year period. Methods: Data from Florida staffing reports and the Online Survey Certification and Reporting database examine the relationship among staffing…

  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

  14. Characteristics and Recruitment Paths of Certified Nursing Assistants in Rural and Urban Nursing Homes

    Science.gov (United States)

    Probst, Janice C.; Baek, Jong-Deuk; Laditka, Sarah B.

    2009-01-01

    Context: Most nursing home care is provided by certified nursing assistants (CNAs), but little is known about rural CNAs. Purpose: To develop a representative geographic profile of the CNA workforce, focusing on paths leading to present job. Methods: Cross-sectional analysis of data from the 2004 National Nursing Assistant Survey (NNAS), a…

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

    OpenAIRE

    Havig Anders; Skogstad Anders; Kjekshus Lars; Romøren Tor

    2011-01-01

    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 ...

  16. Essential elements of the nursing practice environment in nursing homes: Psychometric evaluation.

    Science.gov (United States)

    de Brouwer, Brigitte Johanna Maria; Kaljouw, Marian J; Schoonhoven, Lisette; van Achterberg, Theo

    2017-06-01

    To develop and psychometrically test the Essentials of Magnetism II in nursing homes. Increasing numbers and complex needs of older people in nursing homes strain the nursing workforce. Fewer adequately trained staff and increased care complexity raise concerns about declining quality. Nurses' practice environment has been reported to affect quality of care and productivity. The Essentials of Magnetism II © measures processes and relationships of practice environments that contribute to productivity and quality of care and can therefore be useful in identifying processes requiring change to pursue excellent practice environments. However, this instrument was not explicitly evaluated for its use in nursing home settings so far. In a preparatory phase, a cross-sectional survey study focused on face validity of the essentials of magnetism in nursing homes. A second cross-sectional survey design was then used to further test the instrument's validity and reliability. Psychometric testing included evaluation of content and construct validity, and reliability. Nurses (N = 456) working at 44 units of three nursing homes were included. Respondent acceptance, relevance and clarity were adequate. Five of the eight subscales and 54 of the 58 items did meet preset psychometric criteria. All essentials of magnetism are considered relevant for nursing homes. The subscales Adequacy of Staffing, Clinically Competent Peers, Patient Centered Culture, Autonomy and Nurse Manager Support can be used in nursing homes without problems. The other subscales cannot be directly applied to this setting. The valid subscales of the Essentials of Magnetism II instrument can be used to design excellent nursing practice environments that support nurses' delivery of care. Before using the entire instrument, however, the other subscales have to be improved. © 2016 John Wiley & Sons Ltd.

  17. 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\

  18. Innovative leadership and management in a nursing home.

    Science.gov (United States)

    Jeong, Sarah Yeun-Sim; Keatinge, Diana

    2004-11-01

    The Australian Aged Care Reform Package, implemented from October 1997, has led radical changes in nursing practice in residential aged care facilities. Apart from anecdotal evidence, however, little is known about the impact of the Reform Package on nursing staff and their practice in nursing home facilities. In an attempt to explore these issues a qualitative explorative research study was conducted in one nursing home during 2000-2001. The study found that the impact of policy change on nursing staff and their practice depended on the management's leadership in interpreted the new policy and implemented innovative strategies in order to meet its requirements. The findings of the study highlight management's 'no them vs. us' and 'holistic' approach that considered both nursing staff and residents as whole beings. Integral to this approach was management's recognition that in order to facilitate teamwork, appropriate standards of nursing practice and resident care, and staff job satisfaction four resource elements must be provided. These elements comprise material, environmental, psychosocial and psychological resources. Management's provision of each of these resources ensured that nurses considered this nursing home 'a nice place to work'.

  19. Do public nursing home care providers deliver higher quality than private providers? Evidence from Sweden.

    Science.gov (United States)

    Winblad, Ulrika; Blomqvist, Paula; Karlsson, Andreas

    2017-07-14

    Swedish nursing home care has undergone a transformation, where the previous virtual public monopoly on providing such services has been replaced by a system of mixed provision. This has led to a rapidly growing share of private actors, the majority of which are large, for-profit firms. In the wake of this development, concerns have been voiced regarding the implications for care quality. In this article, we investigate the relationship between ownership and care quality in nursing homes for the elderly by comparing quality levels between public, for-profit, and non-profit nursing home care providers. We also look at a special category of for-profit providers; private equity companies. The source of data is a national survey conducted by the Swedish National Board of Health and Welfare in 2011 at 2710 nursing homes. Data from 14 quality indicators are analyzed, including structure and process measures such as staff levels, staff competence, resident participation, and screening for pressure ulcers, nutrition status, and risk of falling. The main statistical method employed is multiple OLS regression analysis. We differentiate in the analysis between structural and processual quality measures. The results indicate that public nursing homes have higher quality than privately operated homes with regard to two structural quality measures: staffing levels and individual accommodation. Privately operated nursing homes, on the other hand, tend to score higher on process-based quality indicators such as medication review and screening for falls and malnutrition. No significant differences were found between different ownership categories of privately operated nursing homes. Ownership does appear to be related to quality outcomes in Swedish nursing home care, but the results are mixed and inconclusive. That staffing levels, which has been regarded as a key quality indicator in previous research, are higher in publicly operated homes than private is consistent with earlier

  20. 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.

  1. Esker Ri Nursing Home, Kilnabinnia, Clara, Offaly.

    LENUS (Irish Health Repository)

    Sheehan, Aisling

    2015-02-01

    Nursing is experiencing a significant deficit in research capacity needed to meet future global healthcare demands-there is a call to double the number of nurses and healthcare professionals with a doctorate.

  2. Nurses' experiences of caring encounters with older people living in Swedish nursing homes.

    Science.gov (United States)

    Westin, Lars; Danielson, Ella

    2006-03-01

    Aim.  The aim of the study was to describe and interpret the meaning of nurses' experiences of caring encounters with residents in nursing homes. Background.  Life for residents in nursing homes can be characterized as a process of decreased physical and psychological resources. Therefore, encounters with nurses are important activities for providing meaning and security for the residents. Research in this field has previously focused on communication, attitudes and job satisfaction, but gives limited knowledge about what the human encounters in this context mean for the nurses. Method.  A hermeneutic method was used in this study. Interviews were conducted with 14 nurses from two nursing homes about their experiences of caring encounters. The transcribed interview texts were interpreted as a whole. Results.  In the interpretation of the text concerning the meaning of nurses' experiences of encounters with resident's four themes and 11 subthemes emerged. The comprehensive interpretation mainly showed possible ways available being present, being significant and being aware of opportunities for the nurse to find meaning in the encounter with the resident, but impossible ways as being inadequately were also revealed. Conclusion.  This study shows the importance of caring encounters between nurses and residents in nursing homes. The good encounters provide various possible ways for nurses to find meaning and a sense of communion with residents. However, bad encounters, described as being inadequate, were found to inhibit nurses from finding meaning in their encounters with residents. Relevance to clinical practice.  Meeting the needs of older people in nursing homes requires special knowledge about the importance of the caring encounter. Therefore, nurses in this care context need supervision and continuous education in order to gain relevant knowledge about the meaning of caring encounters for themselves and residents.

  3. Fatigue and Mood States in Nursing Home and Nonambulatory Home-Based Patients with Multiple Sclerosis.

    Science.gov (United States)

    Younus, Zilfah; Vaughn, Caila B; Sanai, Shaik Ahmed; Kavak, Katelyn S; Gupta, Sahil; Nadeem, Muhammad; Teter, Barbara E; Noyes, Katia; Zivadinov, Robert; Edwards, Keith; Coyle, Patricia K; Goodman, Andrew; Weinstock-Guttman, Bianca

    2017-01-01

    Multiple sclerosis (MS) is a chronic, progressively disabling condition of the central nervous system. We sought to evaluate and compare mood states in patients with MS with increased disability residing in nursing homes and those receiving home-based care. We conducted a cross-sectional analysis of the New York State Multiple Sclerosis Consortium to identify patients with MS using a Kurtzke Expanded Disability Status Scale (EDSS) score of 7.0 or greater. The nursing home group was compared with home-based care patients regarding self-reported levels of loneliness, pessimism, tension, panic, irritation, morbid thoughts, feelings of guilt, and fatigue using independent-samples t tests and χ 2 tests. Multivariate logistic regression analyses were used to investigate risk-adjusted differences in mood states. Ninety-four of 924 patients with EDSS scores of at least 7.0 lived in a nursing home (10.2%). Nursing home patients were less likely to use disease-modifying therapy and had higher mean EDSS scores compared with home-based patients. However, nursing home patients were less likely than home-based patients to report fatigue (odds ratio [OR] for no fatigue, 3.8; 95% CI, 2.1-7.2), feeling tense (OR for no tension, 1.7; 95% CI, 1.1-2.7), and having feelings of pessimism (OR for no pessimism, 1.8; 95% CI, 1.2-2.8). The nursing home patients with MS were less likely to report fatigue, pessimism, and tension than those receiving home-based care. Further studies should examine ways of facilitating a greater degree of autonomy and decision-making control in MS patients receiving home-based care.

  4. How registered nurses, licensed practical nurses and resident aides spend time in nursing homes: An observational study.

    Science.gov (United States)

    McCloskey, Rose; Donovan, Cindy; Stewart, Connie; Donovan, Alicia

    2015-09-01

    Calls for improved conditions in nursing homes have pointed to the importance of optimizing the levels and skills of care providers. Understanding the work of care providers will help to determine if staff are being used to their full potential and if opportunities exist for improved efficiencies. To explore the activities of care providers in different nursing homes and to identify if variations exist within and across homes and shifts. A multi-centre cross-sectional observational work flow study was conducted in seven different nursing homes sites in one Canadian province. Data were collected by a research assistant who conducted 368 h of observation. The research assistant collected data by following an identical route in each site and recording observations on staff activities. Findings indicate staff activities vary across roles, sites and shifts. Licensed practical nurses (nursing assistants) have the greatest variation in their role while registered nurses have the least amount of variability. In some sites both registered nurses and licensed practical nurses perform activities that may be safely delegated to others. Care providers spend as much as 53.7% of their time engaged in non-value added activities. There may be opportunities for registered nurses and licensed practical nurses to delegate some of their activities to non-regulated workers. The time care providers spend in non-value activities suggest there may be opportunities to improve efficiencies within the nursing home setting. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Home heating & human health

    NARCIS (Netherlands)

    Jongeneel, Sophie

    2008-01-01

    Human health is influenced by pollutants in the air. Since people spend over 80% of their time indoors, indoor air quality may be more related to health problems than outdoor air qual-ity. Indoor air quality is deteriorating because of energy conservation

  6. The residential continuum from home to nursing home: size, characteristics and unmet needs of older adults.

    Science.gov (United States)

    Freedman, Vicki A; Spillman, Brenda C

    2014-11-01

    Older adults with care needs live in a variety of settings-from traditional community housing to nursing homes. This analysis provides new estimates of the size and characteristics of the older population across settings and examines unmet needs for assistance. Data are from the 2011 National Health and Aging Trends Study (N = 8,077). Multinomial logistic regressions focus on people in settings other than nursing homes who are at risk for unmet needs, defined as receiving help or having difficulty with household, self-care, or mobility activities (N = 4,023). Of 38.1 million Medicare beneficiaries ages 65 and older, 5.5 million (15%) live in settings other than traditional housing: 2.5 million in retirement or senior housing communities, nearly 1 million in independent- and 1 million in assisted-living settings, and 1.1 million in nursing homes. The prevalence of assistance is higher and physical and cognitive capacity lower in each successive setting. Unmet needs are common in traditional community housing (31%), but most prevalent in retirement or senior housing (37%) and assisted living settings (42%). After controlling for differences in resident characteristics across settings, those in retirement or senior housing communities have a higher likelihood of unmet needs than those in traditional community housing, while those in independent or assisted living settings have a lower relative likelihood. Substantial numbers of older adults, many with care needs, live in a continuum of settings other than traditional community housing. Unmet needs are prevalent among older adults with limitations across all settings and warrant further investigation and monitoring. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Hospice family members' perceptions of and experiences with end-of-life care in the nursing home.

    Science.gov (United States)

    Oliver, Debra Parker; Washington, Karla; Kruse, Robin L; Albright, David L; Lewis, Alexandria; Demiris, George

    2014-10-01

    Even though 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 2 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 with 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? 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 members of hospice patients residing in the community. 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. 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 residents. This study suggests that nursing

  8. 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.; van Meijel, B.; Spreeuwenberg, P.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

  9. 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

  10. State hospital patients discharged to nursing homes: are hospitals dumping their more difficult patients?

    Science.gov (United States)

    Dittmar, N D; Franklin, J L

    1980-04-01

    In March 1978 the Texas Department of Mental Health and Mental Retardation, in collaboration with the Texas Department of Health, began a large-scale follow-up and evaluation of state hospital patients placed in nursing homes. Phase one, reported here, compared the social, physical, and psychiatric functioning of a sample of almost 500 patients placed in nursing homes and a matched sample retained in the hospitals. On a large number of variables, the nursing home patients were found to be functioning significantly better at the time of placement than the patients retained in the hospitals. Thus the hospitals appear not to be dumping their more debilitated patients, and the screening process in use in the hospitals appear to be working.

  11. Long-term effects of a 12 weeks high-intensity functional exercise program on physical function and mental health in nursing home residents with dementia: a single blinded randomized controlled trial.

    Science.gov (United States)

    Telenius, Elisabeth Wiken; Engedal, Knut; Bergland, Astrid

    2015-12-03

    Research indicates that exercise can have a positive effect on both physical and mental health in nursing home patients with dementia, however the lasting effect is rarely studied. In a previously published article we investigated the immediate effect of a 12 weeks functional exercise program on physical function and mental health in nursing home residents with dementia. In this paper we studied the long-term effect of this exercise program. We explored the differences between the exercise and control group from baseline to 6 months follow-up and during the detraining period from month 3 to 6. A single blind, randomized controlled trial was conducted and a total of 170 nursing home residents with dementia were included. The participants were randomly allocated to an intervention (n = 87) or a control group (n = 83). The intervention consisted of intensive strengthening and balance exercises in small groups twice a week for 12 weeks. The control condition was leisure activities. Thirty participants were lost between baseline and six-month follow-up. Linear mixed model analyses for repeated measurements were used to investigate the effect of exercise after detraining period. The exercise group improved their scores on Berg Balance Scale from baseline to 6 months follow-up by 2.7 points in average. The control group deteriorated in the same period and the difference between groups was statistically significant (p = 0.031). The exercise group also scored better on NPI agitation sub-score after 6 months (p = 0.045). The results demonstrate long-time positive effects of a high intensity functional exercise program on balance and indicate a positive effect on agitation, after an intervention period of 12 weeks followed by a detraining period of 12 weeks. Identifier at ClinicalTrials.gov: NCT02262104.

  12. Concentrated poverty and nursing home bed supply in Chicago.

    Science.gov (United States)

    Reed, S C; Andes, S; Tobias, R A

    2001-02-01

    This study explores whether poverty areas of Chicago have fewer nursing home beds and unique staffing patterns. Using 1990 census data and Illinois's 1994 Long-Term Care Facility Survey, census tracts were compared by need for long-term care, bed supply, and nursing home characteristics. While facilities cluster on the north side, and the number of beds follow the elderly, the supply of beds per elderly is actually greater in tracts with high proportions of poverty, disability, and African American residents due, in part, to the predominance of larger facilities. Ironically, economic segregation may work together with Medicaid's policy of serving the poorest to increase the supply of beds to those who might otherwise remain unserved. Nursing homes in the poorest communities have high percentages of Medicaid residents, are larger, and employ fewer staff per resident; homes with a high Medicaid population are more likely to employ LPNs, which may reflect labor supply differences.

  13. A Case Study Approach to Nursing Home Placement: Smooth and Difficult Cases and Implications for Nursing.

    Science.gov (United States)

    Koplow, Sarah M; Gallo, Agatha M; Knafl, Kathleen A; Vincent, Catherine; Paun, Olimpia; Gruss, Valerie

    2015-07-01

    Nursing home placement is one of the most challenging aspects of the caregiving journey. A case study approach was used to understand the experiences of caregivers during the first few months following nursing home placement. Two caregivers were selected from a larger qualitative descriptive study because their experiences exemplified smooth and difficult transitions for both themselves and their older family member. The caregivers were interviewed shortly after placement and 3 months post-placement. Four major contextual issues were identified that indicated the similarities and differences between the two cases, including (a) the caregiver's relationship with the older adult during the home caregiving time and post nursing home placement, (b) the circumstances surrounding placement, (c) support systems, and (d) continued involvement in care post-placement. Nursing home staff who understand these issues and address concerns through family-centered care can ease the transition and promote successful collaborations between staff and families. Copyright 2015, SLACK Incorporated.

  14. Practices of Depression Care in Home Health Care: Home Health Clinician Perspectives.

    Science.gov (United States)

    Bao, Yuhua; Eggman, Ashley A; Richardson, Joshua E; Sheeran, Thomas F; Bruce, Martha L

    2015-12-01

    The study assessed gaps between published best practices and real-world practices of treating depression in home health care (HHC) and barriers to closing gaps. The qualitative study used semistructured interviews with nurses and administrators (N=20) from five HHC agencies in five states. Audio-recorded interviews were transcribed and analyzed by a multidisciplinary team using grounded theory method to identify themes. Routine HHC nursing overlapped with all functional areas of depression care. However, gaps were noted between best and real-world practices. Gaps were associated with perceived scope of practice by HHC nurses, knowledge gaps and low self-efficacy in depression treatment, stigma attached to depression, poor quality of antidepressant management in primary care, and poor communication between HHC and primary care clinicians. Strategies to close gaps between typical and best practices include enhancing HHC clinicians' knowledge and self-efficacy with depression treatment and improving the quality of antidepressant management and communication with primary care.

  15. Experiences of home and institution in a secured nursing home ward in the Netherlands : A participatory intervention study

    NARCIS (Netherlands)

    Klaassens, Mirjam; Meijering, Louise

    Nursing homes have been criticised for not providing a home for their residents. This article aims to provide insight into (I) the features of home and institution as experienced by residents and caregivers of a secured ward in a nursing home, and (2) how interventions implemented on the ward can

  16. The Importance of Personal Possessions for the Development of a Sense of Home of Nursing Home Residents

    NARCIS (Netherlands)

    Joost van Hoof; M.L. Janssen; C.M.C. Heesakkers; L.A.G. Willems; B.M. Janssen; H.R. Marston; W. van Kersbergen; M.E. Nieboer; L.E.J. Severijns

    2016-01-01

    Personal possessions of nursing home residents can contribute to their sense of home. This study investigated which of the personal belongings were considered most important, and if these items indeed contributed to a sense of home. A qualitative research was conducted with 27 nursing home

  17. 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.

  18. Nurse-patient interaction is a resource for hope, meaning in life and self-transcendence in nursing home patients.

    Science.gov (United States)

    Haugan, Gørill

    2014-03-01

    Spiritual dimensions such as hope, meaning in life and self-transcendence have been found to be predictors of successful ageing, life satisfaction and well-being in older individuals. Connectedness and communicating with others have been seen to facilitate hope, meaning in life and self-transcendence among nursing home patients. This study aimed to investigate the associations between hope, meaning in life, self-transcendence and nurse-patient interaction in a nursing home population. A cross-sectional design was employed, collecting data in 44 different Norwegian nursing homes (NHs) from 250 patients who met the inclusion criteria. Approval by all regulatory institutions dealing with research issues in Norway and the Management Unit at the 44 NHs was obtained. A sample of 202 cognitively intact nursing home patients responded to the Herth Hope Index, the Purpose in Life test, the Self-Transcendence Scale and the Nurse-Patient Interaction Scale. A structural equation model (SEM) of the hypothesized relationships between the constructs was tested. The SEM model fit well with the present data. Significant direct relationships of nurse-patient interaction on hope, meaning in life and self-transcendence were displayed. Meaning and the interconnectedness dimension of hope appeared to be particularly dynamic resources, revealing significant influences on all the constructs in the SEM model tested. Nurse-patient interaction influences hope, meaning in life and self-transcendence in cognitively intact nursing home patients and might be an important resource in relation to patients' health and global well-being. Thus, care providers are above all fundamental for nursing home patients. Advancing caregivers' interacting and communicating skills might facilitate patients' health and global well-being and inspire professional caregivers as they perform their daily care practices. More research of the effectiveness of such strategies is greatly needed. The SEM model tested

  19. The relationship of staffing and work environment with implicit rationing of nursing care in Swiss nursing homes--A cross-sectional study.

    Science.gov (United States)

    Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René

    2015-09-01

    Implicit rationing of nursing care refers to the withdrawal of or failure to carry out necessary nursing care activities due to lack of resources, in the literature also described as missed care, omitted care, or nursing care left undone. Under time constraints, nurses give priority to activities related to vital medical needs and the safety of the patient, leaving out documentation, rehabilitation, or emotional support of patients. In nursing homes, little is known about the occurrence of implicit rationing of nursing care and possible contributing factors. The purpose of this study was (1) to describe levels and patterns of self-reported implicit rationing of nursing care in Swiss nursing homes and (2) to explore the relationship between staffing level, turnover, and work environment factors and implicit rationing of nursing care. Cross-sectional, multi-center sub-study of the Swiss Nursing Home Human Resources Project (SHURP). Nursing homes from all three language regions of Switzerland. A random selection of 156 facilities with 402 units and 4307 direct care workers from all educational levels (including 25% registered nurses). We utilized data from established scales to measure implicit rationing of nursing care (Basel Extent of Rationing of Nursing Care), perceptions of leadership ability and staffing resources (Practice Environment Scale of the Nursing Work Index), teamwork and safety climate (Safety Attitudes Questionnaire), and work stressors (Health Professions Stress Inventory). Staffing level and turnover at the unit level were measured with self-developed questions. Multilevel linear regression models were used to explore the proposed relationships. Implicit rationing of nursing care does not occur frequently in Swiss nursing homes. Care workers ration support in activities of daily living, such as eating, drinking, elimination and mobilization less often than documentation of care and the social care of nursing homes residents. Statistically

  20. Adherence of Pain Assessment to the German National Standard for Pain Management in 12 Nursing Homes

    Directory of Open Access Journals (Sweden)

    Jürgen Osterbrink

    2014-01-01

    Full Text Available BACKGROUND: Pain is very common among nursing home residents. The assessment of pain is a prerequisite for effective multiprofessional pain management. Within the framework of the German health services research project, ‘Action Alliance Pain-Free City Muenster’, the authors investigated pain assessment adherence according to the German national Expert Standard for Pain Management in Nursing, which is a general standard applicable to all chronic/acute pain-affected persons and highly recommended for practice.

  1. Public Health Interventions for School Nursing Practice

    Science.gov (United States)

    Schaffer, Marjorie A.; Anderson, Linda J. W.; Rising, Shannon

    2016-01-01

    School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic…

  2. Advance Care Planning in Norwegian nursing homes-Who is it for?

    Science.gov (United States)

    Thoresen, Lisbeth; Ahlzén, Rolf; Solbrække, Kari Nyheim

    2016-08-01

    Advance care planning (ACP) is an international concept for improving patient autonomy and communication in the context of anticipated deterioration and end-of-life care. In a preparatory conversation, health care professionals facilitate one or more conversations where nursing home residents are invited to reflect on, and articulate wishes and preferences concerning future medical treatment and end-of-life care. Our aim with this study was to increase knowledge of existing ACP practices in Norwegian nursing homes. We wanted to know how nursing home residents, relatives and nursing home staff take part in the conversations, and to what extent these conversations can be regarded as promoting autonomy, legal rights and individual needs for the residents. We conducted participant observation of seven preparatory conversations, followed by interviews with health care staff (together) and resident and relative (together). In the result section, we present an informative case example of an ACP conversation where common and important characteristics running through our data are present. These are further elaborated under the following headings: Life critical questions, Residents' quiet participation in the conversations, the Dying phase - a clinical issue, Nurses and physicians; different domains and Timing. We find that nursing home staff in our study wants to contribute to open awareness, autonomy and a good death, but there are little reflections about the purpose and content of the conversations, how they should be carried out and when, and what frail nursing home residents are able to understand and express in ACP conversations. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Meaning-in-life in nursing-home patients: a correlate with physical and emotional symptoms.

    Science.gov (United States)

    Haugan, Gørill

    2014-04-01

    To investigate the prevalence of physical and emotional symptoms and the associations between symptoms and meaning-in-life in a cognitively intact nursing-home population. Meaning has been found to be a strong individual predictor of successful ageing and life satisfaction as well as an important psychological variable that promotes well-being. Meaning serves as a mediating variable in both psychological and physical health. The study employed a cross-sectional design. Data were collected in 2008 and 2009 using the QLQ-C15-PAL quality-of-life questionnaire, the purpose-in-life test and the Hospital Anxiety and Depression Scale. A total of 250 cognitively intact nursing-home patients who met the inclusion criteria were approached and 202 attended. The prevalence of symptoms was fairly high, with fatigue (57%), pain (49%), constipation (43%) and dyspnoea (41%) as the most frequent physical symptoms, while 30% were depressed and 12% had anxiety. Significant correlations between meaning-in-life and symptom severity were displayed. The level of symptom severity among cognitively intact nursing-home patients is high, requiring highly competent staff nurses. Meaning-in-life might be an important resource in relation to a patient's physical and emotional health and global well-being. Facilitating patients' meaning-in-life might help reducing symptom severity and fostering quality of life in cognitively intact nursing-home patients. However, advancing staff nurses' competence in palliative care, symptom management and nurse-patient interaction is important for care quality and quality if life in nursing homes. © 2013 John Wiley & Sons Ltd.

  4. [Influence of in-home nursing care on the weight of the early discharged preterm newborn].

    Science.gov (United States)

    Alvarez Miró, R; Lluch Canut, M T; Figueras Aloy, J; Esqué Ruiz, M T; Arroyo Gili, L; Bella Rodríguez, J; Carbonell Estrany, X

    2014-12-01

    In-Home nursing care of the preterm newborn helps to bring the family situation to normal, promotes breastfeeding and development of the newborn, and enables the reorganization of health care resources. The purpose of this paper is to demonstrate that in-home nursing care of the preterm newborn leads to an increase in weight and a similar morbidity. A total of 65 cases and 65 controls (matched by weight, age and sex) were studied, all of them preterm newborns born in hospital and weighing less than 2100 g at discharge. In-home nursing care was carried out by a pediatrician neonatologist, as well as two nurses specialized in neonatology who made several visits to the home. Weight gain was calculated as g/day and g/Kg/day, comparing the first week of the study with the week prior to the beginning of the study. The groups were comparable. Weight gain in the group with home nursing care was 38 g per day, significantly higher than the weight gain in the control group (31 g/day). The independent predictive variables of the increase in g/Kg/day during the study were in-home nursing care, male gender, breastfeeding less, and not having suffered from a peri-intraventricular hemorrhage. Neonatal morbidity was similar in both groups. In-home care was associated with a greater weight gain of the newborn at home than during their stay in the hospital, and can be considered safe because neonatal morbidity was not increased. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  5. The prevalence of advance directives: lessons from a nursing home.

    Science.gov (United States)

    Palker, N B; Nettles-Carson, B

    1995-02-01

    This study of an elderly population examined the prevalence of advance directives, the barriers to documentation, and the relation of anxiety to advance directives. Elders (mean age 77.7 years) residing in a nursing home comprised the convenience sample (n = 104). Data were obtained by record review for the total sample, and personal interviews with 17 residents. Descriptive statistics and the chi 2-test of proportions were employed for analysis. The prevalence of documentation was 51.9% (n = 104), including 35 do-not-resuscitate orders, 17 health care powers of attorney, 16 medical directives, and 13 living wills; 18 records contained more than one directive. Those interviewed, both with and without advance directives, revealed low death anxiety (Templer's Death Anxiety Scale) reminiscing freely about their lives and experiences. Barriers suggested by the self-reports were misconceptions, little knowledge, opportunity, or interest in preparing directives, and the belief that clinicians or family were responsible for end-of-life decisions.

  6. Antibiotic Stewardship Programs in Nursing Homes: A Systematic Review.

    Science.gov (United States)

    Feldstein, Diana; Sloane, Philip D; Feltner, Cynthia

    2017-08-07

    Antibiotic stewardship programs (ASPs) are coordinated interventions promoting the appropriate use of antibiotics to improve patient outcomes and reduce microbial resistance. These programs are now mandated in nursing homes (NHs) but it is unclear if these programs improve resident outcomes. This systematic review evaluated the current evidence regarding outcomes of ASPs in the NH. PubMed, CINAHL, EMBASE, and the Cochrane Library were systematically searched for intervention trials of ASPs performed in NHs that evaluated final health outcomes (mortality and Clostridium difficile infections), healthcare utilization outcomes (emergency department visits and hospital admissions) and intermediate health outcomes (number of antibiotics prescribed, adherence to recommended guidelines). A total of 14 studies rated good or fair quality were included. Eight studies reported a reduction in antibiotic prescriptions. Ten found an increase in adherence to guidelines proposed by the studied ASP. None reported a statistically significant change in NH mortality rates, C. difficile infection rates, or hospitalizations. The limited research to date suggests that NH ASPs can affect intermediate health outcomes, but not key health outcomes or health care utilization. Larger trials evaluating more intensive interventions over longer durations may be needed to determine whether ASPs in NHs improve health outcomes as they have in hospitals. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  7. The availability and use of allied health care in care homes in the Midlands, UK: commentaries.

    NARCIS (Netherlands)

    Leemrijse, C.; Veenhof, C.; Boer, M.E. de

    2009-01-01

    The demographic trends of continuing growth of the number of older people will lead to an increasing need for long-term services such as nursing homes. The intensive work delivered by the rehabilitative services provided in the nursing homes includes care by a variety of allied health care

  8. Falls in the nursing home: are they preventable?

    Science.gov (United States)

    Vu, Man Quang; Weintraub, Nancy; Rubenstein, Laurence Z

    2004-01-01

    Falls are prevalent in elderly patients residing in nursing homes, with approximately 1.5 falls occurring per nursing home bed-years. Although most are benign and injury-free, 10% to 25% result in hospital admission and/or fractures. Primary care providers for nursing home residents must therefore aim to reduce both the fall rate as well as the rate of fall-related morbidity in the long-term care setting. Interventions have been demonstrated to be successful in reducing falls in community-dwelling elderly patients. However, less evidence supports the efficacy of fall prevention in nursing home residents. The authors conducted a Medline search using the key words Falls and Nursing Homes. Several studies examined the efficacy of multifaceted intervention programs on reducing falls in nursing homes with varied results. Components of these intervention programs include: environmental assessment, assistive device evaluation and modification, medication changes, gait assessment and training, staff education, exercise programs, hip protector use, and blood pressure evaluation. Current literature supports the use of environmental assessment and intervention in reducing falls in nursing homes, and demonstrates an association between certain medications and falls. However, there are no studies that examine the effect of medication adjustments on fall rates. Also, the literature does not strongly suggest that exercise programs are effective in fall reduction. Although not effective in reducing fall rates, the use of hip protectors appears to result in less fall-related morbidity. More studies must be done to clarify the effects of high-risk medication reduction, the optimal nature and intensity of exercise programs, and patient targeting criteria to maximize the effectiveness of nursing home fall prevention programs. Based on the current literature, an effective multifaceted fall prevention program for nursing home residents should include risk factor assessment and

  9. Home care patients in four Nordic capitals – predictors of nursing home admission during one-year followup

    Directory of Open Access Journals (Sweden)

    Liv W Sørbye

    2010-03-01

    Full Text Available Liv W Sørbye1, Torunn Hamran2, Nils Henriksen2, Astrid Norberg2,31Diakonhjemmet University College, Oslo, Norway; 2Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø, Norway; 3Umeå University, Umeå, Ersta Sköndal University College, Stockholm, SwedenAbstract: The aim was to predict nursing home admission (NHA for home care patients after a 12-month follow-up study. This Nordic study is derived from the aged in home care (AdHOC project conducted in 2001–2003 with patients at 11 sites in Europe. The participants in the cohort study were randomly selected individuals, aged 65 years or older, receiving homecare in Oslo, Stockholm, Copenhagen, and Reykjavik. The Resident Assessment Instrument for Home Care (version 2.0 was used. Epidemiological and medical characteristics of patients and service utilization were recorded for 1508 home care patients (participation rate 74%. In this sample 75% were female. The mean age was 82.1 (6.9 years for men and 84.0 (6.6 for women. The most consistent predictor of NHA was receiving skilled nursing procedures at baseline (help with medication and injections, administration or help with oxygen, intravenous, catheter and stoma care, wounds and skin care (adjusted odds ratio = 3.7, 95% confidence interval: 1.7–7.8; P < 0.001. In this Nordic material, stronger emphasizing on higher qualified nurses in a home care setting could prevent or delay NHA.Keywords: aged, home care, cross-sectional study, self-rated health, level of care, care burden, comprehensive assessment, RAI, Nordic

  10. Nursing Home Self-assessment of Implementation of Emergency Preparedness Standards.

    Science.gov (United States)

    Lane, Sandi J; McGrady, Elizabeth

    2016-08-01

    Introduction Disasters often overwhelm a community's capacity to respond and recover, creating a gap between the needs of the community and the resources available to provide services. In the wake of multiple disasters affecting nursing homes in the last decade, increased focus has shifted to this vital component of the health care system. However, the long-term care sector has often fallen through the cracks in both planning and response. Problem Two recent reports (2006 and 2012) published by the US Department of Health and Human Services (DHHS), Office of Inspector General (OIG), elucidate the need for improvements in nursing homes' comprehensive emergency preparedness and response. The Center for Medicare and Medicaid Services (CMS) has developed an emergency preparedness checklist as a guidance tool and proposed emergency preparedness regulations. The purpose of this study was to evaluate the progress made in nursing home preparedness by determining the level of completion of the 70 tasks noted on the checklist. The study objectives were to: (1) determine the preparedness levels of nursing homes in North and South Carolina (USA), and (2) compare these findings with the 2012 OIG's report on nursing home preparedness to identify current gaps. A survey developed from the checklist of items was emailed to 418 North Carolina and 193 South Carolina nursing home administrators during 2014. One hundred seventeen were returned/"bounced back" as not received. Follow-up emails and phone calls were made to encourage participation. Sixty-three completed surveys and 32 partial surveys were received. Responses were compared to data obtained in a 2010 study to determine progress. Progress had been made in many of the overall planning and sheltering-in-place tasks, such as having contact information of local emergency managers as well as specifications for availability of potable water. Yet, gaps still persisted, especially in evacuation standards, interfacing with emergency

  11. Nursing and mHealth

    Directory of Open Access Journals (Sweden)

    Catherine Samples

    2014-12-01

    Full Text Available Innovations in mobile health (mHealth technology offer applications to promote wellness management and health behavior change outside of formal clinical settings. Nurses can help to move mHealth into mainstream health care by understanding its potential to change the landscape of health intervention delivery, incorporating mHealth into patients' day to day preventive care strategies, and supporting the science of mHealth's effectiveness.

  12. 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.

  13. Positive experience of a mobile radiography service in nursing homes.

    Science.gov (United States)

    Eklund, Karin; Klefsgård, Rosemarie; Ivarsson, Bodil; Geijer, Mats

    2012-01-01

    For elderly people living in nursing homes, a transport to hospital for a radiological examination can lead to increased anxiety, disorientation and other problems related to the new environment. To investigate the usefulness of a mobile radiography service for radiological assessment of patients in nursing homes from the patient and staff perspectives. Lightweight equipment with a digital flat-panel detector was used for mobile radiography on nursing home patients in their own rooms. Data on patient and staff experiences from the service were collected using a questionnaire with closed and open-ended questions. Image quality was evaluated by the radiographer and a radiologist. The majority of 241 radiography examinations were of the musculoskeletal system (94%). Twelve of 123 patients had pathology that required hospital treatment, while 22 patients with radiographic pathology could be treated locally. The main beneficial factors were security and comfort, acceptance from the patients, no need for transportation, no need for staff to be absent from the nursing homes. Mobile radiography in nursing homes is technically feasible, with good image quality. The most beneficial results were that patients avoided unnecessary transport back and forth to the hospital, and that the majority of patients could be treated locally. Copyright © 2011 S. Karger AG, Basel.

  14. Lack of ear care knowledge in nursing homes

    Directory of Open Access Journals (Sweden)

    Solheim J

    2016-09-01

    Full Text Available Jorunn Solheim,1 Olga Shiryaeva,1 Kari J Kvaerner2 1Department of Ear, Nose and Throat, Lovisenberg Diakonale Hospital, 2C3 Centre for Connected Care, Oslo University Hospital, Oslo, Norway Background: Rising life expectancy means an increase in the number of elderly people with hearing loss in the population. Many elderly people live in nursing homes, with varying care needs. A substantial proportion of these people will need help with their hearing aids and other hearing devices. Objective: The objective of the study has been to assess the knowledge, experience, skills, competence, and need for information of staff at nursing homes in relation to residents’ hearing loss and hearing aids. Materials and methods: One hundred and ninety-five employees at seven nursing homes participated in the study. The main approach was a descriptive study, using questionnaires. Results: The main findings are that 73% of informants found that many residents need help with their hearing aids. Only one-tenth report that they know enough about the residents’ hearing aids. Almost four out of five informants find that the residents become socially isolated as a result of hearing loss. Seventy-eight percent agree to some extent that more residents would benefit from hearing aids. Conclusion: Staff at nursing homes have insufficient knowledge about hearing loss and hearing aids. Increased focus on the elderly with hearing impairment in nursing homes is needed. Contact between nursing homes and audiological specialists should be improved to best follow-up hearing loss and hearing aids. Keywords: hearing aids, nursing staff, hearing impairment, institutionalized elderly

  15. Determinants of staff job satisfaction of caregivers in two nursing homes in Pennsylvania

    OpenAIRE

    Degenholtz Howard; Castle Nicholas G; Rosen Jules

    2006-01-01

    Abstract Background Job satisfaction is important for nursing home staff and nursing home management, as it is associated with absenteeism, turnover, and quality of care. However, we know little about factors associated with job satisfaction and dissatisfaction for nursing home workers. Methods In this investigation, we use data from 251 caregivers (i.e., Registered Nurses, Licensed Practical Nurses, and Nurse Aides) to examine: job satisfaction scores of these caregivers and what characteris...

  16. Successfully Reducing Hospitalizations of Nursing Home Residents: Results of the Missouri Quality Initiative.

    Science.gov (United States)

    Rantz, Marilyn J; Popejoy, Lori; Vogelsmeier, Amy; Galambos, Colleen; Alexander, Greg; Flesner, Marcia; Crecelius, Charles; Ge, Bin; Petroski, Gregory

    2017-11-01

    The goals of the Missouri Quality Initiative (MOQI) for long-stay nursing home residents were to reduce the frequency of avoidable hospital admissions and readmissions, improve resident health outcomes, improve the process of transitioning between inpatient hospitals and nursing facilities, and reduce overall healthcare spending without restricting access to care or choice of providers. The MOQI was one of 7 program sites in the United States, with specific interventions unique to each site tested for the Centers for Medicaid and Medicare Services (CMS) Innovations Center. A prospective, single group intervention design, the MOQI included an advanced practice registered nurse (APRN) embedded full-time within each nursing home (NH) to influence resident care outcomes. Data were collected continuously for more than 3 years from an average of 1750 long-stay Medicare, Medicaid, and private pay residents living each day in 16 participating nursing homes in urban, metro, and rural communities within 80 miles of a major Midwestern city in Missouri. Performance feedback reports were provided to each facility summarizing their all-cause hospitalizations and potentially avoidable hospitalizations as well as a support team of social work, health information technology, and INTERACT/Quality Improvement Coaches. The MOQI achieved a 30% reduction in all-cause hospitalizations and statistically significant reductions in 4 single quarters of the 2.75 years of full implementation of the intervention for long-stay nursing home residents. As the population of older people explodes in upcoming decades, it is critical to find good solutions to deal with increasing costs of health care. APRNs, working with multidisciplinary support teams, are a good solution to improving care and reducing costs if all nursing home residents have access to APRNs nationwide. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  17. The composition of old age homes in South Africa in relation to the residents and nursing personnel

    Directory of Open Access Journals (Sweden)

    A. Perold

    2000-09-01

    Full Text Available This research project is the first phase of a larger study aimed at describing and exploring the cost-effective utilisation of nursing personnel in old age homes in South Africa. The aim in the first phase was to describe the composition of the residents and nursing personnel of old age homes in South Africa. An exploratory and descriptive survey was conducted and the data was collected by means of a questionnaire. The questionnaire also included data on the financial implications of utilising professional nursing personnel to manage the care of the frail residents/older persons in old age homes in South Africa. The questionnaires were mailed to 612 old age homes published in the Hospital and Nursing Yearbook of 1997 (100% sample. A total of 145 (23.69% questionnaires were returned and included in the descriptive data analysis. The residents are mainly female (77%, older than 85 years of age, belong to the white race group (83,74% and are highly dependent on nursing care and supervision (69,7%. Old age homes are mainly managed/ controlled by welfare organisations and lay health care workers are utilised to a large extent (42,22% of the nursing workforce to render nursing care to the frail residents. The cost-effective utilisation of nursing personnel (registered and enrolled, as well as the utilisation of lay health workers in old age homes, needs to be critically examined.

  18. Leadership education, certification and resident outcomes in US nursing homes: cross-sectional secondary data analysis.

    Science.gov (United States)

    Trinkoff, Alison M; Lerner, Nancy B; Storr, Carla L; Han, Kihye; Johantgen, Mary E; Gartrell, Kyungsook

    2015-01-01

    Leadership is a key consideration in improving nursing home care quality. Previous research found nursing homes with more credentialed leaders had lower rates of care deficiencies than nursing homes with less credentialed leaders. Evidence that nursing home administrator (NHA) and director of nursing (DON) education and certification is related to resident outcomes is limited. To examine associations of education and certification among NHAs and DONs with resident outcomes. Cross-sectional secondary data analysis. This study used National Nursing Home Survey data on leadership education and certification and Nursing Home Compare quality outcomes (e.g. pain, catheter use). 1142 nursing homes in the survey which represented 16628 nursing homes in the US. Leadership education and certification were assessed separately for NHAs and DONs. Nursing home resident outcomes were measured using facility-level nursing home quality indicator rates selected from the Minimum Data Set. Facility-level quality indicators were regressed onto leadership variables in models that also held constant facility size and ownership status. Nursing homes led by NHAs with both Master's degrees or higher and certification had significantly better outcomes for pain. Nursing homes led by DONs with Bachelor's degrees or higher plus certification also had significantly lower pain and catheter use. Whereas pressure ulcer rates were higher in facilities led by DONs with more education. Selected outcomes for nursing home residents might be improved by increasing the education and certification requirements for NHAs and DONs. Additional research is needed to clarify these relationships. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Teaching Home Environmental Health to Resident Physicians

    OpenAIRE

    Zickafoose, Joseph S.; Greenberg, Stuart; Dearborn, Dorr G.

    2011-01-01

    Healthy Homes programs seek to integrate the evaluation and management of a multitude of health and safety risks in households. The education of physicians in the identification, evaluation, and management of these home health and safety issues continues to be deficient. Healthy Homes programs represent a unique opportunity to educate physicians in the home environment and stimulate ongoing, specific patient-physician discussions and more general learning about home environmental health. The ...

  20. Design of the DIRECT-project: interventions to increase job resources and recovery opportunities to improve job-related health, well-being, and performance outcomes in nursing homes.

    Science.gov (United States)

    Spoor, Ellen; de Jonge, Jan; Hamers, Jan P H

    2010-05-28

    Because of high demands at work, nurses are at high risk for occupational burnout and physical complaints. The presence of job resources (such as job autonomy or social support) and recovery opportunities could counteract the adverse effect of high job demands. However, it is still unclear how job resources and recovery opportunities can be translated into effective workplace interventions aiming to improve employee health, well-being, and performance-related outcomes. The aim of the current research project is developing and implementing interventions to optimize job resources and recovery opportunities, which may lead to improved health, well-being and performance of nurses. The DIRECT-project (DIsc Risk Evaluating Controlled Trial) is a longitudinal, quasi-experimental field study. Nursing home staff of 4 intervention wards and 4 comparison wards will be involved. Based on the results of a base-line survey, interventions will be implemented to optimize job resources and recovery opportunities. After 12 and 24 month the effect of the interventions will be investigated with follow-up surveys. Additionally, a process evaluation will be conducted to map factors that either stimulated or hindered successful implementation as well as the effectiveness of the interventions. The DIRECT-project fulfils a strong need for intervention research in the field of work, stress, performance, and health. The results could reveal (1) how interventions can be tailored to optimize job resources and recovery opportunities, in order to counteract job demands, and (2) what the effects of these interventions will be on health, well-being, and performance of nursing staff.

  1. Design of the DIRECT-project: interventions to increase job resources and recovery opportunities to improve job-related health, well-being, and performance outcomes in nursing homes

    Directory of Open Access Journals (Sweden)

    Hamers Jan PH

    2010-05-01

    Full Text Available Abstract Background Because of high demands at work, nurses are at high risk for occupational burnout and physical complaints. The presence of job resources (such as job autonomy or social support and recovery opportunities could counteract the adverse effect of high job demands. However, it is still unclear how job resources and recovery opportunities can be translated into effective workplace interventions aiming to improve employee health, well-being, and performance-related outcomes. The aim of the current research project is developing and implementing interventions to optimize job resources and recovery opportunities, which may lead to improved health, well-being and performance of nurses. Methods/design The DIRECT-project (DIsc Risk Evaluating Controlled Trial is a longitudinal, quasi-experimental field study. Nursing home staff of 4 intervention wards and 4 comparison wards will be involved. Based on the results of a base-line survey, interventions will be implemented to optimize job resources and recovery opportunities. After 12 and 24 month the effect of the interventions will be investigated with follow-up surveys. Additionally, a process evaluation will be conducted to map factors that either stimulated or hindered successful implementation as well as the effectiveness of the interventions. Discussion The DIRECT-project fulfils a strong need for intervention research in the field of work, stress, performance, and health. The results could reveal (1 how interventions can be tailored to optimize job resources and recovery opportunities, in order to counteract job demands, and (2 what the effects of these interventions will be on health, well-being, and performance of nursing staff.

  2. The prevalence, incidence and risk factors for delirium in Dutch nursing homes and residential care homes

    NARCIS (Netherlands)

    Boorsma, M.; Joling, K.J.; Frijters, D.H.M.; Ribbe, M.W.; Nijpels, G.; van Hout, H.P.J.

    2012-01-01

    Objective To estimate and compare the prevalence and incidence of delirium and its risk factors in residents of Dutch nursing homes and residential care homes. Methods Data were extracted from the Long-Term Care Facility (inter RAI-LTCF) version of the Resident Assessment Instrument, which was

  3. The incidence of depression and its risk factors in Dutch nursing homes and residential care homes

    NARCIS (Netherlands)

    Boorsma, M.; Joling, K.J.; Dussel, M.; Ribbe, M.W.; Frijters, D.H.M.; van Marwijk, H.W.J.; Nijpels, G.; van Hout, H.P.J.

    2012-01-01

    Objective: Although it is known that depression is highly prevalent in institutionalized older adults, little is known about its incidence and risk factors in nursing homes and residential care homes. The aim of this study was to investigate and compare the incidence and associated risk factors for

  4. Racial Segregation and Quality of Care Disparity in US Nursing Homes

    Science.gov (United States)

    Rahman, Momotazur; Foster, Andrew D.

    2014-01-01

    In this paper we examine the contributions of travel distance and preferences for racial homogeneity as sources of nursing home segregation and racial disparities in nursing home quality. We first theoretically characterize the distinctive implications of these mechanisms for nursing home racial segregation. We then use this model to structure an empirical analysis of nursing home sorting. We find little evidence of differential willingness to pay for quality by race among first-time nursing home entrants, but do find significant distance and race-based preference effects. Simulation exercises suggest that both effects contribute importantly to racial disparities in nursing home quality. PMID:25461895

  5. Racial segregation and quality of care disparity in US nursing homes.

    Science.gov (United States)

    Rahman, Momotazur; Foster, Andrew D

    2015-01-01

    In this paper, we examine the contributions of travel distance and preferences for racial homogeneity as sources of nursing home segregation and racial disparities in nursing home quality. We first theoretically characterize the distinctive implications of these mechanisms for nursing home racial segregation. We then use this model to structure an empirical analysis of nursing home sorting. We find little evidence of differential willingness to pay for quality by race among first-time nursing home entrants, but do find significant distance and race-based preference effects. Simulation exercises suggest that both effects contribute importantly to racial disparities in nursing home quality. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Proud to be a nurse? Recently graduated nurses' experiences in municipal health care settings.

    Science.gov (United States)

    Sneltvedt, Torild; Bondas, Terese

    2016-09-01

    Recently graduated nurses are the future of the nursing profession and the municipal health care that will need nursing competency for an increasing number of frail elderly persons. This study is part of a larger project on newly graduated nurses where previous research indicated that building professional pride at their workplace could be important for remaining in the profession and in municipal health care. However, the recently graduated nurse's first job assignment in municipal health care can also be a critical period with cuts in their pride as nurses who may have an impact on nursing care for their patients. The aim of this study is to illuminate recently graduated nurses' experiences with professional pride in municipal health and care services. A phenomenological hermeneutic approach was chosen to illuminate meaning. A purposive sample of eight recently graduated nurses working in nursing homes or home health care was chosen for this study with narrative interviews and diaries. Three themes were identified: doing the good thing and doing what is right; being recognized and confirmed; and finally thriving in a community of practice. An important source of pride is the relation to patients. Recently graduated nurses build their professional pride in an active and social process in a community of practice. The first cut in their professional pride seems to take place when they were not recognized and confirmed as professional persons. Recently graduated nurses in municipal health care describe their professional pride as a complex phenomenon with relational, dynamic and collective dimensions. The cuts in their pride may hurt their identity and nursing care. © 2015 Nordic College of Caring Science.

  7. Polypharmacy and Renal Failure in Nursing Home Residents: Results of the Inappropriate Medication in Patients with Renal Insufficiency in Nursing Homes (IMREN) Study.

    Science.gov (United States)

    Dörks, Michael; Herget-Rosenthal, Stefan; Schmiemann, Guido; Hoffmann, Falk

    2016-01-01

    Polypharmacy has become an emerging public health issue in recent years, since use of multiple medications or polypharmacy is beneficial for many conditions, but may also have negative effects like adverse drug reactions. The risk further increases in patients with chronic renal failure, a comorbidity very frequent in nursing home residents. Since more than 50% of all drugs were renally excreted, dose adjustments in patients with renal failure are required. To assess polypharmacy in German nursing homes, in particular in residents with renal failure. Multi-center cross-sectional study in 21 nursing homes in Bremen and Lower Saxony/Germany. Baseline data were analysed using descriptive statistics. Multivariable logistic regression model and 95% confidence intervals were used to study the association of renal failure and polypharmacy. Of all 852 residents, the analysis comprised those 685 with at least one serum creatinine value so that the estimated creatinine clearance could be calculated. Of those, 436 (63.6%) had a severe or moderate renal failure, defined as estimated creatinine clearance renal failure (estimated creatinine clearance renal failure are common in German nursing home residents and an association of both could be found. Further studies are needed to assess the appropriateness of polypharmacy in these patients.

  8. Geographic Disparities in Access to Nursing Home Services: Assessing Fiscal Stress and Quality of Care.

    Science.gov (United States)

    Park, Young Joo; Martin, Erika G

    2017-11-12

    We test whether nursing homes serving predominately low-income and racial minority residents (compositional explanation) or located in neighborhoods with higher concentrations of low-income and racial minority residents (contextual explanation) have worse financial outcomes and care quality. Healthcare Cost Report Information System, Nursing Home Compare, Online Survey Certification and Reporting Certification, and American Community Survey. A cross-sectional study design of nursing homes within U.S. metropolitan areas. Data were obtained from Centers for Medicare & Medicaid Services and U.S. Census Bureau. Medicaid-dependent nursing homes have a 3.5 percentage point lower operating ratio. Those serving primarily racial minorities have a 2.64-point lower quality rating. A 1 percent increase in the neighborhood population living in poverty is associated with a 1.20-point lower quality rating, on a scale from 10 to 50, and a 1 percent increase in the portion of neighborhood black residents is associated with a 0.8 percentage point lower operating ratio and a 0.37 lower quality rating. Medicaid dependency (compositional effect) and concentration of racial minority residents in neighborhoods (contextual effect) are associated with higher fiscal stress and lower quality of care, indicating that nursing homes' geographic location may exacerbate long-term care inequalities. © Health Research and Educational Trust.

  9. Maximizing federal Medicaid dollars: nursing home provider tax adoption, 2000-2004.

    Science.gov (United States)

    Miller, Edward Alan; Wang, Lili

    2009-12-01

    Since Medicaid is jointly financed by the federal and state governments, state officials have sought to offset state expenditures by maximizing federal contributions. One such strategy is to adopt a provider tax, which enables states to collect revenues from providers; those revenues are then used to pay for services rendered to Medicaid recipients, thereby leveraging federal matching dollars without concomitant increases in state expenditures. The number of states adopting a nursing home tax increased from thirteen to thirty-one between 2000 and 2004. This study seeks to identify the factors that spurred the rapid increase in nursing home provider taxes following implementation of the Balanced Budget Act of 1997. Results indicate that states with more powerful nursing home lobbies, lower proportions of private pay nursing home residents, worse fiscal health, weaker fiscal capacity, broader Medicaid eligibility, and nursing home supply restrictions were more likely to adopt. This implies that state officials react rationally to prevailing fiscal and programmatic circumstances when formulating policy under Medicaid and that providers seek relief, in part, from the adverse fiscal consequences of federal policy changes by promoting policy change at the state level.

  10. Content analysis of public opinion on sexual expression and dementia: Implications for nursing home policy development.

    Science.gov (United States)

    Syme, Maggie L; Yelland, Erin; Cornelison, Laci; Poey, Judith L; Krajicek, Ryan; Doll, Gayle

    2017-08-01

    We examined public opinion of sexual expression and dementia to inform nursing home policy and practice. A content analysis was conducted on public comments (N=1194) posted in response to a New York Times article about a highly publicized legal case involving a husband engaging in sexual acts with his wife who had dementia, living in a nursing home. Researchers utilized constant comparative analysis to code the comments; reliability analysis showed moderately strong agreement at the subcategory level. Data were also coded to indicate whether the commenter thought the couple should or should not have been allowed to be sexual. One primary theme was identified: conditions necessary for someone to be sexual. Six categories were identified within this theme, with the public commentary considering factors such as marital relationships, intimacy needs and several sexual consent-related issues as key conditions necessary to be sexual in a nursing home setting. Overall, the majority of commenters were in support of sexual expression for an individual with dementia in the described situation. This study revealed sexual expression among individuals with dementia is a contentious issue with strong public opinions about how this should be managed in a nursing home setting. These opinions should be considered as policy related to sexual expression in nursing homes is developed. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  11. Affective Organizational Commitment in Swiss Nursing Homes: A Cross-Sectional Study.

    Science.gov (United States)

    Graf, Elisabeth; Cignacco, Eva; Zimmermann, Karin; Zúñiga, Franziska

    2016-12-01

    This substudy of the Swiss Nursing Homes Human Resources Project (SHURP) explored the relationships between affective organizational commitment (AOC) levels and organizational, situational, and care personnel characteristics, and between AOC and care personnel outcomes. SHURP was a representative national cross-sectional study in 163 Swiss nursing homes. Its data sources were: (a) a care personnel questionnaire, (b) a facility questionnaire, (c) a unit questionnaire, and (d) administrative resident data. Generalized estimating equations (GEEs) were applied to examine AOC's relationships with selected antecedents and care personnel outcomes. Data were collected from 5,323 care personnel in 163 nursing homes (return rate: 76%). On a scale from 1 to 5, the mean level of AOC was 3.86 (standard deviation = 0.81). Variations in AOC regarding care personnel characteristics (age, education, and experience in nursing home) and organizational characteristics (size, profit status) were statistically significant with minimal effect sizes. The main factors positively related to AOC were leadership, job satisfaction, quality of care, and collaboration with the nursing home director. Care personnel outcomes significantly related to higher AOC were reduced intention to leave, health complaints, presenteeism, and absenteeism. As leadership is a crucial factor of AOC, its development might improve care personnel outcomes such as intention to leave or absenteeism. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. [Facilitators and barriers regarding end of life care at nursing homes: A focus group study].

    Science.gov (United States)

    Sánchez-García, María Remedios; Moreno-Rodríguez, Marina; Hueso-Montoro, César; Campos-Calderón, Concepción; Varella-Safont, Ana; Montoya-Juárez, Rafael

    2017-05-01

    To identify the facilitators and barriers experienced by professional related to end of life care in nursing homes. Descriptive qualitative research with phenomenological orientation, through content analysis. Nursing Homes at Primary Care District in Granada (Spain). Fifteen clinical professionals with, at least 6 months of experience in nursing homes, without specific background in palliative care. Three focus groups were undertaken with professionals of different disciplines and nursing homes. Interviews were recorded and transcribed literally. An open and axial coding was performed to identify relevant categories. Professionals identified difficulties in the communication with families related to relatives' feelings of guilt, difficulty in understanding the deterioration of their relative, and addressing too late the issue of death. Regarding decision making, professionals recognized that they do not encourage participation of patients. Advance directives are valued as a necessary tool, but they do not contemplate implementing them systematically. Other difficulties that professionals highlighted are lack of coordination with other professionals, related to misunderstanding of patients' needs, as well as lack of training, and lack of material and human resources. Facilitators include relationships with primary care teams. It is necessary to improve communication among nursing homes professionals, families, patients and other health workers. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  13. [Outpatient emergency treatment of nursing home residents : Analysis of insurance claims data].

    Science.gov (United States)

    Seeger, Insa; Luque Ramos, Andres; Hoffmann, Falk

    2017-07-14

    Utilization of outpatient emergency services by nursing home residents is increasing; however, out of hours medical care (OOHC) in Germany has not yet been studied. In Bremen the used billing codes enabled a comparison between the use of outpatient emergency care in the year before and the year after admission to a nursing home stratified by emergency departments and OOHC. In this retrospective cohort study we used insurance claims data of residents in Bremen, who were insured in a large German statutory health insurance (DAK-Gesundheit). We compared the use of emergency care in hospitals or OOHC practices in the year before and the year after admission to a nursing home. The incidence rates of visits, distribution on weekdays and coded diagnoses were investigated. We included 1175 nursing home residents (77% female) with a mean age of 85 years. After admission to a nursing home the incidence rate of visits in the OOHC practices increased from 30.4 up to 63.7 and in emergency departments (ED) from 27.4 up to 50.7 per 100 person years. A total of 59% of all visits in OOHC practices were on weekends. The most common diagnoses in ED were injuries and poisoning (75%) while a wide range of diagnoses were coded in the OOHC practices. There is a significant difference between diagnoses in the ED and OOHC practices. More research is needed to assess the appropriateness of care.

  14. Nursing delegation. Implications for home care.

    Science.gov (United States)

    Moll, Janet A; Tripp, Emily

    2002-09-01

    Consumers are advocating for client-directed care and are influencing legislation that regulates delegation within nurse practice acts. Almost 18 months ago, the Visiting Nurse Association of Texas implemented the delegation of insulin administration for appropriate patients. Results indicate that the program is a success and the time invested in developing the program was well spent.

  15. St Paul's Nursing Home, Dooradoyle, Limerick.

    LENUS (Irish Health Repository)

    Sermeus, Walter

    2011-04-18

    Abstract Background Current human resources planning models in nursing are unreliable and ineffective as they consider volumes, but ignore effects on quality in patient care. The project RN4CAST aims innovative forecasting methods by addressing not only volumes, but quality of nursing staff as well as quality of patient care. Methods\\/Design A multi-country, multilevel cross-sectional design is used to obtain important unmeasured factors in forecasting models including how features of hospital work environments impact on nurse recruitment, retention and patient outcomes. In each of the 12 participating European countries, at least 30 general acute hospitals were sampled. Data are gathered via four data sources (nurse, patient and organizational surveys and via routinely collected hospital discharge data). All staff nurses of a random selection of medical and surgical units (at least 2 per hospital) were surveyed. The nurse survey has the purpose to measure the experiences of nurses on their job (e.g. job satisfaction, burnout) as well as to allow the creation of aggregated hospital level measures of staffing and working conditions. The patient survey is organized in a sub-sample of countries and hospitals using a one-day census approach to measure the patient experiences with medical and nursing care. In addition to conducting a patient survey, hospital discharge abstract datasets will be used to calculate additional patient outcomes like in-hospital mortality and failure-to-rescue. Via the organizational survey, information about the organizational profile (e.g. bed size, types of technology available, teaching status) is collected to control the analyses for institutional differences. This information will be linked via common identifiers and the relationships between different aspects of the nursing work environment and patient and nurse outcomes will be studied by using multilevel regression type analyses. These results will be used to simulate the impact of

  16. Delirium during acute illness in nursing home residents.

    Science.gov (United States)

    Boockvar, Kenneth; Signor, Daniel; Ramaswamy, Ravishankar; Hung, William

    2013-09-01

    To ascertain the incidence of delirium during acute illness in nursing home residents, describe the timing of delirium after acute illness onset, describe risk factors for delirium, and explore the relationship between delirium and complications of acute illness. Prospective observational cohort study. Three nursing homes in metropolitan New York. Individuals who were expected to remain in the nursing home for at least 2 months, who, as part of a parent study, were receiving opioids, antidepressants, or antipsychotics on a routine basis, and who did not have an acute medical illness at the time of screening. Acute illness surveillance was performed twice weekly through communication with nursing home nursing staff and medical providers using established clinical criteria for incipient cases. We followed patients for 14 days after illness onset, and, if applicable, an additional 14 days each after hospital admission and hospital discharge. Delirium was assessed 3 times weekly using the Confusion Assessment Method (CAM). Physical function decline was calculated using change in the Minimum Data Set Activities of Daily Living Scale (MDS-ADL) and cognitive function decline using change in the Minimum Data Set Cognitive performance scale (MDS-CPS). Falls were ascertained by record review. Among 136 nursing home patients followed for a mean of 11.7 months, 78 experienced 232 acute illnesses, of which 162 (71%) were managed in the nursing home. The most common diagnoses were urinary tract infection (20%), cellulitis (15%), and lower respiratory tract infection (9%). Subjects experienced delirium during 41 (17.7%) of 232 acute illnesses. Female sex was associated with a greater risk of delirium (odds ratio 2.59; 95% confidence interval [CI] 1.04-6.43) but there were no other risk factors identified. Delirium was a risk factor for cognitive function decline (odds ratio 4.59; 95% CI 1.99-10.59; P = .0004), but not ADL function decline or falling. Delirium occurred frequently

  17. Results of a 29-state survey of tuberculosis in nursing homes and correctional facilities.

    OpenAIRE

    Hutton, M D; Cauthen, G M; Bloch, A B

    1993-01-01

    A survey of the 15,379 cases of tuberculosis reported to the Centers for Disease Control and Prevention by 29 State health departments in 1984 and 1985 revealed that 7.7 percent of the victims older than age 64 were living in a nursing home at the time of diagnosis and 1.8 percent between the ages of 15 and 64 were living in a correctional institution at the time of diagnosis. Incidence rates of tuberculosis for residents of nursing homes and for inmates of Federal and State prisons and local...

  18. Representing public health nursing intervention concepts with HHCC and NIC.

    Science.gov (United States)

    Lee, Nam-Ju; Bakken, Suzanne; Saba, Virginia

    2004-01-01

    It is imperative that public health nurses define their services and provide evidence supporting the effectiveness of interventions. The purpose of this paper is to examine the ex-tent to which two standardized nursing terminologies--Home Health Care Classification (HHCC) and Nursing Interventions Classification (NIC)--represent public health nursing practice according to core public health function in Public Health Nursing Intervention model. First, we divided all HHCC and NIC interventions into intervention focus levels: individual/family-focused, community-focused, and system-focused. Second, we categorized HHCC and NIC interventions according to core public health functions: assessment, policy development, and assurance and the categories of interventions in the PHI Model. We identified HHCC and NIC Nursing interventions that represented public health nursing concepts across core public health functions and categories of the PHI model. Analysis of the findings demonstrated that HHCC and NIC have terms for the concepts in the PHI model. Although HHCC and NIC cover many concepts in public health nursing practice, additional research is needed to extend these terminologies and to evaluate other standardized terminologies that can reflect more comprehensively public health nursing interventions.

  19. Medicare Home Health Services: A Difficult Program to Control

    Science.gov (United States)

    1981-09-25

    second only to skilled nursing visits at 55.7 percent. Physical therapy visits were a distant third at 10.0 per- cent. The growth in the use of home health...from their parents. Thire are several methods available to measure the ability of an inividual to care for him or herself. For example, the Duke

  20. 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

  1. 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.

  2. Barriers in Transitioning Patients With Severe Obesity From Hospitals to Nursing Homes.

    Science.gov (United States)

    Bradway, Christine; Felix, Holly C; Whitfield, Tonya; Li, Xiaocong

    2017-08-01

    This cross-sectional, descriptive study explored perspectives of discharge planners regarding transitions of hospitalized patients who are severely obese seeking discharge to a nursing home. Attention has been focused on care transitions regarding high hospital readmission rates, yet specific needs of patients who are severely obese have been largely overlooked. Ninety-seven (response rate 39.8%) discharge planners returned surveys addressing frequency of, and issues encountered when, arranging placements. Community and hospital characteristics were also collected. One third of the respondents from Pennsylvania and Arkansas reported inability to transfer patients; barriers included reimbursement, staffing, and equipment. Respondents perceiving nursing homes to have equipment concerns were nearly 7 times more likely to report patient size as a barrier ( p = .001). Given increasing obesity rates, health care delivery systems must be prepared to provide necessary resources and all levels of care, including transitions for hospitalized patients who are severely obese needing nursing home care post-discharge.

  3. Perceptions of nurses in nursing homes on the usage of benzodiazepines.

    Science.gov (United States)

    Anthierens, Sibyl; Grypdonck, Mieke; De Pauw, Liesbeth; Christiaens, Thierry

    2009-11-01

    This paper reports the findings of a qualitative study on how nurses perceive their own role in the use of benzodiazepines in nursing homes and to identify the factors that have an impact on the nurses' role in the use of benzodiazepines. The use of benzodiazepines in nursing homes is of particular concern, as nursing-home residents receive considerably more benzodiazepines than non-institutionalised older persons. Evidence of their long-term effectiveness is lacking. Nurses are important partners in the decision-making process of starting and discontinuation of benzodiazepines. Qualitative descriptive. Three focus group interviews and 10 additional semi-structured interviews were used with 33 registered nurses. The interviews were thematically analysed. Nurses' main concern is to work towards the comfort of the patient. Benzodiazepines are an easy option with not too many side effects and administration of benzodiazepines is experienced as a routine action. When prescribed they will almost automatically lead to chronic usage as there is no evaluation of their effect. There are three aspects that have an impact on nurse's perceptions of their role in benzodiazepine usage: their own individual attitude and perceptions, their knowledge and organisational factors. Nurses do not see benzodiazepines as a problem drug and once a prescription is initiated it will almost automatically lead to chronic usage. Nurses should work towards a pro-active promotion of addressing sleeping problems and they can play a key role in non-pharmacological interventions. Nurses can play a key role in suggesting non-pharmacological alternatives. Education to provide more insight into the problems of insomnia and anxiety may positively influence their attitudes and behaviour. All caregivers in nursing homes should be informed about the relevance of this issue.

  4. Staffing subsidies and the quality of care in nursing homes.

    Science.gov (United States)

    Foster, Andrew D; Lee, Yong Suk

    2015-05-01

    Concerns about the quality of state-financed nursing home care has led to the wide-scale adoption by states of pass-through subsidies, in which Medicaid reimbursement rates are directly tied to staffing expenditure. We examine the effects of Medicaid pass-through on nursing home staffing and quality of care by adapting a two-step FGLS method that addresses clustering and state-level temporal autocorrelation. We find that pass-through subsidies increases staffing by about 1% on average and 2.7% in nursing homes with a low share of Medicaid patients. Furthermore, pass-through subsidies reduce the incidences of pressure ulcer worsening by about 0.9%. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Snoezelen activity: the Good Shepherd Nursing Home experience.

    Science.gov (United States)

    Minner, De; Hoffstetter, Patty; Casey, Linda; Jones, Delores

    2004-01-01

    Care of the resident with dementia can be both challenging and unpredictable. Activities provided for nursing home residents often have rules and may be a source of frustration for residents with advancing dementia. Snoezelen, or multisensory therapy, offers a failure-free activity in an enabling environment that can both stimulate and relax the resident with dementia. Good Shepherd Nursing Home in Versailles, Mo, undertook a 1-year outcome-based quality improvement project to find if use of Snoezelen therapy could reduce the number of behavioral symptoms that residents were suffering from. While there are still barriers to the use Snoezelen therapy, employees at Good Shepherd Nursing Home believe that the use of Snoezelen therapy has been a successful and rewarding experience for both residents and staff members.

  6. [A Long Way Home: The Current State of Care Provided by Family Caregivers and Public Health Nurses to Persons With Mental Illness in the Community].

    Science.gov (United States)

    Huang, Yu-Chu; Wang, Yu-Hui

    2015-08-01

    According to Taiwan's Health and Welfare Ministry statistics, Taiwan had a total of 122,538 people who were officially registered as mentally disabled at the end of December 2013. Worldwide, schizophrenia ranks as the sixth most burdensome disease in terms of total expenditures. The present paper uses the two actual care stories of the families of mental illness patients and compares and contrasts these with the community mental illness care models used in other countries. The hospital-based psychiatric and community-based mental illness care that is practiced in Taiwan presents dilemmas and has long focused on "disease-orientated care" rather than holistic care. The gap between institutional and community mental rehabilitation services in Taiwan are examined. We recommend that policy makers create an open space for mental illness family caregivers and public health nurses to engage in dialogue in order to effectively integrate the care resources available to community mental illness patients and to break down the care barriers that currently separate community mental illness patients, family caregivers, and public health nurses.

  7. Factors associated with the quality of life of nursing home residents in Hong Kong.

    Science.gov (United States)

    Lai, C K Y; Leung, D D M; Kwong, E W Y; Lee, R L P

    2015-03-01

    The quality of life of nursing home residents has increasingly become an important dimension when evaluating care in a nursing home. Not a lot is known about the quality of life of nursing home residents in Hong Kong. To investigate factors associated with the quality of life of