Science.gov

Sample records for aged care staff

  1. School Age Child Care Staff Training Evaluation.

    ERIC Educational Resources Information Center

    Gore, Jane S.; And Others

    A formative and summative evaluation was made of eight school-age child care (SACC) training workshops conducted in 1989-90 for 190 participants in upstate New York. (The focus of the SACC workshops was to "train the trainers," as well as to provide trainees with quality materials and instruction for future training with their staff members.) All…

  2. Intentions to Quit Work among Care Staff Working in the Aged Care Sector

    ERIC Educational Resources Information Center

    Karantzas, Gery C.; Mellor, David; McCabe, Marita P.; Davison, Tanya E.; Beaton, Paul; Mrkic, Dejan

    2012-01-01

    Purpose of the Study: The aged care industry experiences high rates of staff turnover. Staff turnover has significant implications for the quality of care provided to care recipients and the financial costs to care agencies. In this study, we applied a model of intention to quit to identify the contextual and personal factors that shape aged care…

  3. 'We're in the sandwich': Aged care staff members' negotiation of constraints and the role of the organisation in enacting and supporting an ethic of care.

    PubMed

    Petriwskyj, Andrea; Gibson, Alexandra; Webby, Glenys

    2015-12-01

    Aged care staff are often seen as holding power in care relationships, particularly in client engagement. Such a perception, however, may limit our understanding and analysis of the dynamics and politics within care spaces. This paper uses interview and focus group data from both staff and clients of an Australian aged care provider to identify the positions given to, and taken up by, staff in client engagement. Focusing on one of these positions, in which staff are seen as managing and negotiating constraints, the paper uses an ethic of care lens to examine the context in which engagement - and this position taking - occurs. Findings reflect the importance of the organisational and systemic context to the practice of care ethics and the potential vulnerability and disempowerment of care giving staff. Implications for the support of staff in client engagement and the role of care organisations beyond structures and processes to an active participant in an ethic of care are discussed. PMID:26568218

  4. Effects of person-centered care on residents and staff in aged-care facilities: a systematic review

    PubMed Central

    Brownie, Sonya; Nancarrow, Susan

    2013-01-01

    Background Several residential aged-care facilities have replaced the institutional model of care to one that accepts person-centered care as the guiding standard of practice. This culture change is impacting the provision of aged-care services around the world. This systematic review evaluates the evidence for an impact of person-centered interventions on aged-care residents and nursing staff. Methods We searched Medline, Cinahl, Academic Search Premier, Scopus, Proquest, and Expanded Academic ASAP databases for studies published between January 1995 and October 2012, using subject headings and free-text search terms (in UK and US English spelling) including person-centered care, patient-centered care, resident-oriented care, Eden Alternative, Green House model, Wellspring model, long-term care, and nursing homes. Results The search identified 323 potentially relevant articles. Once duplicates were removed, 146 were screened for inclusion in this review; 21 were assessed for methodological quality, resulting in nine articles (seven studies) that met our inclusion criteria. There was only one randomized, controlled trial. The majority of studies were quasi-experimental pre-post test designs, with a control group (n = 4). The studies in this review incorporated a range of different outcome measures (ie, dependent variables) to evaluate the impact of person-centered interventions on aged-care residents and staff. One person-centered intervention, ie, the Eden Alternative, was associated with significant improvements in residents’ levels of boredom and helplessness. In contrast, facility-specific person-centered interventions were found to impact nurses’ sense of job satisfaction and their capacity to meet the individual needs of residents in a positive way. Two studies found that person-centered care was actually associated with an increased risk of falls. The findings from this review need to be interpreted cautiously due to limitations in study designs and the

  5. Exploratory Investigation of Communication Management in Residential-Aged Care: A Comparison of Staff Knowledge, Documentation and Observed Resident-Staff Communication

    ERIC Educational Resources Information Center

    Bennett, Michelle K.; Ward, Elizabeth C.; Scarinci, Nerina A.

    2016-01-01

    Background: There is a high prevalence of communication difficulty among older people living in residential-aged care. Such functional deficits can have a negative impact on resident quality of life, staff workplace satisfaction and the provision of quality care. Systematic research investigating the nature of communication management in…

  6. Quality Care for School-Age Children: A Self-Instructional Guide To Help Staff Plan and Implement a Quality Program for School-Age Children.

    ERIC Educational Resources Information Center

    Childcare Resources, Birmingham, AL.

    The purpose of this manual is to provide school-age child care center staff in Alabama with information about school-age children that facilitates program planning and provides a basis for implementing and evaluating a high quality school-age child care (SACC) program. Sections of the manual discuss: (1) teacher competencies addressed by the…

  7. Validating a Marking Rubric for Evaluating Staff Knowledge of Dementia for Competency in Residential Aged Care

    ERIC Educational Resources Information Center

    Aberdeen, Suzanne M.; Leggat, Sandra G.; Barraclough, Simon

    2009-01-01

    The shift to Vocational Education and Training (VET) for the training of the Australian residential aged care workforce has resulted in significant variance in the competencies at graduation of those caring for people with dementia. Competence may be also be enhanced, or conversely, decline over time as a result of implicit learning gained from…

  8. Quality Control in Child Care Staff Selection

    ERIC Educational Resources Information Center

    Crow, Merwin R.

    1975-01-01

    This paper focuses on the process of staff selection of child care staff at a residential treatment center for children, ages 8-16. Phases of candidate selection, an "open-door" interview procedure, the orientation of hired candidates and the agency's philosophy, procedures and practices are discussed. (GO)

  9. Staff supervision in residential care.

    PubMed

    Myers, Peter G; Bibbs, Tonya; Orozco, Candy

    2004-04-01

    Residential care workers must be offered opportunities for formalized and systematic supervision in individual and group formats to provide the highest possible level of care to children and adolescents whom they serve. Effective supervision with residential care staff should be open to exploring issues at all levels of their experience and in relation to each component of the broader organizational structure within which they work. Systems theory offers a useful lens through which to view supervising staff in residential treatment. Systems theory proposes that human behavior is shaped by interactional processes and internal factors. Although the development of the individual occurs within intrinsic cognitive and emotional spheres, it also is believed to be related to several other elements. These additional variables include the point at which the family and system function in their own life cycle, the historical and current emotional context, the current and changing structure of the system, narratives, and the cultural context. This article discussed how methods of training and supervision would be most effective if they were designed specifically for the developmental level of the participants. Some literature reviews have concluded that youth care workers, like all professionals, pass through developmental stages and progress through them in their work. To assist youth care workers in their jobs, supervisors must understand these stages and the ways in which they may be enacted in the workplace. PMID:15062348

  10. "We Have to Work Within the System!": Staff Perceptions of Organizational Barriers to Decision Making for Older Adults With Dementia in Australian Aged Care Facilities.

    PubMed

    Tarzia, Laura; Fetherstonhaugh, Deirdre; Bauer, Michael; Beattie, Elizabeth; Nay, Rhonda

    2015-01-01

    The current study explored the perceptions of direct care staff working in Australian residential aged care facilities (RACFs) regarding the organizational barriers that they believe prevent them from facilitating decision making for individuals with dementia. Normalization process theory (NPT) was used to interpret the findings to understand these barriers in a broader context. The qualitative study involved semi-structured interviews (N = 41) and focus groups (N = 8) with 80 direct care staff members of all levels working in Australian RACFs. Data collection and analysis were conducted in parallel and followed a systematic, inductive approach in line with grounded theory. The perceptions of participants regarding the organizational barriers to facilitating decision making for individuals with dementia can be described by the core category, Working Within the System, and three sub-themes: (a) finding time, (b) competing rights, and (c) not knowing. Examining the views of direct care staff through the lens of NPT allows possible areas for improvement to be identified at an organizational level and the perceived barriers to be understood in the context of promoting normalization of decision making for individuals with dementia. PMID:25975346

  11. Staff Reactions Toward Lesbian, Gay, or Bisexual (LGB) People Living in Residential Aged Care Facilities (RACFs) Who Actively Disclose Their Sexual Orientation.

    PubMed

    Villar, Feliciano; Serrat, Rodrigo; Fabà, Josep; Celdrán, Montserrat

    2015-01-01

    Fifty-three staff members currently working in residential aged care facilities located in Barcelona, Spain, were asked about the way they would react if a resident told them that he or she felt sexually attracted and had maintained sexual relationships with another resident of the same gender. Acceptance of non-heterosexual sexual orientation was a frequent answer, and around one in four professionals stated that they would try helping the resident in question, by offering a private space or giving some emotional support. However, some reactions were not consistent with a respectful approach toward sexual diversity, as, for instance, informing the resident's family or advising the resident to keep his or her sexual orientation hidden. We highlight the importance of developing formal policies and offering formal training to staff in order to address the specific needs of older LGB people living in RACFs. PMID:25710604

  12. The Quality of Life of Palliative Care Staff: A Personal Construct Approach.

    ERIC Educational Resources Information Center

    Viney, Linda L.; And Others

    1994-01-01

    Compared palliative care staff with staff from burn and neonatal units and with mature age general nursing trainees at end of training. Found that palliative care staff expressed better quality of life, in terms of significantly less anxiety and depression, as well as more good feelings than other staff groups. (Author/NB)

  13. 'I give staff time to care'.

    PubMed

    Lomas, Clare

    Flo Panel-Coates is working to improve care at a heavily criticised NHS trust. Since taking on the director of nursing post in October 2012, she has secured more support for ward leaders, giving them time to do their job, improved the skill mix of staff, and cut senior nurses' paperwork. Ensuring staff work consistently to the highest standard is the NHS's biggest challenge, she says. PMID:23905257

  14. Day Care for School-Agers: A Program for School-Agers, Parents, and Day Care Staff.

    ERIC Educational Resources Information Center

    Browne, Gayle, Comp.

    Activities for school age day care programs are presented in detail in this guide for children, parents, and day care staff. The guide consists of 14 illustrated booklets that provide activity instructions and some background information. Topics are: (1) functions of school age day care; (2) quiet and active games and materials; (3) toys and play…

  15. The palliative care needs of ethnic minority patients: staff perspectives.

    PubMed

    Diver, Fiona; Molassiotis, Alexander; Weeks, Les

    2003-08-01

    The aim of this study was to assess palliative care staff's perceptions of multicultural care provision and explore the barriers and facilitators to culturally sensitive care. Qualitative semi-structured interviews with five palliative care staff were conducted. Staff showed awareness of inter-cultural diversity and the importance of individualized care. It also became apparent that staff did not possess ethnocentric attitudes. Facilitators of multicultural care that emerged from the data included training, learning from experience, the use of culturally specific literature and resources, and effective communication channels in the team. However, barriers were present, including limited interpreting services, and some staff and other patients' negative behaviours towards ethnic minority patients. The findings lead to recommendations for better resourcing and expansion of interpreting services, and for more training, based on staff's desire for limited culturally specific knowledge in sensitive combination with an individualized care philosophy. PMID:12968120

  16. Staff-Resident Perceptual Differences in Long-Term Care Settings.

    ERIC Educational Resources Information Center

    Smith, Gregory C.; Nehrke, Milton F.

    Staff and residents of settings for the aged often hold substantially different views of their shared environment, and the literature suggests that these perceptual discrepancies transcend such factors as degree of institutional totality, quality of care, and differences in personal characteristics among staff and residents. Despite the…

  17. Assisted living facility administrator and direct care staff views of resident mental health concerns and staff training needs.

    PubMed

    Dakin, Emily; Quijano, Louise M; McAlister, Courtney

    2011-01-01

    This community needs assessment surveyed 21 administrators and 75 direct care staff at 9 larger and 12 smaller assisted living facilities (ALFs) regarding perceptions of resident mental health concerns, direct care staff capacity to work with residents with mental illness, and direct care staff training needs. Group differences in these perceptions were also examined. Both administrators and directcare staff indicated that direct care staff would benefit from mental health-related training, and direct care staff perceived themselves as being more comfortable working with residents with mental illness than administrators perceived them to be. Implications for gerontological social work are discussed. PMID:21170779

  18. Child Care Staff Working Conditions Project: Summary of the Project.

    ERIC Educational Resources Information Center

    Modigliani, Kathy; And Others

    The goals of the Working Conditions Project were to collect information about child care center staff members and administration in Washtenaw County, Michigan; to identify sources of job satisfaction; and to report administrative practices associated with high commitment to a center by its staff. Results showed that more than 75 percent of the…

  19. Improving patients' and staff's experiences of acute care.

    PubMed

    Chaplin, Rob; Crawshaw, Jacob; Hood, Chloe

    2015-03-01

    The aim of this audit was to assess the effect of the Quality Mark programme on the quality of acute care received by older patients by comparing the experiences of staff and older adults before and after the programme. Data from 31 wards in 12 acute hospitals were collected over two stages. Patients and staff completed questionnaires on the perceived quality of care on the ward. Patients rated improved experiences of nutrition, staff availability and dignity. Staff received an increase in training and reported better access to support, increased time and skill to deliver care and improved morale, leadership and teamwork. Problems remained with ward comfort and mealtimes. Overall, results indicated an improvement in ratings of care quality in most domains during Quality Mark data collection. Further audits need to explore ways of improving ward comfort and mealtime experience. PMID:25727634

  20. [Burnout among elderly care staff. A review of its prevalence].

    PubMed

    Nienhaus, A; Westermann, C; Kuhnert, S

    2012-02-01

    Provision of inpatient elderly care is characterized by factors that favor the onset of burnout, with psychosomatic complaints, a drop in performance, periods of absence due to sickness, and early retirement from the sector regularly being observed in this respect. This study summarizes the research of the past 11 years, regarding the prevalence of burnout among inpatient elderly care employees. A total of 24 studies were identified during a systematic database search conducted in May 2011. As the studies conceptualize burnout differently and are based on different survey tools, it is not possible to draw a clear conclusion regarding its prevalence. There is empirical evidence of a correlation between burnout and the care staff/patient ratio, workloads, the freedom to make decisions, job satisfaction, and neuroticism. There is no confirmation of a correlation between burnout and marital status, income, or shift work. There are contradictory findings regarding the correlation between burnout and sociodemographic aspects (e.g., age and gender) as well as burnout and the type of care institution, working hours, and violence perpetrated by patients. PMID:22290165

  1. Fostering Humane Care of Dying Persons in Long-Term Care. Guidebook for Staff Development Instructors.

    ERIC Educational Resources Information Center

    Wilson, Sarah A.; Daley, Barbara

    This guide is intended for staff development instructors responsible for inservice education on the topic of fostering humane care for dying persons in long-term care. The introduction discusses the guide's development based on input from administrators, staff, and families of residents in long-term care facilities and focus group interviews in…

  2. Practice of preventive dentistry for nursing staff in primary care

    PubMed Central

    Acuña-Reyes, Raquel; Cigarroa-Martínez, Didier; Ureña-Bogarín, Enrique; Orgaz-Fernández, Jose David

    2014-01-01

    Objectives: Determine the domain of preventive dentistry in nursing personnel assigned to a primary care unit. Methods: Prospective descriptive study, questionnaire validation, and prevalence study. In the first stage, the questionnaire for the practice of preventive dentistry (CPEP, for the term in Spanish) was validated; consistency and reliability were measured by Cronbach's alpha, Pearson's correlation, factor analysis with intra-class correlation coefficient (ICC). In the second stage, the domain in preventive dental nurses was explored. Results: The overall internal consistency of CPEP is α= 0.66, ICC= 0.64, CI95%: 0.29-0.87 (p >0.01). Twenty-one subjects in the study, average age 43, 81.0% female, average seniority of 12.5 were included. A total of 71.5% showed weak domain, 28.5% regular domain, and there was no questionnaire with good domain result. The older the subjects were, the smaller the domain; female nurses showed greater mastery of preventive dentistry (29%, CI95%: 0.1-15.1) than male nurses. Public health nurses showed greater mastery with respect to other categories (50%, CI95%: 0.56-2.8). Conclusions: The CDEP has enough consistency to explore the domain of preventive dentistry in health-care staff. The domain of preventive dentistry in primary care nursing is poor, required to strengthen to provide education in preventive dentistry to the insured population. PMID:25386037

  3. The role of leadership in overcoming staff turnover in critical care.

    PubMed

    Roy, Kelly; Brunet, Fabrice

    2005-10-01

    This commentary discusses Laporta and coworkers analysis of a case study on the causes of and solutions for staff turnover in an intensive care setting. Staff turnover is a significant issue for health care leaders due to the shrinking workforce in Western countries and an increased demand for intensive care services as the population ages. The commentary considers reasons for turnover such as burnout and generational diversity, and highlights the importance of a team work approach to address the issue of turnover. PMID:16277725

  4. Putting the 'care' back into aged care.

    PubMed

    Beadnell, Cathy

    2006-04-01

    Aged care is well and truly back on the political agenda in Australia. While the mainstream media has recently exposed a number of horrific cases of alleged abuse in aged care facilities it has done little to highlight the failings of social policy over time or to foster debate on how to improve the care of older Australians. What are the barriers to providing safe and quality aged care to a growing number of our citizens and how do we overcome them? If you relied on the recent media coverage for your impression of aged care you could be forgiven for thinking it is all bad news. But there are facilities providing high quality care and stories of nurses working wonders in the face of adversity. Cathy Beadnell considers some of the broader cultural and workforce issues in aged care. PMID:16629211

  5. Workplace incivility and productivity losses among direct care staff.

    PubMed

    Hutton, Scott; Gates, Donna

    2008-04-01

    The purpose of this study was to examine incivility experienced by direct health care staff in their workplaces. The sample (N = 184) was 91% female and 77% White, with 71% of the participants having earned an associate degree or above and 81% being registered nurses. The Work Limitations Questionnaire and the Incivility in Healthcare Survey were distributed to all direct care staff at a major metropolitan hospital (22% response rate). Correlations were found between workplace incivility from direct supervisors and productivity (r = 0.284, p = .000) and workplace incivility from patients and productivity (r = 0.204, p = .006). Incivility from physicians, incivility from other direct care staff, and general environmental incivility were not shown to be significantly related to productivity. Demographics were not related to levels of workplace incivility. Workplace incivility from patients and management appears to have a greater impact on employees' productivity than workplace incivility from other sources. PMID:18444405

  6. Creating accountable care organizations: the extended hospital medical staff.

    PubMed

    Fisher, Elliott S; Staiger, Douglas O; Bynum, Julie P W; Gottlieb, Daniel J

    2007-01-01

    Many current policies and approaches to performance measurement and payment reform focus on individual providers; they risk reinforcing the fragmented care and lack of coordination experienced by patients with serious illness. In this paper we show that Medicare beneficiaries receive most of their care from relatively coherent local delivery systems comprising physicians and the hospitals where they work or admit their patients. Efforts to create accountable care organizations at this level--the extended hospital medical staff--deserve consideration as a potential means of improving the quality and lowering the cost of care. PMID:17148490

  7. Staff Morale in Day Care Centres for Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Mascha, Katerina

    2007-01-01

    Background: Levels of burnout, job satisfaction and intended turnover of staff working in day care centres for adults with intellectual disabilities are investigated in relation to role clarity, staff support and supervision, and coping strategies used by staff. Materials and methods: Thirty six direct-care staff of four day care centres in the UK…

  8. Staff Carers' Understanding of End of Life Care

    ERIC Educational Resources Information Center

    Friedman, Sandra L.; Choueiri, Roula; Gilmore, Dana

    2008-01-01

    Staff carers in pediatric skilled nursing facilities (PSNF) deal directly with dying residents, and are on the forefront of communication with families. These providers have expressed misunderstandings regarding the meaning of resuscitation status and redirection of care. This descriptive study evaluated perceptions and understanding of end of…

  9. Producing a caring environment for staff: forging old paradigms.

    PubMed

    Veronesi, J F

    2001-01-01

    Modern health care has evolved into technological wizardry that defies the traditional concept of caring by the bedside nurse. Industry constraints have created an environment where caring for the patient and employee has become easily discarded in favor of the rigors of technological care. With an aging and diminished work force, nursing leaders must be prepared to create a caring environment where nurses are empowered to deliver the humanitarian as well as technological aspects of caring. From a concept of work redesign that mirrors traditional nursing paradigms, nurses can enrich not only their professional work environment but also deliver the high touch aspect of care in their daily work. PMID:18193592

  10. Skin Care and Aging

    MedlinePlus

    ... Age Spots and Skin Tags Click for more information Age spots, once called "liver spots," are flat, brown ... surface. They are a common occurrence as people age, especially for women. They are ... options, specific conditions, and related issues. ...

  11. Resident-Directed Long-Term Care: Staff Provision of Choice during Morning Care

    ERIC Educational Resources Information Center

    Simmons, Sandra F.; Rahman, Annie; Beuscher, Linda; Jani, Victoria; Durkin, Daniel W.; Schnelle, John F.

    2011-01-01

    Purpose: To develop an observational protocol to assess the quality of staff-resident communication relevant to choice and describe staff-resident interactions as preliminary evidence of the usefulness of the tool to assess current nursing home practices related to offering choice during morning care provision. Design and Methods: This study…

  12. Physicians’ leadership styles in rural primary medical care: How are they perceived by staff?

    PubMed Central

    Kirkhaug, Rudi

    2014-01-01

    Abstract Aim. This study investigates which leadership styles can be identified among general practice lead physicians and how they are associated with and predicted by staff and context characteristics like profession, gender, age, work experience, and team size. Method/material. In a cross-sectional study self-administered questionnaires were distributed to staff physicians (42% females) and support staff (98% females) at 101 primary health care centres in North Norway. A total of 127 and 222, respectively, responded (response rate 59%). Items were ranked on Likert scales (range 1–5). Results. Analysis revealed three significantly different styles (mean scores/Cronbach's alpha): change style (3.36/0.898), task style (3.17/0.885), and relation style (2.88/0.900). The lead physicians were perceived as practising change style the most and relation style the least. Males experienced significantly more of all three styles. Support staff scored lowest for all styles. Age was negatively correlated with relation style and change style, while work experience was negatively correlated with change style. No significant association was found between styles and team size. Conclusion. Leadership in rural general practice can be identified in terms of task, relation, and change styles. Change style is the most perceived style. Males seem to be most attentive to leadership styles. However, within the staff physician group, there is less difference between genders. Support staff scores lowest for all styles; this might indicate either less need for leadership or dissatisfaction with leadership. Age and work experience seem to reduce employees’ attention to relation and change styles, indicating that maturity reduces needs for these leadership styles. Due to growing demands for leaders to take care of efficiency and change in general practice, more young female physicians, and more diverse staff groups, these findings may be useful to understand leadership and leadership

  13. Staff attitudes and expectations about music therapy: pediatric oncology versus neonatal intensive care unit.

    PubMed

    Bouhairie, Annie; Kemper, Kathi J; Martin, Kathleen; Woods, Charles

    2006-01-01

    Music is commonly used to reduce stress, but it has not been universally adopted in inpatient and outpatient settings. We compared the attitudes of staff in the neonatal intensive care unit (NICU) and the pediatric outpatient hematology oncology unit (PEDS ONC) toward music therapy. A cross-sectional survey of NICU staff was performed in the winter of 2003 and of PEDS ONC staff in the summer of 2005. Eligible subjects were 187 NICU and 20 PEDS ONC staff members. Surveys were distributed by e-mail, in person, and in staff mail boxes. Data were analyzed using simple descriptive statistics, chi-square test, and logistic regression. t-Tests and chi-square test were used to compare responses in the two units. The response rate was 75% in the NICU and 100% in PEDS ONC unit. Staff in the two locations were similar: the mean age of the staff was 37 years in NICU and 40 years in the PEDS ONC (p>.1); over 80% of the staff were female in both units and most (70% in the NICU, 75% in PEDS ONC) reported some previous musical training . Most agreed that music enjoyed by patients could reduce stress (86% in the NICU, 100% in PEDS ONC) and improve sleep (79% in the NICU, 95% in PEDS ONC). Attitudes toward music in both clinical settings were significantly associated with prior musical training , experience, and profession. Staff in both the NICU and PEDS ONC hold favorable attitudes toward music for patients. Staff attitudes in both inpatient and outpatient settings are not barriers to providing music therapy. PMID:19442339

  14. Post-Traumatic Stress, Trauma-Informed Care, and Compassion Fatigue in Psychiatric Hospital Staff: A Correlational Study.

    PubMed

    Jacobowitz, William; Moran, Christine; Best, Cheryl; Mensah, Lucy

    2015-01-01

    Assault of staff in psychiatric hospitals is a frequent occurrence, and studies indicate that hospital staff are at risk of developing post-traumatic stress disorder (PTSD). We performed a correlational study with a convenience sample of 172 staff in a psychiatric hospital and compared the rate of traumatic events (TEs), resilience, confidence, and compassion fatigue to PTSD symptoms (PTSS). Regression analyses identified two variables that were unique predictors of PTSS: (1) trauma-informed care (TIC) meeting attendance and (2) burnout symptoms. Severe TEs, age, and compassion satisfaction also contributed to the model. Attention to these factors may help reduce PTSS in psychiatric staff. PMID:26631861

  15. Age to age: insight into managing a multigenerational staff.

    PubMed

    Stanley, Kay B

    2007-01-01

    Diversity in age and culture-medical practices and healthcare entities mirror the business world in the diversity of culture and age groups among their employees and patients. Differences create challenges, but with understanding and skillful communication, distinctions become opportunities for growth and excellence. The concept we are exploring is that as a generation we are who we are because of what was going on in our world during our formative years. We find that just naming ourselves aspart ofa group is a good starting point. The objective of this article is to identify characteristics of various age groups and to present ways to promote harmony and to maximize performance through practical management techniques. The goal is to better understand ourselves and each other so that our work is more productive and rewarding. PMID:17494481

  16. Comfort Care Rounds: a staff capacity-building initiative in long-term care homes.

    PubMed

    Wickson-Griffiths, Abigail; Kaasalainen, Sharon; Brazil, Kevin; McAiney, Carrie; Crawshaw, Diane; Turner, Mickey; Kelley, Mary Lou

    2015-01-01

    This article reports a pilot evaluation of Comfort Care Rounds (CCRs)--a strategy for addressing long-term care home staff's palliative and end-of-life care educational and support needs. Using a qualitative descriptive design, semistructured individual and focus group interviews were conducted to understand staff members' perspectives and feedback on the implementation and application of CCRs. Study participants identified that effective advertising, interest, and assigning staff to attend CCRs facilitated their participation. The key barriers to their attendance included difficulty in balancing heavy workloads and scheduling logistics. Interprofessional team member representation was sought but was not consistent. Study participants recognized the benefits of attending; however, they provided feedback on how the scheduling, content, and focus could be improved. Overall, study participants found CCRs to be beneficial to their palliative and end-of-life care knowledge, practice, and confidence. However, they identified barriers and recommendations, which warrant ongoing evaluation. PMID:24971588

  17. On aging and aged care in Serbia.

    PubMed

    Sevo, G; Davidovic, M; Erceg, P; Despotovic, N; Milosevic, D P; Tasic, M

    2015-06-01

    Serbia is a demographically old nation, with 17.4 % of its residents being aged 65 years and older in 2011. The previous two decades of turbulent history have significantly affected the demographic picture of this country, and their ramifications remain visible in Serbia's economic, political, cultural, and health spheres. Major demographic forces behind population aging in Serbia can be attributed to lower fertility rates, migrations, and declining mortality (reflecting improvements in overall health leading to a longer life expectancy). In Serbia, low fertility and migrations appear to play major roles, although the relative contribution of recent migrations cannot be measured with accuracy. Patterns of demographic aging vary considerably across different geographic, socioeconomic, and cultural settings. The common denominator throughout present day Serbia is extensive political and economic transition. One would expect that, given sufficient time, this process will result in improved population health, and yet, at this stage outcomes of major health care reform in Serbia are somewhat perplexing. For the second consecutive year, Serbia's health care system has been ranked at the very bottom of the scale among 34 European countries. It is then no surprise that the elderly represent particularly vulnerable population segment. This paper discusses some of the issues relevant to these demographic patterns of aging and aged care in contemporary Serbia, focusing on the period after 2000. PMID:25943380

  18. Staff "Burnout" in Child Care Settings. ERIC/EECE Short Report-4.

    ERIC Educational Resources Information Center

    ERIC Clearinghouse on Elementary and Early Childhood Education, Urbana, IL.

    Derived from a study by Whitebook and others (1982), this ERIC Short Report presents findings, recommendations, and other information on staff burnout in child care settings. Child care staff were found to be underpaid and overworked. Differences in working conditions among centers and job satisfaction among staff appeared to be related to such…

  19. An Initial Evaluation of Direct Care Staff Resilience Workshops in Intellectual Disabilities Services

    ERIC Educational Resources Information Center

    Ingham, Barry; Riley, Jenny; Nevin, Helen; Evans, Gemma; Gair, Elodie

    2013-01-01

    The emotional responses to challenging behaviour of direct care staff who support people with intellectual disabilities is thought to be an important mediating factor within the stress experienced by staff and a potential maintaining factor in challenging behaviour. A brief workshop to improve direct care staff resilience was developed and…

  20. Preparing professional staff to care for cancer survivors

    PubMed Central

    Economou, Denice; Ferrell, Betty; Bhatia, Smita

    2010-01-01

    Introduction Oncology health care professionals frequently lack the background to implement needed survivorship activities and follow-up care. The purpose of this project is to assist providers in the clarification and initiation of potentially durable changes in survivorship care by developing a health professional curriculum, recruiting participants, implementing the course, conducting course evaluation and following participants’ defined goals over time. Materials and methods The curriculum was developed based on recommendations from the Institute of Medicine Report-From Cancer Patient to Cancer Survivor—Lost in Transition. Three concepts were used to structure the course: cancer survivorship quality of life, changing practice via performance improvement, and principles of adult education. Expert faculty designed and implemented the curriculum and teaching methods using adult learning principles and an interactive approach. Competitively-selected, two-person interdisciplinary teams for the first course (July 12–15, 2006, Pasadena, California) were selected based on stated interests, three projected goals, and letters of commitment from administrators. Results Participants represented 52 cancer care settings from 28 states. Teams included Nurses (48.1%), Social Workers (20.7%), Physicians (18.8%), Directors/Administrators (6.6%), Psychologists (2.8%), and others (3%). The institutional barriers identified by teams were lack of survivorship knowledge (94 %), financial constraints (61%), lack of administrative support (6%), and staff philosophy that excluded survivorship (15%). Evaluation of content from the first course was consistently positive. Conclusions Dissemination of survivorship education for health care professionals stimulates participants to define and begin to implement goals for improving survivors’ care. Implications for cancer survivors A training program such as the one described provides professional knowledge regarding survivorship that

  1. Caring for Ethnic Older People Living with Dementia - Experiences of Nursing Staff.

    PubMed

    Söderman, Mirkka; Rosendahl, Sirpa Pietilä

    2016-09-01

    The total number of persons living with dementia is estimated to double every 20 years and ageing migrant populations are growing in several countries. There are gaps in the health and social care of people from other countries, regardless of the efforts made when someone has a dementia diagnosis; similarly, receiving care in sheltered accommodation is less common. The aim of this study was to explore and describe the nursing staff's experiences of caring for non-Swedish speaking persons living with dementia in a Finnish speaking group home in relation to a Swedish speaking group home in Sweden. 27 qualitative semi-structured interviews were analysed using qualitative content analyses. The first main category, "communication", concentrated on language abilities and deficiencies, non-verbal language, highlighting the consequences of not understanding and the benefits of a common language. The second main category, "culturally oriented activities", focused on being served traditional food, celebrating holidays at the group home, the importance of traditions and the importance of familiar music as cultural elements. The Swedish speaking nursing staff could provide qualitative and equitable care, but the challenge was greater for them than for the bilingual nursing staff who spoke the same language as the residents. PMID:27287438

  2. Space age health care delivery

    NASA Technical Reports Server (NTRS)

    Jones, W. L.

    1977-01-01

    Space age health care delivery is being delivered to both NASA astronauts and employees with primary emphasis on preventive medicine. The program relies heavily on comprehensive health physical exams, health education, screening programs and physical fitness programs. Medical data from the program is stored in a computer bank so epidemiological significance can be established and better procedures can be obtained. Besides health care delivery to the NASA population, NASA is working with HEW on a telemedicine project STARPAHC, applying space technology to provide health care delivery to remotely located populations.

  3. Empowering Staff in Dementia Long-Term Care: Towards a More Supportive Approach to Interventions

    ERIC Educational Resources Information Center

    Figueiredo, Daniela; Barbosa, Ana; Cruz, Joana; Marques, Alda; Sousa, Liliana

    2013-01-01

    This pilot-study aimed to assess a psychoeducational program for staff in care homes. The program was designed to increase knowledge regarding dementia care, promote skills to integrate motor and multisensory stimulation in daily care, and develop coping strategies to manage emotional work-related demands. Six staff members received eight…

  4. Mental Illness Training for Long Term Care Staff

    PubMed Central

    Irvine, A. Blair; Billow, Molly B.; Bourgeois, Michelle; Seeley, John R.

    2011-01-01

    Objectives Mental illness is prevalent among nursing home residents, but staff are not well trained to deal with it. This research evaluated an Internet mental illness training program designed for certified direct care workers i.e., Nurse Aides (NAs). Pilot research was also conducted to explore effects and acceptance of the same program with a sample of Licensed Health Professionals (LHPs). Design Trial 1: Pre-post randomized treatment and control design for NAs; Trial 2: Quasi-experimental pre-post within-subjects design for LHPs. Setting Both studies were conducted on the Internet. Participants Trial 1: N=62 NAs; Trial 2: N=16 LHPs Intervention Internet-based behavioral skills training and knowledge building, using video modeling with mastery learning instructional design. Measurements Video situations testing and assessment of psycho-social constructs associated with behavior change; follow-up interviews with a sample of treatment NAs. Results Trial 1: MANCOVA analysis showed positive results (p=.003) for knowledge, attitudes, self efficacy, and behavioral intention, with medium-large effect sizes. The training was well received by the users. Trial 2: Paired t-tests showed significant effects on five of six outcome measures, with medium-large effect sizes, and it was well received by the LHP sample. Conclusions Internet training can be an effective approach to help staff work with residents with mental illness. In this research, it showed significant positive effects and was well received by NAs and by LHPs. PMID:21450251

  5. Care of the comatose patient: building mutual staff values.

    PubMed

    Hofmann, P B; Smoot, F L

    1985-05-01

    Recognizing individuals' value differences is important to the success of health teams that care for comatose patients, since decisions to withhold or withdraw life-support treatment may lead to conflicts among team members. Such conflicts can adversely affect professional and family relationships. For example, health care personnel cannot work together in harmony or help the family effectively if they disagree about treatment decisions. Although institutional procedures for "do not resuscitate" orders, the treatment of incompetent patients, and other complex issues are helpful, they rarely address value conflicts, which inevitably influence a problem's resolution. Staff members therefore must acknowledge and confront differences they have faced. Such reflection enables catharsis as well as reconciliation of unresolved conflict and permits the group to develop guidelines for future situations. A fictional case also may be used to help work groups gain an understanding of the need for community. Ideally, the team members will sharpen their decision-making skills and gain the confidence to make tough choices in an imperfect, unpredictable world. PMID:10271501

  6. The Importance of Sexuality Program Objectives to Long-Term Care Staff.

    ERIC Educational Resources Information Center

    Walker, Bonnie L.; Osgood, Nancy J.

    The opinions of long-term care staff were surveyed regarding the importance of objectives of a program that would provide staff education and training regarding the sexuality of older people. A literature review determined what staff needed to know about elderly sexuality, the needs of elderly people related to their sexuality, and how caregivers…

  7. Understanding inequities in home health care outcomes: staff views on agency and system factors.

    PubMed

    Davitt, Joan K; Bourjolly, Joretha; Frasso, Rosemary

    2015-01-01

    Results regarding staff perspectives on contributing factors to racial/ethnic disparities in home health care outcomes are discussed. Focus group interviews were conducted with home health care staff (N = 23) who represented various agencies from three Northeastern states. Participants identified agency and system factors that contribute to disparities, including: (a) administrative staff bias/discretion, (b) communication challenges, (c) patient/staff cultural discordance, (d) cost control, and (e) poor access to community resources. Participants reported that bias can influence staff at all levels and is expressed via poor coverage of predominantly minority service areas, resulting in reduced intensity and continuity of service for minority patients. PMID:25706958

  8. Population ageing and dental care.

    PubMed

    Harford, Jane

    2009-04-01

    Population ageing is a fact in both developed and developing countries. The concern about population ageing largely arises from the combination of a greater number of older people requiring greater amounts of healthcare services and pensions, and relatively fewer people working to pay for them. Oral health and dental care are important aspects of health and health care. Lower rates of edentulism and an ageing population mean that older people will feature more prominently in dental services. Traditionally, economic studies of ageing have focused on the fiscal implications of ageing, projecting the increased burden on health and welfare services that accompanies ageing. It assumed that ageing is the major driver of recent changes and those past trends will simply be amplified by faster population ageing in the future. Less work has been done to understand other past drivers of increased healthcare spending and their implications for the future. The conclusion of these reports is usually that population ageing is unaffordable with current policy settings. They have proposed policies to deal with population ageing which focused on increasing workforce participation and worker productivity to increase the tax base and reducing entitlements. However, the affordability question is as much political as a numerical. There are no clearly articulated criteria for affordability and little opportunity for public discourse about what citizens are willing to pay in taxes to support an ageing population. While the reports do not necessarily reflect public opinion, they will certainly shape it. Predicting the future for oral health is more fraught than for general health, as oral health is in the midst of an epidemiological transition from high rates of edentulism and tooth loss to low rates. Changes in the pattern of dental expenditure in the past do not mirror the experience of rapid increases in per capita expenditure on older age groups as regards general health. Dentistry

  9. Implementation of newly adopted technology in acute care settings: a qualitative analysis of clinical staff

    PubMed Central

    Langhan, Melissa L.; Riera, Antonio; Kurtz, Jordan C.; Schaeffer, Paula; Asnes, Andrea G.

    2015-01-01

    Objective Technologies are not always successfully implemented into practise. We elicited experiences of acute care providers with the introduction of technology and identified barriers and facilitators in the implementation process. Methods A qualitative study using one-on-one interviews among a purposeful sample of 19 physicians and nurses within ten emergency departments and intensive care units was performed. Grounded theory, iterative data analysis and the constant comparative method were used to inductively generate ideas and build theories. Results Five major categories emerged: decision-making factors, the impact on practise, technology's perceived value, facilitators and barriers to implementation. Barriers included negative experiences, age, infrequent use, and access difficulties. A positive outlook, sufficient training, support staff, and user friendliness were facilitators. Conclusions This study describes strategies implicated in the successful implementation of newly adopted technology in acute care settings. Improved implementation methods and evaluation of implementation processes are necessary for successful adoption of new technology. PMID:25367721

  10. Implementation of newly adopted technology in acute care settings: a qualitative analysis of clinical staff.

    PubMed

    Langhan, Melissa L; Riera, Antonio; Kurtz, Jordan C; Schaeffer, Paula; Asnes, Andrea G

    2015-01-01

    Technologies are not always successfully implemented into practice. This study elicited experiences of acute care providers with the introduction of technology and identified barriers and facilitators in the implementation process. A qualitative study using one-on-one interviews among a purposeful sample of 19 physicians and nurses within 10 emergency departments and intensive care units was performed. Grounded theory, iterative data analysis and the constant comparative method were used to inductively generate ideas and build theories. Five major categories emerged: decision-making factors, the impact on practice, technology's perceived value, facilitators and barriers to implementation. Barriers included negative experiences, age, infrequent use and access difficulties. A positive outlook, sufficient training, support staff and user friendliness were facilitators. This study describes strategies implicated in the successful implementation of newly adopted technology in acute care settings. Improved implementation methods and evaluation of implementation processes are necessary for successful adoption of new technology. PMID:25367721

  11. Care and feeding of a staff for filmless radiology.

    PubMed

    Mensch, B; Honea, R; Orand, M

    1999-05-01

    Texas Children's Hospital, a definitive care pediatric hospital located in the Texas Medical Center, has been constructing a large-scale picture archival and communications system (PACS) including ultrasound (US), computed tomography (CT), magnetic resonance (MR), and computed radiography (CR). Developing staffing adequate to meet the demands of filmless radiology operations has been a continuous challenge. Overall guidance for the PACS effort is provided by a hospital-level PACS Committee, a department-level PACS Steering Committee, and an Operations Committee. Operational Subcommittees have been formed to address service-specific implementation, such as the Emergency Center Operations Subcommittee. These committees include membership by those affected by the change, as well as those effecting the change. Initially, personnel resources for PACS were provided through additional duties of existing imaging service personnel. As the PACS effort became more complex, full-time positions were created, including a PACS Coordinator, a PACS Analyst, and a Digital Imaging Assistant. Each position requires a job description, qualifications, and personnel development plans that are difficult to anticipate in an evolving PACS implementation. These positions have been augmented by temporary full-time assignments, position reclassifications, and cross-training of other imaging personnel. Imaging personnel are assisted by other hospital personnel from Biomedical Engineering and Information Services. Ultimately, the PACS staff grows to include all those who must operate the PACS equipment in the normal course of their duties. The effectiveness of the PACS staff is limited by their level of their expertise. This report discusses our methods to obtain training from outside our institution and to develop, conduct, and document standardized in-house training. We describe some of the products of this work, including policies and procedures, clinical competency criteria, PACS inservice

  12. Organizational Climate as a Tool for Child Care Staff Retention

    ERIC Educational Resources Information Center

    Klinkner, Joan M.; Riley, Dave; Roach, Mary A.

    2005-01-01

    A successful early childhood program that is a nurturing place for children must also be a good place for staff to work. Too often it is not, and employees leave. Coping with staff turnover in early childhood programs is a constant struggle, not only for administrators but also for children and their families and the staff who remain behind. Both…

  13. Improvement critical care patient safety: using nursing staff development strategies, at Saudi Arabia.

    PubMed

    Basuni, Enas M; Bayoumi, Magda M

    2015-01-01

    Intensive care units (ICUs) provide lifesaving care for the critically ill patients and are associated with significant risks. Moreover complexity of care within ICUs requires that the health care professionals exhibit a trans-disciplinary level of competency to improve patient safety. This study aimed at using staff development strategies through implementing patient safety educational program that may minimize the medical errors and improve patient outcome in hospital. The study was carried out using a quasi experimental design. The settings included the intensive care units at General Mohail Hospital and National Mohail Hospital, King Khalid University, Saudi Arabia. The study was conducted from March to June 2012. A convenience sample of all prevalent nurses at three shifts in the aforementioned settings during the study period was recruited. The program was implemented on 50 staff nurses in different ICUs. Their age ranged between 25-40 years. Statistically significant relation was revealed between safety climate and job satisfaction among nurses in the study sample (p=0.001). The years of experiences in ICU ranged between one year 11 (16.4) to 10 years 20 (29.8), most of them (68%) were working in variable shift, while 32% were day shift only. Improvements were observed in safety climate, teamwork climate, and nurse turnover rates on ICUs after implementing a safety program. On the heels of this improvement; nurses' total knowledge, skills and attitude were enhanced regarding patient safety dimensions. Continuous educational program for ICUs nursing staff through organized in-service training is needed to increase their knowledge and skills about the importance of improving patient safety measure. Emphasizing on effective collaborative system also will improve patient safety measures in ICUS. PMID:25716409

  14. Exploring staff perceptions on the role of physical environment in dementia care setting.

    PubMed

    Lee, Sook Y; Chaudhury, Habib; Hung, Lillian

    2016-07-01

    This study explored staff perceptions of the role of physical environment in dementia care facilities in affecting resident's behaviors and staff care practice. We conducted focus groups with staff (n = 15) in two purposely selected care facilities in Vancouver, Canada. Focus group participants included nurses, care aides, recreation staff, administrative staff, and family. Data analysis revealed two themes: (a) a supportive physical environment contributes positively to both quality of staff care interaction and residents' quality of life and (b) an unsupportive physical environment contributes negatively to residents' quality of life and thereby makes the work of staff more challenging. The staff participants collectively viewed that comfort, familiarity, and an organized space were important therapeutic resources for supporting the well-being of residents. Certain behaviors of residents were influenced by poor environmental factors, including stimulation overload, safety risks, wayfinding challenge, and rushed care This study demonstrates the complex interrelationships among the dementia care setting's physical environment, staff experiences, and residents' quality of life. PMID:24864321

  15. Exploring the Patient and Staff Experience With the Process of Primary Care

    PubMed Central

    Brown, Elizabeth J.; Kangovi, Shreya; Sha, Christopher; Johnson, Sarah; Chanton, Casey; Carter, Tamala; Grande, David T.

    2015-01-01

    PURPOSE Previous studies suggest that the highest-risk patients value accessible, coordinated primary care that they perceive to be of high technical quality. We have limited understanding, however, of how low-income, chronically ill patients and the staff who care for them experience each individual step in the primary care process. METHODS We conducted qualitative interviews with uninsured or Medicaid patients with chronic illnesses, as well as with primary care staff. We interviewed 21 patients and 30 staff members with a variety of job titles from 3 primary care practices (1 federally qualified health center and 2 academically affiliated clinics).] RESULTS The interviews revealed 3 major issues that were present at all stages of a primary care episode: (1) information flow throughout an episode of care is a frequent challenge, despite systems that are intended to improve communication; (2) misaligned goals and expectations among patients, clinicians, and staff members are often an impediment to providing and obtaining care; and (3) personal relationships are highly valued by both patients and staff. CONCLUSIONS Vulnerable populations and the primary care staff who work with them perceive some of the same challenges throughout the primary care process. Improving information flow, aligning goals and expectations, and developing personal relationships may improve the experience of both patients and staff. PMID:26195680

  16. Increasing the Efficiency of Program Status Reporting by Residential Direct Care Staff

    ERIC Educational Resources Information Center

    Bastien, James S.; Burns, William J.; Kelly, Francis D.; Schumm, Patricia A.; Allen, Theresa P.

    2005-01-01

    In large residential treatment centers for adolescent youth, program administrators and clinical staff rely on the information imparted to them by direct care staff to make appropriate decisions regarding administrative and clinical support functions so that the residents in care can receive the best treatment possible. This study was designed to…

  17. Spica cast care: a collaborative staff-led education initiative for improved patient care.

    PubMed

    Reed, Cynthia; Carroll, Lee; Baccari, Susan; Shermont, Herminia

    2011-01-01

    One of the most challenging aspects for nurses caring for incontinent children in spica casts is maintaining healthy skin integrity. Noting an increase in the number of phone calls from parents of discharged children in spica casts concerning diaper rash and skin breakdown, inpatient orthopedics staff nurses lead an interdisciplinary quality improvement and educational initiative. They standardized pediatric spica cast care and education by creating an intranet narrated PowerPoint presentation for staff and parents of children with spica casts. A take-home DVD of this education module is now produced and given to parents, reinforcing nursing discharge teaching and giving parents the opportunity to review these new skills at home as needed. The purpose of this article is to share this experience of improving patient outcomes and empowering other orthopedics nurses to develop creative educational solutions. PMID:22124183

  18. Can district nurses and care home staff improve bowel care for older people using a clinical benchmarking tool?

    PubMed

    Goodman, Claire; L Davies, Sue; Norton, Christine; Fader, Mandy; Morris, Jackie; Wells, Mandy; Gage, Heather

    2013-12-01

    A quasi-experimental study tested a clinical benchmarking tool (Essence of Care) to improve bowel-related care for older people living in six care homes. In the intervention care homes, district nurses and care home staff used the clinical benchmarking tool to discuss and plan how to improve bowel care for residents. In the control care homes, staff were provided with detailed information about the residents and continence services contact details. The intervention was acceptable to care home and district nursing staff, and possible to incorporate into existing working patterns. The study did not demonstrate a significant reduction in bowel-related problems, although there was evidence in one care home of reduction in episodes of avoidable faecal incontinence. At an individual level of care, there were observable benefits, and examples of person-centred care were prompted through participating in the intervention and improved staff awareness. Clinical benchmarking tools can be used to structure discussion between district nurses and care home staff to review and plan care for residents. However, it takes time to achieve change and embedding this kind of approach requires either robust pre-existing working relationships or the involvement of a facilitator. PMID:24335790

  19. Exploring the Relationship between Teaching Staff Age and Their Attitude towards Information and Communications Technologies (ICT)

    ERIC Educational Resources Information Center

    Elsaadani, Mohamed Abdelaziz

    2013-01-01

    Current research seeks to understand the relationship between teaching staff' age and their attitude toward ICT. Survey methodology is facilitated through the use of the questionnaires. The survey domain is a random sampling of teaching staff in Egyptian HEI. The population for this study was 500 full-time Faculty staff, and only 412 returned and…

  20. Responding to vulnerability in old age: patient-centred care.

    PubMed

    Abley, Clare

    Patient-centred care is a term widely used in health policy and is familiar to staff as a principle or commonly agreed approach to care. However, nursing and multidisciplinary teams often do not agree how it should be provided for older patients. This article outlines three different models of patient-centred care applicable to the care of older people. The article also explores the concept of vulnerability in old age, highlighting differences between the perspectives of older people and those of professionals and how clinical practice can be improved to achieve a more patient-centred approach. The links between patient-centred care and vulnerability in old age are considered along with the implications of this for clinical practice. PMID:23240515

  1. Foregoing prehospital care: should ambulance staff always resuscitate?

    PubMed Central

    Iserson, K V

    1991-01-01

    Approximately 400,000 people die outside US hospitals or chronic care facilities each year. While there has been some recent movement towards initiating procedures for prehospital Do Not Resuscitate (DNR) orders, the most common situation in the US is that emergency medical systems (EMS) personnel are not authorized to pronounce patients dead, but are required to attempt resuscitation with all of the modalities at their disposal in virtually all patients. It is unfair and probably unrealistic for EMS personnel to have to make a determination of the validity of a non-standard prehospital DNR order (for example, a living will or a durable power of attorney for health care). Existing prehospital DNR protocols range from being very restrictive in the scope of patients allowed to participate and in their implementation, to those that are more liberal. Potential benefits of prehospital DNR orders include freeing up vital personnel and material for use by those who would more fully benefit, and alleviating the enormous emotional strain on patients, families, EMS personnel, and hospital medical staffs involved in unwanted resuscitations that only prolong the dying process. Given this, prehospital DNR orders present several legal and moral problems. These include proper patient identification, the nature of the document itself, precautions incorporated into a DNR system to prevent misuse, potential liability for EMS and hospital personnel, and potential errors in implementation. Functioning prehospital DNR systems need to include: 1) specific legislation detailing the circumstances in which such a document could be used, the wording of such a document, and protection from liability for those implementing the document's directives; 2) having the currently valid document immediately available to the EMS personnel or base station doctors; and 3) acceptable means of identifying the patient. Relatively few US jurisdictions as yet have a prehospital DNR order system, although it

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

    PubMed

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

    2015-12-01

    The aim of this study was to explore nursing staffs' perceptions of the physical and psychological care needs of elderly residents, their views on the relative importance of these needs and their perceived ability to meet them. The literature reveals that the quality of elder care in nursing homes should comprise both physical and psychosocial care. Despite this, the nursing staffs' perceptions of the physical and psychosocial care provision have not often been researched. As a method cross-sectional research design was used, with structured questionnaires and unstructured interviews. Our sample consisted of members of the nursing staff from four nursing homes in Slovenia (survey: N = 148; interview: N = 16). The resulting data was processed by means of statistical analysis and conventional content analysis. The nursing staff reported more knowledge of, skills with and willingness to meet residents'physical needs than psychosocial needs. On the other hand, communication, conversation, self-care and a home-like environment were considered by nursing staff as marking quality elder care. Consequently, nursing home administrators should try to strengthen psychosocial care provision to improve the residents' quality of life. Conversation, as the most often recognised aspect of psychosocial care, should be promoted, since improvements in this area would not be costly, and each nursing staff member may decide individually how best to include more conversation in the daily routines of elder care provision. PMID:26987155

  3. Quality of advance care planning policy and practice in residential aged care facilities in Australia

    PubMed Central

    Silvester, William; Fullam, Rachael S; Parslow, Ruth A; Lewis, Virginia J; Sjanta, Rebekah; Jackson, Lynne; White, Vanessa; Gilchrist, Jane

    2013-01-01

    Objectives To assess existing advance care planning (ACP) practices in residential aged care facilities (RACFs) in Victoria, Australia before a systematic intervention; to assess RACF staff experience, understanding of and attitudes towards ACP. Design Surveys of participating organisations concerning ACP-related policies and procedures, review of existing ACP-related documentation, and pre-intervention survey of RACF staff covering their role, experiences and attitudes towards ACP-related procedures. Setting 19 selected RACFs in Victoria. Participants 12 aged care organisations (representing 19 RACFs) who provided existing ACP-related documentation for review, 12 RACFs who completed an organisational survey and 45 staff (from 19 RACFs) who completed a pre-intervention survey of knowledge, attitudes and behaviour. Results Findings suggested that some ACP-related practices were already occurring in RACFs; however, these activities were inconsistent and variable in quality. Six of the 12 responding RACFs had written policies and procedures for ACP; however, none of the ACP-related documents submitted covered all information required to meet ACP best practice. Surveyed staff had limited experience of ACP, and discrepancies between self reported comfort, and levels of knowledge and confidence to undertake ACP-related activities, indicated a need for training and ongoing organisational support. Conclusions Surveyed organisations â policies and procedures related to ACP were limited and the quality of existing documentation was poor. RACF staff had relatively limited experience in developing advance care plans with facility residents, although attitudes were positive. A systematic approach to the implementation of ACP in residential aged care settings is required to ensure best practice is implemented and sustained. PMID:24644755

  4. Solving the staff's problem or meeting the patients' needs: staff members' reasoning about choice of action in challenging situations in psychiatric inpatient care.

    PubMed

    Looi Rpn, Git-Marie Ejneborn; Gabrielsson, Sebastian; Sävenstedt, Stefan; Zingmark, Karin

    2014-06-01

    Coercion in challenging situations is often seen as a necessary component of psychiatric care. This study aims to describe staff members' reasoning about their choice of action in challenging situations in inpatient psychiatric care. Focus group interviews with 26 staff members were analyzed using qualitative content analysis. The results provide an overview of the integrated structure of participants' reasoning and suggest that staff members' reasoning about choice of action can be described as a matter of either solving the staff's problems or meeting the patients' needs. These results can be of use in further research, educational interventions, and staff development activities. PMID:24857531

  5. Effect of Resident and Direct-Care Staff Training on Responding during Social Interactions.

    ERIC Educational Resources Information Center

    Embregts, Petri J. C. M.

    2002-01-01

    A multi-faceted training package for inappropriate social behavior was evaluated with five children with mild mental retardation and attention deficit hyperactivity disorder in a residential program. Residents were individually trained in self-management skills with video feedback. Direct-care staff also received training. Although staff increased…

  6. Hiring and Retaining Direct-Care Staff: After Fifty Years of Research, What Do We Know?.

    ERIC Educational Resources Information Center

    Hall, Philip S.; Hall, Nancy D.

    2002-01-01

    This literature review finds that efforts since the 1950s to develop research-based selection tools for recruiting direct-care staff to work with people with developmental disabilities have not been successful. However, researchers have identified practices that can reduce staff turnover, such as articulating the mission and improving human…

  7. Staff and Institutional Factors Associated with Substandard Care in the Management of Postpartum Hemorrhage

    PubMed Central

    Perrodeau, E.; Deneux-Tharaux, C.

    2016-01-01

    Objective to identify staff and institutional factors associated with substandard care by midwives managing postpartum hemorrhage (PPH). Methods A multicenter vignette-based study was e-mailed to a random sample of midwives at 145 French maternity units that belonged to 15 randomly selected perinatal networks. Midwives were asked to describe how they would manage two case-vignettes about PPH and to complete a short questionnaire about their individual (e.g., age, experience, and full- vs. part-time practice) and institutional (private or public status and level of care) characteristics. These previously validated case-vignettes described two different scenarios: vignette 1, a typical immediate, severe PPH, and vignette 2, a severe but gradual hemorrhage. Experts consensually defined 14 criteria to judge adherence to guidelines. The number of errors (possible range: 0 to 14) for the 14 criteria quantified PPH guideline adherence, separately for each vignette. Results 450 midwives from 87 maternity units provided complete responses. Perfect adherence (no error for any of the 14 criteria) was low: 25.1% for vignette 1 and 4.2% for vignette 2. After multivariate analysis, midwives’ age remained significantly associated with a greater risk of error in guideline adherence in both vignettes (IRR 1.19 [1.09; 1.29] for vignette 1, and IRR 1.11 [1.05; 1.18] for vignette 2), and the practice of mortality and morbidity reviews in the unit with a lower risk (IRR 0.80 [0.64; 0.99], IRR 0.78 [0.66; 0.93] respectively). Risk-taking scores (IRR 1.41 [1.19; 1.67]) and full-time practice (IRR 0.83 [0.71; 0.97]) were significantly associated with adherence only in vignette 1. Conclusions Both staff and institutional factors may be associated with substandard care in midwives’ PPH management. PMID:27010407

  8. Authoritarianism, Dogmatism and Coercion in Child Caring Institutions: A Study of Staff Attitudes

    ERIC Educational Resources Information Center

    Krause, Kenneth

    1974-01-01

    Investigated the attitudes of child care institution staff members on dimensions of authoritarianism, dogmatism, and coercion, and related attitudes to type of institution in which subject was employed and position held in the institution. (DP)

  9. Resident Reactions to Person-Centered Communication by Long-Term Care Staff.

    PubMed

    Savundranayagam, Marie Y; Sibalija, Jovana; Scotchmer, Emma

    2016-09-01

    Long-term care staff caregivers who are person centered incorporate the life history, preferences, and feelings of residents with dementia during care interactions. Communication is essential for person-centered care. However, little is known about residents' verbal reactions when staff use person-centered communication. Accordingly, this study investigated the impact of person-centered communication and missed opportunities for such communication by staff on resident reactions. Conversations (N = 46) between staff-resident dyads were audio-recorded during routine care tasks over 12 weeks. Staff utterances were coded for person-centered communication and missed opportunities. Resident utterances were coded for positive reactions, such as cooperation, and negative reactions, such as distress. Linear regression analyses revealed that the more staff used person-centered communication, the more likely that residents reacted positively. Additionally, the more missed opportunities in a conversation, the more likely that the residents reacted negatively. Conversation illustrations elaborate on the quantitative findings and implications for staff training are discussed. PMID:26744507

  10. Need or right: Sexual expression and intimacy in aged care.

    PubMed

    Rowntree, Margaret R; Zufferey, Carole

    2015-12-01

    This paper explores how the residential aged care sector could engage with residents' sexual expression and intimacy. It is informed by a study of 19 aged care staff members and 23 community members, and initially designed on the principles of Appreciative Inquiry methodology. The data were collected through focus groups and interviews and analyzed using discourse analysis. We found that staff members mainly conceptualize sexual expression as a need to be met, while community members (current and prospective residents) understand it as a right to be exercised. We conclude that the way in which sexual expression is conceptualized has critical implications for the sector's engagement with this topic. A 'needs' discourse informs policies, procedures and practices that enable staff to meet residents' needs, while a 'rights' discourse shapes policies, practices and physical designs that improve residents' privacy and autonomy, shifting the balance of power towards them. The former approach fits with a nursing home medical model of care, and the latter with a social model of service provision and consumption. PMID:26568211

  11. Mother, daughter, patient, nurse: women's emotion work in aged care.

    PubMed

    Gattuso, S; Bevan, C

    2000-04-01

    This paper examines emotion work within the predominantly female environment of aged-care nursing, identifying phenomena which must be accounted for in a theory of emotional labour. These phenomena include the blurring of public and private in women's experiences and maternal models of care. Initial findings demonstrate the high levels of stress experienced by staff, related to emotional labour and to conflicts around the erosion of care standards. Sixteen women, from rural Australia, participated in the first stage of the research. The oldest was in her sixties, the youngest in her thirties. Length of aged-care experience ranged from 2 to 33 years. Although most of the women expected to still be in aged care in 5 years' time, they were negative in their attitudes to personal ageing, suggesting an ambivalence in their feelings about working in aged care. Three women nurses are the particular focus of this paper. Their narratives illustrate the intersection of private and public caring in nurses' lives and the implications of this for emotional labour. Phenomena such as dual caring, conflicts in insider-outsider roles, and transference are revealed in their narratives. We argue that the welfare of the recipient of gerontic nursing is linked to the well-being of the nurse-carer but that a cultural change is needed so as to recognize and value emotion work. However, endorsing Staden, we agree that such a change is dependent on the politicization of 'caring'. There is also need for further and broader research concerning the nature of emotional labour and the ethics of care. PMID:10759986

  12. [The need for training in gerontology and geriatrics among the staff providing services at a geriatric care institution].

    PubMed

    Baerga Duperoy, Rachel; Castro Rojas, Nydia; Orta Rodríguez, Brenda; González Caraballo, Enid; Cruz González, Angel; Vázquez Fernández, José; Oliver Vázquez, Marlén

    2002-12-01

    The purpose of this qualitative study was to explore and identify the basic training needs of nursing home staff, in terms of attitudes, knowledge and skills required to work effectively with geriatric patients. Three focus groups were performed, two groups of employees, and a group of elderly residents of the institution, in order to explore issues pertaining to the following topics: personal attributes required to work with geriatric patients, basic knowledge and skills needed to provide effective services. Group discussions were transcribed and themes were extracted through consensus reached by the investigators. Results indicated that the interviewed staff lack of formal preparation or continuing education in gerontology or geriatrics. Needs identified were the following: the aging process, caring behaviors, management of common health conditions, administration of medications, transference and mobility of residents, among others. Finding were use to design an educational program aimed in assisting nursing home staff in providing an effective service to their geriatric patients. PMID:12572242

  13. Well-Child Care Clinical Practice Redesign at a Community Health Center: Provider and Staff Perspectives

    PubMed Central

    Mooney, Kelly; Moreno, Candice; Chung, Paul J.; Elijah, Jacinta; Coker, Tumaini R.

    2014-01-01

    Background Community health centers (CHCs) are a key element of the health care safety net for underserved children. They may be an ideal setting to create well-child care (WCC) clinical practice redesign to drastically improve WCC delivery. Objective To examine the perspectives of clinical and administrative staff at a large, multisite urban CHC on alternative ways to deliver WCC services for low-income children aged 0 to 3 years. Methods Eight semistructured interviews were conducted with 4 pediatric teams (each consisting of 1 pediatrician and 2 medical assistants) and 4 CHC executive/administrative staff (Medical Director, COO, CEO, and Nurse Supervisor). Discussions were recorded, transcribed, and analyzed using the constant comparative method of qualitative analysis. Salient themes included WCC delivery challenges and endorsed WCC clinical practice redesign solutions. Results The 3 main WCC delivery challenges included long wait times due to insurance verification and intake paperwork, lack of time for parent education and sick visits due to WCC visit volume, and absence of a system to encourage physicians to use non–face-to-face communication with parents. To address WCC delivery challenges, CHC providers and administrators endorsed several options for clinical practice redesign in their setting. These included use of a health educator in a team-based model of care, a previsit tool for screening and surveillance, Web site health education, a structured system for non–face-to-face (eg, phone) parent communication, and group visits. Conclusion CHC-specific strategies for WCC clinical practice redesign endorsed by a large, multisite safety net clinic may lead to more efficient, effective, and family-centered WCC for low-income populations. PMID:24327599

  14. Providing and financing aged care in Australia

    PubMed Central

    Ergas, Henry; Paolucci, Francesco

    2011-01-01

    This article focuses on the provision and financing of aged care in Australia. Demand for aged care will increase substantially as a result of population aging, with the number of Australians aged 85 and over projected to increase from 400,000 in 2010 to over 1.8 million in 2051. Meeting this demand will greatly strain the current system, and makes it important to exploit opportunities for increased efficiency. A move to greater beneficiary co-payments is also likely, though its extent may depend on whether aged care insurance and other forms of pre-payment can develop. PMID:22312229

  15. Factors associated with constructive staff-family relationships in the care of older adults in the institutional setting.

    PubMed

    Haesler, Emily; Bauer, Michael; Nay, Rhonda

    2006-12-01

    Background  Modern healthcare philosophy espouses the virtues of holistic care and acknowledges that family involvement is appropriate and something to be encouraged due to the role it plays in physical and emotional healing. In the aged care sector, the involvement of families is a strong guarantee of a resident's well-being. The important role family plays in the support and care of the older adult in the residential aged care environment has been enshrined in the Australian Commonwealth Charter of Residents' Rights and Responsibilities and the Aged Care Standards of Practice. Despite wide acknowledgement of the importance of family involvement in the healthcare of the older adult, many barriers to the implementation of participatory family care have been identified in past research. For older adults in the healthcare environment to benefit from the involvement of their family members, healthcare professionals need an understanding of the issues surrounding family presence in the healthcare environment and the strategies to best support it. Objectives  The objectives of the systematic review were to present the best available evidence on the strategies, practices and organisational characteristics that promote constructive staff-family relationships in the care of older adults in the healthcare setting. Specifically this review sought to investigate how staff and family members perceive their relationships with each other; staff characteristics that promote constructive relationships with the family; and interventions that support staff-family relationships. Search strategy  A literature search was performed using the following databases for the years 1990-2005: Ageline, APAIS Health, Australian Family and Society Abstracts (FAMILY), CINAHL, Cochrane Library, Dare, Dissertation Abstracts, Embase, MEDLINE, PsycINFO and Social Science Index. Personal communication from expert panel members was also used to identify studies for inclusion. A second search stage

  16. Role of urgent care staff in organ donation.

    PubMed

    Garside, Marie; Garside, Jules

    2010-10-01

    A detailed review of donation activity since the introduction of an embedded specialist nurse in organ donation (SNOD) in Norfolk and Norwich University Hospitals NHS Foundation Trust has confirmed the benefits of this role for the identification and referral of potential donors by emergency department (ED) staff. This article argues that, as EDs across the U.K. introduce SNODs, more organs will become available for transplant. PMID:21066923

  17. 76 FR 74834 - Interim Staff Guidance on Aging Management Program for Steam Generators

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-01

    ... provided to the NRC on May 6, 2011. On September 30, 2011 (76 FR 60937), the NRC published a request for... COMMISSION Interim Staff Guidance on Aging Management Program for Steam Generators AGENCY: Nuclear Regulatory... Program for Steam Generators.'' This LR-ISG provides the NRC staff's evaluation of the suitability...

  18. In-Service Training of Professional and Para-Professional Staff in Institutions for the Aged.

    ERIC Educational Resources Information Center

    Ron, Pnina; Lowenstein, Ariela

    2002-01-01

    Paraprofessional staff in six Israeli institutions for the elderly received training in psychological and social aspects of aging, loneliness and loss, communication, multiprofessional staff work, and elders with disabilities. They expressed a need for additional training in following up on physiotherapy. (Contains 18 references.) (SK)

  19. Staff opinions about the leadership and organisation of municipal dementia care.

    PubMed

    Albinsson, L; Strang, P

    2002-09-01

    The present study describes the opinions of experienced staff providing direct care to patients with dementia in municipal units in Sweden. The focus is mainly on leadership and other organisational factors. A purposeful sample of 31 staff members employed in municipal dementia care in both urban and rural areas in mid-Sweden were selected. Data were collected within a qualitative paradigm using semi-structured interviews which were tape-recorded and analysed using a modified phenomenographical approach. The nearly unanimous opinions of the interviewees indicated that there was a great lack of daily leadership in the units. Thus, few units had clearly formulated goals and few had regular care planning for their residents. Poorly developed teamwork was reported in the care of people with dementia especially regarding doctors, whose visits to the unit were too infrequent and too short, and did not include a direct exchange of information with other staff. In addition, little or no staff education and guidance/supervision was provided on a regular basis. In conclusion, without any unreasonable increase in cost, measures such as introducing clear leadership at the care unit level, concentrating on multi-professional teamwork, and providing education and guidance/supervision to the staff would probably result in better care for patients with dementia and their families. PMID:12390217

  20. Measuring Staff Empowerment Regarding Health Care for Clients with Intellectual Disabilities

    PubMed Central

    Wilkinson, Joanne; Greenwood, Nechama W.; Wang, Claire Tienwey; White, Laura F.; Culpepper, Larry

    2014-01-01

    Background. Women with intellectual disabilities (ID) contract breast cancer at the same rate as the general population but have higher breast cancer mortality and lower rates of breast cancer screening. Many women with ID live in group homes or supported residences where they are cared for by direct support workers. While direct support workers are thought to influence client health, this effect is underresearched, and we lack tools for measuring staff empowerment and perceptions regarding client health. Methods. We developed and validated an instrument, the staff empowerment tool (SET), to measure staff empowerment as related to supporting clients in preventive health. Results. The SET was found to be a reliable instrument for measuring staff activation and empowerment in helping clients access mammography screening. Discussion. Quantifying staff empowerment and perspectives is important in studying and reducing disparities among adults with ID, a vulnerable population. Further research to determine the impact of staff empowerment levels on their clients' health and health care access is suggested. The SET is a valuable tool for measuring the construct of staff empowerment, evaluating interventions, and collecting data regarding variation in staff empowerment. PMID:24719760

  1. Sexual incidents in an extended care unit for aged men.

    PubMed

    Szasz, G

    1983-07-01

    A survey was conducted among the nursing staff of a 400-bed extended-care unit for aged men by questionnaire to find out what patient behaviors were identified as sexual by the staff and how they reacted to these behaviors. Three types of behavior were identified as sexual and as "causing problems": sex talk (e.g., using foul language); sexual acts (e.g., touching or grabbing, exposing genitalia); and implied sexual behavior (e.g., openly reading pornographic magazines). As many as 25 per cent of the residents were thought to create such incidents. Acceptable sexual behavior identified by the staff were limited to hugging and kissing on the cheek, although their answers implied that residents could need more intimate touching and affection. The survey raised questions about the nature and causes of different types of sexual behavior in the institutionalized elderly and about the roles nursing staff, physicians, and administrators can play in recognizing individual needs while safeguarding both the residents and the staff from the consequences of unacceptable incidents. PMID:6863791

  2. School Age Child Care: A Preliminary Report.

    ERIC Educational Resources Information Center

    Jacobs, Ellen; And Others

    This paper examines on-site, school-age child care and the relationship between attendance at on-site, after-school child care programs and familial, environmental, and developmental factors. Topics discussed include: (1) the quality of school-based environments in kindergarten and child care; (2) the socioeconomic status and size of families of…

  3. [The difficulties of staff retention in neonatal intensive care units].

    PubMed

    Deparis, Corinne

    2015-01-01

    Neonatal intensive care units attract nurses due to the technical and highly specific nature of the work. However, there is a high turnover in these departments. Work-related distress and the lack of team cohesion are the two main causes of this problem. Support from the health care manager is essential in this context. PMID:26183101

  4. Child Care Staff Compensation Guidelines for California 1998.

    ERIC Educational Resources Information Center

    Burton, Alice; Whitebook, Marcy

    Noting a growing consensus that inadequate compensation contributes to turnover among child care teachers and providers, and undermines the quality of services available to children through the state of California, this report presents compensation guidelines developed as a means for Title 5 child care centers and others in California to assess…

  5. Safety Hazards in Child Care Settings. CPSC Staff Study.

    ERIC Educational Resources Information Center

    Consumer Product Safety Commission, Washington, DC.

    Each year, thousands of children in child care settings are injured seriously enough to need emergency medical treatment. This national study identified potential safety hazards in 220 licensed child care settings in October and November 1998. Eight product areas were examined: cribs, soft bedding, playground surfacing, playground surface…

  6. Cash Incentives and Turnover in Center-Based Child Care Staff

    ERIC Educational Resources Information Center

    Gable, Sara; Rothrauff, Tanja C.; Thornburg, Kathy R.; Mauzy, Denise

    2007-01-01

    The current study evaluates the Workforce INcentive Project (WIN), a programmatic effort to increase child care workforce stability in center- and home-based child care providers via the provision of bi-annual cash incentives based on educational attainment. Five hundred and thirteen center-based teaching staff (304 WIN and 209 comparison) and 167…

  7. E-assessment of prior learning: a pilot study of interactive assessment of staff with no formal education who are working in Swedish elderly care

    PubMed Central

    2014-01-01

    Background The current paper presents a pilot study of interactive assessment using information and communication technology (ICT) to evaluate the knowledge, skills and abilities of staff with no formal education who are working in Swedish elderly care. Methods Theoretical and practical assessment methods were developed and used with simulated patients and computer-based tests to identify strengths and areas for personal development among staff with no formal education. Results Of the 157 staff with no formal education, 87 began the practical and/or theoretical assessments, and 63 completed both assessments. Several of the staff passed the practical assessments, except the morning hygiene assessment, where several failed. Other areas for staff development, i.e. where several failed (>50%), were the theoretical assessment of the learning objectives: Health, Oral care, Ergonomics, hygiene, esthetic, environmental, Rehabilitation, Assistive technology, Basic healthcare and Laws and organization. None of the staff passed all assessments. Number of years working in elderly care and staff age were not statistically significantly related to the total score of grades on the various learning objectives. Conclusion The interactive assessments were useful in assessing staff members’ practical and theoretical knowledge, skills, and abilities and in identifying areas in need of development. It is important that personnel who lack formal qualifications be clearly identified and given a chance to develop their competence through training, both theoretical and practical. The interactive e-assessment approach analyzed in the present pilot study could serve as a starting point. PMID:24742168

  8. Predictors of Job Satisfaction Among Staff Working With the Aged.

    ERIC Educational Resources Information Center

    Neale, Anne Victoria; And Others

    Severe problems in turnover and absenteeism among workers in geriatric and long-term care organizations have sparked great interest in the impact of job satisfaction on the quality of care provided to the elderly. The Job Description Index (JDI) is a job satisfaction index which measures satisfaction with several dimensions of the job: co-workers,…

  9. Autonomy, Choice, Patient-Centered Care, and Hip Protectors: The Experience of Residents and Staff in Long-Term Care

    PubMed Central

    Sims-Gould, Joanie; McKay, Heather A.; Feldman, Fabio; Scott, Victoria; Robinovitch, Stephen N.

    2013-01-01

    The purpose of this study was to examine long-term care (LTC) resident and staff perceptions on the decision to use hip protectors and identify the factors that influence attitudes toward hip protector use. Staff (N = 39) and residents (N = 27) at two residential care facilities in British Columbia, Canada were invited to participate in focus groups on fall prevention and hip protector use. A total of 11 focus groups were conducted. Using framework analysis results show that residents and staff shared concerns on aesthetic and comfort issues with hip protectors. Residents also generally felt they did not need, or want to use, hip protectors. However, they also had desire to be cooperative within the LTC environment. Staff underscored their role in advocating for hip protector use and their desire to protect residents from harm. Practice considerations for facilities wishing to promote hip protectors within a patient centered framework are highlighted. PMID:24652886

  10. Primary Care Clinician Expectations Regarding Aging

    ERIC Educational Resources Information Center

    Davis, Melinda M.; Bond, Lynne A.; Howard, Alan; Sarkisian, Catherine A.

    2011-01-01

    Purpose: Expectations regarding aging (ERA) in community-dwelling older adults are associated with personal health behaviors and health resource usage. Clinicians' age expectations likely influence patients' expectations and care delivery patterns; yet, limited research has explored clinicians' age expectations. The Expectations Regarding Aging…

  11. 25 CFR 900.199 - Does FTCA coverage extend to health care practitioners to whom staff privileges have been...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Does FTCA coverage extend to health care practitioners to whom staff privileges have been extended in contractor health care facilities operated under a self... Claims § 900.199 Does FTCA coverage extend to health care practitioners to whom staff privileges...

  12. Stress, Social Support, and Burnout Among Long-Term Care Nursing Staff.

    PubMed

    Woodhead, Erin L; Northrop, Lynn; Edelstein, Barry

    2016-01-01

    Long-term care nursing staff are subject to considerable occupational stress and report high levels of burnout, yet little is known about how stress and social support are associated with burnout in this population. The present study utilized the job demands-resources model of burnout to examine relations between job demands (occupational and personal stress), job resources (sources and functions of social support), and burnout in a sample of nursing staff at a long-term care facility (N = 250). Hierarchical linear regression analyses revealed that job demands (greater occupational stress) were associated with more emotional exhaustion, more depersonalization, and less personal accomplishment. Job resources (support from supervisors and friends or family members, reassurance of worth, opportunity for nurturing) were associated with less emotional exhaustion and higher levels of personal accomplishment. Interventions to reduce burnout that include a focus on stress and social support outside of work may be particularly beneficial for long-term care staff. PMID:25098251

  13. Working Atmosphere and Job Satisfaction of Health Care Staff in Kenya: An Exploratory Study

    PubMed Central

    Goetz, Katja; Marx, Michael; Marx, Irmgard; Brodowski, Marc; Nafula, Maureen; Prytherch, Helen; Omogi Awour, Irene K. E.; Szecsenyi, Joachim

    2015-01-01

    Background. Job satisfaction and working atmosphere are important for optimal health care delivery. The study aimed to document working atmosphere and job satisfaction of health care professionals in Kenya and to explore associations between job satisfaction, staff characteristics, and working atmosphere. Methods. Data from the integrated quality management system (IQMS) for the health sector in Kenya were used. Job satisfaction was measured with 10 items and with additional 5 items adapted to job situation in Kenya. Working atmosphere was measured with 13 item questionnaire. A stepwise linear regression analysis was performed with overall job satisfaction and working atmosphere, aspects of job satisfaction, and individual characteristics. Results. Out of 832 questionnaires handed out, 435 questionnaires were completed (response rate: 52.3%). Health care staff indicated high commitment to provide quality services and low levels regarding the adequacy and functionality of equipment at their work station. The aspect “support of the ministry of health” (β = 0.577) showed the highest score of explained variance (32.9%) regarding overall job satisfaction. Conclusions. IQMS which also evaluates job satisfaction and working atmosphere of health care staff provides a good opportunity for strengthening the recruitment and retention of health care staff as well as improving the provision of good quality of care. PMID:26504793

  14. Preparing Corrections Staff for the Future: Results of a 2-Day Training About Aging Inmates.

    PubMed

    Masters, Julie L; Magnuson, Thomas M; Bayer, Barbara L; Potter, Jane F; Falkowski, Paul P

    2016-04-01

    The aging of the prison population presents corrections staff with unique challenges in knowing how to support inmates while maintaining security. This article describes a 2-day training program to introduce the aging process to select staff at all levels. While the results of a pre-posttest measure, using a modified version of Palmore's Facts on Aging Quiz, did not produce a statistically significant difference at the conclusion of the training, attendees did express satisfaction with the training and their newfound insight into the challenges faced by aging inmates. They also offered recommendations for future training to include more practical suggestions for the work environment. PMID:26984135

  15. Training Staff To Provide Developmentally Appropriate Child Care.

    ERIC Educational Resources Information Center

    Blazier, R. Elaine

    The director of a proprietary child care center implemented a practicum designed to train child caregivers in child development and developmentally appropriate practices. The practicum consisted of three evening workshops and used supplementary reading materials, discussion groups, classroom observations, and individual conferences. After…

  16. House Staff Attitudes toward Psychosocial Aspects of Patient Care.

    ERIC Educational Resources Information Center

    Levinson, Wendy; And Others

    1990-01-01

    Attitudes of 120 residents from three teaching hospitals about psychosocial aspects of patient care and the feasibility of teaching psychosocial skills to residents were compared to those of 86 practicing internists, 42 psychiatrists, 29 academic general internists, and 63 surgeons. The newly developed scale was seen as useful in evaluating…

  17. Caring for inpatient boarders in the emergency department: improving safety and patient and staff satisfaction.

    PubMed

    Bornemann-Shepherd, Melanie; Le-Lazar, Jamie; Makic, Mary Beth Flynn; DeVine, Deborah; McDevitt, Kelly; Paul, Marcee

    2015-01-01

    Hospital capacity constraints lead to large numbers of inpatients being held for extended periods in the emergency department. This creates concerns with safety, quality of care, and dissatisfaction of patients and staff. The aim of this quality-improvement project was to improve satisfaction and processes in which nurses provided care to inpatient boarders held in the emergency department. A quality-improvement project framework that included the use of a questionnaire was used to ascertain employee and patient dissatisfaction and identify opportunities for improvement. A task force was created to develop action plans related to holding and caring for inpatients in the emergency department. A questionnaire was sent to nursing staff in spring 2012, and responses from the questionnaire identified improvements that could be implemented to improve care for inpatient boarders. Situation-background-assessment-recommendation (SBAR) communications and direct observations were also used to identify specific improvements. Post-questionnaire results indicated improved satisfaction for both staff and patients. It was recognized early that the ED inpatient area would benefit from the supervision of an inpatient director, managers, and staff. Outcomes showed that creating an inpatient unit within the emergency department had a positive effect on staff and patient satisfaction. PMID:24985747

  18. A Cluster-Randomised Trial of Staff Education to Improve the Quality of Life of People with Dementia Living in Residential Care: The DIRECT Study

    PubMed Central

    Beer, Christopher; Horner, Barbara; Flicker, Leon; Scherer, Samuel; Lautenschlager, Nicola T.; Bretland, Nick; Flett, Penelope; Schaper, Frank; Almeida, Osvaldo P.

    2011-01-01

    Background The Dementia In Residential care: EduCation intervention Trial (DIRECT) was conducted to determine if delivery of education designed to meet the perceived need of GPs and care staff improves the quality of life of participants with dementia living in residential care. Methodology/Principal Findings This cluster-randomised controlled trial was conducted in 39 residential aged care facilities in the metropolitan area of Perth, Western Australia. 351 care facility residents aged 65 years and older with Mini-Mental State Examination ≤24, their GPs and facility staff participated. Flexible education designed to meet the perceived needs of learners was delivered to GPs and care facility staff in intervention groups. The primary outcome of the study was self-rated quality of life of participants with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD) at 4 weeks and 6 months after the conclusion of the intervention. Analysis accounted for the effect of clustering by using multi-level regression analysis. Education of GPs or care facility staff did not affect the primary outcome at either 4 weeks or 6 months. In a post hoc analysis excluding facilities in which fewer than 50% of staff attended an education session, self-rated QOL-AD scores were 6.14 points (adjusted 95%CI 1.14, 11.15) higher at four-week follow-up among residents in facilities randomly assigned to the education intervention. Conclusion The education intervention directed at care facilities or GPs did not improve the quality of life ratings of participants with dementia as a group. This may be explained by the poor adherence to the intervention programme, as participants with dementia living in facilities where staff participated at least minimally seemed to benefit. Trial Registration ANZCTR.org.au ACTRN12607000417482 PMID:22140531

  19. Effects of Dementia-Care Mapping on Residents and Staff of Care Homes: A Pragmatic Cluster-Randomised Controlled Trial

    PubMed Central

    van de Ven, Geertje; Draskovic, Irena; Adang, Eddy M. M.; Donders, Rogier; Zuidema, Sytse U.; Koopmans, Raymond T. C. M.; Vernooij-Dassen, Myrra J. F. J.

    2013-01-01

    Background The effectiveness of dementia-care mapping (DCM) for institutionalised people with dementia has been demonstrated in an explanatory cluster-randomised controlled trial (cRCT) with two DCM researchers carrying out the DCM intervention. In order to be able to inform daily practice, we studied DCM effectiveness in a pragmatic cRCT involving a wide range of care homes with trained nursing staff carrying out the intervention. Methods Dementia special care units were randomly assigned to DCM or usual care. Nurses from the intervention care homes received DCM training and conducted the 4-months DCM-intervention twice during the study. The primary outcome was agitation, measured with the Cohen-Mansfield agitation inventory (CMAI). The secondary outcomes included residents’ neuropsychiatric symptoms (NPSs) and quality of life, and staff stress and job satisfaction. The nursing staff made all measurements at baseline and two follow-ups at 4-month intervals. We used linear mixed-effect models to test treatment and time effects. Results 34 units from 11 care homes, including 434 residents and 382 nursing staff members, were randomly assigned. Ten nurses from the intervention units completed the basic and advanced DCM training. Intention-to-treat analysis showed no statistically significant effect on the CMAI (mean difference between groups 2·4, 95% CI −2·7 to 7·6; p = 0·34). More NPSs were reported in the intervention group than in usual care (p = 0·02). Intervention staff reported fewer negative and more positive emotional reactions during work (p = 0·02). There were no other significant effects. Conclusions Our pragmatic findings did not confirm the effect on the primary outcome of agitation in the explanatory study. Perhaps the variability of the extent of implementation of DCM may explain the lack of effect. Trial Registration Dutch Trials Registry NTR2314. PMID:23844003

  20. Staff working in ancillary departments at a tertiary care hospital in Bengaluru, Karnataka, India: How healthy are they?

    PubMed Central

    Balasubramanya, Bhavya; Nisha, Catherin; Ramesh, Naveen; Joseph, Bobby

    2016-01-01

    Background: Ancillary health services are those supplemental services other than room, board, and medical/nursing services provided to hospital patients in the course of care. Ancillary department staff forms an integral part in the smooth functioning of a hospital. There is a need to focus on the health of these individuals to ensure their well-being and in turn, productivity at the workplace. Objective: To study the morbidity profile of the staff working at ancillary departments of a tertiary care hospital in Bengaluru, Karnataka, India. Materials and Methods: We conducted our study in a 1,200-bedded tertiary care hospital in Bengaluru, Karnataka, India. Annual medical checkup (AMC) for all the staff working at the ancillary departments has been started in recent years and is provided free of cost and during working hours. A total of 150 employees from ancillary departments underwent AMC in the year 2013. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 20.0. Spearman's correlation and Chi-square test were used. Results: Of the 150 employees, the majority was male (72%); the mean age was 38 ± 11 years. The most common morbidities were diabetes mellitus (11%), hypertension (10.6%), musculoskeletal disorders (9.3%), surgical problems (8.6%, hemorrhoids, varicose veins), and dental caries (6.6%). On stool microscopy, 12% of the dietary workers showed ova/cyst. There was a significant positive correlation between age and the number of chronic morbidities (P < 0.01). Conclusion: Lifestyle disorders such as diabetes mellitus and hypertension were the major morbidities among the staff in the ancillary departments of the hospital. We ensured regular follow-up, adherence to medication, and lifestyle modifications in terms of diet and exercise. PMID:27390479

  1. Literacy in the World of the Aged Care Worker.

    ERIC Educational Resources Information Center

    Wyse, Linda; Casarotto, Nadia

    Australia's Aged Care Act of 1997 mandates a number of key reforms aimed at ensuring consistency in the quality of care and well-being for all residents of aged care facilities. The law required residential aged care facilities to provide high-quality care within a framework of continuous improvement which requires aged care workers to perform the…

  2. The Aging Brain Care Medical Home: Preliminary Data.

    PubMed

    LaMantia, Michael A; Alder, Catherine A; Callahan, Christopher M; Gao, Sujuan; French, Dustin D; Austrom, Mary G; Boustany, Karim; Livin, Lee; Bynagari, Bharath; Boustani, Malaz A

    2015-06-01

    The Aging Brain Care (ABC) Medical Home aims to improve the care, health outcomes, and medical costs of Medicare beneficiaries with dementia or depression across central Indiana. This population health management program, funded by the Centers for Medicare and Medicaid Services Innovation Center, expanded an existing collaborative dementia and depression care program to serve 1,650 older adults in a local safety-net hospital system. During the first year, 20 full-time clinical staff were hired, trained, and deployed to deliver a collaborative care intervention. In the first 18 months, an average of 13 visits was provided per person. Thirty percent of the sample had a diagnosis of dementia, and 77% had a diagnosis of depression. Sixty-six percent of participants with high depression scores (Patient Health Questionnaire-9 score ≥14) had at least a 50% reduction in their depressive symptoms. Fifty-one percent of caregivers of individuals with dementia had at least a 50% reduction in caregiver stress symptoms (measured by the Healthy Aging Brain Care Monitor-Caregiver Version). After 18 months, the ABC Medical Home has demonstrated progress toward improving the health of older adults with dementia and depression. Scalable and practical models like this show initial promise for answering the challenges posed by the nation's rapidly aging population. PMID:26096394

  3. Sharing skills in dementia care with staff overseas.

    PubMed

    Marçal-Grilo, João

    2014-05-01

    More than 35 million people worldwide are living with dementia. In some countries the existence of a health and social welfare state offers a level of support to those affected, but in many others resources are limited and inadequate, with responsibility for care lying primarily with relatives and friends. Significant efforts are being made by low and middle income nations to respond to the health needs of patients and carers, yet insufficient numbers of professionals and lack of specialist training opportunities are barriers that are difficult to overcome. Based on the author's volunteering experience in Sri Lanka, this article explores the role of UK trained nurses in supporting the development of dementia care services in countries where resources are limited. It discusses the contribution that nurses can make to the creation of services and reflects on the benefits that such exchanges can have on nursing practice in the UK. PMID:24787946

  4. Training day care staff to facilitate children's language.

    PubMed

    Girolametto, Luigi; Weitzman, Elaine; Greenberg, Janice

    2003-08-01

    This exploratory study investigated the outcome of in-service training on language facilitation strategies of child care providers in day care centers. Sixteen caregivers were randomly assigned to experimental and control groups. Caregivers were taught to be responsive to children's initiations, engage children in interactions, model simplified language, and encourage peer interactions. At posttest, the experimental group waited for children to initiate, engaged them in turn-taking, used face to face interaction, and included uninvolved children more frequently than the control group. In turn, children in the experimental group talked more, produced more combinations, and talked to peers more often than the control group. The results support the viability of this training model in early childhood education settings and suggest directions for future research. PMID:12971819

  5. Servant leadership: enhancing quality of care and staff satisfaction.

    PubMed

    Neill, Mark W; Saunders, Nena S

    2008-09-01

    Servant leadership encompasses a powerful skill set that is particularly effective in implementing a team approach to the delivery of nursing practice. This model encourages the professional growth of nurses and simultaneously promotes the improved delivery of healthcare services through a combination of interdisciplinary teamwork, shared decision making, and ethical behavior. The authors describe the case application of servant leadership principles in a Department of Veterans Affairs Medical Intensive Care Unit located in a large urban center. PMID:18791423

  6. Care of Aging Parents by Adult Offspring.

    ERIC Educational Resources Information Center

    Ames, Barbara D.

    A prevailing myth holds that modern families, characterized by high mobility and individualistic life styles, do not care for their aging members. To assess the quantity and characteristics of the care of noninstitutionalized elderly parents by their adult children, parents and adult child pairs (N=50) responded to interviews. Specific research…

  7. Planning and Decision Making about the Future Care of Older Group Home Residents and Transition to Residential Aged Care

    ERIC Educational Resources Information Center

    Bigby, C.; Bowers, B.; Webber, R.

    2011-01-01

    Background: Planning for future care after the death of parental caregivers and adapting disability support systems to achieve the best possible quality of life for people with intellectual disability as they age have been important issues for more than two decades. This study examined perceptions held by family members, group home staff and…

  8. A gap between Need and Reality: Neonatal Nursing Staff Requirements on a German Intensive Care Unit.

    PubMed

    Patry, Christian; Schindler, Monika; Reinhard, Julia; Hien, Steffen; Demirakca, Süha; Böhler, Thomas; Schaible, Thomas

    2014-02-17

    Recently, new staffing rules for neonatal nurses in intensive care units (ICU) were issued in Germany, using categories of care of the British Association of Perinatal Medicine as blueprint. Neonates on intensive care require a nurse-to-patient ratio of 1:1, on intensive surveillance (high dependency care) of 1:2. No requirements exist for special care, transitional care, and pediatric ICU patients. Using these rules, nursing staff requirement was calculated over a period of 31 consecutive days once a day in a combined pediatric and neonatal ICU of a metropolitan academic medical center in southwest Germany. Each day, 18.9±0.98 patients (mean±standard deviation) were assessed (14.26±1.21 neonatal, 4.65±0.98 pediatric). Among neonates, 9.94±2.56 received intensive therapy, 3.77±1.85 intensive surveillance, and 0.65±0.71 special care. Average nursing staff requirement was 12.10±1.81 full time equivalents (FTE) per shift. Considering additional pediatric patients in the ICU and actual nursing staff availability (8.97±0.87 FTE per shift), this ICU seems understaffed. PMID:24711913

  9. The Impact of an Implementation Project on Primary Care Staff Perceptions of Delivering Brief Alcohol Advice

    PubMed Central

    Reinholdz, Hanna; Bendtsen, Preben; Spak, Fredrik

    2016-01-01

    Objective. To explore how the perceptions and experiences of working with risky drinkers change over time among primary health care staff during a systematic implementation project. Methods. Qualitative focus group interviews took place before and after the implementation of the project. Results. The staff displayed a positive change during the implementation period with regard to awareness, knowledge, and confidence that led to a change in routine practice. Throughout the project, staff were committed to engaging with risky drinkers and appeared to have been learning-by-doing. Conclusions. The results indicated a positive attitude to alcohol prevention work but staff lack knowledge and confidence in the area. The more practical experience during the study is, the more confidence seems to have been gained. This adds new knowledge to the science of implementation studies concerning alcohol prevention measures, which have otherwise shown disappointing results, emphasizing the importance of learning in practice. PMID:27446626

  10. The Impact of Simulated Aging on Nursing Staff Self Reports of Job Satisfaction and Performance.

    ERIC Educational Resources Information Center

    Robinson, James D.; Nussbaum, Jon F.

    A study examined the impact of a simulated aging experience on nursing staff perceptions of job satisfaction and job performance. It was hypothesized that nurses and nurse aides who participated in the simulated aging experience would be more satisfied with their jobs and would receive fewer complaints from residents than those who did not…

  11. Staff training and turnover in Alzheimer special care units: comparisons with non-special care units.

    PubMed

    Grant, L A; Kane, R A; Potthoff, S J; Ryden, M

    1996-01-01

    Nursing facility staff may not be properly trained to deal with behavioral symptoms of Alzheimer's disease. We collected data about specialized dementia training and turnover among licensed nurses and nursing assistants in 400 nursing units in 124 Minnesota nursing facilities. Staff training may affect the retention of paraprofessional and professional nursing staff. A diversity of training methods, including workshops or seminars, films or videos, outside consultants, reading materials, training manuals, in-house experts, role playing techniques, or an orientation program for new staff, might be used to develop more effective training programs and reduce rates of nursing assistant turnover. PMID:9060276

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

    ERIC Educational Resources Information Center

    Sheridan, John E.; And Others

    1992-01-01

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

  13. Ways that Families Engage with Staff in Long-Term Care Facilities

    ERIC Educational Resources Information Center

    Gladstone, James W.; Dupuis, Sherry L.; Wexler, Evelyn

    2007-01-01

    The purpose of this qualitative study was to explore styles of engagement used by families with staff in long-term care facilities. Data were gathered through personal interviews with 35 family members. Five styles of engagement were identified: positive, negative, peremptory, cautious, and limited. Factors associated with these different styles…

  14. Stress and Burnout among Health-Care Staff Working with People Affected by HIV.

    ERIC Educational Resources Information Center

    Miller, David

    1995-01-01

    The nature, causes, consequences, and symptoms of stress and burnout among health-care staff working with people affected by HIV are identified. The extent to which these characteristics are specific to HIV/AIDS workers is discussed. Some options for prevention and management of burnout are presented. (Author)

  15. Measuring Child-Staff Ratios in Child Care Centers: Balancing Effort and Representativeness

    ERIC Educational Resources Information Center

    Le, Vi-Nhuan; Perlman, Michal; Zellman, Gail L.; Hamilton, Laura S.

    2006-01-01

    Child-staff ratios are an important quality indicator. They are often collected by observing one randomly selected classroom several times during a 2-h period on a single day. However, it is unclear whether these measures represent the ratios that children actually experience during most of their time in care. This study compared ratio data…

  16. SUPPORTING PRETERM INFANT ATTACHMENT AND SOCIOEMOTIONAL DEVELOPMENT IN THE NEONATAL INTENSIVE CARE UNIT: STAFF PERCEPTIONS.

    PubMed

    Twohig, Aoife; Reulbach, Udo; Figuerdo, Ricardo; McCarthy, Anthony; McNicholas, Fiona; Molloy, Eleanor Joan

    2016-01-01

    The infant-parent relationship has been shown to be of particular significance to preterm infant socioemotional development. Supporting parents and infants in this process of developing their relationships is an integral part of neonatal intensive care; however, there is limited knowledge of NICU staff perceptions about this aspect of care. To explore NICU staff perceptions about attachment and socioemotional development of preterm infants, experience of training in this area and the emotional impact of their work. A cross-sectional questionnaire survey of staff perceptions of the emotional experiences of parents and the developing parent-infant relationship in an NICU was conducted in a Level III NICU, after pilot testing, revision, and ethical approval. Fifty-seven (68%) of NICU staff responded to the survey. Respondents identified parents' emotional experiences such as "anxiety," "shock," "loss of control," and "lack of feelings of competence as parents" as highly prevalent. Infant cues of "responding to parent's voice" and "quieting-alerting" were ranked most highly; "crying" and "physiological changes" were ranked lowest. Preterm infant medical risk, maternal emotional state, and mental health are perceived to impact most highly on the developing relationship, as compared with infant state or behavior and socioeconomic factors. Fifty-three (93%) respondents felt confident, and 50 (87.8%) felt competent discussing their emotional experiences with parents. Fifty-four (95%) responded that attending to these areas was an integral part of their role; however, staff had seldom received education in this area. Respondents also perceived that specific psychological support for parents was lacking both during and after the infant's discharge. While all staff surveyed perceived the nature of their work to be emotionally stressful, there were differences among NICU staff disciplines and with years of experience in the NICU in terms of their perceptions about education in

  17. 76 FR 24494 - Draft Guidance for Industry and FDA Staff: Processing/Reprocessing Medical Devices in Health Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-02

    .../ Reprocessing Medical Devices in Health Care Settings: Validation Methods and Labeling; Availability AGENCY... Staff: Processing/Reprocessing Medical Devices in Health Care Settings: Validation Methods and Labeling... ``Draft Guidance for Industry and FDA Staff: Processing/Reprocessing Medical Devices in Health...

  18. Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers

    PubMed Central

    Odusola, Aina O.; Stronks, Karien; Hendriks, Marleen E.; Schultsz, Constance; Akande, Tanimola; Osibogun, Akin; van Weert, Henk; Haafkens, Joke A.

    2016-01-01

    Background Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA) that can be modified through timely and long-term treatment in primary care. Objective We explored perspectives of primary care staff and health insurance managers on enablers and barriers for implementing high-quality hypertension care, in the context of a community-based health insurance programme in rural Nigeria. Design Qualitative study using semi-structured individual interviews with primary care staff (n = 11) and health insurance managers (n=4). Data were analysed using standard qualitative techniques. Results Both stakeholder groups perceived health insurance as an important facilitator for implementing high-quality hypertension care because it covered costs of care for patients and provided essential resources and incentives to clinics: guidelines, staff training, medications, and diagnostic equipment. Perceived inhibitors included the following: high staff workload; administrative challenges at facilities; discordance between healthcare provider and insurer on how health insurance and provider payment methods work; and insufficient fit between some guideline recommendations and tools for patient education and characteristics/needs of the local patient population. Perceived strategies to address inhibitors included the following: task-shifting; adequate provider payment benchmarking; good provider–insurer relationships; automated administration systems; and tailoring guidelines/patient education. Conclusions By providing insights into perspectives of primary care providers and health insurance managers, this study offers information on potential strategies for implementing high-quality hypertension care for insured patients in SSA. PMID:26880152

  19. Extending Our Understanding of Burnout and Its Associated Factors: Providers and Staff in Primary Care Clinics.

    PubMed

    Spinelli, William M; Fernstrom, Karl M; Galos, Dylan L; Britt, Heather R

    2016-09-01

    Burnout has been identified as an occupational hazard in the helping professions for many years and is often overlooked, as health-care systems strive to improve cost and quality. The Maslach Burnout Inventory (MBI) and the Areas of Worklife Survey (AWS) are tools for assessing burnout prevalence and its associated factors. We describe how we used them in outpatient clinics to assess burnout for multiple job types. Traditional statistical techniques and seemingly unrelated regression were used to describe the sample and evaluate the association between work life domains and burnout. Of 838 eligible participants, 467 (55.7%) were included for analysis. Burnout prevalence varied across three job categories: providers (37.5%), clinical assistants (24.6%), and other staff (28.0%). It was not related to age, gender, or years of tenure but was lower in part-time workers (24.6%) than in full-time workers (33.9%). Analysis of the AWS subscales identified organizational correlates of burnout. Accurately identifying and defining the operative system factors associated with burnout will make it possible to create successful interventions. Using the MBI and the AWS together can highlight the relationship between system work experiences and burnout. PMID:27000131

  20. Bench-to-bedside review: dealing with increased intensive care unit staff turnover: a leadership challenge.

    PubMed

    Laporta, Denny P; Burns, Judy; Doig, Chip J

    2005-10-01

    Critical care leaders frequently must face challenging situations requiring specific leadership and management skills for which they are, not uncommonly, poorly prepared. Such a fictitious scenario was discussed at a Canadian interdisciplinary critical care leadership meeting, whereby increasing intensive care unit (ICU) staff turnover had led to problems with staff recruitment. Participants discussed and proposed solutions to the scenario in a structured format. The results of the discussion are presented. In situations such as this, the ICU leader should first define the core problem, its complexity, its duration and its potential for reversibility. These factors often reside within workload and staff support issues. Some examples of core problems discussed that are frequently associated with poor retention and recruitment are a lack of a positive team culture, a lack of a favorable ICU image, a lack of good working relationships between staff and disciplines, and a lack of specific supportive resources. Several tools or individuals (typically outside the ICU environment) are available to help determine the core problem. Once the core problem is identified, specific solutions can be developed. Such solutions often require originality and flexibility, and must be planned, with specific short-term, medium-term and long-term goals. The ICU leader will need to develop an implementation strategy for these solutions, in which partners who can assist are identified from within the ICU and from outside the ICU. It is important that the leader communicates to all stakeholders frequently as the process moves forward. PMID:16277732

  1. Bench-to-bedside review: Dealing with increased intensive care unit staff turnover: a leadership challenge

    PubMed Central

    Laporta, Denny P; Burns, Judy; Doig, Chip J

    2005-01-01

    Critical care leaders frequently must face challenging situations requiring specific leadership and management skills for which they are, not uncommonly, poorly prepared. Such a fictitious scenario was discussed at a Canadian interdisciplinary critical care leadership meeting, whereby increasing intensive care unit (ICU) staff turnover had led to problems with staff recruitment. Participants discussed and proposed solutions to the scenario in a structured format. The results of the discussion are presented. In situations such as this, the ICU leader should first define the core problem, its complexity, its duration and its potential for reversibility. These factors often reside within workload and staff support issues. Some examples of core problems discussed that are frequently associated with poor retention and recruitment are a lack of a positive team culture, a lack of a favorable ICU image, a lack of good working relationships between staff and disciplines, and a lack of specific supportive resources. Several tools or individuals (typically outside the ICU environment) are available to help determine the core problem. Once the core problem is identified, specific solutions can be developed. Such solutions often require originality and flexibility, and must be planned, with specific short-term, medium-term and long-term goals. The ICU leader will need to develop an implementation strategy for these solutions, in which partners who can assist are identified from within the ICU and from outside the ICU. It is important that the leader communicates to all stakeholders frequently as the process moves forward. PMID:16277732

  2. Primary Care Clinician Expectations Regarding Aging

    PubMed Central

    Davis, Melinda M.; Bond, Lynne A.; Howard, Alan; Sarkisian, Catherine A.

    2011-01-01

    Purpose: Expectations regarding aging (ERA) in community-dwelling older adults are associated with personal health behaviors and health resource usage. Clinicians’ age expectations likely influence patients’ expectations and care delivery patterns; yet, limited research has explored clinicians’ age expectations. The Expectations Regarding Aging Survey (ERA-12) was used to assess (a) age expectations in a sample of primary care clinicians practicing in the United States and (b) clinician characteristics associated with ERA-12 scores. Design and Methods: This study was a cross-sectional survey of primary care clinicians affiliated with 5 practice-based research networks, October 2008 to June 2009. A total of 374 of the 1,510 distributed surveys were returned (24.8% response rate); 357 analyzed. Mean respondent age was 48.6 years (SD = 11.6; range 23–87 years); 88.0% physicians, 96.0% family medicine, 94.9% White, and 61.9% male. Results: Female clinicians reported higher ERA-12 scores; clinicians’ age expectations decreased with greater years in practice. Among the clinicians, higher ERA-12 scores were associated with higher clinician ratings of the importance of and personal skill in administering preventive counseling and the importance of delivering preventive services. Agreement with individual ERA-12 items varied widely. Implications: Unrealistically high or low ERA could negatively influence the quality of care provided to patients and patients’ own age expectations. Research should examine the etiology of clinicians’ age expectations and their association with older adult diagnoses and treatment. Medical education must incorporate strategies to promote clinician attitudes that facilitate successful patient aging. PMID:21430129

  3. Annual influenza vaccination: coverage and attitudes of primary care staff in Australia

    PubMed Central

    Ward, Kirsten; Seale, Holly; Zwar, Nicholas; Leask, Julie; MacIntyre, C. Raina

    2010-01-01

    Please cite this paper as: Ward et al. (2011) Annual influenza vaccination: coverage and attitudes of primary care staff in Australia. Influenza and Other Respiratory Viruses 5(2), 135–141. Background  Annual influenza vaccination is recommended for all Australian health care workers (HCWs) including those working in primary health care. There is limited published data on coverage, workplace provision, attitudes and personal barriers to influenza vaccination amongst primary health care staff. The aim of this study was to contribute to the limited literature base in this important area by investigating these issues in the primary health care setting in New South Wales (NSW), Australia. Methods  A postal survey was sent to general practitioners (GPs) and practice nurses (PNs) from inner city, semi‐urban and rural areas of NSW, Australia. There were 139 responses in total (response rate 36%) from 79 GPs (response rate 30%) and 60 PNs (response rate 46%). Results  Reported influenza vaccination coverage in both 2007 and 2008 was greater than 70%, with GPs reporting higher coverage than PNs in both years. The main barriers identified were lack of awareness of vaccination recommendations for general practice staff and concern about adverse effects from the vaccine. Conclusions  Rates of influenza vaccination coverage reported in this study were higher than in previous studies of hospital and institutional HCWs, though it is possible that the study design may have contributed to these higher results. Nevertheless, these findings highlight that more needs to be done to understand barriers to vaccination in this group, to inform the development of appropriate strategies to increase vaccination coverage in primary health care staff, with a special focus on PNs. PMID:21306577

  4. Training and Retaining Early Care and Education Staff. Bay Area Child-Care Retention Incentive Programs: Evaluation. Year One Progress Report, 2001-2002. PACE Policy Brief.

    ERIC Educational Resources Information Center

    Bridges, Margaret; Carlat, Jennifer

    Over half of this nation's children 5 years and under are in nonparental care while their parents work. Research indicates that children benefit from being with well-trained, consistent early care and education staff. Staff retention is crucial because frequent turnover impedes the formation of positive nurturing relationships between caregivers…

  5. A study of knowledge and attitudes towards contraception among health care staff in Kelantan (Malaysia).

    PubMed

    Suhaimi, H; Monga, D; Siva, A

    1996-02-01

    711 government health clinic nursing staff in Kelantan state were surveyed about their knowledge, attitudes, and use of various contraceptive methods. 11 sisters, 122 staff nurses, 173 assistant nurses, and 334 midwives returned the questionnaire the same day of receipt. Most respondents were older than age 30 years, married, multiparous, and working for more than 5 years. 80-90% practiced contraception, with the majority of midwives preferring oral pills and the majority of staff nurses preferring condoms. 30-40% from each subgroup of respondents believed folk methods of contraception are effective and worthy of being encouraged. Approximately 50%, 33%, and 33% of staff nurses, assistant nurses, and midwives, respectively, were well informed on all contraceptive methods. A high proportion of staff felt that the nursing curriculum fails to adequately address the subject. The authors stress that in order to realize success in the family planning program, more information must first be imparted to these health personnel. To that end, more lectures could be provided during training, followed by frequent and thorough refresher courses for all nursing staff. PMID:8783914

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

    PubMed Central

    2009-01-01

    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 should be improved especially

  7. Supervision Requirements: Criteria for the Nurse and Auxiliary Staff When Providing Patient Care Visits.

    PubMed

    Vargo, Deanna; Vargo, Paige

    2016-01-01

    Physician or advanced care clinicians' (advanced practice nurses, physician assistants) orders are routinely carried out by nursing staff, with the goals of implementing treatment plans and improving patient outcomes. In the outpatient setting, nurses must consider the regulations imposed by the Centers for Medicare & Medicaid Services when initiating care and billing for services. Nurses, advanced practice nurses, and other clinicians may deliver care ordered by physicians without the physician being physically present in the room. Such services are considered to be "incident to" the physician's care, and there are requirements of supervision that must be met pertaining to the specific care setting. These guidelines and the implications for WOC nurses are the focus of this article. PMID:27163681

  8. Survey of abuse and violence by patients and relatives towards intensive care staff.

    PubMed

    Lynch, J; Appelboam, R; McQuillan, P J

    2003-09-01

    A postal survey of senior nurses in intensive care units in England and Wales was conducted. The aim was to ascertain the frequency of abusive and violent behaviour by patients and relatives towards intensive care staff, discover the perceived causes, effects and documentation of such behaviour and define the current and proposed security arrangements for intensive care units. Response rate was 94%. During the study period, verbal abuse of nurses by patients and by relatives occurred in 87% and 74% of intensive care units, respectively. The relevant figures for doctors were 65% and 59%, respectively. Nurses experienced physical abuse by patients and by relatives in at least 77% and 17% of intensive care units, respectively (doctors 38% and 8%). Illness was the main perceived cause of offences by patients whereas 'distress' (45%), alcohol (24%), sociopathic behaviour (27%) were the main putative causes amongst relatives. Whilst 43% of intensive care units have no security system at the door, staff awareness, training and communication skills may be the principle tools in reducing the frequency and consequences of violent and abusive behaviour. This survey probably underestimates the problem. PMID:12911365

  9. Staff and youth views on autonomy and emancipation from residential care: a participatory research study.

    PubMed

    Calheiros, Maria Manuela; Patrício, Joana Nunes; Graça, João

    2013-08-01

    The use of participatory approaches in designing services is still relatively uncommon. In this study, we helped design a service to support the transition of youth from residential care to independent living by exploring the perspectives of staff and of youth regarding: (a) the concept and development of autonomy; and (b) key factors in developing this type of service. We gathered the data through 10 interviews with staff (n=10) and 4 focus groups with youth (n=21), and subjected the data to a thematic content analysis. Staff defined autonomy as self-regulation and self-care, and identified three paths to foster autonomy--a sense of normality, meaningful relationships, and planning for emancipation. The staff and youth identified the following important aspects in designing the service: achieving normality (e.g. limited number of residents), promoting youth capacity (e.g. skill-building activities), providing social support (e.g. trust and respect between residents), and assuring guidance and boundaries (e.g. supervision of youth). PMID:23681252

  10. Radiation Exposure to Staff in Intensive Care Unit with Portable CT Scanner

    PubMed Central

    Xie, Zhichao; Liao, Xuelian; Zhang, Jiangqian; Jia, Lingli

    2016-01-01

    Background. Bedside radiological procedures pose a risk of radiation exposure to ICU staff. The perception of risk may increase the degree of caution among the health care staff and raise new barriers preventing patients from obtaining prompt care. Objective. The aim of this study was to estimate the annual cumulative radiation dose to individual ICU staff. Methods. In this prospective study, forty subjects were required to wear thermoluminescent dosimeter badges during their working hours. The badges were analyzed to determine the exposure after 3 months. Results. A total of 802 radiological procedures were completed at bedside during the study period. The estimated annual dosage to doctors and nurses on average was 0.99 mSv and 0.88 mSv (p < 0.001), respectively. Residents were subjected to the highest radiation exposure (1.04 mSv per year, p = 0.002). The radiation dose was correlated with day shift working hours (r = 0.426; p = 0.006) and length of service (r = −0.403; p < 0.01). Conclusions. With standard precautions, bedside radiological procedures—including portable CT scans—do not expose ICU staff to high dose of ionizing radiation. The level of radiation exposure is related to the daytime working hours and length of service. PMID:27556036

  11. Staff Perception on Biomedical or Health Care Waste Management: A Qualitative Study in a Rural Tertiary Care Hospital in India

    PubMed Central

    Joshi, Rita; Shah, Harshada; Sharma, Megha; Pathak, Ashish; Macaden, Ragini; Stålsby Lundborg, Cecilia

    2015-01-01

    Background Health care or biomedical waste, if not managed properly, can be of high risk to the hospital staff, the patients, the community, public health and the environment, especially in low and middle income settings where proper disposal norms are often not followed. Our aim was to explore perceptions of staff of an Indian rural tertiary care teaching hospital on hospital waste management. Method A qualitative study was conducted using 10 focus group discussions (FGDs), with different professional groups, cleaning staff, nurses, medical students, doctors and administrators. The FGD guide included the following topics: (i) role of Health Care Waste Management (HCWM) in prevention of health care associated infections, (ii) awareness of and views about HCWM-related guidelines/legislation, (iii) current HCWM practices, (iv) perception and preparedness related to improvements of the current practices, and (v) proper implementation of the available guidelines/legislation. The FGDs were recorded, transcribed verbatim, translated to English (when conducted in Hindi) and analysed using content analysis. Results Two themes were identified: Theme (A), ‘Challenges in integration of HCWM in organizational practice,’ with the categories (I) Awareness and views about HCWM, (II) Organizational practices regarding HCWM, and (III) Challenges in Implementation of HCWM; and Theme (B), ‘Interventions to improve HCWM,’ with three categories, (I) Educational and motivational interventions, (II) Organizational culture change, and (III) Policy-related interventions. Conclusion A gap between knowledge and actual practice regarding HCWM was highlighted in the perception of the hospital staff. The participants suggested organizational changes, training and monitoring to address this. The information generated is relevant not merely to the microsystem studied but to other institutions in similar settings. PMID:26023783

  12. Supporting Children's Transition to School Age Care

    ERIC Educational Resources Information Center

    Dockett, Sue; Perry, Bob

    2016-01-01

    While a great deal of research has focused on children's experiences as they start school, less attention has been directed to their experiences--and those of their families and educators--as they start school age care. This paper draws from a recent research project investigating practices that promote positive transitions to school and school…

  13. Job satisfaction and career commitment among Alzheimer's care providers: addressing turnover and improving staff empowerment.

    PubMed

    Coogle, Constance L; Parham, Iris A; Rachel, Colleen A

    2011-11-01

    This study investigated the relation between job satisfaction and career commitment among 262 Alzheimer's care staff working in long-term and community-based care settings. It was anticipated that the results would suggest whether career commitment could be enhanced to positively influence job satisfaction, and conversely, if improvements in job satisfaction might contribute to a deepened sense of vocational empowerment. Participants attended dementia-specific training and completed 2 short work-related questionnaires that measured job satisfaction and career commitment. The results of stepwise regression revealed interrelations between the 2 constructs. Congruence appeared to be reciprocal with respect to the overall scale scores and the intrinsic job satisfaction measure. Unexpected relations appeared in analyses of the extrinsic job satisfaction measure and the career planning subscale. Results are indicative of the fundamental distinction between job satisfaction and career commitment. Implications for efforts to reduce turnover and improve staff empowerment are also considered. PMID:22207693

  14. The Dementia Friendly Hospital Initiative education program for acute care nurses and staff.

    PubMed

    Palmer, Janice L; Lach, Helen W; McGillick, Janis; Murphy-White, Maggie; Carroll, Maria B; Armstrong, Johanna L

    2014-09-01

    Individuals with Alzheimer's disease and other dementias have 3.2 million hospital stays annually, which is significantly more than older individuals without dementia. Hospitalized patients with dementia are at greater risk of delirium, falls, overwhelming functional decline that may extend the hospital stay, and prolonged or complicated rehabilitation. These risks highlight the need for staff education on the special care needs of this vulnerable population. This article describes a one-day education program, the Dementia Friendly Hospital Initiative, designed to teach staff how to provide the specialized care required by patients with dementia. Participants (N = 355) from five different hospitals, including 221 nurses, completed a pretest-posttest evaluation for the program. Changes in participants attitudes and practices, confidence, and knowledge were evaluated. Scores indicated significant improvement on the posttest. The evaluation provides further evidence for recommending dissemination of the Dementia Friendly Hospital Initiative. PMID:25299008

  15. Educating Aging Service Agency Staff About Discussing End-of-Life Wishes.

    PubMed

    Flowers, Kimberlie; Howe, Judith L

    2015-01-01

    Seventy-five percent of Americans support the idea of Advance Directives (ADs) but less than 20% complete one, resulting in increased hospitalization costs, unwanted treatment, and difficult family decisions. Engaging community resources for public education may be effective for increasing understanding and completion of ADs. This project focused on workers in an agency serving older adults. A training program was developed with the goal of increasing their understanding of the process and benefits of Health Care Proxies (HCPs) and ADs through hands-on experience, increasing relevant skills and willingness to discuss with consumers, and to implement an agency protocol increasing documentation of HCPs for consumers. After a small proof-of-concept pilot, all staff members were asked to participate in the educational program. The pilot program delivery found increased staff knowledge as well as motivation to complete HCPs among the staff themselves and their own families. This program resulted in increased staff knowledge of EOL documents, willingness to engage in EOL discussions, and an increase in documented HCPs. This program has relevance for workers in other agencies as they engage older consumers to encourage completion of ADs. This experiential approach to staff education increased their understanding and willingness to initiate EOL discussion with consumers. PMID:26380924

  16. Staff Knowledge, Awareness, Perceptions, and Beliefs About Infection Prevention in Pediatric Long-term Care Facilities

    PubMed Central

    Løyland, Borghild; Wilmont, Sibyl; Hessels, Amanda J.; Larson, Elaine

    2016-01-01

    Background The burden of healthcare-associated infection worldwide is considerable, and there is a need to improve surveillance and infection control practices such as hand hygiene. Objectives The aims of this study were to explore direct care providers’ knowledge about infection prevention and hand hygiene, their attitudes regarding their own and others’ hand hygiene practices, and their ideas and advice for improving infection prevention efforts. Methods This exploratory study included interviews with direct care providers in three pediatric long-term care facilities. Two trained nurse interviewers conducted semistructured interviews using an interview guide with open-ended questions. Two other nurse researchers independently transcribed the audio recordings and conducted a thematic analysis using a strategy adapted from the systematic text condensation approach. Results From 31 interviews, four major thematic categories with subthemes emerged from the analysis: (a) hand hygiene products; (b) knowledge, awareness, perceptions, and beliefs; (c) barriers to infection prevention practices; and (d) suggested improvements. There was confusion regarding hand hygiene recommendations, use of soap or sanitizer, and isolation precaution policies. There was a robust “us” and “them” mentality between professionals. Discussion One essential driver of staff behavior change is having expectations that are meaningful to staff, and many staff members stated that they wanted more in-person staff meetings with education and hands-on, practical advice. Workflow patterns and/or the physical environment need to be carefully evaluated to identify systems and methods to minimize cross-contamination. Further studies need to evaluate if personal sized containers of hand sanitizer (e.g., for the pocket, attached to a belt or lanyard) would facilitate improvement of hand hygiene in these facilities. PMID:26938362

  17. Knowledge, Skills, and Attitudes in Caring for Older Adults With Advanced Illness Among Staff Members of Long-Term Care and Assisted Living Facilities: An Educational Needs Assessment.

    PubMed

    Cimino, Nina M; Lockman, Kashelle; Grant, Marian; McPherson, Mary Lynn

    2016-05-01

    In long-term care and assisted living facilities, many groups of health care professionals contribute to the work of the health care team. These staff members perform essential, direct patient care activities. An educational needs assessment was conducted to determine the learning needs and preferences of staff members related to providing care for patients with life-limiting illnesses. Staff members placed importance on understanding topics such as principles of palliative care, pain assessment, pain management, and nonpain symptom management. The majority of survey respondents were also interested in learning more about these topics. The results of this educational needs analysis suggest staff members would benefit from a course tailored to these identified educational needs and designed to overcome previously identified educational barriers. PMID:25473091

  18. Oral health care in residential aged care services: barriers to engaging health-care providers.

    PubMed

    Hearn, Lydia; Slack-Smith, Linda

    2015-01-01

    The oral health of older people living in residential aged care facilities has been widely recognised as inadequate. The aim of this paper is to identify barriers to effective engagement of health-care providers in oral care in residential aged care facilities. A literature review was conducted using MEDline, CINAHL, Web of Science, Academic Search Complete and PsychInfo between 2000 and 2013, with a grey literature search of government and non-government organisation policy papers, conference proceedings and theses. Keywords included: dental/oral care, residential aged care, health-care providers, barriers, constraints, and limitations. A thematic framework was used to synthesise the literature according to a series of oral health-care provision barriers, health-care provider barriers, and cross-sector collaborative barriers. A range of system, service and practitioner level barriers were identified that could impede effective communication/collaboration between different health-care providers, residents and carers regarding oral care, and these were further impeded by internal barriers at each level. Findings indicated several areas for investigation and consideration regarding policy and practice improvements. While further research is required, some key areas should be addressed if oral health care in residential aged care services is to be improved. PMID:25155109

  19. Improving the safety of neonatal care through the development and implementation of a staff-focused delta team.

    PubMed

    Schwoebel, Ann; Creely, Janet

    2010-01-01

    Patient safety is one of the greatest imperatives in healthcare today, yet there are many obstacles that must be overcome to make healthcare delivery truly safe. Critically ill newborns are among the most medically fragile patients in hospitals today. Given their size and gestational age, the tolerance for error within this population is extremely small. Medical errors that may be less consequential in adults can be disastrous for infants. Developing a culture of safety demands a mind-set that continuously seeks out vulnerabilities and prospectively addresses them through systems-based rather than individual-based solutions. The complexities of clinical care and intricacies of human behavior may prevent total elimination of risk, but caregivers are in a position to develop a culture of safety that can minimize risks for adverse events in the neonatal intensive care unit. Specific strategies used to successfully implement a staff-focused patient safety program are described in this article. These strategies include the development of systemwide and unit-based interdisciplinary safety teams to proactively identify and address safety concerns, development of specific tools and techniques used for analysis and prioritization of risk, resources that teams used to support an environment of safety; and implementation of staff-driven solutions to address safety concerns. PMID:20147835

  20. Here's How We Set Up a Staff-Run Day-Care Center for Our Own Kids.

    ERIC Educational Resources Information Center

    Ancell, Allen; Haugen, Merry

    1986-01-01

    School systems can set up staff-run day care centers for their own children, deriving planning ideas from the many corporations that perceive meeting employees' child-care needs as an asset. Planning involves employee child-care scheduling, cost estimates, and program development. (CJH)

  1. 75 FR 69449 - Draft Guidance for Industry and Food and Drug Administration Staff on Dear Health Care Provider...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-12

    ... Staff on Dear Health Care Provider Letters: Improving Communication of Important Safety Information... ``Dear Health Care Provider Letters: Improving Communication of Important Safety Information.'' Dear Health Care Provider (DHCP) Letters are correspondence--usually in the form of a mass mailing from...

  2. Staff Perspectives on the Use of a Computer-Based Concept for Lifestyle Intervention Implemented in Primary Health Care

    ERIC Educational Resources Information Center

    Carlfjord, Siw; Johansson, Kjell; Bendtsen, Preben; Nilsen, Per; Andersson, Agneta

    2010-01-01

    Objective: The aim of this study was to evaluate staff experiences of the use of a computer-based concept for lifestyle testing and tailored advice implemented in routine primary health care (PHC). Design: The design of the study was a cross-sectional, retrospective survey. Setting: The study population consisted of staff at nine PHC units in the…

  3. Effect of Service Structure and Organization on Staff Care Practices in Small Community Homes for People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Mansell, Jim; Beadle-Brown, Julie; Whelton, Beckie; Beckett, Celia; Hutchinson, Aislinn

    2008-01-01

    Background: An important question in community living is what factors influence the extent to which staff provide "active support". Methods: Engagement, care practices and a range of staff and organizational characteristics were studied in 72 residential homes serving 359 adults with intellectual disabilities. Managers in 36 settings were trained…

  4. The Effects of Staff Training on the Types of Interactions Observed at Two Group Homes for Foster Care Children

    ERIC Educational Resources Information Center

    Crosland, Kimberly A.; Dunlap, Glen; Sager, Wayne; Neff, Bryon; Wilcox, Catherine; Blanco, Alfredo; Giddings, Tamela

    2008-01-01

    Objectives: An extensive literature base exists for behavioral parent training; however, few studies have focused on training direct care staff at group home and residential facilities for children. This study was conducted to determine whether a behavioral staff training program consisting of classroom training and in-home feedback would improve…

  5. A Comparison of Computer-based and Instructor-led Training for Long-term Care Staff.

    ERIC Educational Resources Information Center

    Harrington, Susan S.; Walker, Bonnie L.

    2002-01-01

    Fire safety training was provided to long-term care staff by computer (n=47) or a print-based, instructor-led program (n=47). Compared to 47 controls, both treatment groups significantly increased knowledge. The computer-trained staff were enthusiastic about the learning method and expressed greater interest in additional safety topics. (SK)

  6. Family Day Care and the School-Age Child.

    ERIC Educational Resources Information Center

    Seltzer, Michelle Seligson

    This paper provides portions of a workshop discussion at the Wheelock Conference on School-Age Child Care concerning the role of family day care for school-age children. The workshop participants included family day care providers affiliated with the day care system in the Greater Boston area, administrators of a family day care system which also…

  7. Staff experiences in implementing guidelines for Kangaroo Mother Care--a qualitative study.

    PubMed

    Wallin, Lars; Rudberg, Agneta; Gunningberg, Lena

    2005-01-01

    The aim of this study was to investigate staff experiences in implementing guidelines for Kangaroo Mother Care in neonatal care. The study was part of a randomized controlled trial, the overall goal of which was to assess the impact of external facilitation. A total of eight focus group interviews were held at two intervention and two control units. The establishment of a change team to implement the guideline resulted in activities that impacted staff behaviour, which in turn was perceived to influence patients' well-being. The guideline and contextual factors, such as leadership and staff colleagues' attitudes, were of significant importance in that process. The study intervention--facilitation--promoted implementation activities and was highly appreciated by the change teams. However, reviewing the development of events at one of the control units, the provided facilitation appeared to be no more effective than an improvement-focused organizational culture in which the nurse manager was actively involved in the change process. Overall, learning and behaviour change seemed to be a social phenomenon, something that greatly benefited from people's interaction with one another. PMID:15582640

  8. Patient and staff dosimetry during radiographic procedures in an intensive care unit.

    PubMed

    Fernández, Rosario; Moreno-Torres, Miguel; Contreras, Antonia M; Núñez, María I; Guirado, Damián; Peñas, Luis

    2015-09-01

    The performance of radiography in the Intensive Care Unit (ICU) may be associated with a certain level of radiation exposure for staff and patients in the unit. Little evidence on exposure levels is available in the literature. However, healthcare professionals in the ICUs at our centre tend to leave the room during radiographic examinations, potentially compromising patient care. The objectives of this study were to quantify dose levels within the ICU and to evaluate the performance of ICU x-ray studies according to patient dose measurements. This study was conducted in the 18-bed ICU of a third-level hospital. The scattering radiation due to mobile x-ray examinations was measured by using four personal thermoluminiscent dosimeters (TLDs). The dose area product (DAP) was measured at each examination using a transmission chamber installed on the diaphragm of the x-ray equipment. Based on the TLD readings and taking account of the error margin, the annual dose to patients and staff was less than 0.6 mSv. The value given by the DAP meter for chest x-rays was 94  ±  17 mGy cm(2); this value is well below the lower limit recommended by different agencies and committees. Exposure levels were found to be extremely low and pose no apparent risk to staff or to those in beds adjacent to the patients undergoing x-ray examinations, which were correctly performed in the unit. PMID:26344655

  9. House Staff Quality Council: One Institution's Experience to Integrate Resident Involvement in Patient Care Improvement Initiatives

    PubMed Central

    Dixon, Jennifer L.; Papaconstantinou, Harry T.; Erwin, John P.; McAllister, Russell Keith; Berry, Tiffany; Wehbe-Janek, Hania

    2013-01-01

    Background Residents and fellows perform a large portion of the hands-on patient care in tertiary referral centers. As frontline providers, they are well suited to identify quality and patient safety issues. As payment reform shifts hospitals to a fee-for-value–type system with reimbursement contingent on quality outcomes, preventive health, and patient satisfaction, house staff must be intimately involved in identifying and solving care delivery problems related to quality, outcomes, and patient safety. Many challenges exist in integrating house staff into the quality improvement infrastructure; these challenges may ideally be managed by the development of a house staff quality council (HSQC). Methods Residents and fellows at Scott & White Memorial Hospital interested in participating in a quality council submitted an application, curriculum vitae, and letter of support from their program director. Twelve residents and fellows were selected based on their prior quality improvement experience and/or their interest in quality and safety initiatives. Results In only 1 year, our HSQC, an Alliance of Independent Academic Medical Centers National Initiative III project, initiated 3 quality projects and began development of a fourth project. Conclusion Academic medical centers should consider establishing HSQCs to align institutional quality goals with residency training and medical education. PMID:24052771

  10. Creating Better School-Age Care Jobs: Model Work Standards.

    ERIC Educational Resources Information Center

    Haack, Peggy

    Built on the premise that good school-age care jobs are the cornerstone of high-quality services for school-age youth and their families, this guide presents model work standards for school-age care providers. The guide begins with a description of the strengths and challenges of the school-age care profession. The model work standards are…

  11. Mental Illness Training for Licensed Staff in Long-Term Care

    PubMed Central

    Irvine, A. Blair; Billow, Molly B.; Eberhage, Mark G.; Seeley, John R.; McMahon, Edward; Bourgeois, Michelle

    2013-01-01

    Licensed care staff working in long-term care facilities may be poorly prepared to work with residents with mental illness. This research reports on the program evaluation of Caring Skills: Working with Mental Illness, a training program delivered on the Internet. It was tested with a randomized treatment-control design, with an eight-week follow-up. The training provided video-based behavioral skills and knowledge training. Measures included video situations testing and assessment of psycho-social constructs including empathy and stigmatization. ANCOVA analysis at 4-weeks posttest showed significant positive effects with medium-large effect sizes, which were largely maintained at the 8-week follow-up. The training was well-received by the users. PMID:22364430

  12. Stakeholder involvement in designing an oral care training package for care home staff.

    PubMed

    Patel, R S; Walls, K L; Drugan, C S

    2013-12-01

    This paper describes the principles applied and the challenges met while seeking user and other stakeholder perspectives before designing an oral care training package for carers in nursing and residential care facilities. The public health competencies it illustrates include the application of appropriate leadership styles, strategic management, collaborative working and knowledge of research methodology. PMID:24575522

  13. Newborn care and knowledge translation - perceptions among primary healthcare staff in northern Vietnam

    PubMed Central

    2011-01-01

    Background Nearly four million neonatal deaths occur annually in the world despite existing evidence-based knowledge with the potential to prevent many of these deaths. Effective knowledge translation (KT) could help to bridge this know-do gap in global health. The aim of this study was to explore aspects of KT at the primary healthcare level in a northern province in Vietnam. Methods Six focus-group discussions were conducted with primary healthcare staff members who provided neonatal care in districts that represented three types of geographical areas existing in the province (urban, rural, and mountainous). Recordings were transcribed verbatim, translated into English, and analyzed using content analysis. Results We identified three main categories of importance for KT. Healthcare staff used several channels for acquisition and management of knowledge (1), but none appeared to work well. Participants preferred formal training to reading guideline documents, and they expressed interest in interacting with colleagues at higher levels, which rarely happened. In some geographical areas, traditional medicine (2) seemed to compete with evidence-based practices, whereas in other areas it was a complement. Lack of resources, low frequency of deliveries and, poorly paid staff were observed barriers to keeping skills at an adequate level in the healthcare context (3). Conclusions This study indicates that primary healthcare staff work in a context that to some extent enables them to translate knowledge into practice. However, the established and structured healthcare system in Vietnam does constitute a base where such processes could be expected to work more effectively. To accelerate the development, thorough considerations over the current situation and carefully targeted actions are required. PMID:21447179

  14. Health-promoting residential aged care: a pilot project in Austria.

    PubMed

    Krajic, Karl; Cichocki, Martin; Quehenberger, Viktoria

    2015-09-01

    Long-term care for the aged is an area that has not been in the focus of health promotion so far. The paper describes context, concept and project plan of a 2-year pilot project of comprehensive health-promoting setting development in residential aged care in Austria, and provides an overview over main experiences and results. Austria's most relevant health promotion agencies, a specialized scientific institute and Austria's largest provider of aged care acted as partners. The project aimed at developing elements of a comprehensive approach, but also providing evidence for the effectiveness of health promotion. Therefore, the project combined an organizational development approach with a scientific, randomized controlled study on mobility enhancement for residents. A comprehensive settings approach turned out acceptable for the main stakeholders of aged care (owners and management, staff, residents and residents' relatives). Strategy development, based on a systematic needs assessment, found staff health to be of special interest for the organization (ergonomics, workability over life course), and residents' relatives, got more attention. The mobility study was able to achieve positive results on occupational performance, concerning quality-of-life indicators and reached also formerly inactive groups. After the end of the project, health promotion is still on the agenda of the organization; further developments will be monitored. Good support from the policy level and well-established networking between the aged care provider, health promotion agencies and a network for health promotion in health care seems to have been an important resource for success. PMID:24682545

  15. A review of the regulatory and functional aspects of prison health care and nursing staff.

    PubMed

    Arribas-López, E

    2015-01-01

    The aim of this study of prison health care staff in Prison Health Care and Nursing Units is twofold. The first one is to consider those aspects of the legal system applicable to them as government employees of the General State Administration at the service of Prisons, highlighting the peculiarities of the legal regulations that can be applied as a result of providing said service. The second, based on the general regulations on prison health contained in Organic Law 1/1979, of 26 September, General Penitentiary Law and the implementing regulations thereof, approved by Royal Decree 190/1966, of 9 February, sets out to provide a critical analysis of the obligatory and functional framework for health care and nursing staff established in the old Penitentiary Regulations of 1981, to determine from a legal perspective if it is possible to impede or brake so that the Prison Administration may develop or carry out the functions for which it is responsible in terms of planning, organization and management of activities geared towards maintaining and improving hygiene and health in the prison environment. PMID:26501590

  16. Approaches to School-Age Child Care. ERIC Digest.

    ERIC Educational Resources Information Center

    Seligson, Michelle; Coltin, Lillian

    This ERIC Digest provides basic information about school-age day care programs. Discussion focuses briefly on options available to families with school-age children, developmental needs of school-age children, characteristics of high quality school-age programs, supportive services for self-care, and ways of improving school-age child care…

  17. Implications of the World Health Organization study of mental illness in general health care for training primary care staff.

    PubMed

    Goldberg, D; Gater, R

    1996-08-01

    A substantial international study of mental disorders seen in primary care settings has shown that there are marked differences in prevalence between centres. Detection of mental disorders is better in centres using a 'personal' style of clinical service, and where there has been close collaboration between psychiatrists and general practitioners. However, even in the better centres, substantial numbers of mental disorders are missed and treatment often appears to be given regardless of diagnosis. It is argued that changes need to be made to the way in which both undergraduates and vocational trainees are taught about mental disorders, so that teaching emphasizes the psychological syndromes that general practitioners are likely to meet in their everyday work. Training packages need to be developed for primary care staff in the detection and management of mental disorders. PMID:8949331

  18. Implications of the World Health Organization study of mental illness in general health care for training primary care staff.

    PubMed Central

    Goldberg, D; Gater, R

    1996-01-01

    A substantial international study of mental disorders seen in primary care settings has shown that there are marked differences in prevalence between centres. Detection of mental disorders is better in centres using a 'personal' style of clinical service, and where there has been close collaboration between psychiatrists and general practitioners. However, even in the better centres, substantial numbers of mental disorders are missed and treatment often appears to be given regardless of diagnosis. It is argued that changes need to be made to the way in which both undergraduates and vocational trainees are taught about mental disorders, so that teaching emphasizes the psychological syndromes that general practitioners are likely to meet in their everyday work. Training packages need to be developed for primary care staff in the detection and management of mental disorders. PMID:8949331

  19. Resident transfers from aged care facilities to emergency departments: Can they be avoided?

    PubMed Central

    Innes, Kelli; Griffiths, Debra L; Crawford, Kimberley; Williams, Allison

    2015-01-01

    Abstract Objective Residents from aged care facilities make up a considerable proportion of ED presentations. There is evidence that many residents transferred from aged care facilities to EDs could be managed by primary care services. The present study aimed to describe the characteristics of residents transferred from residential aged care facilities to EDs, and to evaluate the appropriateness and cost of these presentations. Methods A retrospective review of ED records was undertaken for residents transferred from residential aged care facilities to two EDs in Melbourne, Victoria, in 2012. Data examined included residents' mode and time of arrival to ED, presenting complaint, triage category, procedures within ED, diagnosis, length of stay, and disposition. Data were examined against a previously established tool to identify resident transfers that might be ‘potentially avoidable’. Results There were 2880 resident transfers included in the sample, of which 408 transfers were randomly selected for scrutiny of documentation. Seventy‐one residents (17.4%) were identified as being potentially avoidable transfers. Conclusion Many resident transfers might have been avoided with better primary care services in place. Future strategies to improve resident care might include aged care staff skill mix and the availability of outreach or primary care services. PMID:26095333

  20. A controlled investigation of continuing pain education for long-term care staff

    PubMed Central

    Ghandehari, Omeed O; Hadjistavropoulos, Thomas; Williams, Jaime; Thorpe, Lilian; Alfano, Dennis P; Bello-Haas, Vanina Dal; Malloy, David C; Martin, Ronald R; Rahaman, Omar; Zwakhalen, Sandra MG; Carleton, R Nicholas; Hunter, Paulette V; Lix, Lisa M

    2013-01-01

    BACKGROUND: The underassessment and undertreatment of pain in residents of long-term care (LTC) facilities has been well documented. Gaps in staff knowledge and inaccurate beliefs have been identified as contributors. OBJECTIVES: To investigate the effectiveness of an expert-based continuing education program in pain assessment/management for LTC staff. METHODS: Participants included 131 LTC staff members who were randomly assigned to either an interactive pain education (PE) program, which addressed gaps in knowledge such as medication management, or an interactive control program consisting of general dementia education without a specific clinical focus. Participants attended three sessions, each lasting 3 h, and completed measures of pain-related knowledge and attitudes/beliefs before, immediately after and two weeks following the program. Focus groups were conducted with a subset of participants to gauge perception of the training program and barriers to implementing pain-related strategies. RESULTS: Analysis using ANOVA revealed that PE participants demonstrated larger gains compared with control participants with regard to pain knowledge and pain beliefs. Barriers to implementing pain-related strategies certainly exist. Nonetheless, qualitative analyses demonstrated that PE participants reported that they overcame many of these barriers and used pain management strategies four times more frequently than control participants. CONCLUSIONS: Contrary to previous research, the present study found that the interactive PE program was effective in changing pain beliefs and improving knowledge. Continuing PE in LTC has the potential to address knowledge gaps among front-line LTC providers. PMID:23457681

  1. Quality Care through Multi-Age Grouping of Children.

    ERIC Educational Resources Information Center

    Prendergast, Leo

    2002-01-01

    Asserts that multi-age grouping in early childhood settings can and does work. Addresses four main hurdles to successful implementation: (1) laws and regulations that act as barriers; (2) health concerns; (3) overcoming educational values that conflict with those of the age-grouped classroom; and (4) staff misunderstanding of multi-age grouping…

  2. Head nurse leadership style with staff nurse burnout and job satisfaction in neonatal intensive care units.

    PubMed

    Duxbury, M L; Armstrong, G D; Drew, D J; Henly, S J

    1984-01-01

    Leadership style has been defined as a two-factor construct composed of "consideration" and "initiating structure." Research has suggested that these factors affect the behavior and attitude of subordinates. This study's purpose was to quantify the relationships of head nurse leadership style with self-reported staff nurse burnout and job satisfaction in Neonatal Intensive Care Units (NICUs). Three instruments--the Minnesota Satisfaction Questionnaire, the Tedium Scale, and the Leadership Opinion Questionnaire--were voluntarily completed by 283 registered nurses employed by 14 level-III NICUs in the United States. The leadership dimensions of consideration and structure were distinct (r = -.10). Staff nurse satisfaction and burnout were related (r = -.41). Head nurse consideration was clearly related to staff nurse satisfaction (r = -.55) and to a lesser extent to burnout (r = -.29). Initiating structure alone was not related to satisfaction or burnout. Aggregate perceptions of head nurse leadership were ranked across NICUs in order to classify the head nurses on consideration and structure. The 14 head nurses were separated into four groups: high consideration-high structure, high consideration-low structure, low consideration-high structure, and low consideration-low structure. Satisfaction and burnout of staff nurses in each of the leadership-style groups were then compared. Analysis of variance for satisfaction (F(3,279) = 3.10, p = .03) and burnout (F(3,279) = 3.90, p = .01) were both significant. For both satisfaction and burnout, the head nurse leadership classification of low consideration-high structure was most deviant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6560431

  3. Self Esteem and Organizational Commitment Among Health Information Management Staff in Tertiary Care Hospitals in Tehran

    PubMed Central

    Sadoughi, Farahnaz; Ebrahimi, Kamal

    2015-01-01

    Background: Self esteem (SE) and organizational commitment (OC) have significant impact on the quality of work life. Aim: This study aims to gain a better understanding of the relationships between SE and OC among health information management staff in tertiary care hospitals in Tehran (Iran). Methods: This was a descriptive correlational and cross sectional study conducted on the health information management staff of tertiary care hospitals in Tehran, Iran. A total of 155 participants were randomly selected from 400 staff. Data were collected by two standard questionnaires. The SE and OC was measured using Eysenck SE scale and Meyer and Allen’s three component model, respectively. The collected data were analyzed with the SPSS (version 16) using statistical tests of of independent T-test, Pearson Correlation coefficient, one way ANOVA and F tests. Results: The OC and SE of the employees’ were 67.8, out of 120 (weak and 21.0 out of 30 (moderate), respectively. The values for affective commitment, normative commitment, and continuance commitment were respectively 21.3 out of 40 (moderate), 23.9 out of 40 (moderate), and 22.7 out of 40 (moderate). The Pearson correlation coefficient test showed a significant OC and SE was statistically significant (P<0.05). The one way ANOVA test (P<0.05) did not show any significant difference between educational degree and work experience with SE and OC. Conclusion: This research showed that SE and OC are moderate. SE and OC have strong correlation with turnover, critical thinking, job satisfaction, and individual and organizational improvement. Therefore, applying appropriate human resource policies is crucial to reinforce these measures. PMID:25716374

  4. Development and Evaluation of a Staff Training Program on Palliative Care for Persons with Intellectual and Developmental Disabilities

    ERIC Educational Resources Information Center

    Hahn, Joan E.; Cadogan, Mary P.

    2011-01-01

    Persons with intellectual and developmental disabilities (I/DD) face barriers and disparities at end of life. Among these barriers are limited educational opportunities and a paucity of targeted training materials on palliative care for staff who provide their day-to-day care. This paper reports on a three-phase project undertaken to develop,…

  5. Crisis Nursery and Respite Care Programs: Site Visit Results of Staff and Family Interviews (Winter and Spring of 1991).

    ERIC Educational Resources Information Center

    Huntington, Gail S.; And Others

    Visits were made to selected respite care and crisis nursery programs in order to describe the programs and services they offered to families of young children with special needs and to learn more about the families who used the services and the staff who provided them. The visits to 10 crisis nurseries and 24 respite care programs resulted in…

  6. Care is not rocket science, it is about employing the right staff.

    PubMed

    Rowe, Marie J

    2016-02-24

    I read with great interest the article on nursing theory and the delivery of compassionate care (Art & science, February 10). Having worked as a care assistant since the age of 17, I returned to university at 42 to study adult nursing. I thoroughly enjoyed all of my placements during training, but I recall cliques, which resulted in unfair rosters being drawn up and sloppy paperwork. PMID:26907139

  7. Verbal and nonverbal indicators of quality of communication between care staff and residents in ethnoculturally and linguistically diverse long-term care settings.

    PubMed

    Small, Jeff; Chan, Sing Mei; Drance, Elisabeth; Globerman, Judith; Hulko, Wendy; O'Connor, Deborah; Perry, JoAnn; Stern, Louise; Ho, Lorraine

    2015-09-01

    Linguistic and ethnocultural diversity in long-term residential care is a growing trend in many urban settings. When long-term care staff and residents do not share the same language or ethnocultural background, the quality of their communication and care are jeopardized. There is very little research addressing how staff and residents communicate when they experience a mismatch in their language and ethnocultural backgrounds. Thus, the goals of the present study were to 1) document the verbal and nonverbal behaviours used by staff and residents in diverse interactions, and 2) identify and account for behaviours that either promoted or detracted from positive communication by drawing on principles from 'Communication Accommodation Theory'. Two long-term care facilities in British Columbia Canada were selected due to the diverse linguistic and ethnocultural backgrounds of their staff and residents. Twenty-seven staff and 27 residents consented to being video-recorded during routine activities (e.g., mealtimes, recreational activities). The recorded observations were transcribed, translated, and coded using qualitative descriptive and interpretive analyses. A number of verbal and nonverbal behaviours were identified and interpreted in relation to whether they promoted or detracted from positive communication. The findings point to considering a variety of proactive strategies that staff and administrators could employ to effectively accommodate to language and ethnocultural diversity in long-term care practice. PMID:26260486

  8. Can staff and patient perspectives on hospital safety predict harm-free care? An analysis of staff and patient survey data and routinely collected outcomes

    PubMed Central

    Lawton, Rebecca; O'Hara, Jane Kathryn; Sheard, Laura; Reynolds, Caroline; Cocks, Kim; Armitage, Gerry; Wright, John

    2015-01-01

    Background Patients have the potential to provide feedback on the safety of their care. Recently, tools have been developed that ask patients to provide feedback on those factors that are known to contribute to safety, therefore providing information that can be used proactively to manage safety in hospitals. The aim of this study was to investigate whether the safety information provided by patients is different from that provided by staff and whether it is related to safety outcomes. Method Data were collected from 33 hospital wards across 3 acute hospital Trusts in the UK. Staff on these wards were asked to complete the four outcome measures of the Hospital Survey of Patient Safety Culture, while patients were asked to complete the Patient Measure of Safety and the friends and family test. We also collated publicly reported safety outcome data for ‘harm-free care’ on each ward. This patient safety thermometer measure is used in the UK NHS to record the percentage of patients on a single day of each month on every ward who have received harm-free care (ie, no pressure ulcers, falls, urinary tract infections and hospital acquired new venous thromboembolisms). These data were used to address questions about the relationship between measures and the extent to which patient and staff perceptions of safety predict safety outcomes. Results The friends and family test, a single item measure of patient experience was associated with patients’ perceptions of safety, but was not associated with safety outcomes. Staff responses to the patient safety culture survey were not significantly correlated with patient responses to the patient measure of safety, but both independently predicted safety outcomes. The regression models showed that staff perceptions (adjusted r2=0.39) and patient perceptions (adjusted r2=0.30) of safety independently predicted safety outcomes. When entered together both measures accounted for 49% of the variance in safety outcomes (adjusted r2

  9. The role of conflict resolution styles on nursing staff morale, burnout, and job satisfaction in long-term care.

    PubMed

    Montoro-Rodriguez, Julian; Small, Jeff A

    2006-06-01

    This study focuses on the ability of nursing staff to interact with residents in a way that affects positively on the nurses' well-being and occupational satisfaction. It investigates the role of coping skills related to staff-resident interactions, in particular, the use of conflict resolution styles and their influence on the level of morale, burnout and job satisfaction of nursing professionals. A self-administered questionnaire was used to collect information from 161 direct care nursing staff. The authors used a multiple regression procedure to examine the influence of predictors on nursing staff outcomes. Multivariate analyses indicated that nurses' psychological morale, occupational stress, and job satisfaction are influenced by conflict resolution styles, after controlling by individual characteristics, work demands, and work resources factors. The findings highlight the importance of considering personal coping abilities to foster positive staff-resident interactions and to increase nurses' morale and job satisfaction. PMID:16648392

  10. Huddle-coaching: a dynamic intervention for trainees and staff to support team-based care.

    PubMed

    Shunk, Rebecca; Dulay, Maya; Chou, Calvin L; Janson, Susan; O'Brien, Bridget C

    2014-02-01

    Many outpatient clinics where health professionals train will transition to a team-based medical home model over the next several years. Therefore, training programs need innovative approaches to prepare and incorporate trainees into team-based delivery systems. To address this need, educators at the San Francisco Veterans Affairs (VA) Medical Center included trainees in preclinic team "huddles," or briefing meetings to facilitate care coordination, and developed an interprofessional huddle-coaching program for nurse practitioner students and internal medicine residents who function as primary providers for patient panels in VA outpatient primary care clinics. The program aimed to support trainees' partnerships with staff and full participation in the VA's Patient Aligned Care Teams. The huddle-coaching program focuses on structuring the huddle process via scheduling, checklists, and designated huddle coaches; building relationships among team members through team-building activities; and teaching core skills to support collaborative practice. A multifaceted evaluation of the program showed positive results. Participants rated training sessions and team-building activities favorably. In interviews, trainees valued their team members and identified improvements in efficiency and quality of patient care as a result of the team-based approach. Huddle checklists and scores on the Team Development Measure indicated progress in team processes and relationships as the year progressed. These findings suggest that the huddle-coaching program was a worthwhile investment in trainee development that also supported the clinic's larger mission to deliver team-based, patient-aligned care. As more training sites shift to team-based care, the huddle-coaching program offers a strategy for successfully incorporating trainees. PMID:24362383

  11. 76 FR 60937 - Draft License Renewal Interim Staff Guidance LR-ISG-2011-02; Aging Management Program for Steam...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ... Generators AGENCY: Nuclear Regulatory Commission. ACTION: Request for public comment. SUMMARY: The U.S...), LR-ISG-2011-02, ``Aging Management Program for Steam Generators,'' for public comment. This Draft LR... steam generator aging. The Draft LR-ISG revises the NRC staff's aging management...

  12. Ageism and age discrimination in health care: Fact or fiction? A narrative review of the literature.

    PubMed

    Kydd, Angela; Fleming, Anne

    2015-08-01

    Ageism and age discrimination are terms used in best practice statements and in the literature to define negative attitudes towards older people and towards people because of their age (whether old or young). However, 'old age' is a nebulous concept with definitions ranging from the over 50s to the over 85s. In seeking to explore ageism and age discrimination within health care, this paper discusses the concept of 'old' and discusses the findings of a narrative review of the literature on these two concepts. Results show that negative attitudes have been perceived by users of health care services, but the reasons are not clear. Such attitudes are usually reported in acute health care settings, where targets and quick turnover are encouraged. Thus people, usually those with complex needs, who require longer periods of recuperation and rehabilitation following an episode of ill health, are troublesome to staff working in a system geared up for early discharges. This type of service user is usually over the age of 85. Recommendations from this paper include the need for acute frailty units, with well trained staff, where frail older people can be comprehensively assessed, receive timely and targeted care, followed by a supported discharge. PMID:26044073

  13. Can Brief Workshop Interventions Change Care Staff Understanding of Challenging Behaviours?

    ERIC Educational Resources Information Center

    Dowey, Alan; Toogood, Sandy; Hastings, Richard P.; Nash, Susie

    2007-01-01

    Background: The working culture surrounding challenging behaviour may have a strong effect on staff behaviour. As a first step to influencing staff talk about challenging behaviour, the aim of the present study was to explore whether a 1-day training workshop could have an effect on staff causal explanations. Methods: Fifty-four front line staff,…

  14. The decision-making process when starting terminal care as assessed by nursing staff.

    PubMed

    Kuuppelomäki, Merja

    2002-01-01

    This article deals with making decisions about starting terminal care. The results are part of a larger survey on nurses' conceptions of terminal care in community health centres in Finland. The importance, frequency and timing of decision making as well as communication and the number of investigations and procedures carried out are examined. The relationship between decision making and the size of a health centre's catchment population is also discussed. The results make it possible to compare the current situation in Finland with the national law on patients' rights. The sample consisted of 328 nurses who worked on the wards of 32 community health centres. The data were collected by means of a structured questionnaire and processed with the Statistical Package for Social Sciences software. The nurses agreed that explicit decision making and documentation about starting terminal care were necessary, but it was highlighted that the practice had many shortcomings. Decisions were often made too late and the patients were not always aware of their situation; family members and the nursing staff were mostly better informed. It was noted that many investigations and other procedures were carried out on terminally ill patients, often at the request of family members. Decision making was found to have some relationship to the size of a health centre's catchment area. PMID:16010895

  15. Use education to get staff on board with a team-approach to care.

    PubMed

    2014-09-01

    Immediate bedding and the practice of swarming--delivering patient care as a team--can significantly slash wait times and overall length-of-stay in the ED. However, getting physicians and nurses to transition to such approaches is challenging because they must work at a higher pace than they are used to. Veterans of these approaches from Henrico Doctor's Hospital in Richmond, VA advise ED administrators to think through how these approaches would work in their own settings and obtain staff buy-in prior to implementation. Swarming typically requires repeated practice before it gels. Assigning personalities that work well together to the same team on a consistent basis may enhance effectiveness. Explain to staff that the transition to a swarming approach will be hard, but it will deliver dividends over the long term. Make contingency plans for days when the ED is short-staffed or volume is unusually high. Swarming does not work well in departments that are under-staffed. Consider the creation of an "expeditor" position. This is a veteran nurse who has the skills and experience to float wherever she is needed in the ED. PMID:25141496

  16. Staff perceptions on patient motives for attending GP-led urgent care centres in London: a qualitative study

    PubMed Central

    Greenfield, Geva; Ignatowicz, Agnieszka; Gnani, Shamini; Bucktowonsing, Medhavi; Ladbrooke, Tim; Millington, Hugh; Car, Josip

    2016-01-01

    Objectives General practitioner (GP)-led urgent care centres were established to meet the growing demand for urgent care. Staff members working in such centres are central in influencing patients’ choices about which services they use, but little is known about staff perceptions of patients’ motives for attending urgent care. We hence aimed to explore their perceptions of patients’ motives for attending such centres. Design A phenomenological, qualitative study, including semistructured interviews. The interviews were analysed using thematic content analysis. Setting 2 GP-led urgent care centres in 2 academic hospitals in London. Participants 15 staff members working at the centres including 8 GPs, 5 emergency nurse practitioners and 2 receptionists. Results We identified 4 main themes: ‘Confusion about choices’, ‘As if increase of appetite had grown; By what it fed on’, ‘Overt reasons, covert motives’ and ‘A question of legitimacy’. The participants thought that the centres introduce convenient and fast access for patients. So convenient, that an increasing number of patients use them as a regular alternative to their community GP. The participants perceived that patients attend the centres because they are anxious about their symptoms and view them as serious, cannot get an appointment with their GP quickly and conveniently, are dissatisfied with the GP, or lack self-care skills. Staff members perceived some motives as legitimate (an acute health need and difficulties in getting an appointment), and others as less legitimate (convenience, minor illness, and seeking quicker access to hospital facilities). Conclusions The participants perceived that patients attend urgent care centres because of the convenience of access relative to primary care, as well as sense of acuity and anxiety, lack self-care skills and other reasons. They perceived some motives as more legitimate than others. Attention to unmet needs in primary care can help in

  17. Communicating for Quality in School Age Care Services

    ERIC Educational Resources Information Center

    Cartmel, Jennifer; Grieshaber, Susan

    2014-01-01

    School Age Care (SAC) services have existed in Australia for over 100 years but they have tended to take a back seat when compared with provision for school-aged children and those under school age using early childhood education and care (ECEC) services. Many SAC services are housed in shared premises and many children attending preparatory or…

  18. School-Age Child Care Trend Report: Part 2

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    2007-01-01

    According to the author, school-age care is the fastest growing segment of the early childhood arena and possibly the least visible. While programs have been serving school-age children in out-of-school hours since the turn of the century, it is only in recent years that professionals have started to view school-age care as a distinct discipline…

  19. Education and training to enhance end-of-life care for nursing home staff: a systematic literature review

    PubMed Central

    Anstey, Sally; Powell, Tom; Coles, Bernadette; Hale, Rachel; Gould, Dinah

    2016-01-01

    Background The delivery of end-of-life care in nursing homes is challenging. This situation is of concern as 20% of the population die in this setting. Commonly reported reasons include limited access to medical care, inadequate clinical leadership and poor communication between nursing home and medical staff. Education for nursing home staff is suggested as the most important way of overcoming these obstacles. Objectives To identify educational interventions to enhance end-of-life care for nursing home staff and to identify types of study designs and outcomes to indicate success and benchmark interventions against recent international guidelines for education for palliative and end-of-life care. Design Thirteen databases and reference lists of key journals were searched from the inception of each up to September 2014. Included studies were appraised for quality and data were synthesised thematically. Results Twenty-one studies were reviewed. Methodological quality was poor. Education was not of a standard that could be expected to alter clinical behaviour and was evaluated mainly from the perspectives of staff: self-reported increase in knowledge, skills and confidence delivering care rather than direct evidence of impact on clinical practice and patient outcomes. Follow-up was often short term, and despite sound economic arguments for delivering effective end-of-life care to reduce burden on the health service, no economic analyses were reported. Conclusions There is a clear and urgent need to design educational interventions that have the potential to improve end-of-life care in nursing homes. Robust evaluation of these interventions should include impact on residents, families and staff and include economic analysis. PMID:27329513

  20. Silence, shame and abuse in health care: theoretical development on basis of an intervention project among staff.

    PubMed

    Wijma, Barbro; Zbikowski, Anke; Brüggemann, A Jelmer

    2016-01-01

    As health care exists to alleviate patients' suffering it is unacceptable that it inflicts unnecessary suffering on patients. We therefore have developed and evaluated a drama pedagogical model for staff interventions using Forum Play, focusing on staff's experiences of failed encounters where they have perceived that the patient felt abused. In the current paper we present how our preliminary theoretical framework of intervening against abuse in health care developed and was revised during this intervention. During and after the intervention, five important lessons were learned and incorporated in our present theoretical framework. First, a Forum Play intervention may break the silence culture that surrounds abuse in health care. Second, organizing staff training in groups was essential and transformed abuse from being an individual problem inflicting shame into a collective responsibility. Third, initial theoretical concepts "moral resources" and "the vicious violence triangle" proved valuable and became useful pedagogical tools during the intervention. Four, the intervention can be understood as having strengthened staff's moral resources. Five, regret appeared to be an underexplored resource in medical training and clinical work.The occurrence of abuse in health care is a complex phenomenon and the research area is in need of theoretical understanding. We hope this paper can inspire others to further develop theories and interventions in order to counteract abuse in health care. PMID:26922381

  1. A Systematic Review of Interventions to Change Staff Care Practices in Order to Improve Resident Outcomes in Nursing Homes

    PubMed Central

    Low, Lee-Fay; Fletcher, Jennifer; Goodenough, Belinda; Jeon, Yun-Hee; Etherton-Beer, Christopher; MacAndrew, Margaret; Beattie, Elizabeth

    2015-01-01

    Background We systematically reviewed interventions that attempted to change staff practice to improve long-term care resident outcomes. Methods Studies met criteria if they used a control group, included 6 or more nursing home units and quantitatively assessed staff behavior or resident outcomes. Intervention components were coded as including education material, training, audit and feedback, monitoring, champions, team meetings, policy or procedures and organizational restructure. Results Sixty-three unique studies were broadly grouped according to clinical domain—oral health (3 studies), hygiene and infection control (3 studies), nutrition (2 studies), nursing home acquired pneumonia (2 studies), depression (2 studies) appropriate prescribing (7 studies), reduction of physical restraints (3 studies), management of behavioral and psychological symptoms of dementia (6 studies), falls reduction and prevention (11 studies), quality improvement (9 studies), philosophy of care (10 studies) and other (5 studies). No single intervention component, combination of, or increased number of components was associated with greater likelihood of positive outcomes. Studies with positive outcomes for residents also tended to change staff behavior, however changing staff behavior did not necessarily improve resident outcomes. Studies targeting specific care tasks (e.g. oral care, physical restraints) were more likely to produce positive outcomes than those requiring global practice changes (e.g. care philosophy). Studies using intervention theories were more likely to be successful. Program logic was rarely articulated, so it was often unclear whether there was a coherent connection between the intervention components and measured outcomes. Many studies reported barriers relating to staff (e.g. turnover, high workload, attitudes) or organizational factors (e.g. funding, resources, logistics). Conclusion Changing staff practice in nursing homes is possible but complex

  2. Aging in poverty: making the case for comprehensive care management.

    PubMed

    Judd, Rebecca G; Moore, Brenda A

    2011-10-01

    A model for holistic care management that would enhance outcomes for economically vulnerable older adults who receive an array of disjointed services administered through the older Americans Act (OAA) and local Area Agencies on Aging (AAA) is proposed. Fragmented service delivery is typically wasteful and ineffectual, but comprehensive care management that includes an autonomous care manager, a single interagency plan of care and ongoing monitoring that is client-centered may protect those aging in poverty from negative health outcomes. PMID:21967136

  3. Sma Barn Pa Daghem: En studie av personalens samspel med barn och foraldrar vid lamning, hamtning och fri lek (Infants at Day Care: A Study of Staff Interaction with Children and Their Parents during Leaving, Collecting and Free Play).

    ERIC Educational Resources Information Center

    Lothigius, Anita Holmstedt

    This thesis presents a picture of how staff interact with infants (age group 1-3 years old) and parents at three day care centers. The study focused on the situations of leaving and collecting the children and the children's time of free play both in and outdoors. The theoretical content has an attachment/psycho-dynamical perspective with emphasis…

  4. Providing end-of-life care in care homes for older people: a qualitative study of the views of care home staff and community nurses.

    PubMed

    Goddard, Cassie; Stewart, Frances; Thompson, Genevieve; Hall, Sue

    2013-02-01

    The study aimed to explore the views of care home staff (CHS) and community nurses (CNs) on providing end-of-life care (EOLC) in care homes. Participants were randomly selected and qualitative interviews conducted with 80 CHS and 10 CNs. Themes emerging from the data included the following: The meaning of EOLC; starting EOLC; dying in the care home; stress of providing EOLC; improving EOLC; and the role of the CN. CHS felt that planning for the end of life was important before residents reached the dying phase, which some found difficult to determine. Although CHS wished to avoid residents being transferred to hospital to die, they acknowledged that improvements in their skills and the resources available to them were needed to manage EOLC effectively. CNs were critical of the EOLC provided in some care homes, reporting tensions over their relationship with CHS. As the number of older people who die in care homes increases, there is a need to overcome these barriers to provide good EOLC. PMID:25473926

  5. 77 FR 46127 - Interim Staff Guidance on Changes to the Generic Aging Lessons Learned (GALL) Report Revision 2...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-02

    ...The U.S. Nuclear Regulatory Commission (NRC) is issuing the final License Renewal Interim Staff Guidance (LR-ISG), LR-ISG-2011-03, ``Changes to GALL Report Revision 2 Aging Management Program (AMP) XI.M41, `Buried and Underground Piping and Tanks'.'' This LR-ISG provides changes to the recommendations in GALL Report Revision 2 AMP XI.M41 based on the staff's review of several license renewal......

  6. Using a book chat to improve attitudes and perceptions of long-term care staff about dementia.

    PubMed

    Larocque, Natasha; Schotsman, Chloe; Kaasalainen, Sharon; Crawshaw, Diane; McAiney, Carrie; Brazil, Emma

    2014-05-01

    This study sought to evaluate a book chat intervention based on Lisa Genova's novel, Still Alice, to influence long-term care (LTC) staff perceptions and attitudes when caring for individuals with dementia. A qualitative descriptive design was used. Eleven participants partook in a 2.5-hour book chat at a southern Ontario LTC facility. Following the book chat, participants answered two open-ended questions to assess how the book chat influenced their views on dementia. Thematic content analysis was used to analyze the qualitative questionnaire. Content analysis of the participants' responses revealed that the book chat positively influenced their attitudes and perceptions toward dementia, particularly by providing more insight into the individual's personal struggle with the disease. Furthermore, participants found that the book chat influenced their care practices. By creating innovative learning opportunities, attitudes and perceptions about dementia care can be transcended and greatly benefit staff, family, and residents. PMID:24443888

  7. The Role of Training in Improving Community Care Staff Awareness of Mental Health Problems in People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Costello, Helen; Bouras, Nick; Davis, Hilton

    2007-01-01

    Background: Care staff play a key role in identifying individuals with intellectual disabilities and additional mental health problems. Yet, few receive training in mental health, and evidence about the effectiveness of training is scant. Materials and Methods: A pre-post study is reported, using a mental health screen and a self-report…

  8. A Fire Safety Certification System for Board and Care Operators and Staff. SBIR Phase I: Final Report.

    ERIC Educational Resources Information Center

    Walker, Bonnie L.

    This report describes the development and pilot testing of a fire safety certification system for board and care operators and staff who serve clients with developmental disabilities. During Phase 1, training materials were developed, including a trainer's manual, a participant's coursebook a videotape, an audiotape, and a pre-/post test which was…

  9. Using School Staff to Establish a Preventive Network of Care to Improve Elementary School Students' Control of Asthma

    ERIC Educational Resources Information Center

    Bruzzese, Jean-Marie; Evans, David; Wiesemann, Sandra; Pinkett-Heller, Marcia; Levison, Moshe J.; Du, Yunling; Fitzpatrick, Cecilia; Krigsman, Gary; Ramos-Bonoan, Carmen; Turner, Levonne; Mellins, Robert B.

    2006-01-01

    School-based asthma interventions delivered by nonschool staff have been successful but are limited in their reach because of the cost and effort of bringing in outside educators and their inability to establish improved communication about asthma between schools, families, and primary care providers (PCPs). To address these problems, Columbia…

  10. Personality Impact on Experiences of Strain among Staff Exposed to Violence in Care of People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Lundstrom, Mats; Graneheim, Ulla H.; Eisemann, Martin; Richter, Jorg; Astrom, Sture

    2007-01-01

    Explored are the relationships among personality and emotional reactions, work-related strain, and experiences of burnout among staff exposed vs. not exposed to violence when caring for people with intellectual disabilities (ID). Questionnaires measuring personality, emotional reactions, strain and burnout, and exposure to violence were…

  11. The Response to Challenging Behaviour by Care Staff: Emotional Responses, Attributions of Cause and Observations of Practice

    ERIC Educational Resources Information Center

    Bailey, B. A.; Hare, D. J.; Hatton, C.; Limb, K.

    2006-01-01

    Background: Previous studies have attempted to apply Weiner's attributional model of helping behaviour to care staff who work with service users with intellectual disabilities and challenging behaviours by using studies based on vignettes. The aims of the current study were to investigate the application of Weiner's model to "real" service users…

  12. Partners in Caregiving in a Special Care Environment: Cooperative Communication between Staff and Families on Dementia Units

    ERIC Educational Resources Information Center

    Robison, Julie; Curry, Leslie; Gruman, Cynthia; Porter, Martha; Henderson, Charles R., Jr.; Pillemer, Karl

    2007-01-01

    Purpose: This article reports the results of a randomized, controlled evaluation of Partners in Caregiving in a Special Care Environment, an intervention designed to improve communication and cooperation between staff and families of residents in nursing home dementia programs. Design and Methods: Participants included 388 family members and 384…

  13. The Inclusion of Children with a Disability in Child Care: The Influence of Experience, Training and Attitudes of Childcare Staff

    ERIC Educational Resources Information Center

    Mohay, Heather; Reid, Emma

    2006-01-01

    Seventy-seven directors of childcare centres and 77 childcare staff were surveyed about their training to work with children with a disability, experience with these children, attitudes to disability, inclusive practices and barriers to inclusion. General support was expressed for the inclusion of children with a disability in child care,…

  14. [Stress level assessment of the nursing staff in the Intensive Care Unit of a university hospital].

    PubMed

    Carrillo-García, C; Ríos-Rísquez, M I; Martínez-Hurtado, R; Noguera-Villaescusa, P

    2016-01-01

    The objective was to determine the work stress level among nursing staff in the Intensive Care Unit of a university hospital and to analyse its relationship with the various sociodemographic and working variables of the studied sample. A study was designed using a quantitative, descriptive and cross-sectional approach. The target population of the study was the nursing staff selected by non-random sampling. The instrument used was the Job Content Questionnaire. Data analysis was performed using SPSS 20. The mean, ranges and standard deviation for each of the variables were calculated. A bivariate analysis was also performed on the social and occupational variables of the sample. The participation rate was 80.90% (N=89). The mean of the Social support dimension was 3.13±0.397, for the Psychological demands at work dimension it was 3.10±0.384, with a mean of 2.96±0.436 being obtained for the Control over the work dimension. In the analysis of sociodemographic and work variables of the sample, only the professional category was significant, with nurses recording higher values in perception of job demands and control over their work compared to nursing assistants. In conclusion, there is a moderate perception of work stress in the analysed group of professionals. Among the sources of stress in the workplace was the low control in decision-making by practitioners, as well as the need to continually learn new things. On the other hand, the support received from colleagues is valued positively by the sample. PMID:27267958

  15. Incidence and risk factors of workplace violence on nursing staffs caring for chronic psychiatric patients in taiwan.

    PubMed

    Chen, Wen-Ching; Sun, Yu-Hua; Lan, Tsuo-Hung; Chiu, Hsien-Jane

    2009-11-01

    This one-year follow-up study determined the incidence and risk factors of workplace violence against nursing staff in a psychiatric hospital. The cohort members had a website to report events whenever they came across violence. A total of 971 events were reported. The incidence rates of physical violence, verbal abuse, bullying/mobbing, sexual harassment, and racial harassment were 1.7, 3.7, 0.2, 0.3, and 0 per staff-year, respectively. Young age, female sex, lower education, shorter duration of employment, and high level of anxiety of staff seemed to be the determinants of violence. Pre-placement education should focus on these staff to reduce workplace violence. PMID:20049226

  16. Incidence and Risk Factors of Workplace Violence on Nursing Staffs Caring for Chronic Psychiatric Patients in Taiwan

    PubMed Central

    Chen, Wen-Ching; Sun, Yu-Hua; Lan, Tsuo-Hung; Chiu, Hsien-Jane

    2009-01-01

    This one-year follow-up study determined the incidence and risk factors of workplace violence against nursing staff in a psychiatric hospital. The cohort members had a website to report events whenever they came across violence. A total of 971 events were reported. The incidence rates of physical violence, verbal abuse, bullying/mobbing, sexual harassment, and racial harassment were 1.7, 3.7, 0.2, 0.3, and 0 per staff-year, respectively. Young age, female sex, lower education, shorter duration of employment, and high level of anxiety of staff seemed to be the determinants of violence. Pre-placement education should focus on these staff to reduce workplace violence. PMID:20049226

  17. Nursing staff's actions during older residents’ transition into long-term care facility in a nursing home in rural Norway

    PubMed Central

    Eika, Marianne; Espnes, Geir Arild; Hvalvik, Sigrun

    2014-01-01

    Working in long-term care units poses particular staff challenges as these facilities are expected to provide services for seriously ill residents and give help in a homelike atmosphere. Licensed and unlicensed personnel work together in these surroundings, and their contributions may ease or inhibit a smooth transition for recently admitted residents. The aim of the study was to describe and explore different nursing staff's actions during the initial transition period for older people into a long-term care facility. Participant observation periods were undertaken following staff during 10 new residents’ admissions and their first week in the facility. In addition 16 interviews of different staff categories and reading of written documents were carried out. The findings show great variations of the staff's actions during the older residents’ initial transition period. Characteristics of their actions were (1) in the preparation period: “actions of sharing, sorting out, and ignoring information”; (2) on admission day: “actions of involvement and ignorance”; and (3) in the initial period: “targeted and random actions,” “actions influenced by embedded knowledge,” and “actions influenced by local transparency.” PMID:25301634

  18. Factors Affecting the Involvement of Day Centre Care Staff in the Delivery of Physiotherapy to Adults with Intellectual Disabilities: An Exploratory Study in One London Borough

    ERIC Educational Resources Information Center

    Middleton, M. -J.; Kitchen, S. S.

    2008-01-01

    Background: Physiotherapists for adults with intellectual disabilities often work in day centres, relying on care staff to support programmes. This study investigates factors affecting physiotherapy delivery in 4 day centres in one London borough. Materials and Method: Semi-structured interviews were carried out with day centre care staff,…

  19. Hellos and How Are Yous: Predictors and Correlates of Communication between Staff and Families during Morning Drop-Off in Child Care Centers

    ERIC Educational Resources Information Center

    Perlman, Michal; Fletcher, Brooke A.

    2012-01-01

    Research Findings: The amount and quality of communication between staff and guardians in child care centers was examined using extensive naturalistic observations. Interactions between staff and more than 1,000 guardians who dropped their child off at their child care center were captured through a series of 20-s time-sampled observations.…

  20. School's Out! Group Day Care for the School Age Child.

    ERIC Educational Resources Information Center

    Prescott, Elizabeth; Milich, Cynthia

    This report on group day care is designed to: (1) examine the kinds of group programs for school-age children which exist in Los Angeles County, (2) describe the conditions necessary for program operation, and (3) consider the issue of quality as it relates to community expansion of day care services for children of school age. The report is…

  1. Enhancing a primary care environment: a case study of effects on patients and staff in a single general practice

    PubMed Central

    Rice, Gillian; Ingram, Jenny; Mizan, Jacques

    2008-01-01

    Background Few studies have examined the effect on patients and staff of the physical environment in primary care facilities. Aim To explore changes in patient and staff satisfaction, patient anxiety, and patient–doctor communication when a GP surgery moves from old premises to enhanced purpose-built accommodation. Design of study Questionnaire surveys, interviews, and focus groups preand post move. Setting An urban general practice in Bristol. Method Patient questionnaires assessed anxiety (Spielberger State-Trait Anxiety Inventory; STAI), satisfaction with the environment, and communication during the consultation. Staff questionnaires assessed satisfaction with the environment and job satisfaction. Qualitative methods explored patient and staff views in more depth. Results A total of 1118 pre-move and 954 post-move patient questionnaires showed significant increases in satisfaction scores for reception/waiting areas (mean 6.46, 95% confidence interval [CI] = 5.97 to 6.95) and consulting rooms (mean 3.80, 95% CI = 3.44 to 4.15) in the new premises. Patients' satisfaction with patient–doctor communication also increased (mean 0.88, 95% CI = 0.30 to 1.46) and anxiety scores were significantly reduced before and after the consultation in the new premises compared with the old (STAI mean difference before consultation 0.72, 95% CI = 0.37 to 1.08; mean after consultation 0.37, 95% CI = 0.03 to 0.72). Patients highlighted the increased space and light, more modern appearance, greater comfort, and novel works of art in the new surgery. Staff workplace satisfaction increased significantly after moving and remained higher than in the old building. Conclusion This large-scale study examining the effects of a UK primary care environment on patients and staff shows that an enhanced environment is associated with improvements in patients' perception of patient–doctor communication, reduction in anxiety, and increases in patient and staff satisfaction. PMID:18611307

  2. [Single-family rooms for neonatal intensive care units impacts on preterm newborns, families, and health-care staff. A systematic literature review].

    PubMed

    Servel, A-C; Rideau Batista Novais, A

    2016-09-01

    The quality of the environment is an essential point in the care of preterm newborns. The design of neonatal intensive care units (NICUs) (open-bay, single-patient room, single-family room) directly affects both the preterm newborns and their caregivers (parents, healthcare staff). The aim of this systematic review was to evaluate the impact of single-family rooms on the preterm newborn, its parents, and the staff. Single-family rooms improve outcome for the preterm newborn, with increasing parental involvement and better control of the environment (fewer inappropriate stimulations such as high levels of noise and illumination). This kind of NICU design also improves parental and staff satisfaction. PMID:27369099

  3. Critical Care staffs' attitudes, confidence levels and educational needs correlate with countries' donation rates: data from the Donor Action database.

    PubMed

    Roels, Leo; Spaight, Caroline; Smits, Jacqueline; Cohen, Bernard

    2010-08-01

    To investigate on the impact of Critical Care (CC) staffs' attitudes to donation, their acceptance of the brain death (BD) concept, their confidence with donation-related tasks and educational needs on national donation rates. Donor Action (DA) Hospital Attitude Survey (HAS) data were collected from 19 537 CC staff in 11 countries, including personal attitudes to donation, self-reported knowledge, involvement and comfort levels with donation-related tasks and educational requirements. Countries' donation performance was expressed as Procurement Efficiency Index (PEI) (organs procured and transplanted/deaths from eligible causes). National PEI rates correlated well with CC staffs' average support to donation (R = 0.700, P = 0.014), acceptance of the BD concept (R = 0.742, P = 0.007), confidence levels (R = 0.796, P = 0.002) and average educational requirements with donation-related tasks (R = -0.661, P = 0.025). Nurses reported significantly lower positive attitudes (P < 0.0001), acceptance of the BD concept (P < 0.0001), comfort levels (P < 0.0001) and requested more education (P = 0.0025) than medical staff members. DA's HAS is a powerful, standardized tool to assess CC staffs' attitudes and donation-related skills in different environments. Measures to improve countries' donation performance should focus on guidance and education of CC staff so as to ensure that all practitioners have sufficient knowledge and feel comfortable with donation-related issues. PMID:20210934

  4. Designed sound and music environment in postanaesthesia care units--a multicentre study of patients and staff.

    PubMed

    Thorgaard, Per; Ertmann, Ellen; Hansen, Vibeke; Noerregaard, Anni; Hansen, Vibeke; Spanggaard, Lene

    2005-08-01

    A multicentre study in five postanaesthesia care units (PACUs) was performed to investigate patient and staff opinion of a specially designed music environment (DME), related to geographical location. Patients (325) and staff (91) described their opinion by means of a questionnaire-anonymously in the case of staff. Patients were not asked beforehand for permission to play music. Amongst patients 267 (83%) found the sound environment with DME pleasant or very pleasant, 26 (6%) found it unpleasant, whereas 32 (11%) answered "no opinion". The opinion of the patients did not differ significantly with geographical location. A strong correlation (P<0.05) between a positive attitude towards DME and degree of relaxation and satisfaction with stay was found. The staff had an equally positive attitude towards the DME; but theirs varied significantly with location. The opinion of the staff was more similar concerning the beneficial effect on working conditions and distress, but varied still significantly. The opinion of the staff had no demonstrable impact on that of the patients. PMID:16039959

  5. Semelparous Penna Ageing Model with Parental Care

    NASA Astrophysics Data System (ADS)

    Fehsenfeld, K. M.; Sá Martins, J. S.; de Oliveira, S. Moss; Bernardes, A. T.

    In this paper we study the importance of parental care for the survival of semelparous species, that reproduce only once in life. We perform our simulations for sexual and asexual reproductions and show that catastrophic senescence (death soon after reproduction) is delayed if parental care is considered.

  6. A multi-organisation aged care emergency service for acute care management of older residents in aged care facilities.

    PubMed

    Conway, Jane; Dilworth, Sophie; Hullick, Carolyn; Hewitt, Jacqueline; Turner, Catherine; Higgins, Isabel

    2015-11-01

    This case study describes a multi-organisation aged care emergency (ACE) service. The service was designed to enable point-of-care assessment and management for older people in residential aged care facilities (RACFs). Design of the ACE service involved consultation and engagement of multiple key stakeholders. The ACE service was implemented in a large geographical region of a single Medicare Local (ML) in New South Wales, Australia. The service was developed over several phases. A case control pilot evaluation of one emergency department (ED) and four RACFs revealed a 16% reduction in presentations to the ED as well as reductions in admission to the hospital following ED presentation. Following initial pilot work, the ACE service transitioned across another five EDs and 85 RACFs in the local health district. The service has now been implemented in a further 10 sites (six metropolitan and four rural EDs) across New South Wales. Ongoing evaluation of the implementation continues to show positive outcomes. The ACE service offers a model shown to reduce ED presentations and admissions from RACFs, and provide quality care with a focus on the needs of the older person. PMID:25981903

  7. Perceptions and employment intentions among aged care nurses and nursing assistants from diverse cultural backgrounds: A qualitative interview study.

    PubMed

    Gao, Fengsong; Tilse, Cheryl; Wilson, Jill; Tuckett, Anthony; Newcombe, Peter

    2015-12-01

    The residential aged care industry faces shortages and high turnover rates of direct care workers. This situation is further complicated by the increasing cultural diversity of residents and staff. To retain direct care workers, it is crucial to explore their perceptions of the rewards and difficulties of care work, and their employment intentions in multicultural environments. A qualitative descriptive study was used to understand perceptions of the rewards and difficulties of residential aged care work for core direct care workers (i.e. nurses and nursing assistants), how these were related to their intentions to stay or leave, and how these varied between nurses and nursing assistants, and between locally and overseas born workers. Individual interviews were conducted between June and September 2013 with 16 direct care workers in an Australian residential aged care facility with a specific focus on people from culturally and linguistically diverse backgrounds. It was found that direct care workers' employment intentions were related to their perceptions and management of the rewards and difficulties of care work. Their experiences of care work, the employment characteristics, and the organizational resources that fitted their personality, ability, expectations, and essential needs were viewed as rewards. Evaluating their jobs as meaningful was a shared perception for direct care workers who intended to stay. Individual workers' perceptions of the rewarding aspects of care work served to counterbalance the challenges of care work, and promoted their intentions to stay. Perceptions and employment intentions varied by occupational groups and by cultural backgrounds. Overseas born direct care workers are valuable resources in residential aged care facility rather than a limitation, but they do require organizational support, such as cultural awareness of the management, English language support, a sense of family, and appropriate job responsibility. The findings

  8. Understanding and improving communication processes in an increasingly multicultural aged care workforce.

    PubMed

    Nichols, Pam; Horner, Barbara; Fyfe, Katrina

    2015-01-01

    This study explored how culture shapes relationships in aged care and the extent to which the residential aged care sector supports a cohesive multicultural workforce. An exploratory methodology utilising semi-structured questionnaires collected data from 58 participants comprising: staff who provide direct care to residents; managers; and family members from six residential care facilities in Perth, Western Australia. Communication issues emerged as an over-arching theme, and included interpersonal communication, the effect of cultural norms on communication and the impact of informal and formal workplace policies relating to spoken and written language. Sixty percent of participants from a culturally and linguistically diverse (CaLD) background had experienced negative reactions from residents with dementia, linked to visible cultural difference. They used a range of coping strategies including ignoring, resilience and avoidance in such situations. CaLD participants also reported prejudicial treatment from non-CaLD staff. The findings highlight the need for organisations to incorporate explicit processes which address the multiple layers of influence on cross cultural communication: internalised beliefs and values; moderating effects of education, experience and social circumstance; and factors external to the individuals, including workplace culture and the broader political economy, to develop a cohesive multicultural workplace. PMID:25661853

  9. Learning opportunities in a residential aged care facility: the role of supported placements for first-year nursing students.

    PubMed

    Lea, Emma; Marlow, Annette; Bramble, Marguerite; Andrews, Sharon; Crisp, Elaine; Eccleston, Claire; Mason, Ron; Robinson, Andrew

    2014-07-01

    The residential aged care sector is reportedly a less attractive career choice for nursing students than other sectors. Research shows that students are often fearful of working with residents with dementia when they are inadequately supported on clinical placements by aged care staff. Thirty first-year nursing students attended a 2-week placement in one of two Tasmanian aged care facilities as part of the Wicking Dementia Research and Education Centre Teaching Aged Care Facilities Program, which aims to provide students with a quality aged care placement focusing on dementia palliation. Placement experience and dementia knowledge were evaluated through preplacement and postplacement questionnaires and weekly feedback meetings with mentors and students. Students had more positive attitudes related to aged care and higher dementia knowledge at the end of placement. Students described their interactions with residents with dementia and thought that the placement had increased their capacity to provide quality care to these residents. The findings indicate that residential aged care placements can be productive learning environments for novice nursing students. PMID:24972402

  10. [Social representations on aging by primary care health workers].

    PubMed

    Mendes, Cristina Katya Torres Teixeira; Alves, Maria do Socorro Costa Feitosa; Silva, Antonia Oliveira; Paredes, Maria Adelaide Silva; Rodrigues, Tatyanni Peixoto

    2012-09-01

    The objective of this study was to get to know the social representations on aging developed by primary care health workers. This is an exploratory study involving 204 primary health care workers, in the city of João Pessoa, in the state of Paraíba. For data collection we used a semi-structured interview. The data obtained from 204 interviews was analyzed with the help of the Alceste software version 2010. The results indicated five classes or categories: vision of aging,psychosocial dimensions, a time of doubts, aging as a process, and aging versus disease, with positive content: joy, care, children, retirement, caregiver rights, maturity and wisdom, as well as negative factors: impairments, decadence, neglect, fragility, limitation, wrinkles, dependency and disease. It was observed that these meanings associated with aging express the need for total and humanized elderly care. PMID:23405821

  11. Client Characteristics, Organizational Variables and Burnout in Care Staff: The Mediating Role of Fear of Assault

    ERIC Educational Resources Information Center

    Rose, John; Mills, Sophie; Silva, Daniel; Thompson, Lauren

    2013-01-01

    A broad range of factors have been identified as having an impact on burnout and performance. To improve our understanding of how these factors interact, a model of carer stress is tested. Staff were surveyed in residential units, assessments included burnout, organizational factors, staff cognitions and ratings of resident challenging behavior.…

  12. Supporting residents’ expression of sexuality: the initial construction of a sexuality assessment tool for residential aged care facilities

    PubMed Central

    2014-01-01

    Background Sexuality is a key component of quality of life and well-being and a need to express one’s sexuality continues into old age. Staff and families in residential aged care facilities often find expressions of sexuality by residents, particularly those living with dementia, challenging and facilities often struggle to address individuals’ needs in this area. This paper describes the development of an assessment tool which enables residential aged care facilities to identify how supportive their organisation is of all residents’ expression of their sexuality, and thereby improve where required. Methods Multi-phase design using qualitative methods and a Delphi technique. Tool items were derived from the literature and verified by qualitative interviews with aged care facility staff, residents and families. The final item pool was confirmed via a reactive Delphi process. Results A final item pool of sixty-nine items grouped into seven key areas allows facilities to score their compliance with the areas identified as being supportive of older people’s expression of their sexuality in a residential aged care environment. Conclusions The sexuality assessment tool (SexAT) guides practice to support the normalization of sexuality in aged care homes and assists facilities to identify where enhancements to the environment, policies, procedures and practices, information and education/training are required. The tool also enables facilities to monitor initiatives in these areas over time. PMID:24980463

  13. Client characteristics, organizational variables and burnout in care staff: the mediating role of fear of assault.

    PubMed

    Rose, John; Mills, Sophie; Silva, Daniel; Thompson, Lauren

    2013-03-01

    A broad range of factors have been identified as having an impact on burnout and performance. To improve our understanding of how these factors interact, a model of carer stress is tested. Staff were surveyed in residential units, assessments included burnout, organizational factors, staff cognitions and ratings of resident challenging behavior. The relationship between challenging behavior and emotional exhaustion was fully mediated by fear of assault. The relationship between emotional exhaustion and experienced safety (an organizational variable) was also fully mediated by fear of assault. The use of the model with staff is supported and it suggests that staff burnout can be reduced by influencing either staff cognitions, organizational factors or challenging behavior or a combination of these factors. PMID:23291511

  14. Staff and relatives' perspectives on the aggressive behaviour of older people with dementia in residential care: a qualitative study.

    PubMed

    Duxbury, J; Pulsford, D; Hadi, M; Sykes, S

    2013-11-01

    Staff and relative perspectives on patient aggression in dementia care units are seriously under researched in the U.K. Any work that has been conducted has relied upon quantitative studies. Qualitative research on aggression management in older peoples services are rare. In-depth views that can offer insights into causation and management strategies are therefore under represented in the literature. In order to investigate this issue further we interviewed a number of nursing staff and relatives in four U.K. care homes in the North West of England. Using a combined approach of one-to-one interviews (for staff) and focus groups (for relatives) we explored their views as to the reasons for and ways of responding to aggressive behaviour. This was part of a larger study reported upon elsewhere. Using thematic analysis we found similar results from both staff and relatives and as such their views were categorized into two broad areas: causation and management. In regards to causation we noted three sub-themes; internal, external and interpersonal factors which are further subdivided in the paper and for management two broad categories: the compassionate approach and 'don't go in strong'. The results indicated that staff in the participating units embraced a person-centred approach to aggression management. They predominantly respond to aggressive incidents with interpersonal strategies, such as distraction as opposed to medication or restraint. Overall they adopt a person centre approach to patient care. Relatives were clear in their perceptions of aggression as an interpersonal challenge, which is compounded or mediated by the illness of dementia. Consequently they were positive in their views of staff using non-coercive interventions. While the results of this and our earlier study are promising suggesting a less invasive approach to this aspect of dementia care, given the limitations of a small sample, more research of a similar nature is warranted. Findings from

  15. Should euthanasia be legal? An international survey of neonatal intensive care units staff

    PubMed Central

    Cuttini, M; Casotto, V; Kaminski, M; de Beaufort, I; Berbik, I; Hansen, G; Kollee, L; Kucinskas, A; Lenoir, S; Levin, A; Orzalesi, M; Persson, J; Rebagliato, M; Reid, M; Saracci, R

    2004-01-01

    Objective: To present the views of a representative sample of neonatal doctors and nurses in 10 European countries on the moral acceptability of active euthanasia and its legal regulation. Design: A total of 142 neonatal intensive care units were recruited by census (in the Netherlands, Sweden, Hungary, and the Baltic countries) or random sampling (in France, Germany, Italy, Spain, and the United Kingdom); 1391 doctors and 3410 nurses completed an anonymous questionnaire (response rates 89% and 86% respectively). Main outcome measure: The staff opinion that the law in their country should be changed to allow active euthanasia "more than now". Results: Active euthanasia appeared to be both acceptable and practiced in the Netherlands, France, and to a lesser extent Lithuania, and less acceptable in Sweden, Hungary, Italy, and Spain. More then half (53%) of the doctors in the Netherlands, but only a quarter (24%) in France felt that the law should be changed to allow active euthanasia "more than now". For 40% of French doctors, end of life issues should not be regulated by law. Being male, regular involvement in research, less than six years professional experience, and having ever participated in a decision of active euthanasia were positively associated with an opinion favouring relaxation of legal constraints. Having had children, religiousness, and believing in the absolute value of human life showed a negative association. Nurses were slightly more likely to consider active euthanasia acceptable in selected circumstances, and to feel that the law should be changed to allow it more than now. Conclusions: Opinions of health professionals vary widely between countries, and, even where neonatal euthanasia is already practiced, do not uniformly support its legalisation. PMID:14711848

  16. Preparing for an epidemic: cancer care in an aging population.

    PubMed

    Shih, Ya-Chen Tina; Hurria, Arti

    2014-01-01

    The Institute of Medicine's (IOM) Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population was charged with evaluating and proposing recommendations on how to improve the quality of cancer care, with a specific focus on the aging population. Based on their findings, the IOM committee recently released a report highlighting their 10 recommendations for improving the quality of cancer care. Based on those recommendations, this article highlights ways to improve evidence-based care and addresses rising costs in health care for older adults with cancer. The IOM highlighted three recommendations to address the current research gaps in providing evidence-based care in older adults with cancer, which included (1) studying populations which match the age and health-risk profile of the population with the disease, (2) legislative incentives for companies to include patients that are older or with multiple morbidities in new cancer drug trials, and (3) expansion of research that contributes to the depth and breadth of data available for assessing interventions. The recommendations also highlighted the need to maintain affordable and accessible care for older adults with cancer, with an emphasis on finding creative solutions within both the care delivery system and payment models in order to balance costs while preserving quality of care. The implementation of the IOM's recommendations will be a key step in moving closer to the goal of providing accessible, affordable, evidence-based, high-quality care to all patients with cancer. PMID:24857069

  17. Does informal care reduce public care expenditure on elderly care? Estimates based on Finland’s Age Study

    PubMed Central

    2013-01-01

    Background To formulate sustainable long-term care policies, it is critical first to understand the relationship between informal care and formal care expenditure. The aim of this paper is to examine to what extent informal care reduces public expenditure on elderly care. Methods Data from a geriatric rehabilitation program conducted in Finland (Age Study, n = 732) were used to estimate the annual public care expenditure on elderly care. We first constructed hierarchical multilevel regression models to determine the factors associated with elderly care expenditure. Second, we calculated the adjusted mean costs of care in four care patterns: 1) informal care only for elderly living alone; 2) informal care only from a co-resident family member; 3) a combination of formal and informal care; and 4) formal care only. We included functional independence and health-related quality of life (15D score) measures into our models. This method standardizes the care needs of a heterogeneous subject group and enabled us to compare expenditure among various care categories even when differences were observed in the subjects’ physical health. Results Elder care that consisted of formal care only had the highest expenditure at 25,300 Euros annually. The combination of formal and informal care had an annual expenditure of 22,300 Euros. If a person received mainly informal care from a co-resident family member, then the annual expenditure was only 4,900 Euros and just 6,000 Euros for a person living alone and receiving informal care. Conclusions Our analysis of a frail elderly Finnish population shows that the availability of informal care considerably reduces public care expenditure. Therefore, informal care should be taken into account when formulating policies for long-term care. The process whereby families choose to provide care for their elderly relatives has a significant impact on long-term care expenditure. PMID:23947622

  18. Summary Statement: Appropriate Medical Care for the Secondary School-Aged Athlete

    PubMed Central

    Almquist, Jon; Valovich McLeod, Tamara C; Cavanna, Angela; Jenkinson, Dave; Lincoln, Andrew E; Loud, Keith; Peterson, Bart C; Portwood, Craig; Reynolds, John; Woods, Thomas S

    2008-01-01

    Objective: To present the recommendations made by the Appropriate Medical Care for Secondary School-Aged Athletes Task Force and to summarize the subsequent monograph developed around 11 consensus points. Data Sources: The MEDLINE, CINAHL, and SportDiscus databases were searched for relevant literature regarding secondary school-aged athletes; health care administration; preparticipation physical examination; facilities; athletic equipment; emergency action planning; environmental conditions; recognition, evaluation, and treatment of injuries; rehabilitation and reconditioning; psychosocial consultation; nutrition; and prevention strategies. Conclusions and Recommendations: Organizations that sponsor athletic programs for secondary school-aged athletes should establish an athletic health care team to ensure that appropriate medical care is provided to all participants. The 11 consensus points provide a framework—one that is supported by the medical literature and case law—for the development of an athletic health care team and for assigning responsibilities to the team, administrators, and staff members of institutions sponsoring secondary school and club-level athletic programs. PMID:18668175

  19. The effectiveness of an aged care specific leadership and management program on workforce, work environment, and care quality outcomes: design of a cluster randomised controlled trial

    PubMed Central

    2013-01-01

    Background A plethora of observational evidence exists concerning the impact of management and leadership on workforce, work environment, and care quality. Yet, no randomised controlled trial has been conducted to test the effectiveness of leadership and management interventions in aged care. An innovative aged care clinical leadership program (Clinical Leadership in Aged Care − CLiAC) was developed to improve managers’ leadership capacities to support the delivery of quality care in Australia. This paper describes the study design of the cluster randomised controlled trial testing the effectiveness of the program. Methods Twenty-four residential and community aged care sites were recruited as managers at each site agreed in writing to participate in the study and ensure that leaders allocated to the control arm would not be offered the intervention program. Sites undergoing major managerial or structural changes were excluded. The 24 sites were randomly allocated to receive the CLiAC program (intervention) or usual care (control), stratified by type (residential vs. community, six each for each arm). Treatment allocation was masked to assessors and staff of all participating sites. The objective is to establish the effectiveness of the CLiAC program in improving work environment, workforce retention, as well as care safety and quality, when compared to usual care. The primary outcomes are measures of work environment, care quality and safety, and staff turnover rates. Secondary outcomes include manager leadership capacity, staff absenteeism, intention to leave, stress levels, and job satisfaction. Differences between intervention and control groups will be analysed by researchers blinded to treatment allocation using linear regression of individual results adjusted for stratification and clustering by site (primary analysis), and additionally for baseline values and potential confounders (secondary analysis). Outcomes measured at the site level will be

  20. How to Select Anti-Aging Skin Care Products

    MedlinePlus

    ... zone Video library Find a dermatologist How to select anti-aging skin care products Dermatologists share their ... make a noticeable difference. When shopping for sunscreen, select one that offers all of the following: Broad ...

  1. Surviving the Silver Tsunami: Training a Health Care Workforce to Care for North Carolina's Aging Population.

    PubMed

    Heflin, Mitchell T

    2016-01-01

    North Carolina's aging population will require a health care workforce prepared to meet patients' complex care needs. The keys to training this workforce include continuing to mobilize the state's educational infrastructure to provide interprofessional, community-based experiences and maximizing exposure to new models of care. PMID:26961830

  2. Development of a hospital reiki training program: training volunteers to provide reiki to patients, families, and staff in the acute care setting.

    PubMed

    Hahn, Julie; Reilly, Patricia M; Buchanan, Teresa M

    2014-01-01

    Creating a healing and healthy environment for patients, families, and staff is an ongoing challenge. As part of our hospital's Integrative Care Program, a Reiki Volunteer Program has helped to foster a caring and healing environment, providing a means for patients, family, and staff to reduce pain and anxiety and improve their ability to relax and be present. Because direct care providers manage multiple and competing needs at any given time, they may not be available to provide Reiki when it is needed. This program demonstrates that a volunteer-based program can successfully support nurses in meeting patient, family, and staff demand for Reiki services. PMID:24310710

  3. School-Age Child Care. Fastback 454.

    ERIC Educational Resources Information Center

    LeBuffe, James R.; Hargreaves, Sherran A.

    Currently at least 5 million children--some estimates are as high as 15 million--are left unsupervised before or after school for 3 or more hours a day. In response to the problems of these latchkey children, many public schools are now developing some form of school-based or school-related before- and after-school child care programs. The purpose…

  4. Resident Satisfaction and Its Components in Residential Aged Care

    ERIC Educational Resources Information Center

    Chou, Shu-Chiung; Boldy, Duncan P.; Lee, Andy H.

    2002-01-01

    Purpose: The purpose of this study was to assess the direction and magnitude of the effects among the components of resident satisfaction in residential aged care and to examine if the relationships among satisfaction components vary according to facility type (i.e., nursing home and hostel). Briefly, a hostel is a low-care facility in which…

  5. Schools Out! Family Day Care for the School Age Child.

    ERIC Educational Resources Information Center

    Prescott, Elizabeth; Milich, Cynthia

    This paper presents a study of family day care services for school age children. The study involved telephone and home interviews concerning services provided by a sample of 247 family day care mothers from the Los Angeles area. The paper is divided into two parts. Part I describes the results of the interviews in numerical form and includes short…

  6. Home care in jeopardy. The impact of severe fiscal pressures on patients, management, and staff: the perspective of management and staff.

    PubMed

    Lechich, A J

    2000-01-01

    This article has summarized staff experiences and reactions to a revolutionary financing methodology which has been mandated for the nation's Skilled Nursing Facilities. The true impact, beyond the initial observations outlined above, has yet to be realized. In an industry that is characterized as a large cost center of the nation's health bill, it is expected that severe measures will be taken to stem the rising costs; but it is also an industry that directly fulfills a nation's solemn obligation to its most vulnerable and needy constituents. The long-term-care industry has always suffered from marginal staffing ratios and heavy workloads for its providers, thus any new measure that gives nurses more to write with less time to write it means decreased morale, burnout, and career migration. This package will be more palatable when the computer technology, so prevalent elsewhere in our society, is effectively visited on this process. To date, none of these technologies has made the grade. It is of more than passing interest that the pressure brought by PPS and the heavier care patients in SNFs have produced legislation on mandatory staffing with bills in Arkansas, California, Florida, and Minnesota. It will be of great interest to see how the new U.S. President and Congress will address these vital issues. PMID:11107666

  7. The 2030 Problem: Caring for Aging Baby Boomers

    PubMed Central

    Knickman, James R; Snell, Emily K

    2002-01-01

    Objective To assess the coming challenges of caring for large numbers of frail elderly as the Baby Boom generation ages. Study Setting A review of economic and demographic data as well as simulations of projected socioeconomic and demographic patterns in the year 2030 form the basis of a review of the challenges related to caring for seniors that need to be faced by society. Study Design A series of analyses are used to consider the challenges related to caring for elders in the year 2030: (1) measures of macroeconomic burden are developed and analyzed, (2) the literatures on trends in disability, payment approaches for long-term care, healthy aging, and cultural views of aging are analyzed and synthesized, and(3)simulations of future income and assets patterns of the Baby Boom generation are developed. Principal Findings The economic burden of aging in 2030 should be no greater than the economic burden associated with raising large numbers of baby boom children in the 1960s. The real challenges of caring for the elderly in 2030 will involve: (1) making sure society develops payment and insurance systems for long-term care that work better than existing ones, (2) taking advantage of advances in medicine and behavioral health to keep the elderly as healthy and active as possible, (3) changing the way society organizes community services so that care is more accessible, and (4) altering the cultural view of aging to make sure all ages are integrated into the fabric of community life. Conclusions To meet the long-term care needs of Baby Boomers, social and public policy changes must begin soon. Meeting the financial and social service burdens of growing numbers of elders will not be a daunting task if necessary changes are made now rather than when Baby Boomers actually need long-term care. PMID:12236388

  8. Attitudes of clinical staff toward the causes and management of aggression in acute old age psychiatry inpatient units

    PubMed Central

    2014-01-01

    Background In psychiatry, most of the focus on patient aggression has been in adolescent and adult inpatient settings. This behaviour is also common in elderly people with mental illness, but little research has been conducted into this problem in old age psychiatry settings. The attitudes of clinical staff toward aggression may affect the way they manage this behaviour. The purpose of this study was to examine the attitudes of clinical staff toward the causes and management of aggression in acute old age psychiatry inpatient settings. Methods A convenience sample of clinical staff were recruited from three locked acute old age psychiatry inpatient units in Melbourne, Australia. They completed the Management of Aggression and Violence Scale, which assessed the causes and managment of aggression in psychiatric settings. Results Eighty-five staff completed the questionnaire, comprising registered nurses (61.1%, n = 52), enrolled nurses (27.1%, n = 23) and medical and allied health staff (11.8%, n = 10). A range of causative factors contributed to aggression. The respondents had a tendency to disagree that factors directly related to the patient contributed to this behaviour. They agreed patients were aggressive because of the environment they were in, other people contributed to them becoming aggressive, and patients from certain cultural groups were prone to these behaviours. However, there were mixed views about whether patient aggression could be prevented, and this type of behaviour took place because staff did not listen to patients. There was agreement medication was a valuable approach for the management of aggression, negotiation could be used more effectively in such challenging behaviour, and seclusion and physical restraint were sometimes used more than necessary. However, there was disagreement about whether the practice of secluding patients should be discontinued. Conclusions Aggression in acute old age psychiatry inpatient units occurs

  9. Implementing UK Autism Policy & National Institute for Health and Care Excellence Guidance--Assessing the Impact of Autism Training for Frontline Staff in Community Learning Disabilities Teams

    ERIC Educational Resources Information Center

    Clark, Alex; Browne, Sarah; Boardman, Liz; Hewitt, Lealah; Light, Sophie

    2016-01-01

    UK National Autism Strategy (Department of Health, 2010 and National Institute for Health and Care Excellence guidance (NICE, 2012) states that frontline staff should have a good understanding of Autism. Fifty-six clinical and administrative staff from a multidisciplinary community Learning Disability service completed an electronic questionnaire…

  10. Training teachers to teach mental health skills to staff in primary care settings in a vast, under-populated area.

    PubMed

    Goldberg, D P; Gask, L; Zakroyeva, A; Proselkova, E; Ryzhkova, N; Williams, P

    2012-12-01

    Background The Arkhangelsk Oblast is an area the size of France with a sparsely distributed population. The existing primary care staff have had very little training in the management of mental health disorders, despite the frequency of these disorders in the population. They requested special teaching on depression, suicide, somatisation and alcohol problems. Methods An educational intervention was developed in partnership with mental health and primary care staff in Russia, to develop mental health skills using established, evidence-based methods. After a preliminary demonstration of teaching methods to be employed, a 5-day full-time teaching course was offered to trainers of general practitioners and feldshers. Results The findings are presented by providing details of improvements that occurred over a 3-month period in four areas, namely depression in primary care, somatic presentations of distress, dealing with suicidal patients, and alcohol problems. We present preliminary data on how the training has generalised since our visits to Archangelsk. Conclusions Teachers who are used to teaching by didactic lectures can be taught the value of short introductory talks that invite discussion, and mental health skills can be taught using role play. The content of such training should be driven by perceived local needs, and developed in conjunction with local leaders and teachers within primary care services. Further research will be needed to establish the impact on clinical outcomes. PMID:24294296

  11. Training teachers to teach mental health skills to staff in primary care settings in a vast, under-populated area

    PubMed Central

    2012-01-01

    Background The Arkhangelsk Oblast is an area the size of France with a sparsely distributed population. The existing primary care staff have had very little training in the management of mental health disorders, despite the frequency of these disorders in the population. They requested special teaching on depression, suicide, somatisation and alcohol problems. Methods An educational intervention was developed in partnership with mental health and primary care staff in Russia, to develop mental health skills using established, evidence-based methods. After a preliminary demonstration of teaching methods to be employed, a 5-day full-time teaching course was offered to trainers of general practitioners and feldshers. Results The findings are presented by providing details of improvements that occurred over a 3-month period in four areas, namely depression in primary care, somatic presentations of distress, dealing with suicidal patients, and alcohol problems. We present preliminary data on how the training has generalised since our visits to Archangelsk. Conclusions Teachers who are used to teaching by didactic lectures can be taught the value of short introductory talks that invite discussion, and mental health skills can be taught using role play. The content of such training should be driven by perceived local needs, and developed in conjunction with local leaders and teachers within primary care services. Further research will be needed to establish the impact on clinical outcomes. PMID:24294296

  12. Old age, disability and care in public health.

    PubMed

    Giacomin, Karla Cristina; Firmo, Josélia Oliveira Araújo

    2015-12-01

    Aging of the population profoundly changes the scope of action of public health, altering the profile of morbidity-mortality and increasing the demand for chronic care. In the aging population, disability serves as an indicator of health and a guideline for actions and policies. This enquiry, with a qualitative approach, based on interpretative anthropology and the emic perspective, aims to understand the way of thinking and acting of old people in the face of 'old age with disability' and their relationships with public health. Individual interviews were held at the subject's homes, using a semi-structured script, with 57 old people living in the city, including participants from the cohort of Bambuí. Collection and analysis of the data was oriented by the methodology of Signs, Meanings and Actions, making possible anthropological investigation of the representations and concrete behaviors associated with disability in old age in the local culture. Two categories relating to the relationships between old age, disability and public healthcare emerged from the analysis: (i) experience of care in old age with disability; and (ii) the fear of lack of care. The results reveal that public health needs to review its concepts about disability in old age and incorporate disability into the agenda of the functional dimension of health and care for old age. PMID:26691789

  13. Demographics, Management, Preventive Health Care and Disease in Aged Horses.

    PubMed

    Ireland, Joanne L

    2016-08-01

    Gerontology has become increasingly important in equine veterinary medicine, with aged animals representing a significant proportion of the equine population. Horses are defined as geriatric or aged from age 15 years onwards but can have a life span of more than 40 years. Despite a high level of owner concern for the well-being of their geriatric animal, provision of preventive health care may be suboptimal. Owners seem to under-recognize some of the most prevalent diseases identified in geriatric horses. This review focuses on the demographic characteristics of the equine geriatric population and management and preventive care practices of older horses. PMID:27449388

  14. Development and evaluation of an aged care specific Advance Care Plan

    PubMed Central

    Silvester, William; Parslow, Ruth A; Lewis, Virginia J; Fullam, Rachael S; Sjanta, Rebekah; Jackson, Lynne; White, Vanessa; Hudson, Rosalie

    2013-01-01

    Objectives To report on the quality of advance care planning (ACP) documents in use in residential aged care facilities (RACF) in areas of Victoria Australia prior to a systematic intervention; to report on the development and performance of an aged care specific Advance Care Plan template used during the intervention. Design An audit of the quality of pre-existing documentation used to record resident treatment preferences and end-of-life wishes at participating RACFs; development and pilot of an aged care specific Advance Care Plan template; an audit of the completeness and quality of Advance Care Plans completed on the new template during a systematic ACP intervention. Participants and setting 19 selected RACFs (managed by 12 aged care organisations) in metropolitan and regional areas of Victoria. Results Documentation in use at facilities prior to the ACP intervention most commonly recorded preferences regarding hospital transfer, life prolonging treatment and personal/cultural/religious wishes. However, 7 of 12 document sets failed to adequately and clearly specify the resident's preferences as regards life prolonging medical treatment. The newly developed aged care specific Advance Care Plan template was met with approval by participating RACFs. Of 203 Advance Care Plans completed on the template throughout the project period, 49% included the appointment of a Medical Enduring Power of Attorney. Requests concerning medical treatment were specified in almost all completed documents (97%), with 73% nominating the option of refusal of life-prolonging treatment. Over 90% of plans included information concerning residents’ values and beliefs, and future health situations that the resident would find to be unacceptable were specified in 78% of completed plans. Conclusions Standardised procedures and documentation are needed to improve the quality of processes, documents and outcomes of ACP in the residential aged care sector. PMID:23626906

  15. Phenomenological perspectives on self-care in aging

    PubMed Central

    Söderhamn, Olle

    2013-01-01

    Self-care is a central concept in health care and may be considered as a means to maintain, restore, and improve one’s health and well-being. When performed effectively, self-care contributes not only to human functioning but also to human structural integrity and human development (ie, to a dynamic and holistic state of health). Self-care as a clinical concept is relevant for health care professionals, and it should be meaningful to investigate it at a philosophical level and to further elaborate upon this concept. The aim of this article is to discuss and elaborate upon a phenomenological perspective on self-care in aging that is relevant for the health sciences. Self-care may be preliminarily regarded as a fundamental perspective for the conscious older individual, and as a way of being in the world with both the objective body and with the lived body. The lived body is the personal center of perception and the field of action, and it is also the center of self-care. The potentiality or ability for self-care activity and self-care activity itself are structures given to perception, with self-care ability as an integral part of the lived body. The actualization of self-care ability comes about through a certain meaning, which can be regarded as an important driving force. It is constituted by communication, a healthy lifestyle, and by building meaning and socializing. Successful self-care involves having contacts with the health care system, being conscious of a sound lifestyle, being physically and mentally active, being engaged, having social contacts with family and others, as well as being satisfied, positive, and being able to look forward. One fundamental cornerstone is serenity on behalf of the individual. Self-care can facilitate transitions, and it may also be an outcome of transitions. PMID:23807842

  16. A Systematic Review of Clinician and Staff Views on the Acceptability of Incorporating Remote Monitoring Technology into Primary Care

    PubMed Central

    Freeman, Michele; Kaye, Jeffrey; Vuckovic, Nancy; Buckley, David I.

    2014-01-01

    Abstract Objective: Remote monitoring technology (RMT) may enhance healthcare quality and reduce costs. RMT adoption depends on perceptions of the end-user (e.g., patients, caregivers, healthcare providers). We conducted a systematic review exploring the acceptability and feasibility of RMT use in routine adult patient care, from the perspectives of primary care clinicians, administrators, and clinic staff. Materials and Methods: We searched the databases of Medline, IEEE Xplore, and Compendex for original articles published from January 1996 through February 2013. We manually screened bibliographies of pertinent studies and consulted experts to identify English-language studies meeting our inclusion criteria. Results: Of 939 citations identified, 15 studies reported in 16 publications met inclusion criteria. Studies were heterogeneous by country, type of RMT used, patient and provider characteristics, and method of implementation and evaluation. Clinicians, staff, and administrators generally held positive views about RMTs. Concerns emerged regarding clinical relevance of RMT data, changing clinical roles and patterns of care (e.g., reduced quality of care from fewer patient visits, overtreatment), insufficient staffing or time to monitor and discuss RMT data, data incompatibility with a clinic's electronic health record (EHR), and unclear legal liability regarding response protocols. Conclusions: This small body of heterogeneous literature suggests that for RMTs to be adopted in primary care, researchers and developers must ensure clinical relevance, support adequate infrastructure, streamline data transmission into EHR systems, attend to changing care patterns and professional roles, and clarify response protocols. There is a critical need to engage end-users in the development and implementation of RMT. PMID:24731239

  17. A Survey of the Knowledge of Venous Thromboembolism Prophylaxis among the Medical Staff of Intensive Care Units in North China

    PubMed Central

    Tang, Xiao; Sun, Bing; Yang, Yuanhua; Tong, Zhaohui

    2015-01-01

    Background Guideline concordance for venous thromboembolism (VTE) prophylaxis in critically ill patients in intensive care units (ICUs) varies across different countries. Objective To explore how the medical staff of ICUs in China comprehend and practice VTE prophylaxis. Method Questionnaires comprising 39 questions and including 4 dimensions of thromboprophylaxis were administered in ICUs in North China. Results In all, 52 ICUs at 23 tertiary hospitals in 7 Chinese provinces and municipalities were surveyed. A total of 2500 questionnaires were sent, and 1861 were returned, corresponding to a response rate of approximately 74.4%. Of all surveyed medical staff, 36.5% of physicians and 22.2% of nurses were aware of the guidelines in China, and 19.0% of physicians and 9.5% of nurses comprehended the 9th edition of the guidelines of the American College of Chest Physicians (ACCP). Additionally, 37.6% of the medical staff chose a prophylaxis method based on the related guidelines, and 10.3% could demonstrate the exact indication for mechanical pattern application. Worries about skin injury, difficulty with removal and discomfort during mechanical thromboprophylaxis were cited by more than 30% of nurses, which was significantly more frequent than for physicians (graduated compression stockings: 54.3% VS 34.1%, 60.7% VS 49%, and 59.4% VS 54%, p = 0.000; intermittent pneumatic compression: 31% VS 22.2%, 19.2% VS 13.9%, and 37.8% VS 27.2%, p = 0.000). Conclusions and Relevance The knowledge of VTE prophylaxis among the medical staff of ICUs in North China remains limited, which may lead to a lack of standardization of VTE prophylaxis. Strengthened, standardized training may help medical staff to improve their comprehension of the relevant guidelines and may finally reduce the occurrence of VTE in ICUs and improve the prognosis of critically ill patients with VTE. PMID:26418162

  18. Creating Better Child Care Jobs: Model Work Standards for Teaching Staff in Center-Based Child Care.

    ERIC Educational Resources Information Center

    Center for the Child Care Workforce, Washington, DC.

    This document presents model work standards articulating components of the child care center-based work environment that enable teachers to do their jobs well. These standards establish criteria to assess child care work environments and identify areas to improve in order to assure good jobs for adults and good care for children. The standards are…

  19. Policy options to improve leadership of middle managers in the Australian residential aged care setting: a narrative synthesis

    PubMed Central

    2010-01-01

    Background The prevalence of both chronic diseases and multi-morbidity increases with longer life spans. As Australia's population ages, the aged care sector is under increasing pressure to ensure that quality aged care is available. Key to responding to this pressure is leadership and management capability within the aged care workforce. A systematic literature review was conducted to inform the policy development necessary for the enhancement of clinical and managerial leadership skills of middle managers within residential aged care. Methods Using scientific journal databases, hand searching of specialist journals, Google, snowballing and suggestions from experts, 4,484 papers were found. After a seven-tiered culling process, we conducted a detailed review (narrative synthesis) of 153 papers relevant to leadership and management development in aged care, incorporating expert and key stakeholder consultations. Results • Positive staff experiences of a manager's leadership are critical to ensure job satisfaction and workforce retention, the provision of quality care and the well-being of care recipients, and potentially a reduction of associated costs. • The essential attributes of good leadership for aged care middle management are a hands-on accessibility and professional expertise in nurturing respect, recognition and team building, along with effective communication and flexibility. However, successful leadership and management outcomes depend on coherent and good organisational leadership (structural and psychological empowerment). • There is inadequate preparation for middle management leadership roles in the aged care sector and a lack of clear guidelines and key performance indicators to assess leadership and management skills. • Theory development in aged care leadership and management research is limited. A few effective generic clinical leadership programs targeting both clinical and managerial leaders exist. However, little is known regarding

  20. Crafting a Caring and Inclusive Environment for LGBTQ Community College Students, Faculty, and Staff

    ERIC Educational Resources Information Center

    Ottenritter, Nan

    2012-01-01

    This article provides a framework for understanding and supporting lesbian, gay, bisexual, and transgendered students in community colleges. It should be noted that many of the understandings and structural supports often apply to lesbian, gay, bisexual, transgender, and questioning (LGBTQ) faculty and staff as well. The study is based upon…

  1. Quality of Care in the Nursing Home: Effects of Staff Assignment and Work Shift

    ERIC Educational Resources Information Center

    Burgio, Louis D.; Fisher, Susan E.; Fairchild, J. Kaci; Scilley, Kay; Hardin, J. Michael

    2004-01-01

    Purpose: The purpose of this study was to compare a variety of resident and staff outcomes across two types of staffing patterns, permanent and rotating assignment, and work shift. Although studies have examined these staffing patterns as part of multicomponent intervention packages, few studies have examined the isolated effects of staffing…

  2. Principles for communicating with aging health-care consumers.

    PubMed

    Schewe, C D; Spotts, H E

    1990-01-01

    The health-care marketplace is aging by leaps and bounds and bringing with it new and different medical needs. As costs soar and public assistance programs dwindle in impact, health-care providers will need better marketing strategies to bring treatments to patients/consumers. This article looks at the research findings of behavioral scientists and offers guidelines for effective communication with aging audiences. Health-care providers can use these findings to design more effective advertising, promotional brochures, newsletters, and a host of other communication tools targeted at an older market. Health-care managers and other professionals should find the guidelines useful in their daily interactions with patients and colleagues. PMID:10107270

  3. Patient Age Influences Perceptions About Health Care Communication

    PubMed Central

    DeVoe, Jennifer E.; Wallace, Lorraine S.; Fryer, George E.

    2016-01-01

    Objective The study’s objective was to determine if a patient’s age is independently associated with how he/she perceives interactions with health care providers Methods We used a secondary, cross-sectional analysis of nationally representative data from the 2002 Medical Expenditure Panel Survey (MEPS). We measured the independent association between patient age and six outcomes pertaining to communication and decision-making autonomy, while simultaneously controlling for gender, race, ethnicity, family income, educational attainment, census region, rural residence, insurance status, and usual source of care. Results Compared to patients ≥ 65 years, patients ages 18–64 were less likely to report that their provider “always” listened to them, “always” showed respect for what they had to say, and “always” spent enough time with them. Discussion Patient perceptions of health care interactions vary by age. A better understanding of how and why age is associated with patient-provider communication could be useful to design practice-level interventions that enhance services and also to develop national policies that improve health care delivery and health outcomes. PMID:19184691

  4. Staff nurses' responsibilities when caring for patients in a research study.

    PubMed

    Connelly, Lynne M

    2009-01-01

    The primary principle in the care of the patient involved in health care research is that the patient's welfare has priority. The patient's rights to provide informed consent and to withdraw from any study should be upheld and facilitated at all times. Nurses have an important role as patient advocates and direct care providers in ensuring research is conducted in clinical settings in an ethical, scientifically valid manner. PMID:20088195

  5. Auditing the needs of recovery room staff providing care for the child in an acute hospital.

    PubMed

    Nicholas-Holley, J

    2016-05-01

    This article examines the results of an audit into recovery nurse knowledge and understanding of paediatric care standards. It will critically analyse the availability of current standards for children's services in the recovery room and discuss the need for a national document specifically dedicated to standards of practise for the care of the child in the recovery room providing immediate post operative care. The article will also look at the development of such a document. PMID:27400487

  6. A prospective audit of the impact of additional staff on the care of diabetic patients in a community podiatry service

    PubMed Central

    Ryan, Alexandra; Uppal, Meenakshi; Cunning, Imelda; Buckley, Claire M.

    2015-01-01

    Objective The purpose of this study was to evaluate the impact of the employment of additional podiatry staff on patients with diabetes attending a community-based podiatry service. Methods An audit was conducted to evaluate the intervention of two additional podiatry staff. All patients with diabetes referred to and attending community podiatry services in a specified area in the Republic of Ireland between June 2011 and June 2012 were included. The service was benchmarked against the UK gold standard outlined in the ‘Guidelines on prevention & management of foot problems in Type 2 Diabetes’ by the National Institute of Clinical Excellence (NICE). Process of care measures addressed were the number of patients with diabetes receiving treatment and the waiting times of patients with diabetes from referral to initial review. Results An increase in the number of patients with diabetes receiving treatment was seen in all risk categories (ranging from low risk to the emergency foot). Waiting times for patients with diabetes decreased post-intervention but did not reach the targets outlined in the NICE guidelines. The average time from referral to initial review of patients with an emergency diabetic foot was 37 weeks post-intervention. NICE guidelines recommend that these patients are seen within 24 hours. Discussion During the life cycle of this audit, increased numbers of patients were treated and waiting times for patients with diabetes were reduced. An internal re-organisation of the services coincided with the commencement of the additional staff. The improvements observed were due to the effects of a combination of additional staff and service re-organisation. Efficient organisation of services is key to optimal performance. Continued efforts to improve services are required to reach the standards outlined in the NICE guidelines. PMID:26048860

  7. Perspectives of Cardiac Care Unit Nursing Staff about Developing Hospice Services in Iran for Terminally ill Cardiovascular Patients: A Qualitative Study

    PubMed Central

    Azami-Aghdash, Saber; Ghojazadeh, Morteza; Naghavi-Behzad, Mohammad; Imani, Shahin; Aghaei, Mir Hossein

    2015-01-01

    Introduction: The present study was conducted aiming to determine the points of view of cardiac care units’ nursing staff about designing and providing Hospice services in Iran for cardiovascular patients in the final stages of life. Materials and Methods: In this qualitative study, the perspectives of 16 Cardiac Care Unit (CCU) nurses selected purposefully among hospitals of Tabriz-Iran University of Medical Sciences were investigated using semi-structured interviews and were analyzed in content analysis method. Results: 33 themes were finally extracted. Some nurses were for and some were against designing and providing Hospice services in Iran. The main reasons identified for supporting this plan included: Possibility of designing and providing these services consistent with high ethical values of Iranian society; approval of authorities due to increasing the load of chronic diseases and aged population; need of families due to the problems in taking care of patients and life concerns; better pain relief and respectful death; decrease of costs as a result of lower usage of diagnostic-therapeutic services, less use of expensive facilities and drugs, and better usage of hospital beds. Conclusion: Growing load of chronic diseases has made the need for Hospice as a necessary issue in Iran. In order to provide these services, studying the viewpoints of health service providers is inevitable. Therefore using and applying the results of this study in planning and policy making about designing and providing these services in Iran for cardiovascular patients in their final stages of lives could be helpful. PMID:25709187

  8. “We can't provide season tickets to the opera”: Staff perceptions of providing preference based person centered care

    PubMed Central

    Abbott, Katherine M.; Heid, Allison R.; Van Haitsma, Kimberly

    2016-01-01

    Knowledge of a nursing home resident's everyday living preferences provides the foundation for ongoing individualized care planning. Objective The purpose of this study is to identify nursing home (NH) staff perceptions of facilitators and barriers to learning about and meeting residents’ preferences and reasons why staff feel residents change their minds about preferences. Methods Focus group sessions and interviews were conducted with 36 NH staff members working in a facility that has been actively assessing resident preferences for five years. Results Thematic codes classifying facilitators, barriers, and dependencies were identified. Staff shared ways they are able to help meet residents’ preferences as well as barriers to fulfilling resident preferences through their own behaviors, facility characteristics, the social environment, and resident characteristics. In addition, staff believe that residents change their minds about important preferences ‘depending on’ several factors including; global environmental characteristics, social environment, resident characteristics, and general staff perceptions. Conclusions This work identifies key facilitators and barriers to consider when implementing quality improvement efforts designed to improve the person-centered nature of care in nursing homes and is intended to further inform the culture change movement, which aims to transform NHs by empowering staff and delivering person-centered care. PMID:27134341

  9. Compliance with best practice: implementing the best available evidence in the use of physical restraint in residential aged care.

    PubMed

    Timmins, Janet

    2008-09-01

    The Aged Care Clinical Fellowship, funded by the Commonwealth Department of Health and Ageing and conducted through the Joanna Briggs Institute is an initiative designed to improve the care of older Australians through clinical leadership and promotion of best practice. This paper outlines one of the projects undertaken at Carinya of Bicton, a residential aged high care facility, using an audit and feedback process to implement best practice standards in the use of physical restraint. Aims  Between 12% and 47% of residents in residential care facilities are restrained; however, initial observation of residents restrained in the project facility showed that restraint devices were utilised in up to 40% of residents. Within the aged care sector there has been a shift in attitude to reducing or eliminating restraint in aged care facilities. Restraint is seen as a negative experience for the resident, being associated with physical discomfort, embarrassment and restriction of freedom and of movement. The purpose of the project was to improve practice in the area of physical restraint through the process of auditing current practice against evidence-based, best practice criteria and ultimately to reduce the level of restraint in the facility. Methods  This practice improvement project utilised an audit and implementation cycle. The Joanna Briggs Institute Practical Application of Clinical Evidence System and best practice criteria developed from a systematic review were used to determine compliance with best practice. The Getting Research into Practice module was then employed to develop strategies to improve practice. Results  The follow-up audit indicated there has been a reduction in the number of residents restrained, increased use of alternatives to restraint and an awareness on the part of all care staff of the policies and procedures, which govern the use of restraint in the facility. Conclusions  It is recognised that the success of this project is in

  10. Who's Minding the Child Care Workers? A Look at Staff Burn-out.

    ERIC Educational Resources Information Center

    Whitebook, Marcy; Howes, Carollee

    This study investigates "burn-out" and turnover among workers in child care settings. A total of 95 persons working in 32 child care centers in San Francisco were interviewed by telephone. One-fifth of the centers in the city were represented and both public and private centers were included. Each category of center was proportinately represented…

  11. Can You Hear Me Now? Staff-Parent Communication in Child Care Centres

    ERIC Educational Resources Information Center

    Reedy, Cindy Kennedy; McGrath, Wendy Hobbins

    2010-01-01

    Supporting the growth and development of young children through effective communication with parents is one of the greatest challenges of the twenty-first century facing early childhood and special educators. This article examines adult communication in child care centres through data gathered via a mixed-method study of child care directors'…

  12. Factors Influencing Residents' Satisfaction in Residential Aged Care

    ERIC Educational Resources Information Center

    Chou, Shu-Chiung; Boldy, Duncan P.; Lee, Andy H.

    2003-01-01

    Purpose: The aim of this study was to identify the important factors influencing residents' satisfaction in residential aged care and to provide a better understanding of their interrelationships. Design and Methods: A cross-sectional survey design was used to collect the required information, including resident satisfaction, resident dependency…

  13. School-Age Child Care: Innovative Public School Programs.

    ERIC Educational Resources Information Center

    ERS Spectrum, 1992

    1992-01-01

    Innovative school-age day care programs include Tennessee's Extended School Program; Hawaii's After-School Plus program; San Antonio's Kid's Involvement Network (offering middle school supervision); Aurora, Colorado's state-licensed Year-Round School Recreation Plan; and Pomona, California's Child Development Program. These public school programs…

  14. Optimising nutrition in residential aged care: A narrative review.

    PubMed

    Agarwal, Ekta; Marshall, Skye; Miller, Michelle; Isenring, Elisabeth

    2016-10-01

    In developed countries the prevalence of protein-energy malnutrition increases with age and multi-morbidities increase nutritional risk in aged care residents in particular. This paper presents a narrative review of the current literature on the identification, prevalence, associated risk factors, consequences, and management of malnutrition in the residential aged care (RAC) setting. We performed searches of English-language publications on Medline, PubMed, Ovid and the Cochrane Library from January 1, 1990 to November 25, 2015. We found that, on average, half of all residents in aged care are malnourished as a result of factors affecting appetite, dietary intake and nutrient absorption. Malnutrition is associated with a multitude of adverse outcomes, including increased risk of infections, falls, pressure ulcers and hospital admissions, all of which can lead to increased health care costs and poorer quality of life. A number of food and nutrition strategies have demonstrated positive nutritional and clinical outcomes in the RAC setting. These strategies extend beyond simply enhancing the nutritional value of foods and hence necessitate the involvement of a range of committed stakeholders. Implementing a nutritional protocol in RAC facilities that comprises routine nutrition screening, assessment, appropriate nutrition intervention, including attention to food service systems, and monitoring by a multidisciplinary team can help prevent decline in residents' nutritional status. Food and nutritional issues should be identified early and managed on admission and regularly in the RAC setting. PMID:27621242

  15. Baby Boom Caregivers: Care in the Age of Individualization

    ERIC Educational Resources Information Center

    Guberman, Nancy; Lavoie, Jean-Pierre; Blein, Laure; Olazabal, Ignace

    2012-01-01

    Purpose: Many Baby Boomers are faced with the care of aging parents, as well as that of disabled or ill spouses or children. This study examines how Baby Boomers in Quebec, Canada, perceive and play their role as caregivers and how this might differ from their parents' generation. Design and methods: This was a qualitative and empirical study…

  16. Latchkey Children and School-Age Child Care. ERIC Digest.

    ERIC Educational Resources Information Center

    Seligson, Michelle; Fink, Dale B.

    This ERIC Digest provides an overview of school-age child care (SACC) programs and suggests reasons for their growth. Discussion points out that escalating interest in SACC has paralleled the raising numbers of children left on their own, and that educators are only the latest in a parade of civic and professional groups which have gone on record…

  17. School Age Child Care in Virginia: 1993 Survey Results.

    ERIC Educational Resources Information Center

    Council on Child Day Care and Early Childhood Programs, Richmond, VA.

    School-age child care (SACC) programs based on-site in Virginia elementary schools were surveyed to determine the scope of such programs across the commonwealth, and to look more comprehensively at existing programs in terms of operators, activities, affordability, and other issues. In January 1993, the survey was sent to school superintendents in…

  18. Valuable human capital: the aging health care worker.

    PubMed

    Collins, Sandra K; Collins, Kevin S

    2006-01-01

    With the workforce growing older and the supply of younger workers diminishing, it is critical for health care managers to understand the factors necessary to capitalize on their vintage employees. Retaining this segment of the workforce has a multitude of benefits including the preservation of valuable intellectual capital, which is necessary to ensure that health care organizations maintain their competitive advantage in the consumer-driven market. Retaining the aging employee is possible if health care managers learn the motivators and training differences associated with this category of the workforce. These employees should be considered a valuable resource of human capital because without their extensive expertise, intense loyalty and work ethic, and superior customer service skills, health care organizations could suffer severe economic repercussions in the near future. PMID:16905991

  19. Caring for Aging Chinese: Lessons Learned From the United States

    PubMed Central

    WAN, HONGWEI; YU, FANG; KOLANOWSKI, ANN

    2009-01-01

    After two birth peaks and the “one child per family” policy, China is facing unprecedented challenges with regard to its aging population. This article analyzes the problems associated with three traditional ways of caring for older Chinese, the current health care system, and social supports available to older Chinese. The “4-2-1” family structure and the “empty nest” undermine family support, the prevalence of chronic illnesses and lack of money reduce older adults’selfcare abilities, and insufficient care facilities threaten social support. Lessons learned from the United States show that community-based nursing models, nursing curriculum reforms with a gerontology focus, and reformed health care systems are pivotal for addressing China’s crisis. PMID:18239066

  20. Ageing with telecare: care or coercion in austerity?

    PubMed

    Mort, Maggie; Roberts, Celia; Callén, Blanca

    2013-07-01

    In recent years images of independence, active ageing and staying at home have come to characterise a successful old age in western societies. 'Telecare' technologies are heavily promoted to assist ageing-in-place and a nexus of demographic ageing, shrinking healthcare and social care budgets and technological ambition has come to promote the 'telehome' as the solution to the problem of the 'age dependency ratio'. Through the adoption of a range of monitoring and telecare devices, it seems that the normative vision of independence will also be achieved. But with falling incomes and pressure for economies of scale, what kind of independence is experienced in the telehome? In this article we engage with the concepts of 'technogenarians' and 'shared work' to illuminate our analysis of telecare in use. Drawing on European-funded research we argue that home-monitoring based telecare has the potential to coerce older people unless we are able to recognise and respect a range of responses including non-use and 'misuse' in daily practice. We propose that re-imagining the aims of telecare and redesigning systems to allow for creative engagement with technologies and the co-production of care relations would help to avoid the application of coercive forms of care technology in times of austerity. PMID:23094945

  1. Social and Environmental Infantilization of Aged Persons: Observations in Two Adult Day Care Centers.

    ERIC Educational Resources Information Center

    Salari, Sonia Miner; Rich, Melinda

    2001-01-01

    Examines the social environments, staff behavior and social interaction of 72 elderly clients in adult day care centers, using qualitative research techniques. When the staff and environment were more infantilizing, provided less autonomy and fewer opportunities for privacy regulation, clients had lower social interaction with peers. In contrast,…

  2. Preventive dental health care experiences of preschool-age children with special health care needs

    PubMed Central

    Huebner, Colleen E.; Chi, Donald L.; Masterson, Erin; Milgrom, Peter

    2014-01-01

    Purpose This study examined the preventive dental health care experiences of young children with special needs and determined the feasibility of conducting clinical dental examinations at a community-based early intervention services center. Methods Study methods included 90 parent interviews and dental examinations of their preschool-age children. Results Thirteen percent of the children received optimal preventive care, defined as twice daily tooth brushing with fluoridated toothpaste and two preventive dental visits in the prior 12 months; 37 percent experienced care that fell short in both areas. Optimal care was more common among children of parents who reported tooth brushing was not a struggle and those with a personal dentist. Parents' opinion of the study experience was generally positive. Conclusions Few children with special needs receive effective preventive care early, when primary prevention could be achieved. Barriers to optimal care could be readily addressed by the dental community in coordination with early intervention providers. PMID:25082666

  3. Should we provide oral health training for staff caring for people with intellectual disabilities in community based residential care? A cost-effectiveness analysis.

    PubMed

    Mac Giolla Phadraig, Caoimhin; Nunn, June; Guerin, Suzanne; Normand, Charles

    2016-04-01

    Oral health training is often introduced into community-based residential settings to improve the oral health of people with intellectual disabilities (ID). There is a lack of appropriate evaluation of such programs, leading to difficulty in deciding how best to allocate scarce resources to achieve maximum effect. This article reports an economic analysis of one such oral health program, undertaken as part of a cluster randomized controlled trial. Firstly, we report a cost-effectiveness analysis of training care-staff compared to no training, using incremental cost-effectiveness ratios (ICERs). Effectiveness was measured as change in knowledge, reported behaviors, attitude and self-efficacy, using validated scales (K&BAS). Secondly, we costed training as it was scaled up to include all staff within the service provider in question. Data were collected in Dublin, Ireland in 2009. It cost between €7000 and €10,000 more to achieve modest improvement in K&BAS scores among a subsample of 162 care-staff, in comparison to doing nothing. Considering scaled up first round training, it cost between €58,000 and €64,000 to train the whole population of staff, from a combined dental and disability service perspective. Less than €15,000-€20,000 of this was additional to the cost of doing nothing (incremental cost). From a dental perspective, a further, second training cycle including all staff would cost between €561 and €3484 (capital costs) and €5815 (operating costs) on a two yearly basis. This study indicates that the program was a cost-effective means of improving self-reported measures and possibly oral health, relative to doing nothing. This was mainly due to low cost, rather than the large effect. In this instance, the use of cost effectiveness analysis has produced evidence, which may be more useful to decision makers than that arising from traditional methods of evaluation. There is a need for CEAs of effective interventions to allow comparison

  4. Memo to Day Care Staff: Helping Children With Minimal Brain Dysfunction

    ERIC Educational Resources Information Center

    Shrier, Diane K.

    1975-01-01

    Presents the emotional factors related to the learning disabilities of children with minimal brain dysfunction and offers suggestions to aid the day care worker in counseling the parents of such children. (Author/SDH)

  5. City Initiatives in School-Age Child Care. SACC Action Research Paper No. 1. School-Age Child Project.

    ERIC Educational Resources Information Center

    Gannett, Ellen

    Features contributing to the success of six city-wide, comprehensive school-age program models are highlighted. Models are Seattle, Washington's Community Partnerships for School-Age Child Care; Madison, Wisconsin's School-Age Child Care Project; Irvine, California's Irvine Child Care Project; Houston, Texas' After-School Partnership; Los Angeles,…

  6. Experiences with Capnography in Acute Care Settings: A Mixed-Methods Analysis of Clinical Staff

    PubMed Central

    Langhan, Melissa L.; Kurtz, Jordan C.; Schaeffer, Paula; Asnes, Andrea G.; Riera, Antonio

    2014-01-01

    Purpose While capnography is being incorporated into clinical guidelines, it is not used to it's full potential. We investigated reasons for limited implementation of capnography in acute care areas and explored facilitators and barriers to its implementation. Methods A purposeful sample of physicians and nurses in emergency departments (ED) and intensive care units (ICU) participated in semistructured interviews. Grounded theory, iterative data analysis and the constant comparative method were used to analyze the data to inductively generate ideas and build theories. Results Nineteen providers were interviewed from five hospitals. Six themes were identified: variability in use of capnography among acute care units, availability and accessibility of capnography equipment, the evidence behind capnography use, the impact of capnography on patient care, personal experiences impacting use of capnography, and variable knowledge about capnography. Barriers and facilitators to use were found within each theme. Conclusions We observed varied responsiveness to capnography and identified factors that work to foster or discourage its use. This data can guide future implementation strategies. A deliberate strategy to foster utilization, mitigate barriers and broadly accelerate implementation has the potential to profoundly impact use of capnography in acute care areas with the goal of improving patient care. PMID:25129575

  7. Integrating chronic care with primary care activities: enriching healthcare staff knowledge and skills and improving glycemic control of a cohort of people with diabetes through the First Line Diabetes Care Project in the Philippines

    PubMed Central

    Ku, Grace Marie V.; Kegels, Guy

    2014-01-01

    Background This study investigated the effects of integrating primary chronic care with current healthcare activities in two local government health units (LGHU) of the Philippines on knowledge and skills of the LGHU staff and clinical outcomes for people with diabetes. Design Integration was accomplished through health service reorganization, (re)distribution of chronic care tasks, and training of LGHU staff. Levels of the staff's pre- and post-training diabetes knowledge and of their self-assessment of diabetes care-related skills were measured. Primary diabetes care with emphasis on self-care development was provided to a cohort of people with diabetes. Glycosylated hemoglobin (HbA1c) and obesity measures were collected prior to and one year after full project implementation. Results The training workshop improved diabetes knowledge (p<0.001) and self-assessed skills (p<0.001) of the LGHU staff. Significant reductions in HbA1c (p<0.001), waist–hip ratio (p<0.001) and waist circumference (p=0.011) of the cohort were noted. Although the reduction in HbA1c was somewhat greater among those whose community-based care providers showed improvement in knowledge and self-assessed skills, the difference was not statistically significant. Conclusions Primary care for chronic conditions such as diabetes may be integrated with other healthcare activities in health services of low-to-middle-income countries such as the Philippines, utilizing pre-existing human resources for health, and may improve clinical endpoints. PMID:25361726

  8. Hospital Collaboration with Emergency Medical Services in the Care of Patients with Acute Myocardial Infarction: Perspectives from Key Hospital Staff

    PubMed Central

    Landman, Adam B.; Spatz, Erica S.; Cherlin, Emily J.; Krumholz, Harlan M.; Bradley, Elizabeth H.; Curry, Leslie A.

    2013-01-01

    Objective Evidence suggests that active collaboration between hospitals and emergency medical services (EMS) is significantly associated with lower acute myocardial infarction (AMI) mortality rates; however, the nature of such collaborations is not well understood. We sought to characterize views of key hospital staff regarding collaboration with EMS in the care of patients hospitalized with AMI. Methods We performed an exploratory analysis of qualitative data previously collected from site visits and in-depth interviews with 11 US hospitals that ranked in the top or bottom 5% of performance on 30-day risk-standardized AMI mortality rates (RSMRs) using Centers for Medicare and Medicaid Services data from 2005–2007. We selected all codes from the first analysis in which EMS was most likely to have been discussed. A multidisciplinary team analyzed the data using the constant comparative method to generate recurrent themes. Results Both higher and lower performing hospitals reported that EMS is critical to the provision of timely care for patients with AMI. However, close, collaborative relationships with EMS were more apparent in the higher performing hospitals. Higher performing hospitals demonstrated specific investment in and attention to EMS through: 1) respect for EMS as valued professionals and colleagues; 2) strong communication and coordination with EMS; and 3) active engagement of EMS in hospital AMI quality improvement efforts. Conclusion Hospital staff from higher performing hospitals described broad, multifaceted strategies to support collaboration with EMS in providing AMI care. The association of these strategies with hospital performance should be tested quantitatively in a larger, representative study. PMID:23146627

  9. Impact Evaluation of Domains of Learning on Universal Work Precautions (UWP) Amongst Nursing Staff in a Tertiary Care Hospital, Western India

    PubMed Central

    Sharma, Rashmi; Kumar, Pradeep; Patel, Brijesh; Gajjar, Sanju

    2016-01-01

    Introduction: Second key strategy of National AIDS Control Program (NACP IV) is comprehensive care and support by providing quality services through zero stigma and discrimination. Quality of services can be improved by eliminating stigma and discrimination and making health care provider aware of associated occupational hazards. Nursing staff play crucial role and are more at risk therefore their understanding, perception and skill must be assessed in different domains of learning to improve the contents and methodology of trainings. Material and Methods: Total 85 nursing staff underwent 1 day training in 3 batches focusing on Universal Work Precautions (UWP), Post Exposure Prophylaxis (PEP) and sensitization of the participants towards PLHA (People living with HIV/AIDS). Their learning was evaluated under different domains (cognitive, psychomotor and affective) using structured questionnaire. Results: In pretest evaluation scores showed minor and statistically not significant variations in terms of participant's gender, age, designation work experience and status of having received any similar training in the past. Impact of the training was visible as overall mean scores increased from 10.6 ± 2.7 to 13.8 ± 5.8; gain being statistically highly significant (P value < 0.001). Gain was highest in cognitive (from 58% to 77%) followed by psychomotor (from 48% to 62%) and minimal in affective domain (from 75% to 76%). Conclusions: After undergoing the training, participants were benefitted more in cognitive domain than psychomotor and affective domain. Acquired knowledge, skill and communication skill if evaluated as done in this study will improve the methodology of such trainings making them more effective. PMID:27051089

  10. The impact of an aging population on palliative care.

    PubMed

    O'Brien, Tony

    2013-12-01

    By 2050, it is predicted that 26% of the population will be aged 80 and over. Although older people have much to contribute, one challenging aspect of an aging population is the increasing rate of dementia. Palliative care is now included as part of the care pathway of a wide variety of nonmalignant diseases. The European Association for Palliative Care (EAPC) and the European Union Geriatric Medicine Society (EUGMS) have jointly called for every older citizen with chronic disease to be offered the best possible palliative care approach wherever they are cared for. This report is adapted from paineurope 2013; Issue 2, ©Haymarket Medical Publications Ltd., and is presented with permission. paineurope is provided as a service to pain management by Mundipharma International LTD. and is distributed free of charge to healthcare professionals in Europe. Archival issues can be accessed via the website: http://www.paineurope.com at which European health professionals can register online to receive copies of the quarterly publication. PMID:24303834

  11. New approaches to health and well-being for dementia day-care clients, family carers and day-care staff.

    PubMed

    Kilstoff, K; Chenoweth, L

    1998-06-01

    This study was conducted in one multicultural dementia day-care centre over a period of 18 months. It introduced a gentle hand treatment for clients using three essential oils. The study evolved out of the process of action research where the family carers and day-care staff participated with the researchers to choose, design, develop and evaluate a hand treatment programme. Data was collected through in-depth interviews pre- and post-treatment, focus group discussions, client observation logbooks and a disability scale. The findings indicate a positive strengthening of the relationship between the person with dementia and their family carer, and an improvement in feelings of health and well-being for both. The specific improvements for clients include increased alertness, self-hygiene, contentment, initiation of toileting, sleeping at night and reduced levels of agitation, withdrawal and wandering. Family carers have reported less distress, improved sleeping patterns and feelings of calm. They also found the treatment useful in helping them manage the difficult behaviours exhibited by their relative with dementia. The benefits of this treatment for nursing practice are that it is safe, effective and easily administered by staff in any setting. PMID:9748936

  12. Intensive Interaction as a Novel Approach in Social Care: Care Staff's Views on the Practice Change Process

    ERIC Educational Resources Information Center

    Firth, Graham; Elford, Helen; Leeming, Catherine; Crabbe, Marion

    2008-01-01

    Background: Intensive Interaction is an approach to developing the pre-verbal communication and sociability of people with severe or profound and multiple learning disabilities and autism. Previous research has indicated many potential benefits; however, the approach is not consistently used in social care. Aim: To report on the significant and…

  13. Raising Other People's Kids: A Guide for Houseparents, Foster Parents, and Direct Care Staff.

    ERIC Educational Resources Information Center

    Camerer, M. C.; Capps, Emerson

    This guide is designed to teach foster parents, direct care providers, and house parents how to help children develop interpersonal relationship skills. The book focuses on developing the whole child through intellectual, psychological, and moral development. Specific techniques for creating a nurturing environment for children are discussed, as…

  14. Turnover Begets Turnover: An Examination of Job and Occupational Instability among Child Care Center Staff.

    ERIC Educational Resources Information Center

    Whitebook, Marcy; Sakai, Laura

    2003-01-01

    Examined job/occupational instability among child care teachers and directors. Found that over half of teachers and a third of directors had left their centers 4 years after initial interviews. Highly trained teachers were more likely to leave jobs if they earned lower wages, worked in less stable climate, or worked with greater percentage of…

  15. Improving an Extended Day Care Environment through Staff Training and Activity Development.

    ERIC Educational Resources Information Center

    Lopez, Mary Kathryn

    The aim of this practicum was to increase parent, child, and caregiver satisfaction with the university lab elementary school site's extended day care program through training of caregivers and development of appropriate activities. Two groups participated, one for preschoolers through first graders, the other for second through fifth graders.…

  16. Intention to Leave, Anticipated Reasons for Leaving, and 12-Month Turnover of Child Care Center Staff.

    ERIC Educational Resources Information Center

    Manlove, Elizabeth E.; Guzell, Jacqueline R.

    1997-01-01

    Job turnover among a sample of child care workers was examined in relation to demographic, work-related, and nonwork-related factors. Findings indicated that the perceived choice of other jobs and job tenure both have an impact on intention to leave, as well as on actual 12-month turnover. (Author)

  17. Residents' perceptions and experiences of social interaction and participation in leisure activities in residential aged care.

    PubMed

    Thomas, Jessica E; O'Connell, Beverly; Gaskin, Cadeyrn J

    2013-10-01

    Social interaction and participation in leisure activities are positively related to the health and well-being of elderly people. The main focus of this exploratory study was to investigate elderly peoples' perceptions and experiences of social interaction and leisure activities living in a residential aged care (RAC) facility. Six residents were interviewed. Themes emerging from discussions about their social interactions included: importance of family, fostering friendships with fellow residents, placement at dining room tables, multiple communication methods, and minimal social isolation and boredom. Excursions away from the RAC facility were favourite activities. Participants commonly were involved in leisure activities to be socially connected. Poor health, family, the RAC facility, staffing, transportation, and geography influenced their social interaction and participation in leisure activities. The use of new technologies and creative problem solving with staff are ways in which residents could enhance their social lives and remain engaged in leisure activities. PMID:24299253

  18. Measuring the Knowledge and Attitudes of Health Care Staff toward Older People: Sensitivity of Measurement Instruments

    ERIC Educational Resources Information Center

    Cowan, David T.; Fitzpatrick, Joanne M.; Roberts, Julia D.; While, Alison E.

    2004-01-01

    This paper discusses the sensitivity of instruments used to measure knowledge and attitudes toward older people. Existing standardized measurement instruments are reviewed, including a detailed examination of Palmore's Facts on Ageing Quiz (FAQ). A recent study conducted by the research team into the knowledge and attitudes of support workers (n =…

  19. Sustained increase in resident meal time hand hygiene through an interdisciplinary intervention engaging long-term care facility residents and staff.

    PubMed

    O'Donnell, Marguerite; Harris, Tony; Horn, Terancita; Midamba, Blondelle; Primes, Vickie; Sullivan, Nancy; Shuler, Rosalyn; Zabarsky, Trina F; Deshpande, Abhishek; Sunkesula, Venkata C K; Kundrapu, Sirisha; Donskey, Curtis J

    2015-02-01

    Hand hygiene by patients may prevent acquisition and dissemination of health care-associated pathogens, but limited efforts have been made to engage patients in hand hygiene interventions. In a long-term care facility, we found that residents were aware of the importance of hand hygiene, but barriers, such as inaccessible products or difficult to use products, limited compliance. A dramatic and sustained improvement in meal time hand hygiene was achieved through engagement of staff and residents. PMID:25637117

  20. Care staff intentions to support adults with an intellectual disability to engage in physical activity: an application of the Theory of Planned Behaviour.

    PubMed

    Martin, Emma; McKenzie, Karen; Newman, Emily; Bowden, Keith; Morris, Paul Graham

    2011-01-01

    Researchers suggest that people with an intellectual disability (ID) undertake less physical activity than the general population and many rely, to some extent, on others to help them to access activities. The Theory of Planned Behaviour (TPB) model was previously found to significantly predict the intention of care staff to facilitate a healthy diet in those they supported. The present study examined whether the TPB was useful in predicting the intentions of 78 Scottish care staff to support people with ID to engage in physical activity. Regression analyses indicated that perceived behavioural control was the most significant predictor of both care staff intention to facilitate physical activity and reported physical activity levels of the people they supported. Attitudes significantly predicted care staff intention to support physical activity, but this intention was not itself significantly predictive of reported activity levels. Increasing carers' sense of control over their ability to support clients' physical activity may be more effective in increasing physical activity than changing their attitudes towards promoting activity. PMID:21803540

  1. Care Staff Intentions to Support Adults with an Intellectual Disability to Engage in Physical Activity: An Application of the Theory of Planned Behaviour

    ERIC Educational Resources Information Center

    Martin, Emma; McKenzie, Karen; Newman, Emily; Bowden, Keith; Morris, Paul Graham

    2011-01-01

    Researchers suggest that people with an intellectual disability (ID) undertake less physical activity than the general population and many rely, to some extent, on others to help them to access activities. The Theory of Planned Behaviour (TPB) model was previously found to significantly predict the intention of care staff to facilitate a healthy…

  2. Extrinsic High-Effort and Low-Reward Conditions at Work among Institutional Staff Caring for People with Intellectual Disabilities in Taiwan

    ERIC Educational Resources Information Center

    Lee, Tzong-Nan; Lin, Jin-Ding; Yen, Chia-Feng; Loh, Ching-Hui; Hsu, Shang-Wei; Tang, Chi-Chieh; Wu, Jia-Ling; Fang, Wen-Hui; Chu, Cordia M.

    2009-01-01

    The purposes of the present study were to determine whether extrinsic high-effort/low-reward conditions at work are associated with personal characteristics and the organizational environments. A cross-sectional survey was conducted (76.7% response rate, N = 1243) by recruiting the staff caring for people with intellectual disabilities of Taiwan…

  3. Pedagogical Staff in Children's Day Care Centres in Germany--Links between Working Conditions, Job Satisfaction, Commitment and Work-Related Stress

    ERIC Educational Resources Information Center

    Schreyer, Inge; Krause, Martin

    2016-01-01

    This article investigates links between staff working conditions in children's day care centres ("Kindertageseinrichtungen"--known as "Kitas" in Germany), job satisfaction, commitment and perceived stress at work. Data are based on the nationwide, representative questionnaire survey AQUA ("Arbeitsplatz und Qualität in…

  4. [Nursing care of a school-age child with asthma: an ecological system theory approach].

    PubMed

    Tzeng, Yu-Fen; Gau, Bih-Shya

    2012-02-01

    This research applied the Ecological System Theory of Dr. Bronfenbrenner (1979) to evaluate and analyze the impact of a school-age asthmatic child's ecological environment on the child's development. This project ran from March 16th to April 16th, 2010. A full range of data was collected during clinical care, outpatient follow-up services, telephone interviews, home visits, and school visits and then identified and analyzed. Results indicated that the family, household environment, campus, teachers, classmates, physical education program, and medical staffs comprised the most immediate microsystem and that parents, school nurses, teachers, and classmates formed the child's mesosystem. Researchers found a lack of understanding and appreciation in the mesosystem regarding asthmatic patient care needs. Hidden factors in the environment induced asthma, which eventually caused the child to be unable to obtain necessary medical care assistance. The exosystem reflected adequacy of the family social economy. The father's flexible working hours allowed him to allocate more time to childcare responsibilities. The government Asthma Medical Payment program also facilitated effective care. The macrosystem demonstrated parental cognition related to asthma treatment and caring to be deeply influenced by local customs. Thus, rather than using advanced medical treatments, parents preferred to follow traditional Chinese medicinal practices. Evaluation using the Ecological of Human Development Theory showed the subject's ecology environment relationships as based upon a foundation of family and school. Therefore, active family and school support for an asthma management plan appropriate to the subject's needs was critical. Asthma symptoms were better controlled after the child and his parents invested greater effort in mastering asthma management protocols. PMID:22314656

  5. In an Age of Open Access to Research Policies: Physician and Public Health NGO Staff Research Use and Policy Awareness

    PubMed Central

    Maggio, Lauren A.; Steinberg, Ryan M.; Willinsky, John

    2015-01-01

    Introduction Through funding agency and publisher policies, an increasing proportion of the health sciences literature is being made open access. Such an increase in access raises questions about the awareness and potential utilization of this literature by those working in health fields. Methods A sample of physicians (N=336) and public health non-governmental organization (NGO) staff (N=92) were provided with relatively complete access to the research literature indexed in PubMed, as well as access to the point-of-care service UpToDate, for up to one year, with their usage monitored through the tracking of web-log data. The physicians also participated in a one-month trial of relatively complete or limited access. Results The study found that participants' research interests were not satisfied by article abstracts alone nor, in the case of the physicians, by a clinical summary service such as UpToDate. On average, a third of the physicians viewed research a little more frequently than once a week, while two-thirds of the public health NGO staff viewed more than three articles a week. Those articles were published since the 2008 adoption of the NIH Public Access Policy, as well as prior to 2008 and during the maximum 12-month embargo period. A portion of the articles in each period was already open access, but complete access encouraged a viewing of more research articles. Conclusion Those working in health fields will utilize more research in the course of their work as a result of (a) increasing open access to research, (b) improving awareness of and preparation for this access, and (c) adjusting public and open access policies to maximize the extent of potential access, through reduction in embargo periods and access to pre-policy literature. PMID:26200794

  6. Survey of home hemodialysis patients and nursing staff regarding vascular access use and care

    PubMed Central

    Spry, Leslie A; Burkart, John M; Holcroft, Christina; Mortier, Leigh; Glickman, Joel D

    2015-01-01

    Vascular access infections are of concern to hemodialysis patients and nurses. Best demonstrated practices (BDPs) have not been developed for home hemodialysis (HHD) access use, but there have been generally accepted practices (GAPs) endorsed by dialysis professionals. We developed a survey to gather information about training provided and actual practices of HHD patients using the NxStage System One HHD machine. We used GAP to assess training used by nurses to teach HHD access care and then assess actual practice (adherence) by HHD patients. We also assessed training and adherence where GAPs do not exist. We received a 43% response rate from patients and 76% response from nurses representing 19 randomly selected HHD training centers. We found that nurses were not uniformly instructing HHD patients according to GAP, patients were not performing access cannulation according to GAP, nor were they adherent to their training procedures. Identification of signs and symptoms of infection was commonly trained appropriately, but we observed a reluctance to report some signs and symptoms of infection by patients. Of particular concern, when aggregating all steps surveyed, not a single nurse or patient reported training or performing all steps in accordance with GAP. We also identified practices for which there are no GAPs that require further study and may or may not impact outcomes such as infection. Further research is needed to develop strategies to implement and expand GAP, measure outcomes, and ultimately develop BDP for HHD to improve infectious complications. PMID:25154423

  7. What Could We Learn from the Influence of Age on Perceptions of a CIS by the Clinical Staff of a French Hospital?

    PubMed

    Ologeanu-Taddei, Roxana; Vitari, Claudio; Morquin, David

    2016-01-01

    Previous research highlighted generation and age effects on the perceptions and uses of technology. The goal of this study was to examine the relationship between age and perceptions of a Clinical Information System (CIS) for the clinical staff (especially physicians, nurses, medical secretaries). A survey was conducted in September 2015 in a French Teaching Hospital, based on a questionnaire consisting of items on the Likert scale. As results, the impact of age has a strong impact on Perceived Ease of Use, anxiety and Self-Efficacy. The result related to Perceived Ease of Use is unexpected. Younger staff reported to be less comfortable with technology than older staff. This result is not consistent with literature. We propose an explanation consisting in the importance of clinical process and organization knowledge and skills while general technology skills of young generations may be less significant. PMID:27577331

  8. Planning Manual for School-Age Child Care in New Mexico.

    ERIC Educational Resources Information Center

    Rainhart, Dolly

    This manual was designed to assist concerned individuals and organizations within communities in New Mexico to develop and plan effective school-age child care programs. Emphasized are the first steps in initiating and implementing school-age child care in a community. Chapter I discusses the need for school-age child care programs and the…

  9. Professional Quality of Life of Veterans Affairs Staff and Providers in a Patient-Centered Care Environment.

    PubMed

    Locatelli, Sara M; LaVela, Sherri L

    2015-01-01

    Changes to the work environment prompted by the movement toward patient-centered care have the potential to improve occupational stress among health care workers by improving team-based work activities, collaboration, and employee-driven quality improvement. This study was conducted to examine professional quality of life among providers at patient-centered care pilot facilities. Surveys were conducted with 76 Veterans Affairs employees/providers at facilities piloting patient-centered care interventions, to assess demographics, workplace practices and views (team-based environment, employee voice, quality of communication, and turnover intention), and professional quality of life (compassion satisfaction, burnout, and secondary traumatic stress).Professional quality-of-life subscales were not related to employee position type, age, or gender. Employee voice measures were related to lower burnout and higher compassion satisfaction. In addition, employees who were considering leaving their position showed higher burnout and lower compassion satisfaction scores. None of the work practices showed relationships with secondary traumatic stress. PMID:26218000

  10. Silent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities

    PubMed Central

    Peisah, Carmelle; Weaver, Judith; Wong, Lisa; Strukovski, Julie-Anne

    2014-01-01

    Background Pain is common in older people, particularly those in residential aged care facilities (RACF) and those with dementia. However, despite 20 years of discourse on pain and dementia, pain is still undetected or misinterpreted in people with dementia in residential aged care facilities, particularly those with communication difficulties. Methods A topical survey typology with semistructured interviews was used to gather attitudes and experiences of staff from 15 RACF across Northern Sydney Local Health District. Results While pain is proactively assessed and pain charts are used in RACF, this is more often regulatory-driven than patient-driven (eg, prior to accreditation). Identification of pain and need for pain relief was ill defined and poorly understood. Both pharmacological and non-pharmacological regimes were used, but in an ad hoc, variable and unsystematic manner, with patient, staff, and attitudinal obstacles between the experience of pain and its relief. Conclusion A laborious “pain communication chain” exists between the experience of pain and its relief for people with severe dementia within RACF. Given the salience of pain for older people with dementia, we recommend early, proactive consideration and management of pain in the approach to behaviors of concern. Individualized pain measures for such residents; empowerment of nursing staff as “needs interpreters”; collaborative partnerships with common care goals between patients where possible; RACF staff, doctors, and family carers; and more meaningful use of pain charts to map response to stepped pain protocols may be useful strategies to explore in clinical settings. PMID:25342895

  11. Caring for people with dementia in residential aged care: successes with a composite person-centered care model featuring Montessori-based activities.

    PubMed

    Roberts, Gail; Morley, Catherine; Walters, Wendy; Malta, Sue; Doyle, Colleen

    2015-01-01

    Person-centered models of dementia care commonly merge aspects of existing models with additional influences from published and unpublished evidence and existing government policy. This study reports on the development and evaluation of one such composite model of person-centered dementia care, the ABLE model. The model was based on building the capacity and ability of residents living with dementia, using environmental changes, staff education and organizational and community engagement. Montessori principles were also used. The evaluation of the model employed mixed methods. Significant behavior changes were evident among residents of the dementia care Unit after the model was introduced, as were reductions in anti-psychotic and sedative medication. Staff reported increased knowledge about meeting the needs of people with dementia, and experienced organizational culture change that supported the ABLE model of care. Families were very satisfied with the changes. PMID:25499658

  12. Factors influencing uptake of HIV care and treatment among children in South Africa - a qualitative study of caregivers and clinic staff.

    PubMed

    Yeap, A D; Hamilton, R; Charalambous, S; Dwadwa, T; Churchyard, G J; Geissler, P W; Grant, A D

    2010-09-01

    Despite antiretroviral therapy rollout in South Africa, fewer children than expected are accessing HIV care services. Our objectives were to describe barriers and facilitators of uptake of HIV care among children. Our study involved six private-sector clinics which provide HIV care free-of-charge in and around Gauteng province, South Africa. In-depth interviews were conducted in July 2008 with 21 caregivers of HIV-infected children attending these clinics, 21 clinic staff members and three lead members of staff from affiliated care centres. Many children were only tested for HIV after being recurrently unwell. The main facility-related barriers reported were long queues, negative staff attitudes, missed testing opportunities at healthcare facilities and provider difficulties with paediatric counselling and venesection. Caregivers reported lack of money for transport, food and treatments for opportunistic infections, poor access to welfare grants and lack of coordination amongst multiple caregivers. Misperceptions about HIV, maternal guilt and fear of negative repercussions from disclosure were common. Reported facilitators included measures implemented by clinics to help with transport, support from family and day-care centres/orphanages, and seeing children's health improve on treatment. Participants felt that better public knowledge about HIV would facilitate uptake. Poverty and the implications of children's HIV infection for their families underlie many of these factors. Some staff-related and practical issues may be addressed by improved training and simple measures employed at clinics. However, changing caregiver attitudes may require interventions at both individual and societal levels. Healthcare providers should actively promote HIV testing and care-seeking for children. PMID:20824563

  13. Telecourses for nursing staff development.

    PubMed

    Clark, C E

    1989-01-01

    Instructional television is a viable option for meeting staff development needs in health care agencies. Telecourses produced by the Intercollegiate Center for Nursing Education provide staff development educators with an efficient and effective alternative for meeting selected educational needs of staff within health care institutions, as well as interested nurses throughout the community. Use of this instructional methodology is described. PMID:2732789

  14. [Scarcity in health care, age as selection criterion and the value of old age. Current discussion].

    PubMed

    Naafs, J

    1993-06-01

    There is a growing attention for setting limits in health care. Contemporary medical scarcity makes choices necessary, but what are the arguments? Only medical criteria for selection are accepted in the Netherlands, but that does not mean at all that age is an unimportant criterion. In this article the discussion on age as criterion for selection is reviewed. It seems that arguments are based on different basic (moral) assumptions and that age and aging can be appreciated from different points of view. There is among other things the principle of justice and the idea of a natural life-span (Daniels), the norm of a worthwhile life-time (the fair-innings argument of Harris) and the idea of old age as a period of its own (Callahan). The different starting points can lead to the same way of thinking about age as a criterion for selection. Daniels, Harris, and Callahan justify this kind of selection. The Dunning-committee however does not accept it, from the point of a fundamental equality of people, the protection of life and the principle of solidarity in our society. It seems that not only the different arguments lead towards different conclusions but also the different views on the value of old age by different groups or by society as a whole. PMID:8328008

  15. An evidence-based program to improve analgesic practice and pain outcomes in residential aged care facilities.

    PubMed

    Savvas, Steven M; Toye, Chris M; Beattie, Elizabeth R A; Gibson, Stephen J

    2014-08-01

    Pain is common in individuals living in residential aged care facilities (RACFs), and a number of obstacles have been identified as recurring barriers to adequate pain management. To address this, the Australian Pain Society developed 27 recommendations for comprehensive good practice in the identification, assessment, and management of pain. This study reviewed preexisting pain management practice at five Australian RACFs and identified changes needed to implement the recommendations and then implemented an evidence-based program that aimed to facilitate better pain management. The program involved staff training and education and revised in-house pain-management procedures. Reviews occurred before and after the program and included the assessment of 282 residents for analgesic use and pain status. Analgesic use improved after the program (P<.001), with a decrease in residents receiving no analgesics (from 15% to 6%) and an increase in residents receiving around-the-clock plus as-needed analgesics (from 24% to 43%). There were improvements in pain relief for residents with scores indicative of pain, with Abbey pain scale (P=.005), Pain Assessment in Advanced Dementia Scale (P=.001), and Non-communicative Patient's Pain Assessment Instrument scale (P<.001) scores all improving. Although physical function declined as expected, Medical Outcomes Study 36-item Short-Form Survey bodily pain scores also showed improvement (P=.001). Better evidence-based practice and outcomes in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce using this program improved analgesic practice and pain relief in participating sites. Further attention to the continued targeted pain management training of aged care staff is likely to improve pain-focused care for residents. PMID:25040607

  16. A critique of using age to ration health care.

    PubMed Central

    Hunt, R W

    1993-01-01

    Daniel Callahan has argued that economic and social benefits would result from a policy of withholding medical treatments which prolong life in persons over a certain age. He claims 'the real goal of medicine' is to conquer death and prolong life with the use of technology, regardless of the age and quality of life of the patient, and this has been responsible for the escalation of health care expenditure. Callahan's proposal is based on economic rationalism but there is little evidence to suggest that substantial economic savings could be achieved. Moreover, his argument raises serious moral objections. A policy of withholding treatments from members of a social group involves elements of compulsion and discrimination, both of which would intrude on the doctor-patient relationship, undermine the autonomy of elderly patients, and invoke the slippery slope towards involuntary forms of euthanasia. Life-death decisions should be based on more than the one criterion of age, and take account of more relevant factors such as the patient's usual state of well-being, her/his expressed wishes, informed consent and the type of illness. Any move to the implementation and enforcement of the policy Callahan recommends would be rejected by health professionals and the public. PMID:8459434

  17. The Evaluation of Existing Federal Interagency Day Care Requirements: Day Care for the School-Age Child.

    ERIC Educational Resources Information Center

    Bergstrom, Joan M.; Dreher, Donna L.

    As part of an evaluation of the existing Federal Interagency Day Care Requirements (FIDCR), this paper reviews the current regulations and presents recommendations for modifications in the requirements as they relate to group or family day care services for school age children from 5 to 14 years of age. The paper is divided into five major…

  18. Banned from working in social care: a secondary analysis of staff characteristics and reasons for their referrals to the POVA list in England and Wales.

    PubMed

    Hussein, Shereen; Stevens, Martin; Manthorpe, Jill; Rapaport, Joan; Martineau, Stephen; Harris, Jess

    2009-09-01

    Since July 2004, employers of social care staff working with vulnerable adults in England and Wales have been legally required to refer workers or volunteers dismissed for misconduct because they have harmed vulnerable adults or placed them at risk of harm to the Protection of Vulnerable Adults (POVA) list. The POVA list is unique to England and Wales, and is a powerful tool of quality assurance for the care sector and for the safeguarding of vulnerable adults. This article reports on part of a multi-method study including quantitative and qualitative elements to produce a rounded picture of the factors involved in decisions to place staff members on the POVA list. Based on secondary data analysis of all records of POVA referrals from August 2004 to November 2006 (5294 records) as well as a detailed sample of 298 referrals, this article focuses on the prevalence of different types of alleged harm and their association with various staff, employer and service-users' characteristics. The most common form of alleged abuse was physical abuse (33%), while the least was sexual abuse (6%). Some of the other key findings are the over-representation of men referred (31% compared to an average of 15% in the workforce) and significantly different types of abuse in care home and domiciliary settings, where financial abuse was less likely in care homes [odds ratio (OR) 0.17; P < 0.001], while physical abuse more likely in the same setting (OR 3.60; P < 0.001). PMID:19220490

  19. What is the role of a case manager in community aged care? A qualitative study in Australia.

    PubMed

    You, Emily Chuanmei; Dunt, David; Doyle, Colleen

    2016-07-01

    This study aimed to explore the perceptions of case managers about their roles in providing community aged care in Australia. Purposeful sampling was used and 33 qualitative semi-structured interviews with 47 participants were conducted. Participants were drawn from a list of all case managers working in aged care organisations that provided publicly funded case-managed community aged care programmes in the State of Victoria, Australia. Participant selection criteria included age, gender, job titles, professional backgrounds, practice locations, organisational attributes and organisational size. Data collection was implemented between September 2012 and March 2013. Thematic analysis was performed. Participants believed that case managers performed diverse roles based on clients' needs. They also articulated 16 important roles of case managers, including advisors, advocates, carers, communicators, co-ordinators, educators, empowering clients, engaging clients and families, liaising with people, managing budgets, navigators, negotiators, networking with people, facilitators, problem solvers and supporters. However, they were concerned about brokers, mediators and counsellors in terms of the terminology or case managers' willingness to perform these roles. Moreover, they perceived that neither gatekeepers nor direct service provision was case managers' role. The findings of this study suggest that case managers working in community aged care sectors may be more effective if they practised the 16 roles aforementioned. With the value of helping rather than obstructing clients to access services, they may not act as gatekeepers. In addition, they may not provide services directly as opposed to their peers working in medical care settings. The findings will also assist organisations to design job descriptions specifying case managers' roles and associated job responsibilities. Clear job descriptions will further benefit the organisations in staff recruitment, orientation

  20. Burnout in Direct Care Staff in Intellectual Disability Services: A Factor Analytic Study of the Maslach Burnout Inventory

    ERIC Educational Resources Information Center

    Hastings, R. P.; Horne, S.; Mitchell, G.

    2004-01-01

    There is gathering research interest in the well-being of staff working in services for people with intellectual disability (ID), including the assessment of burnout and its correlates. However, no previous studies have considered the applicability of the main three dimensions of burnout to staff in ID services. Data were analysed from two samples…

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  2. Complementary Self-Care Strategies for Healthy Aging.

    ERIC Educational Resources Information Center

    Barrett, Sondra

    1993-01-01

    Focuses on alternative self-care practices in terms of collaboration with the primary care physician and individual exploration of self-care practices such as acupuncture, meditation, and nutrition counseling. (JOW)

  3. Client incentives versus contracting and staff incentives: how care continuity interventions in substance abuse treatment can improve residential to outpatient transition.

    PubMed

    Acquavita, Shauna P; Stershic, Sandra; Sharma, Rajni; Stitzer, Maxine

    2013-07-01

    Interventions for improving transition from short-term residential to outpatient treatment were examined. Usual care (UC; n=114) was referral to a preferred outpatient program with advance appointment optional. Client incentive (CI; n=97) offered up to $100 in gift cards for intake and attendance during the first 30days of treatment. Contracting with staff incentives (CSI; n=49) consisted of meeting with an outpatient counselor prior to residential discharge, signing an attendance contract, receiving an appointment and payment to staff if clients attended. CSI significantly improved rates of successful transition (84%) and admission (74%) compared to UC (64% contact; 49% admitted). CI did not result in significantly improved outcomes (74%; 60%). CSI was likely mediated by the reliability (92 versus 52% in UC) and immediacy (1.0 versus 3.9days) of appointment scheduling. This study supports use of CSI for improving rates of transition between residential and outpatient continuing care treatment. PMID:23375361

  4. Impairment and abuse of elderly by staff in long-term care in Michigan: evidence from structural equation modeling.

    PubMed

    Conner, Tom; Prokhorov, Artem; Page, Connie; Fang, Yu; Xiao, Yimin; Post, Lori A

    2011-01-01

    Elder abuse in long-term care has become a very important public health concern. Recent estimates of elder abuse prevalence are in the range of 2% to 10% (Lachs & Pillemer, 2004), and current changes in population structure indicate a potential for an upward trend in prevalence (Malley-Morrison, Nolido, & Chawla, 2006; Post et al., 2006). More than 20 years ago, Karl Pillemer called for sociological research on patient maltreatment in nursing homes and provided an overview model for the conduct of such research (Pillemer, 1988). The research literature since then has not provided the definitive model to account for patient maltreatment that Pillemer hoped for. Instead, it has produced a laundry list of risk factors that includes the patient's functional disability, cognitive impairment, social isolation, age, race, income, family background, life events, dementia, and depression (Dyer, Pavlik, Murphy, & Hyman, 2000; Lachs & Pillemer, 2004; Lachs,Williams, Obrien, Hurst, & Horwitz, 1997; Pavlik, Hyman, Festa, & Dyer, 2001; Schofield & Mishra, 2003). However, no theory exists to place these factors in a causal structure that relates the factors to each other and to whether abuse occurs. This study is a first step in that direction. Nine hypotheses were generated focusing on the effects of two dimensions of impairment--(a) physical and cognitive and (b) age and behavior problems--on susceptibility to abuse among elderly in long-term care.The relationships between factors and from factors to susceptibility to abuse are specified in a structural equation model where "susceptibility to abuse," "physical impairment," and "cognitive impairment" are latent variables, and behavior problems and age are directly measured. PMID:20448233

  5. 'There's only one enabler; come up, help us': staff perspectives of barriers and enablers to continuous quality improvement in Aboriginal primary health-care settings in South Australia.

    PubMed

    Newham, Jo; Schierhout, Gill; Bailie, Ross; Ward, Paul R

    2016-01-01

    This paper presents the findings from a qualitative study, which sought to investigate the barriers and enablers to implementation of a continuous quality improvement (CQI) program by health-care professionals in Aboriginal primary health-care services in South Australia. Eighteen semi-structured interviews across 11 participating services were conducted alongside CQI implementation activities. Multiple barriers exist, from staff perspectives, which can be categorised according to different levels of the primary health-care system. At the macro level, barriers related to resource constraints (workforce issues) and access to project support (CQI coordinator). At the meso level, barriers related to senior level management and leadership for quality improvement and the level of organisational readiness. At the micro level, knowledge and attitudes of staff (such as resistance to change; lack of awareness of CQI) and lack of team tenure were cited as the main barriers to implementation. Staff identified that successful and sustained implementation of CQI requires both organisational systems and individual behaviour change. Improvements through continuing regional level collaborations and using a systems approach to develop an integrated regional level CQI framework, which includes building organisational and clinic team CQI capacity at the health centre level, are recommended. Ideally, this should be supported at the broader national level with dedicated funding. PMID:25719603

  6. Staff perceptions of work quality of a neonatal intensive care unit before and after transition from an open bay to a private room design.

    PubMed

    Smith, Thomas J; Schoenbeck, Kathleen; Clayton, Sandra

    2009-01-01

    This study collected staff responses to an occupancy quality survey before, and 6 and 22 months after, St. Paul Children's Hospitals and Clinics (CHC) replaced an open bay (OB) with a private room (PR) neonatal intensive care unit (NICU) design. Staff interview responses and task activity observations also were collected. The goal was to assess how this change would influence staff perceptions and performance. As a result of the transition from the OB to the PR environment: (1) rankings of overall physical environment, patient care, job, technology, and off-the-job quality significantly improved; but (2) rankings of patient care team interaction quality significantly declined. Results for the 22-month PR survey indicate essentially no meaningful changes in rankings of occupancy quality from the 6-month survey, suggesting no consolidation of quality gains in the intervening 16-month period. Written comments pertaining to private room NICU design issues by survey respondents, targeting problems with unit operations, may explain this finding. Collectively, the findings suggest that NICU operational management was not effectively modified to deal with the new design, and that an OB to PR NICU transition requires a systems approach to macroergonomic challenges imposed by the new design. PMID:19713631

  7. Effects of Staff Training on Staff Knowledge and Attitudes about Sexuality.

    ERIC Educational Resources Information Center

    Walker, Bonnie L.; Harrington, Donna

    2002-01-01

    Four learning modules on elderly sexuality were pilot tested with 109 long-term care staff. On pretests men and whites scored higher than women and African-Americans. Knowledge and attitude improvements resulted from use of modules on the need for sexuality/intimacy, sex and dementia, and sex and aging, but not the family/personal issues module.…

  8. Characteristics and Use of Home Health Care by Men and Women Aged 65 and Over

    MedlinePlus

    ... April 18, 2012 Characteristics and Use of Home Health Care by Men and Women Aged 65 and Over ... and Roberto Valverde, M.P.H., Division of Health Care Statistics Abstract Objective —This report presents national estimates ...

  9. What's the diagnosis? Organisational culture and palliative care delivery in residential aged care in New Zealand.

    PubMed

    Frey, Rosemary; Boyd, Michal; Foster, Sue; Robinson, Jackie; Gott, Merryn

    2016-07-01

    Organisational culture has been shown to impact on resident outcomes in residential aged care (RAC). This is particularly important given the growing number of residents with high palliative care needs. The study described herein (conducted from January 2013 to March 2014) examined survey results from a convenience sample of 46 managers, alongside interviews with a purposively selected sample of 23 bereaved family members in order to explore the perceptions of organisational culture within New Zealand RAC facilities in one large urban District Health Board. Results of the Organisational Culture Assessment Instrument (OCAI) completed by managers indicated a preference for a 'Clan' and the structured 'Hierarchy' culture. Bereaved family interviews emphasised both positive and negative aspects of communication, leadership and teamwork, and relationship with residents. Study results from both managers' OCAI survey scores and next of kin interviews indicate that while the RAC facilities are culturally oriented towards providing quality care for residents, they may face barriers to adopting organisational processes supportive of this goal. PMID:25808936

  10. A comparative study of job satisfaction among regular and staff on contract in the primary health care system in Delhi, India

    PubMed Central

    Kumar, Pawan; Khan, Abdul M.; Inder, Deep; Mehra, Anu

    2014-01-01

    Background: Job satisfaction is a pleasant emotional state associated with the appreciation of one's work and contributes immensely to performance in an organization. The purpose of this study was to assess the comparative job satisfaction among regular and staff on contract in Government Primary Urban Health Centers in Delhi, India. Materials and Methods: The study was conducted in 2013, on a sample of 333 health care providers who were selected using a multistage random sampling technique. The sample included medical officers (MOs), auxiliary nurses and midwives (ANMs), pharmacists and laboratory technicians (LTs)/laboratory assistants (LAs) among regular and staff on contract. Analysis was done using SPSS version 18, and appropriate statistical tests were applied. Results: The job satisfaction for all the regular staff that is, MOs, ANMs, pharmacists, LAs, and LTs were relatively higher (3.3 ± 0.44) than the contract staff (2.7 ± 0.45) with ‘t’value 10.54 (P < 0.01). The mean score for regular and contract MOs was 3.2 ± 0.46 and 2.7 ± 0.56, respectively, and the same trends were found between regular and ANMs on the contract which was 3.4 ± 0.30 and 2.7 ± 0.38, regular and pharmacists on the contract was 3.3 ± 0.50 and 2.8 ± 0.41, respectively. The differences between groups were significant with a P < 0.01. Conclusion: Overall job satisfaction level was relatively low in both regular and contract staff. The factors contributing to satisfaction level were privileges, interpersonal relations, working-environment, patient relationship, the organization's facilities, career development, and the scarcity of human resources (HRs). Therefore, specific recommendations are suggested to policy makers to take cognizance of the scarcity of HRs and the on-going experimentation with different models under primary health care system. PMID:24987280

  11. Comparison of staff and family perceptions of causes of noise pollution in the Pediatric Intensive Care Unit and suggested intervention strategies

    PubMed Central

    Kaur, Harsheen; Rohlik, Gina M.; Nemergut, Michael E.; Tripathi, Sandeep

    2016-01-01

    Noise and excessive, unwanted sound in the Pediatric Intensive Care Unit (PICU) is common and has a major impact on patients’ sleep and recovery. Previous research has focused mostly on absolute noise levels or included only staff as respondents to acknowledge the causes of noise and to plan for its reduction. Thus far, the suggested interventions have not ameliorated noise, and it continues to serve as a barrier to recovery. In addition to surveying PICU providers through internet-based software, patients’ families were evaluated through in-person interviews utilizing a pretested instrument over 3 months. Families of patients admitted for more than 24 h were considered eligible for evaluation. Participants were asked to rank causes of noise from 1 to 8, with eight being highest, and identified potential interventions as effective or ineffective. In total, 50 families from 251 admissions and 65 staff completed the survey. Medical alarms were rated highest (mean ± standard deviation [SD], 4.9 ± 2.1 [2.8-7.0]), followed by noise from medical equipment (mean ± SD, 4.7 ± 2.1 [2.5-6.8]). This response was consistent among PICU providers and families. Suggested interventions to reduce noise included keeping a patient's room door closed, considered effective by 93% of respondents (98% of staff; 88% of families), and designated quiet times, considered effective by 82% (80% of staff; 84% of families). Keeping the patient's door closed was the most effective strategy among survey respondents. Most families and staff considered medical alarms an important contributor to noise level. Because decreasing the volume of alarms such that it cannot be heard is inappropriate, alternative strategies to alert staff of changes in vital signs should be explored. PMID:26960784

  12. Comparison of staff and family perceptions of causes of noise pollution in the Pediatric Intensive Care Unit and suggested intervention strategies.

    PubMed

    Kaur, Harsheen; Rohlik, Gina M; Nemergut, Michael E; Tripathi, Sandeep

    2016-01-01

    Noise and excessive, unwanted sound in the Pediatric Intensive Care Unit (PICU) is common and has a major impact on patients' sleep and recovery. Previous research has focused mostly on absolute noise levels or included only staff as respondents to acknowledge the causes of noise and to plan for its reduction. Thus far, the suggested interventions have not ameliorated noise, and it continues to serve as a barrier to recovery. In addition to surveying PICU providers through internet-based software, patients' families were evaluated through in-person interviews utilizing a pretested instrument over 3 months. Families of patients admitted for more than 24 h were considered eligible for evaluation. Participants were asked to rank causes of noise from 1 to 8, with eight being highest, and identified potential interventions as effective or ineffective. In total, 50 families from 251 admissions and 65 staff completed the survey. Medical alarms were rated highest (mean ± standard deviation [SD], 4.9 ± 2.1 [2.8-7.0]), followed by noise from medical equipment (mean ± SD, 4.7 ± 2.1 [2.5-6.8]). This response was consistent among PICU providers and families. Suggested interventions to reduce noise included keeping a patient's room door closed, considered effective by 93% of respondents (98% of staff; 88% of families), and designated quiet times, considered effective by 82% (80% of staff; 84% of families). Keeping the patient's door closed was the most effective strategy among survey respondents. Most families and staff considered medical alarms an important contributor to noise level. Because decreasing the volume of alarms such that it cannot be heard is inappropriate, alternative strategies to alert staff of changes in vital signs should be explored. PMID:26960784

  13. Does Improving Joint Attention in Low-Quality Child-Care Enhance Language Development?

    ERIC Educational Resources Information Center

    Rudd, Loretta C.; Cain, David W.; Saxon, Terrill F.

    2008-01-01

    This study examined effects of professional development for child-care staff on language acquisition of children ages 14-36 months. Child-care staff from 44 child-care centres agreed to participate in the study. Child-care staff from one-half of the child-care centres were randomly assigned to a one-time, four-hour workshop followed by three…

  14. Most Sick, Aging Americans Live Far from In-Home Care

    MedlinePlus

    ... medlineplus.gov/news/fullstory_160328.html Most Sick, Aging Americans Live Far From In-Home Care Study ... to swell. "The Baby Boomer generation, they're aging fast and they are living longer with multiple ...

  15. Delivery, immediate newborn and cord care practices in Pemba Tanzania: a qualitative study of community, hospital staff and community level care providers for knowledge, attitudes, belief systems and practices

    PubMed Central

    2014-01-01

    Background Deaths during the neonatal period account for almost two-thirds of all deaths in the first year of life and 40 percent of deaths before the age of five. Most of these deaths could be prevented through proven cost-effective interventions. Although there are some recent data from sub-Saharan Africa, but there is paucity of qualitative data from Zanzibar and cord care practices data from most of East Africa. We undertook a qualitative study in Pemba Island as a pilot to explore the attitudes, beliefs and practices of the community and health workers related to delivery, newborn and cord care with the potential to inform the main chlorhexidine (CHX) trial. Methods 80 in-depth interviews (IDI) and 11 focus group discussions (FGD) involving mothers, grandmothers, fathers, traditional birth attendants and other health service providers from the community were undertaken. All IDIs and FGDs were audio taped, transcribed and analyzed using ATLAS ti 6.2. Results Poor transportation, cost of delivery at hospitals, overcrowding and ill treatment by hospital staff are some of the obstacles for achieving higher institutional delivery. TBAs and health professionals understand the need of using sterilized equipments to reduce risk of infection to both mothers and their babies during delivery. Despite this knowledge, use of gloves during delivery and hand washing before delivery were seldom reported. Early initiation of breastfeeding and feeding colostrum was almost universal. Hospital personnel and trained TBAs understood the importance of keeping babies warm after birth and delayed baby’s first bath. The importance of cord care was well recognized in the community. Nearly all TBAs counseled the mothers to protect the cord from dust, flies and mosquitoes or any other kind of infections by covering it with cloth. There was consensus among respondents that CHX liquid cord cleansing could be successfully implemented in the community with appropriate education and

  16. Effectiveness of a Staff Promoted Wellness Program to Improve Health in Residents of a Mental Health Long-Term Care Facility.

    PubMed

    Hutchison, Shari L; Terhorst, Lauren; Murtaugh, Stephanie; Gross, Sarah; Kogan, Jane N; Shaffer, Sherry L

    2016-04-01

    The current study describes physical and mental health outcomes during a health promotion program for individuals with serious mental illness (SMI). A sample of 43 adults in a long-term residential facility volunteered for an individualized, healthy lifestyle program designed to promote physical activity and combat premature mortality among individuals with SMI. Nurses and residential counselors were trained in the program and encouraged to work collaboratively with the program's personal trainers. Weekly nutrition and activity logs were obtained over the year-long evaluation. Assessments of physical and psychological health indicators were collected quarterly. Qualitative data through focus groups described staff experience. Self-report of moderate and vigorous physical activity improved over time as did fitness level as measured through a walking challenge (p = .001). Significant decreases in weight (p < .001), BMI (p = .001), and total cholesterol (p < .001) were observed from baseline through 12 months. Mean recovery scores (RMQ) were significantly higher between baseline and all time points (p < .001). Participants reported decreasing levels of depression (PHQ-9) by the 12-month time point (p < .001). Staff encouraged participation in physical activity and observed improved motivation and socialization among participants. A health promotion program with participation encouraged by health care staff is effective for increasing physical activity and improving physical and mental health outcomes in individuals with SMI in long-term residential care. PMID:27031533

  17. Dermatological disease in the older age group: a cross-sectional study in aged care facilities

    PubMed Central

    Deo, Maneka S; Vandal, Alain C; Jarrett, Paul

    2015-01-01

    Objectives To estimate the prevalence of dermatological disease in aged care facilities, and the relationship between cognitive or physical disability and significant disease. Setting 2 large aged care facilities in Auckland, New Zealand, each providing low and high level care. Participants All 161 residents of the facilities were invited to participate. The only exclusion criterion was inability to obtain consent from the individual or designated guardian. 88 participants were recruited—66 females (75%), 22 males (25%) with average age 87.1 years (SD 5.5 years). Primary and secondary outcome measures Primary—presence of significant skin disease (defined as that which in the opinion of the investigators needed treatment or was identified as a patient concern) diagnosed clinically on full dermatological examination by a dermatologist or dermatology trainee. Secondary—functional and cognitive status (Rehabilitation Complexity Scale and Abbreviated Mental Test Score). Results 81.8% were found to have at least one significant condition. The most common disorders were onychomycosis 42 (47.7%), basal cell carcinoma 13 (14.8%), asteototic eczema 11 (12.5%) and squamous cell carcinoma in situ 9 (10.2%). Other findings were invasive squamous cell carcinoma 7 (8%), bullous pemphigoid 2 (2.3%), melanoma 2 (2.3%), lichen sclerosus 2 (2.3%) and carcinoma of the breast 1 (1.1%). Inflammatory disease was more common in those with little physical disability compared with those with serious physical disability (OR 3.69; 95% CI 1.1 to 12.6, p=0.04). No significant association was found between skin disease and cognitive impairment. Conclusions A high rate of dermatological disease was found. Findings ranged from frequent but not life-threatening conditions (eg, onychomycosis), to those associated with a significant morbidity (eg, eczema, lichen sclerosus and bullous pemphigoid), to potentially life-threatening (eg, squamous cell carcinoma, melanoma and breast cancer

  18. Succeeding Through Service Innovation: Consumer Directed Care in the Aged Care Sector

    NASA Astrophysics Data System (ADS)

    Wilkins, Linda; Laragy, Carmel; Zadeh, Hossein S.

    The growing challenge and diversity of ageing populations is a key global issue for struggling health systems. Consumer Directed Care (CDC), an innovative service delivery system, opens up possibilities for re-defining consumer expectations, prompting change in how health service providers operate. As a service delivery model, CDC offers improved responsiveness to individual requirements; and increased transparency in the use of allocated funding. Where implemented, CDC has established new relationships and interactions between key stakeholders, co-creating value for older citizens. This chapter reviews some drivers for the development of service innovation, surveys various in-country approaches, highlights current trends in CDC delivery and describes an EU policy impact assessment instrument to aid funding bodies. The chapter concludes by speculating on organizational outcomes from CDC and the likelihood that the introduction of this innovative service delivery model will require closer collaborative relationships between service providers and information technology specialists.

  19. Use of personal phones by senior nursing students to access health care information during clinical education: staff nurses' and students' perceptions.

    PubMed

    Wittmann-Price, Ruth A; Kennedy, Lynn D; Godwin, Catherine

    2012-11-01

    Research indicates that having electronic resources readily available increases learners' ability to make clinical decisions and confidence in patient care. This mixed-method, descriptive pilot study collected data about senior prelicensure nursing students using smartphones, a type of mobile electronic device (MED), in the clinical area. The smartphones contained nursing diagnosis, pharmacology, and laboratory information; an encyclopedia; and the MEDLINE database. Student (n = 7) data about smartphone use during a 10-week clinical rotation were collected via student-recorded usage logs and focus group recordings. Staff nurses' (n = 5) perceptions of students' use of smartphones for clinical educational resources were collected by anonymous survey. Both the focus group transcript and staff surveys were evaluated and the themes summarized by content analysis. Positive results and barriers to use, such as cost and technological comfort levels, are discussed. The results may help nurse educators and administrators initiate further research of MEDs as a clinical resource. PMID:22978275

  20. A review of research on direct-care staff data collection regarding the severity and function of challenging behavior in individuals with intellectual and developmental disabilities.

    PubMed

    Madsen, Emily K; Peck, Janelle A; Valdovinos, Maria G

    2016-09-01

    In working with individuals with intellectual and developmental disabilities (IDDs), it is direct care staff who are often required to collect data on individuals' behavior which is used as the basis for implementation of empirically based approaches for intervention and treatment. Due to limited resources, indirect and descriptive measures of challenging behaviors are employed to analyze the function of individuals' behaviors in place of the preferred method of multimodal assessment, which includes experimental functional analysis. To ensure the most effective services and support to individuals with IDDs, accurate and consistent data collection is critical. In this article, we highlight the importance of accurate data collection practices, conduct a comparison of data collection methods, and discuss limitations .… and barriers for staff. The article concludes with recommendations for best practices and future research. PMID:26502891

  1. Developing a Quality School-Age Child Care Program: An Information and Training Manual for Directors of School-Age Child Care Programs.

    ERIC Educational Resources Information Center

    Childcare Resources, Birmingham, AL.

    This manual for directors of school-age child care (SACC) programs contains six sections. Section I provides a rationale for SACC. Section II describes characteristics of school-age children. The extensive Section III discusses characteristics of high quality SACC. After an initial discussion of the importance of out-of-school time, the section…

  2. Barriers to care for sexual assault survivors of childbearing age: An integrative review

    PubMed Central

    Munro, Michelle L.

    2015-01-01

    Research indicates that only a small fraction of sexual assault survivors seek comprehensive care afterward, including physical and mental health care, forensic evidence collection, victim services, and legal support. This integrative review was conducted to identify barriers that may be keeping sexual assault survivors of childbearing age from receiving such comprehensive care. PMID:25664329

  3. Standards for Day Care Centers for Infants and Children Under 3 Years of Age.

    ERIC Educational Resources Information Center

    American Academy of Pediatrics, Evanston, IL.

    The Committee on Infant and Preschool Child of the American Academy of Pediatrics has developed basic standards for quality day care for children under 3 years of age. The availability of day care provides a mother with the choice of group day care as one of the means of providing for her children. Options should include full-time or part-time day…

  4. Attachment Style, Home-Leaving Age and Behavioral Problems among Residential Care Children

    ERIC Educational Resources Information Center

    Shechory, Mally; Sommerfeld, Eliane

    2007-01-01

    In a prospective study, the attachment style, home-leaving age, length of time in residential care, and behavioral problems among Israeli residential care children (N=68), were studied. Data analyses showed that children removed from their homes at a later age suffered from higher levels of anxiety, depression and social problems compared to…

  5. School-Age Child Care: An Action Manual for the 90s and Beyond. Second Edition.

    ERIC Educational Resources Information Center

    Seligson, Michelle; Allenson, Michael

    Evidence suggests that self-care among school-age children has significant costs to the children, in the form of increased fearfulness and loneliness, heightened vulnerability to peer pressure, and greater likelihood of substance abuse. In response to the need for quality school-age care, this book serves as a guide for anyone wanting to implement…

  6. No Time to Waste: An Action Agenda for School-Age Child Care.

    ERIC Educational Resources Information Center

    Seligson, Michelle; Fink, Dale Borman

    This book for persons interested in setting up high quality school-age child care (SACC) programs: (1) provides background information and a rationale; (2) describes a collaborative model of program development; (3) discusses program funding and resources; (4) considers approaches to recognizing high quality school-age child care; and (5) offers…

  7. Join the Revolution: How Montessori for Aging and Dementia can Change Long-Term Care Culture.

    PubMed

    Bourgeois, Michelle S; Brush, Jennifer; Elliot, Gail; Kelly, Anne

    2015-08-01

    Efforts to improve the quality of life of persons with dementia in long-term care through the implementation of various approaches to person-centered care have been underway for the past two decades. Studies have yielded conflicting reports evaluating the evidence for these approaches. The purpose of this article is to outline the findings of several systematic reviews of this literature, highlighting the areas of improvement needs, and to describe a new person-centered care model, DementiAbility Methods: The Montessori Way. This model focuses on the abilities, needs, interests, and strengths of the person and creating worthwhile and meaningful roles, routines, and activities for the person within a supportive physical environment. This is accomplished through gaining the commitment of the facility's leaders, training staff, and monitoring program implementation. The potential for a culture change in long-term care environments is dependent on the development and rigorous evaluation of person-centered care approaches. PMID:26190512

  8. Effectiveness of a low-threshold physical activity intervention in residential aged care – results of a randomized controlled trial

    PubMed Central

    Cichocki, Martin; Quehenberger, Viktoria; Zeiler, Michael; Adamcik, Tanja; Manousek, Matthias; Stamm, Tanja; Krajic, Karl

    2015-01-01

    Purpose Research on effectiveness of low-threshold mobility interventions that are viable for users of residential aged care is scarce. Low-threshold is defined as keeping demands on organizations (staff skills, costs) and participants (health status, discipline) rather low. The study explored the effectiveness of a multi-faceted, low-threshold physical activity program in three residential aged-care facilities in Austria. Main goals were enhancement of mobility by conducting a multi-faceted training program to foster occupational performance and thus improve different aspects of health-related quality of life (QoL). Participants and methods The program consisted of a weekly session of 60 minutes over a period of 20 weeks. A standardized assessment of mobility status and health-related QoL was applied before and after the intervention. A total of 222 of 276 participants completed the randomized controlled trial study (intervention group n=104, control group n=118; average age 84 years, 88% female). Results Subjective health status (EuroQoL-5 dimensions: P=0.001, d=0.36) improved significantly in the intervention group, and there were also positive trends in occupational performance (Canadian Occupational Performance Measure). No clear effects were found concerning the functional and cognitive measures applied. Conclusion Thus, the low-threshold approach turned out to be effective primarily on subjective health-related QoL. This outcome could be a useful asset for organizations offering low-threshold physical activity interventions. PMID:26056438

  9. Staff perceptions of addressing lifestyle in primary health care: a qualitative evaluation 2 years after the introduction of a lifestyle intervention tool

    PubMed Central

    2012-01-01

    Background Preventive services and health promotion in terms of lifestyle counselling provided through primary health care (PHC) has the potential to reduce morbidity and mortality in the population. Health professionals in general are positive about and willing to develop a health-promoting and/or preventive role. A number of obstacles hindering PHC staff from addressing lifestyle issues have been identified, and one facilitator is the use of modern technology. When a computer-based tool for lifestyle intervention (CLT) was introduced at a number of PHC units in Sweden, this provided an opportunity to study staff perspectives on the subject. The aim of this study was to explore PHC staff’s perceptions of handling lifestyle issues, including the consultation situation as well as the perceived usefulness of the CLT. Methods A qualitative study was conducted after the CLT had been in operation for 2 years. Six focus group interviews, one at each participating unit, including a total of 30 staff members with different professions participated. The interviews were designed to capture perceptions of addressing lifestyle issues, and of using the CLT. Interview data were analysed using manifest content analysis. Results Two main themes emerged from the interviews: a challenging task and confidence in handling lifestyle issues. The first theme covered the categories responsibilities and emotions, and the second theme covered the categories first contact, existing tools, and role of the CLT. Staff at the units showed commitment to health promotion/prevention, and saw that patients, caregivers, managers and politicians all have responsibilities regarding the issue. They expressed confidence in handling lifestyle-related conditions, but to a lesser extent had routines for general screening of lifestyle habits, and found addressing alcohol the most problematic issue. The CLT, intended to facilitate screening, was viewed as a complement, but was not considered an important

  10. A staff intervention targeting resident-to-resident elder mistreatment (R-REM) in long-term care increased staff knowledge, recognition and reporting: Results from a cluster randomized trial

    PubMed Central

    Teresi, Jeanne A.; Ramirez, Mildred; Ellis, Julie; Silver, Stephanie; Boratgis, Gabriel; Kong, Jian; Eimicke, Joseph P.; Pillemer, Karl A.; Lachs, Mark S.

    2013-01-01

    Background Elder abuse in long term care has received considerable attention; however, resident-to-resident elder mistreatment (R-REM) has not been well researched. Preliminary findings from studies of R-REM suggest that it is sufficiently widespread to merit concern, and is likely to have serious detrimental outcomes for residents. However, no evidence-based training, intervention and implementation strategies exist that address this issue. Objectives The objective was to evaluate the impact of a newly developed R-REM training intervention for nursing staff on knowledge, recognition and reporting of R-REM. Design The design was a prospective cluster randomized trial with randomization at the unit level. Methods A sample of 1405 residents (685 in the control and 720 in the intervention group) from 47 New York City nursing home units (23 experimental and 24 control) in 5 nursing homes was assessed. Data were collected at three waves: baseline, 6 and 12 months. Staff on the experimental units received the training and implementation protocols, while those on the comparison units did not. Evaluation of outcomes was conducted on an intent-to-treat basis using mixed (random and fixed effects) models for continuous knowledge variables and Poisson regressions for longitudinal count data measuring recognition and reporting. Results There was a significant increase in knowledge post-training, controlling for pre-training levels for the intervention group (p<0.001), significantly increased recognition of R-REM (p<0.001), and longitudinal reporting in the intervention as contrasted with the control group (p=0.0058). Conclusions A longitudinal evaluation demonstrated that the training intervention was effective in enhancing knowledge, recognition and reporting of R-REM. It is recommended that this training program be implemented in long term care facilities. PMID:23159018

  11. Severe punishment of children by staff in Romanian placement centers for school-aged children: effects of child and institutional characteristics.

    PubMed

    Rus, Adrian V; Stativa, Ecaterina; Pennings, Jacquelyn S; Cross, David R; Ekas, Naomi; Purvis, Karyn B; Parris, Sheri R

    2013-12-01

    The objective of this study was to determine whether children's characteristics and/or institutional characteristics were predictors of severe punishments (including beatings) and/or frequency of punishments that children received from staff in Romanian institutions. The data was hierarchical with institutionalized children (N=1391) nested within 44 institutions, and the measurement of punishments by the staff and frequency of punishments had a binary distribution. Thus, multilevel logistic regression models were used to examine the effects of individual and institutional level variables on reported punishments and to account for the clustering of the children within institutions. Two general patterns of results emerged. First, regarding individual level variables, it was found that: (1) amount of time spent by children in their current institutions had a significant effect on the probability of being punished by staff and the frequency of this punishment; (2) the probability of being punished was higher for boys than for girls; and (3) having no siblings in the institution increased the odds of being punished several times. Second, regarding institutional level variables: (4) being in placement centers for school-aged children with a traditional type of institutional organization increased the odds of severe punishment compared to a familial/mixed type. The results of the present study highlight the importance of understanding the consequences of institutionalization in a broader way, where children not only experienced early severe psychosocial deprivation as documented in other studies, but also high levels of severe punishments administered by institutional staff. PMID:23932392

  12. Individual and contextual antecedents of workplace aggression in aged care nurses and certified nursing assistants.

    PubMed

    Rodwell, John; Demir, Defne; Gulyas, Andre

    2015-08-01

    Employees in aged care are at high risk of workplace aggression. Research rarely examines the individual and contextual antecedents of aggression for specific types of workers within these settings, such as nurses and certified nursing assistants (CNAs). The study aimed to explore characteristics of the job demands-resources model (JD-R), negative affectivity (NA) and demographics related to workplace aggression for aged care workers. The survey study was based on 208 nurses and 83 CNAs working within aged care. Data from each group were analysed separately using ordinal regressions. Both aged care nurses and CNAs reported high rates of bullying, external emotional abuse, threat of assault and physical assault. Elements of the JD-R model and individual characteristics were related to aggression types for both groups. Characteristics of the JD-R model, NA and demographics are important in understanding the antecedents of aggression observed among aged care workers. PMID:26224217

  13. Making Sense of Varying Standards of Care: The Experiences of Staff Working in Residential Care Environments for Adults with Learning Disabilities

    ERIC Educational Resources Information Center

    Hutchison, Andrew; Kroese, Biza Stenfert

    2016-01-01

    Research evidence reveals that adults with learning disabilities who live in residential care facilities are being exposed to considerable variation in the standards of care they receive. High profile cases of substandard care have also raised concerns regarding the appropriateness of existing care provisions and practices. While attempts have…

  14. A University Program to Improve Nursing Care to the Aged

    ERIC Educational Resources Information Center

    Marten, Marie Lucille

    1978-01-01

    Proposes a series of university nursing education programs developed to increase knowledge and skills relevant to nursing care of elderly and chronically ill persons who reside in nursing homes. Briefly describes five programs intended for persons engaged in long-term care or in preparation for such roles. (EM)

  15. Studying feasibility and effects of a two-stage nursing staff training in residential geriatric care using a 30 month mixed-methods design [ISRCTN24344776

    PubMed Central

    2011-01-01

    Background Transfer techniques and lifting weights often cause back pain and disorders for nurses in geriatric care. The Kinaesthetics care conception claims to be an alternative, yielding benefits for nurses as well as for clients. Starting a multi-step research program on the effects of Kinaesthetics, we assess the feasibility of a two-stage nursing staff training and a pre-post research design. Using quantitative and qualitative success criteria, we address mobilisation from the bed to a chair and backwards, walking with aid and positioning in bed on the staff level as well as on the resident level. In addition, effect estimates should help to decide on and to prepare a controlled trial. Methods/Design Standard basic and advanced Kinaesthetics courses (each comprising four subsequent days and an additional counselling day during the following four months) are offered to n = 36 out of 60 nurses in a residential geriatric care home, who are in charge of 76 residents. N = 22 residents needing movement support are participating to this study. On the staff level, measurements include focus group discussions, questionnaires, physical strain self-assessment (Borg scale), video recordings and external observation of patient assistance skills using a specialised instrument (SOPMAS). Questionnaires used on the resident level include safety, comfort, pain, and level of own participation during mobilisation. A functional mobility profile is assessed using a specialised test procedure (MOTPA). Measurements will take place at baseline (T0), after basic training (T1), and after the advanced course (T2). Follow-up focus groups will be offered at T1 and 10 months later (T3). Discussion Ten criteria for feasibility success are established before the trial, assigned to resources (missing data), processes (drop-out of nurses and residents) and science (minimum effects) criteria. This will help to make rational decision on entering the next stage of the research program. Trial

  16. Literature review to identify factors that support implementation of evidence-based practice in residential aged care.

    PubMed

    Masso, Malcolm; McCarthy, Grace

    2009-06-01

    The aim was to undertake a review of the literature on change management, quality improvement, evidence-based practice and diffusion of innovations to identify key factors that might influence the uptake and continued use of evidence in residential aged care. The key factors will be used to shape and inform the evaluation of the Encouraging Best Practice in Residential Aged Care Program which commenced in Australia in 2007. MEDLINE, CINAHL and the Cochrane Database of Systematic Reviews were searched using combinations of search terms. Searching focused on existing literature reviews, discussions of relevant conceptual and theoretical frameworks and primary studies that have examined the implementation of evidence-based practice in residential aged care. Keyword searching was supplemented with snowball searching (following up on the references cited in the papers identified by the search), searching by key authors in the field and hand searching of a small number of journals. In general, the period covered by the searches was from 2002 to 2008. The findings from the literature are often equivocal. Analysis and consolidation of factors derived from the literature that might influence the implementation of evidence-based practice resulted in the identification of eight factors: (i) a receptive context for change; (ii) having a model of change to guide implementation; (iii) adequate resources; (iv) staff with the necessary skills; (v) stakeholder engagement, participation and commitment; (vi) the nature of the change in practice; (vii) systems in place to support the use of evidence; and (viii) demonstrable benefits of the change. Most of the literature included in the review is from studies in healthcare and hence the generalisability to residential aged care is largely unknown. However, the focus of this research is on clinical care, within the context of residential aged care, hence the healthcare literature is relevant. The factors are relatively broad and cover

  17. Expert perspectives on Western European prison health services: do ageing prisoners receive equivalent care?

    PubMed

    Bretschneider, Wiebke; Elger, Bernice Simone

    2014-09-01

    Health care in prison and particularly the health care of older prisoners are increasingly important topics due to the growth of the ageing prisoner population. The aim of this paper is to gain insight into the approaches used in the provision of equivalent health care to ageing prisoners and to confront the intuitive definition of equivalent care and the practical and ethical challenges that have been experienced by individuals working in this field. Forty interviews took place with experts working in the prison setting from three Western European countries to discover their views on prison health care. Experts indicated that the provision of equivalent care in prison is difficult mostly due to four factors: variability of care in different prisons, gatekeeper systems, lack of personnel, and delays in providing access. This lack of equivalence can be fixed by allocating adequate budgets and developing standards for health care in prison. PMID:24965437

  18. Do Effects of Early Child Care Extend to Age 15 Years? Results from the NICHD Study of Early Child Care and Youth Development

    ERIC Educational Resources Information Center

    Vandell, Deborah Lowe; Belsky, Jay; Burchinal, Margaret; Steinberg, Laurence; Vandergrift, Nathan

    2010-01-01

    Relations between nonrelative child care (birth to 4 1/2 years) and functioning at age 15 were examined (N = 1,364). Both quality and quantity of child care were linked to adolescent functioning. Effects were similar in size as those observed at younger ages. Higher quality care predicted higher cognitive-academic achievement at age 15, with…

  19. Resident-to-Resident Aggression in Long-Term Care Facilities: Insights from Focus Groups of Nursing Home Residents and Staff

    PubMed Central

    Rosen, Tony; Lachs, Mark S.; Bharucha, Ashok J.; Stevens, Scott M.; Teresi, Jeanne A.; Nebres, Flor; Pillemer, Karl

    2009-01-01

    OBJECTIVES To more fully characterize the spectrum of RRA. DESIGN A focus group study of nursing home staff members and residents who could reliably self-report. SETTING A large urban, not-for-profit long-term care facility in New York City PARTICIPANTS 7 residents and 96 staff members from multiple clinical and non-clinical occupational groups. MEASUREMENTS 16 focus groups were conducted. Content was analyzed with nVivo 7 software for qualitative data. RESULTS 35 different types of physical, verbal and sexual RRA were described, with screaming and/or yelling being the most common. Calling out and making noise were the most frequent of 29 antecedents identified as instigating episodes of RRA. RRA was most frequent in dining and residents’ rooms, and in the afternoon, though it occurred regularly throughout the facility at all times. While no proven strategies exist to manage RRA, staff described 25 self-initiated techniques to address the issue. CONCLUSION RRA is a ubiquitous phenomenon in nursing home settings with important consequences for affected individuals and facilities. Further epidemiologic research is necessary to more fully describe the phenomenon and identify risk factors and preventative strategies. PMID:18637979

  20. An Assessment of Psychological Need in Emergency Medical Staff in the Northern Health and Social Care Trust Area

    PubMed Central

    Aisling, Diamond; David, Curran

    2016-01-01

    Setting Psychological stress is increasingly recognised within emergency medicine, given the environmental and clinical stressors associated with the specialism. The current study assessed whether psychological distress is experienced by emergency medical staff and if so, what is the expressed need within this population? Participants Participants included ambulance personnel, nursing staff, doctors and ancillary support staff within two Accident and Emergency (A&E) departments and twelve ambulance bases within one Trust locality in NI (N = 107). Primary and secondary outcome measures The General Health Questionnaire (GHQ-12, Goldberg, 1972, 1978), Secondary Traumatic Stress Scale (STSS, Bride, 2004) and an assessment of need questionnaire were completed and explored using mixed method analysis. Results Results showed elevated levels of psychological distress within each profession except ambulance service clinical support officers (CSOs). Elevated levels of secondary trauma symptomatology were also found; the highest were within some nursing grades and junior doctors. Decreased enjoyment in job over time was significantly associated with higher scores. Analysis of qualitative data identified sources of stress to include low morale. A total of 65% of participants thought that work related stressors had negatively affected their mental health. Participants explored what they felt could decrease psychological distress including improved resources and psychoeducation. Conclusion There were elevated levels of distress and secondary traumatic stress within this population as well as an expressed level of need, on both systemic and support levels. PMID:27601762

  1. The paradox of the Aged Care Act 1997: the marginalisation of nursing discourse.

    PubMed

    Angus, Jocelyn; Nay, Rhonda

    2003-06-01

    This paper examines the marginalisation of nursing discourse, which followed the enactment of the Aged Care Act 1997. This neo-reform period in aged care, dominated by theories of economic rationalism, enshrined legislation based upon market principles and by implication, the provision of care at the cheapest possible price. This paper exposes some of the gaps in the neo-reform period and challenges the assertion that the amalgamation of nursing homes and hostels in such an environment can provide better quality of care and life for residents. It argues that this amalgamation entails a transformation towards a social model of care and fails to address the professional healthcare needs of the acutely sick and complex extreme old person and makes evident new gaps in the provision of aged care services. The paper proceeds to present strategies where the future for nursing practice in aged care necessarily involves a judicious balancing of individual cases alongside economic prescriptions of care and ever-changing public policy initiatives. It concludes that this can be achieved through a more interactive public, professional and advocacy discourse. The methodology involves extensive analysis of public documents including media, academic journals, government reports and interviews with recognised leaders in the field of aged care. The study utilises a critical interpretative framework consistent with the logic of Michel Foucault. PMID:12755862

  2. Making Our Health and Care Systems Fit for an Ageing Population: Considerations for Canada

    PubMed Central

    Andrew, Melissa K.; Rockwood, Kenneth

    2014-01-01

    A report from the United Kingdom on making health and care systems fit for an ageing population proposes a range of interventions to make care better for older adults, especially those who are frail. Here, we discuss the proposed shift for the acute care hospital to other models of care. The key for these models of care requires a fundamental shift to care that addresses the full range of an individual’s needs, rather than being based around single diseases. How this might apply in the Canadian context is considered. We emphasize strategies to keep people out of hospital but still receive needed care, make acute hospital care less hazardous, and improve the interface between acute and long-term care. PMID:25452826

  3. Technology and home care: implementing systems to enhance aging in place.

    PubMed

    Crossen-Sills, Jackie; Toomey, Irene; Doherty, Mary E

    2009-06-01

    The national healthcare agenda to improve efficiencies, reduce costs, provide high quality evidence and performance based care while simultaneously meeting stricter legal and regulatory requirements, has forced home care and hospice staff to change the way they work. These pressures require a reliance on new technologies to meet these goals. Through the agency-wide introduction and implementation of a variety of technological systems; electronic medical record/ point of care devises, telehealth, telephony and e-learning the Norwell VNA and Hospice has been able to improve efficiencies for employees allowing the focus of services to remain solely on patients and patient care. The technology has enhanced the agency's performance standards, communication and ultimate outcomes. PMID:19463680

  4. Trends in aging and skin care: Ayurvedic concepts.

    PubMed

    Datta, Hema Sharma; Paramesh, Rangesh

    2010-04-01

    The association between Ayurveda, anti-aging and cosmeceuticals is gaining importance in the beauty, health and wellness sector. Ayurvedic cosmeceuticals date back to the Indus Valley Civilization. Modern research trends mainly revolve around principles of anti-aging activity described in Ayurveda: Vayasthapana (age defying), Varnya (brighten skin-glow), Sandhaniya (cell regeneration), Vranaropana (healing), Tvachya (nurturing), Shothahara (anti-inflammatory), Tvachagnivardhani (strengthening skin metabolism) and Tvagrasayana (retarding aging). Many rasayana plants such as Emblica officinalis (Amla) and Centella asiatica (Gotukola) are extensively used. PMID:21836797

  5. Trends in aging and skin care: Ayurvedic concepts

    PubMed Central

    Datta, Hema Sharma; Paramesh, Rangesh

    2010-01-01

    The association between Ayurveda, anti-aging and cosmeceuticals is gaining importance in the beauty, health and wellness sector. Ayurvedic cosmeceuticals date back to the Indus Valley Civilization. Modern research trends mainly revolve around principles of anti-aging activity described in Ayurveda: Vayasthapana (age defying), Varnya (brighten skin-glow), Sandhaniya (cell regeneration), Vranaropana (healing), Tvachya (nurturing), Shothahara (anti-inflammatory), Tvachagnivardhani (strengthening skin metabolism) and Tvagrasayana (retarding aging). Many rasayana plants such as Emblica officinalis (Amla) and Centella asiatica (Gotukola) are extensively used. PMID:21836797

  6. Implementing Role-Changing Versus Time-Changing Innovations in Health Care: Differences in Helpfulness of Staff Improvement Teams, Management, and Network for Learning.

    PubMed

    Nembhard, Ingrid M; Morrow, Christopher T; Bradley, Elizabeth H

    2015-12-01

    Health care organizations often fail in their effort to implement care-improving innovations. This article differentiates role-changing innovations, altering what workers do, from time-changing innovations, altering when tasks are performed or for how long. We examine our hypothesis that the degree to which access to groups that can alter organizational learning--staff, management, and external network--facilitates implementation depends on innovation type. Our longitudinal study using ordinal logistic regression and survey data on 517 hospitals' implementation of evidence-based practices for treating heart attack confirmed our thesis for factors granting access to each group: improvement team's representativeness (of affected staff), senior management engagement, and network membership. Although team representativeness and network membership were positively associated with implementing role-changing practices, senior management engagement was not. In contrast, senior management engagement was positively associated with implementing time-changing practices, whereas team representativeness was not, and network membership was not unless there was limited management engagement. These findings advance implementation science by explaining mixed results across past studies: Nature of change for workers alters potential facilitators' effects on implementation. PMID:26116611

  7. Using existing information from medico-legal death investigations to improve care of older people in residential aged care services.

    PubMed

    Ibrahim, Joseph Elias; Bugeja, Lyndal; Ranson, David

    2013-12-01

    The care of older people in residential aged care services could be improved by optimising the use of existing information gathered for medico-legal death investigations. The authors address three myths contributing to underuse of this information: deaths are not preventable; public health gains are too small; and it is someone else's charter or responsibility A significant proportion of deaths are preventable, specifically those occurring prematurely from natural causes or due to injury and trauma. By addressing these preventable deaths, significant public health cost savings and better health outcomes for our growing ageing population can be achieved. Despite substantive monitoring of the provision of aged care, no single entity is explicitly responsible for systematically analysing medico-legal death information. The data and skills for using information from medico-legal death investigations currently exist. Dispelling the myths removes one impediment to investing in this area of public health. PMID:24597371

  8. Salary Surveys: How to Conduct One in Your Community and Child Care Staff Salary and Working Conditions Survey.

    ERIC Educational Resources Information Center

    Bellm, Dan; Whitebook, Marcy

    Intended for use by child care advocates, this booklet describes ways to gather local information about existing salaries, benefits, and working conditions among child care workers for the purpose of coordinating efforts to upgrade the field. The booklet begins by presenting the rationale behind conducting salary surveys, noting that surveys can…

  9. Women, Work and the Need for Child Care. Opportunities for Programmatic Collaboration: A Review of UNICEF-Supported Programmes in Nepal, Ecuador, and Ethiopia. Staff Working Papers, Number 10.

    ERIC Educational Resources Information Center

    Landers, Cassie, Ed.; Leonard, Ann, Ed.

    This document examines programs in Nepal, Ecuador, and Ethiopia that address the many needs of working women in regard to providing high quality care for their children. The description of each program includes: (1) an account of the identification of the child care need; (2) program planning and implementation; (3) training of staff; (4) effects…

  10. Multisensory installations in residential aged-care facilities: increasing novelty and encouraging social engagement through modest environmental changes.

    PubMed

    Scott, Theresa L; Masser, Barbara M; Pachana, Nancy A

    2014-09-01

    The current study examined the effect of an indoor simulated garden installation that included visual, auditory, and olfactory stimuli on resident well-being, compared to the effect elicited by a reminiscence installation and a control no-installation condition. A quasi-experimental ABA design was used (i.e., two intervention conditions plus a wait-list control condition). A survey instrument was administered to nursing home residents (N = 33) at three time points (pre-, during, and post intervention) over an 8-week period, which measured mood, behavior, health, and social interaction. Additionally, staff reports (N = 24) were collected. Both the nature-based and non-nature-based installations led to enhanced well-being and significantly more social benefits for residents because of their novel and aesthetic appeal, compared with the control condition. Residents in the nature-based installation condition reported more satisfaction with their living environment during the intervention phase than those in the comparison conditions. The results show that an indoor garden simulation is a relatively inexpensive way to transform a disused indoor area of an aged-care facility for the benefit of residents and staff. PMID:25199113

  11. An apocalyptic vision of ageing in China: Old age care for the largest elderly population in the world.

    PubMed

    Liu, Tao; Sun, Li

    2015-06-01

    According to the National Bureau of Statistics of China, by 2010 the number of people aged 60 or over had reached 178 million in China or 13% of its population. With the largest elderly population in the world in absolute numbers, China faces a challenge of providing care for the elderly both in the present and the future. Unlike old age pensions and health protection for the elderly, in Chinese society elderly care had never been considered to be a social problem but rather the individual family's responsibility. After the turn of the millennium, as the repercussions of increasingly ageing demographics, the results of the One-Child Policy and drastic changes in traditional family structures gradually became more apparent, this issue of elderly care has increasingly become one of the most pressing concerns for the ageing society. As there is little existing research on this particular topic, this article aims to shed light on elderly care in China, focusing on the care of elderly needing assistance with activities of daily living, since this group of elderly are most in need of care, their numbers having risen to 33 million in 2010. This article argues it is urgent for China to switch from informal family-based elderly care to the state's formal long-term care, illustrates that a model of social insurance (e.g. as in Germany) is advocated by many Chinese scholars and points out the ways in which it is different from both the commercialized models (e.g. as in the USA) and state organized "Beveridge" models (e.g. as in Sweden). PMID:25323978

  12. Building Peer Relationships in School Age Care. Beginnings Workshop.

    ERIC Educational Resources Information Center

    Teachy, Cindy L.; And Others

    1994-01-01

    This workshop section includes four essays: (1) "Building Lifelong Relationships: School Age Programs at Work" (Cindy L. Teachey); (2) "Building Friendships in School Age Programs" (Joan M. Bergstrom); (3) "On the Rocky Road to Friendship: Emerging Peer Relationships" (Kay Albrecht); (4) "Helping Teachers Understand Their Role in Supporting Peer…

  13. Care dependence in old age: preferences, practices and implications in two Indonesian communities

    PubMed Central

    SCHRÖDER-BUTTERFILL, ELISABETH; FITHRY, TENGKU SYAWILA

    2013-01-01

    The provision of physical care is a sensitive matter in all cultures and is circumscribed by moral injunctions and personal preferences. Research on Western cultures has shown care networks to be narrow subsets of people’s wider networks and revealed dependence to be deeply undermining of full personhood. In non-Western societies these issues have received little attention, although it is sometimes assumed that care provision and dependence are much less problematic. This paper uses longitudinal ethnographic data from two ethnic groups in rural Indonesia to compare care preferences and practices in old age and to examine the implications of care dependence. The groups manifest varying degrees of daughter preference in care and differ in the extent to which notions of shame and avoidance prohibit cross-gender intimate care and care by ‘non-blood’ relatives. Demographic and social constraints often necessitate compromises in actual care arrangements (e.g. dependence on in-laws, neighbours or paid carers), not all of which are compatible with quality care and a valued identity. We argue that by probing the norms and practices surrounding care provision in different socio-cultural settings, it becomes possible to arrive at a deeper understanding of kinship, personhood and sociality. These insights are not only of sociological interest but have implications for people’s vulnerability to poor quality care in old age. PMID:24518962

  14. Successful models of comprehensive care for older adults with chronic conditions: evidence for the Institute of Medicine's "retooling for an aging America" report.

    PubMed

    Boult, Chad; Green, Ariel Frank; Boult, Lisa B; Pacala, James T; Snyder, Claire; Leff, Bruce

    2009-12-01

    The quality of chronic care in America is low, and the cost is high. To help inform efforts to overhaul the ailing U.S. healthcare system, including those related to the "medical home," models of comprehensive health care that have shown the potential to improve the quality, efficiency, or health-related outcomes of care for chronically ill older persons were identified. Using multiple indexing terms, the MEDLINE database was searched for articles published in English between January 1, 1987, and May 30, 2008, that reported statistically significant positive outcomes from high-quality research on models of comprehensive health care for older persons with chronic conditions. Each selected study addressed a model of comprehensive health care; was a meta-analysis, systematic review, or trial with an equivalent concurrent control group; included an adequate number of representative, chronically ill participants aged 65 and older; used valid measures; used reliable methods of data collection; analyzed data rigorously; and reported significantly positive effects on the quality, efficiency, or health-related outcomes of care. Of 2,714 identified articles, 123 (4.5%) met these criteria. Fifteen models have improved at least one outcome: interdisciplinary primary care (1), models that supplement primary care (8), transitional care (1), models of acute care in patients' homes (2), nurse-physician teams for residents of nursing homes (1), and models of comprehensive care in hospitals (2). Policy makers and healthcare leaders should consider including these 15 models of health care in plans to reform the U.S. healthcare system. The Centers for Medicare and Medicaid Services would need new statutory flexibility to pay for care by the nurses, social workers, pharmacists, and physicians who staff these promising models. PMID:20121991

  15. Learning and Caring in the Age of the Five Outcomes

    ERIC Educational Resources Information Center

    Adams, Paul

    2007-01-01

    At its heart "Every Child Matters: change for children" endeavours to engender an ethic of "care for" the client group. However, although its raison d'etre might well espouse such orientations, it has a certain level of internal ambiguity which if not considered might lead education to position subsequent operationalization in ways antithetical to…

  16. A National Study of Residential Care for the Aged.

    ERIC Educational Resources Information Center

    Mor, Vincent; And Others

    1986-01-01

    A national survey of Residential Care Home programs revealed that most facilities were family owned and operated. A provider survey revealed that homes regulated by departments of health were more institutional than were homes regulated by integrated, social service departments. Elderly residents had high satisfaction. (Author/ABB)

  17. Home Care for the Aged: A Fragile Partnership.

    ERIC Educational Resources Information Center

    Kaye, Lenard W.

    1985-01-01

    Examined the efforts of relatives, friends, and professional caregivers in serving the homebound elderly. Results indicate that although the informal support network was perceived to be the preferable source of most home care aid, formal intervention was seen as best for housekeeping functions, specialized duties, and repetitive tasks for the…

  18. Caring for an Ageing Population: Are Physiotherapy Graduates Adequately Prepared?

    ERIC Educational Resources Information Center

    Ramklass, Serela S.; Butau, Anne; Ntinga, Nomusa; Cele, Nozipho

    2010-01-01

    In view of South African policy developments related to the care of older persons, it was necessary to examine the nature of the geriatrics content within physiotherapy curricula. A survey was conducted amongst final-year student physiotherapists at South African universities, together with content analysis of physiotherapy curricula. Very little…

  19. Learning Potentials and Limitations under Globalisation in Aged Care Workplaces.

    ERIC Educational Resources Information Center

    Somerville, Margaret

    2002-01-01

    Analysis of research on the Australian elder care industry used the categories of gender equity, gender differences, and gender deconstruction. Findings revealed the gender segregation of the industry, devaluing of women's work, and persistence of body/mind, male/female dualism. (Contains 16 references.) (SK)

  20. Sexuality and Aging: Implications for Long Term Care.

    ERIC Educational Resources Information Center

    Hinkley, Nancy E.

    With increasing emphasis on treating the whole person, on the maintenance of an individual's former life style, and on patients' rights, long-term care personnel need to become aware that many nursing home residents experience needs related to their sexuality. A model two-day workshop is presented wlth a focus on the following topics: (1) a broad…

  1. Detainees, staff, and health care services in immigration detention centres: a descriptive comparison of detention systems in Sweden and in the Benelux countries

    PubMed Central

    Puthoopparambil, Soorej J.; Bjerneld, Magdalena

    2016-01-01

    Background Immigration detention has been shown to negatively affect the health and well-being of detainees. The aim of the study was to describe and compare policies and practices that could affect the health and well-being of immigrant detainees in the Benelux countries (Belgium, the Netherlands, and Luxembourg) to those in Sweden. Design This was a case study. Data were collected in two phases using a questionnaire developed particularly for this study. In the first phase, authorities in the Benelux countries responded to the questionnaire via email. During the second phase, a research team visited detention centres in the Benelux countries to observe and further explore, strengthening findings through triangulation. Data on Swedish detention centres were collected in previous studies. Results Compared to the Benelux countries, Sweden has limited health care provision available in the detention centres. Swedish detention centres did not have mental health care professionals working at the centres and had fewer restrictions within the centres with regard to access to mobile phone, internet, and various recreational activities. Compared to Sweden, the detention centres in the Benelux countries have more staff categories providing services to the detainees that are provided with relevant and timely on-the-job training. All the countries, except Belgium, provide subsistence allowances to detainees. Conclusion Despite the Common European Asylum System framework, differences exist among the four European Union member states in providing services to immigrant detainees. This study highlights these differences, thereby providing a window on how these diverse approaches may serve as a learning tool for improving services offered to immigrant detainees. In Sweden, the health care available to detainees and training and recruitment of staff should be improved, while the Benelux countries should strive to reduce restrictions within detention centres. PMID:26950568

  2. Engaging Pediatric Intensive Care Unit (PICU) clinical staff to lead practice improvement: the PICU Participatory Action Research Project (PICU-PAR)

    PubMed Central

    2014-01-01

    Background Despite considerable efforts, engaging staff to lead quality improvement activities in practice settings is a persistent challenge. At British Columbia Children’s Hospital (BCCH), the pediatric intensive care unit (PICU) undertook a new phase of quality improvement actions based on the Community of Practice (CoP) model with Participatory Action Research (PAR). This approach aims to mobilize the PICU ‘community’ as a whole with a focus on practice; namely, to create a ‘community of practice’ to support reflection, learning, and innovation in everyday work. Methodology An iterative two-stage PAR process using mixed methods has been developed among the PICU CoP to describe the environment (stage 1) and implement specific interventions (stage 2). Stage 1 is ethnographic description of the unit’s care practice. Surveys, interviews, focus groups, and direct observations describe the clinical staff’s experiences and perspectives around bedside care and quality endeavors in the PICU. Contrasts and comparisons across participants, time and activities help understanding the PICU culture and experience. Stage 2 is a succession of PAR spirals, using results from phase 1 to set up specific interventions aimed at building the staff’s capability to conduct QI projects while acquiring appropriate technical skills and leadership capacity (primary outcome). Team communication, information, and interaction will be enhanced through a knowledge exchange (KE) and a wireless network of iPADs. Relevance Lack of leadership at the staff level in order to improve daily practice is a recognized challenge that faces many hospitals. We believe that the PAR approach within a highly motivated CoP is a sound method to create the social dynamic and cultural context within which clinical teams can grow, reflect, innovate and feel proud to better serve patients. PMID:24401288

  3. The importance of leadership style and psychosocial work environment to staff-assessed quality of care: implications for home help services.

    PubMed

    Westerberg, Kristina; Tafvelin, Susanne

    2014-09-01

    Work in home help services is typically conducted by an assistant nurse or nursing aide in the home of an elderly person, and working conditions have been described as solitary with a high workload, little influence and lack of peer and leader support. Relations between leadership styles, psychosocial work environment and a number of positive and negative employee outcomes have been established in research, but the outcome in terms of quality of care has been addressed to a lesser extent. In the present study, we aimed to focus on working conditions in terms of leadership and the employee psychosocial work environment, and how these conditions are related to the quality of care. The hypothesis was that the relation between a transformational leadership style and quality of care is mediated through organisational and peer support, job control and workload. A cross-sectional survey design was used and a total of 469 questionnaires were distributed (March-April 2012) to assistant nurses in nine Swedish home help organisations, including six municipalities and one private organisation, representing both rural and urban areas (302 questionnaires were returned, yielding a 65% response rate). The results showed that our hypothesis was supported and, when indirect effects were also taken into consideration, there was no direct effect of leadership style on quality of care. The mediated model explained 51% of the variance in quality of care. These results indicate that leadership style is important not only to employee outcomes in home help services but is also indirectly related to quality of care as assessed by staff members. PMID:24313819

  4. Interprofessional education in aged-care facilities: Tensions and opportunities among undergraduate health student cohorts.

    PubMed

    Annear, Michael; Walker, Kim; Lucas, Peter; Lo, Amanda; Robinson, Andrew

    2016-09-01

    This article examines the reflective discourses of medical, nursing, and paramedic students participating in interprofessional education (IPE) activities in the context of aged-care clinical placements. The intent of the research is to explore how students engage with their interprofessional colleagues in an IPE assessment and care planning activity and elucidate how students configure their role as learners within the context of a non-traditional aged-care training environment. Research participants included cohorts of volunteer medical (n = 61), nursing (n = 46), and paramedic (n = 20) students who were on clinical placements at two large teaching aged-care facilities in Tasmania, Australia, over a period of 18 months. A total of 39 facilitated focus group discussions were undertaken with cohorts of undergraduate student volunteers from three health professions between February 2013 and October 2014. Thematic analysis of focus group transcripts was assisted by NVIVO software and verified through secondary coding and member checking procedures. With an acceptable level of agreement across two independent coders, four themes were identified from student focus group transcripts that described the IPE relations and perceptions of the aged-care environment. Emergent themes included reinforcement of professional hierarchies, IPE in aged care perceived as mundane and extraneous, opportunities for reciprocal teaching and learning, and understanding interprofessional roles. While not all students can be engaged with IPE activities in aged care, our evidence suggests that within 1 week of clinical placements there is a possibility to develop reciprocal professional relations, affirm a positive identity within a collaborative healthcare team, and support the health of vulnerable older adults with complex care needs. These important clinical learnings support aged-care-based IPE as a potentially powerful context for undergraduate learning in the 21st Century. PMID

  5. National School-Age Child Care Alliance (NSACCA): National Survey Results. Draft Report.

    ERIC Educational Resources Information Center

    Marx, Fern

    Presenting preliminary results of a National School-Age Child Care Alliance study of child care providers, this report is an initial analysis of 250 out of 427 questionnaires received as of April, 1993, representing practitioners in 40 states and 180 cities. Tables present data from responses to 16 items on the questionnaire soliciting information…

  6. Association between age and use of intensive care among surgical Medicare beneficiaries

    PubMed Central

    Wunsch, Hannah; Gershengorn, Hayley B.; Guerra, Carmen; Rowe, John; Li, Guohua

    2013-01-01

    Purpose To determine the role age plays in use of intensive care for patients who have major surgery. Materials and Methods Retrospective cohort study examining the association between age and admission to an intensive care unit (ICU) for all Medicare beneficiaries aged 65 or older who had a hospitalization for one of five surgical procedures: esophagectomy, cystectomy, pancreaticoduodenectomy (PD), elective open abdominal aortic aneurysm repair (open AAA), and elective endovascular AAA repair (endo AAA) from 2004–08. The primary outcome was admission to an ICU. Secondary outcomes were complications and hospital mortality. We used multi-level mixed-effects logistic regression to adjust for other patient and hospital-level factors associated with each outcome. Results The percentage of hospitalized patients admitted to ICU ranged from 41.3% for endo AAA to 81.5% for open AAA. In-hospital mortality also varied, from 1.1% for endo AAA to 6.8% for esophagectomy. After adjusting for other factors, age was associated with admission to ICU for cystectomy (Adjusted Odds Ratio (AOR) 1.56 (95% CI 1.36–1.78) for age 80–84+; 2.25 (1.85–2.75) age 85+ compared with age 65–69), PD (AOR 1.26 (1.06–1.50) age 80–84; 1.49 (1.11–1.99) age 85+) and esophagectomy (AOR 1.26 (1.02–1.55) age 80–84; 1.28 (0.91–1.80) age 85+). Age was not associated with use of intensive care for open or endo AAA. Older age was associated with increases in complication rates and in-hospital mortality for all five surgical procedures. Conclusions The association between age and use of intensive care was procedure-specific. Complication rates and in-hospital mortality increased with age for all five surgical procedures. PMID:23787024

  7. Care through Authenticity: Teacher Preparation for an Ethic of Care in an Age of Accountability

    ERIC Educational Resources Information Center

    Rabin, Colette

    2013-01-01

    This study elucidates the role that authenticity--knowing and being one's self--plays in preservice teachers' introduction to care ethics in a multicultural urban context. In one teacher education program, in observations, interviews, and surveys, preservice teachers described that caring required authenticity to avoid complying with…

  8. Effectiveness in professional organizations: the impact of surgeons and surgical staff organizations on the quality of care in hospitals.

    PubMed Central

    Flood, A B; Scott, W R; Ewy, W; Forrest, W H

    1982-01-01

    In this research, we examine the relative importance of different structural units in a professional organization, the hospital, as they affect organizational effectiveness. The difficulties of measuring effectiveness in a complex professional organization are discussed, and an adjusted measure of surgical outcome is developed. Data are drawn from a prospective study of over 8,000 surgical patients treated by more than 500 surgeons in 15 hospitals throughout the nation. Two different types of analyses are presented, both indicating that hospital features have more impact on surgical outcomes than do surgeon characteristics. The second analysis assesses the relative importance of specific attributes of the hospital, surgical staff organization, and surgeon characteristics on surgical outcomes. PMID:7152960

  9. Exploring the Legacies of Filmed Patient Narratives: The Interpretation and Appropriation of Patient Films by Health Care Staff.

    PubMed

    Adams, Mary; Robert, Glenn; Maben, Jill

    2015-09-01

    We trace the legacies of filmed patient narratives that were edited and screened to encourage engagement with a participatory quality improvement project in an acute hospital setting in England. Using Gabriel's theory of "narrative contract," we examine the initial success of the films in establishing common grounds for participatory project and later, and more varied, interpretations of the films. Over time, the films were interpreted by staff as either useful sources of learning by critical reflection, dubious (invalid or unreliable) representations of patient experience, or as "closed" items available as auditable evidence of completed quality improvement work. We find these interpretations of the films to be shaped by the effect of social distance, the differential outcomes of project work, and changing organizational agendas. We consider the wider conditions of patient narrative as a form of quality improvement knowledge with immediate potency and fragile or fluid legitimacy over time. PMID:25576480

  10. Staff Development of Direct Care Workers in Pennsylvania: The Relationship between Organizational Structure and Culture and Best-Practices in Training

    ERIC Educational Resources Information Center

    Kemeny, M. Elizabeth

    2010-01-01

    Using the conceptual model of social structure and personality framework (House, 1981) as a theoretical guide, this cross sectional mixed-method design examined how organizational structure and culture relate to practices for training direct care workers in 328 aging and disability network service provider organizations in Pennsylvania. To…

  11. Gaps between policy, protocols and practice: a qualitative study of the views and practice of emergency ambulance staff concerning the care of patients with non-urgent needs

    PubMed Central

    Snooks, H; Kearsley, N; Dale, J; Halter, M; Redhead, J; Foster, J

    2005-01-01

    Aim: To describe emergency ambulance crews' views about (1) how they make decisions on whether to convey patients to hospital; (2) an intervention enabling them to triage patients to non-conveyance; and (3) their experience of using new protocols for undertaking such triage. Methods: Two focus groups were held at the outset of an evaluation of Treat and Refer (T&R) protocols: one with staff based at an ambulance station who were to implement the new service (intervention station), and the other with staff from a neighbouring station who would be continuing their normal practice during the study (control station). A third session was held with staff from the intervention station following training and 3 months' experience of protocol usage. Results: Before the introduction of the T&R protocols, crews reported experience, intuition, training, time of call during shift, patient preference, and home situation as influencing their decisions concerning conveyance. Crews were positive about changing practice but foresaw difficulties with advising patients who wanted to go to hospital, and with referral to other agencies. Following experience of T&R protocol use, crews felt they had needed more training than had been provided. Some felt their practice and job satisfaction had improved. Problems with referral and with persuading some patients that they did not need to go to hospital were discussed. There was consensus that the initiative should be introduced across the service. Conclusions: With crews generally positive about this intervention, an opportunity to tackle this difficult area of emergency care now exists. This study has, however, highlighted the complexity of the change in practice and service delivery, and professional and organisational constraints that need to be considered. PMID:16076788

  12. Staff Caricatures

    ERIC Educational Resources Information Center

    Templeton, Kristine

    2010-01-01

    This article describes how the author brings staff and students together through an art project that deals with caricatures. The author started with a lesson on caricature, and she made a PowerPoint presentation showcasing the work of Al Hirschfeld. Using photos of the staff, students created portraits and hung them in a main hallway after school.…

  13. Self-care and deviance in elementary school-age children.

    PubMed

    Pettine, A; Rosén, L A

    1998-08-01

    Fourth-, fifth- and sixth-grade students were surveyed to investigate whether self-care was related to self-reports of behavioral or attitudinal deviance, liking for school, or both. The Child Self-Care Measure (CSCM), a multiscale self-report instrument, measured self-care as a developmental task with four major dimensions: temporal, physical, structural, and psychological. Self-care in general was not linked to deviance. However, increases in psychological self-care were strongly correlated with reductions in children's liking for school. Additionally, children in self-care who cared for younger siblings for more than a year reported more deviant behaviors than those without responsibility for younger siblings; children in the care of older siblings less than 16 years old for more than 4 years reported more tolerance for deviance than peers in self-care without older sibling caregivers. Findings support earlier speculations that children in self-care may not be developmentally ready to take responsibility for elementary school-aged siblings. Results also indicated that although girls in self-care manifest problems earlier than boys, long term self-care may be more problematic for boys than girls. PMID:9696113

  14. Development and evaluation of the feasibility and effects on staff, patients, and families of a new tool, the Psychosocial Assessment and Communication Evaluation (PACE), to improve communication and palliative care in intensive care and during clinical uncertainty

    PubMed Central

    2013-01-01

    Background There are widespread concerns about communication and support for patients and families, especially when they face clinical uncertainty, a situation most marked in intensive care units (ICUs). Therefore, we aimed to develop and evaluate an interventional tool to improve communication and palliative care, using the ICU as an example of where this is difficult. Methods Our design was a phase I-II study following the Medical Research Council Guidance for the Development and Evaluation of Complex Interventions and the (Methods of Researching End-of-life Care (MORECare) statement. In two ICUs, with over 1900 admissions annually, phase I modeled a new intervention comprising implementation training and an assessment tool. We conducted a literature review, qualitative interviews, and focus groups with 40 staff and 13 family members. This resulted in the new tool, the Psychosocial Assessment and Communication Evaluation (PACE). Phase II evaluated the feasibility and effects of PACE, using observation, record audit, and surveys of staff and family members. Qualitative data were analyzed using the framework approach. The statistical tests used on quantitative data were t-tests (for normally distributed characteristics), the χ2 or Fisher’s exact test (for non-normally distributed characteristics) and the Mann–Whitney U-test (for experience assessments) to compare the characteristics and experience for cases with and without PACE recorded. Results PACE provides individualized assessments of all patients entering the ICU. It is completed within 24 to 48 hours of admission, and covers five aspects (key relationships, social details and needs, patient preferences, communication and information status, and other concerns), followed by recording of an ongoing communication evaluation. Implementation is supported by a training program with specialist palliative care. A post-implementation survey of 95 ICU staff found that 89% rated PACE assessment as very or

  15. Layout Improvement Study to Reduce Staff Walking Distance in a Large Health Care Facility: How to Not Walk an Extra 4740 Miles.

    PubMed

    Ley-Chavez, Adriana; Hmar-Lagroun, Tatiana; Douglas-Ntagha, Pamela; Cumbo, Charlotte L

    2016-01-01

    Inefficient facility layouts have been found to be a challenge in health care, with excessive walking adding to the demands of staff and creating delays, which can impact the quality of care. Minimizing unnecessary transportation during care delivery improves efficiency, reduces delays, and frees up resources for use on value-added activities. This article presents a methodology and application of facility design to improve responsiveness and efficiency at a large hospital. The approach described provides the opportunity to improve existing layouts in facilities in which the floor plan is already defined, but there is some flexibility to relocate key areas. The existing physical constraints and work flows are studied and taken into consideration, and the volume of traffic flow throughout the facility guides the decision of where to relocate areas for maximum efficiency. Details on the steps followed and general recommendations to perform the necessary process and data analyses are provided. We achieved a 34.8% reduction in distance walked (4740 miles saved per year) and a 30% reduction in floors traveled in elevators (344 931 floors, which translate to 842 hours spent using elevators) by relocating 4 areas in which frequently used resources are housed. PMID:27367214

  16. Impairment and Abuse of Elderly by Staff in Long-Term Care in Michigan: Evidence from Structural Equation Modeling

    ERIC Educational Resources Information Center

    Conner, Tom; Prokhorov, Artem; Page, Connie; Fang, Yu; Xiao, Yimin; Post, Lori A.

    2011-01-01

    Elder abuse in long-term care has become a very important public health concern. Recent estimates of elder abuse prevalence are in the range of 2% to 10% (Lachs & Pillemer, 2004), and current changes in population structure indicate a potential for an upward trend in prevalence (Malley-Morrison, Nolido, & Chawla, 2006; Post et al., 2006). More…

  17. Referral and Timing of Referral to Hospice Care in Nursing Homes: The Significant Role of Staff Members

    ERIC Educational Resources Information Center

    Welch, Lisa C.; Miller, Susan C.; Martin, Edward W.; Nanda, Aman

    2008-01-01

    Purpose: Given concerns about end-of-life care for many nursing home (NH) residents, this study sought to understand factors influencing hospice referral or nonreferral as well as timing of referral. Design and Methods: We conducted semistructured interviews with personnel from seven participating NHs and two hospices. We interviewed NH directors…

  18. A Fire Safety Certification System for Board and Care Operators and Staff. SBIR Phase II: Final Report.

    ERIC Educational Resources Information Center

    Walker, Bonnie L.

    This report describes Phase II of a project which developed a system for delivering fire safety training to board and care providers who serve adults with developmental disabilities. Phase II focused on developing and pilot testing a "train the trainers" workshop for instructors and field testing the provider's workshop. Evaluation of the 2-day…

  19. Prevalence of Behavior Disorder and Disturbance to Family and Staff in a Sample of Adult Day Health Care Clients.

    ERIC Educational Resources Information Center

    Teresi, Jeanne A.; Holmes, Douglas; Dichter, Elizabeth; Koren, Mary Jane; Ramirez, Mildred; Fairchild, Susan

    1997-01-01

    Reports on the prevalence of behavior disorders in a sample of residents (N=360) in adult day health care programs. Findings indicate relatively high rates of behavior disorders. Most prevalent were the affective disorders (seeking reassurance, depression, crying) and verbal-vocal agitation. Differences between formal and informal caregivers'…

  20. Factors that Influence Physical Activity in Long-Term Care: Perspectives of Residents, Staff, and Significant Others

    ERIC Educational Resources Information Center

    Benjamin, Kathleen; Edwards, Nancy; Guitard, Paulette; Murray, Mary Ann; Caswell, Wenda; Perrier, Marie Josee

    2011-01-01

    Physical activity has been linked to positive health outcomes for frail seniors. However, our understanding of factors that influence the physical activity of residents in the long-term care (LTC) setting is limited. This article describes our work with focus groups, one component of a multi-component study that examined factors influencing the…

  1. Current Practices for Training Staff to Accommodate Youth with Special Health Care Needs in the 4-H Camp Setting

    ERIC Educational Resources Information Center

    Mouton, Lauren; Bruce, Jacklyn

    2013-01-01

    The theory of inclusion is the foundation for the study reported here; inclusion is a focus not only of formal education, but also of nonformal educational settings such as 4-H. Ideally, 4-H camps are designed to serve youth of all backgrounds and abilities. By accommodating youth with special health care needs, 4-H camps are effectively meeting…

  2. The Education of Staff and Users for the Proper Handling and Care of Archival Materials: A RAMP Study with Guidelines.

    ERIC Educational Resources Information Center

    Ford, Helen

    The United Nations Educational, Scientific and Cultural Organization (UNESCO) Records and Archives Management Programme (RAMP) works primarily to help developing countries meet archive and record management needs. This study is intended to inform archivists, curators, and users in the proper handling and care of archival materials. The publication…

  3. A Descriptive Analysis of Incidents Reported by Community Aged Care Workers.

    PubMed

    Tariq, Amina; Douglas, Heather E; Smith, Cheryl; Georgiou, Andrew; Osmond, Tracey; Armour, Pauline; Westbrook, Johanna I

    2015-07-01

    Little is known about the types of incidents that occur to aged care clients in the community. This limits the development of effective strategies to improve client safety. The objective of the study was to present a profile of incidents reported in Australian community aged care settings. All incident reports made by community care workers employed by one of the largest community aged care provider organizations in Australia during the period November 1, 2012, to August 8, 2013, were analyzed. A total of 356 reports were analyzed, corresponding to a 7.5% incidence rate per client year. Falls and medication incidents were the most prevalent incident types. Clients receiving high-level care and those who attended day therapy centers had the highest rate of incidents with 14% to 20% of these clients having a reported incident. The incident profile indicates that clients on higher levels of care had higher incident rates. Incident data represent an opportunity to improve client safety in community aged care. PMID:25526960

  4. Increasing Public Awareness and Developing Community Based Strategies for Quality School-Age Child Care Initiatives.

    ERIC Educational Resources Information Center

    Zuber, Susan Way

    A framework for gaining community involvement in planning for school-age child care initiatives is reported. The framework incorporates a plan than could be used as a model for the involvement of the public school system. Four primary components are described: (1) a "Kids' Council" Saturday meeting in which third graders in school-age child care…

  5. You're All Grown up Now: Termination of Foster Care Support at Age 18

    ERIC Educational Resources Information Center

    Avery, Rosemary J.; Freundlich, Madelyn

    2009-01-01

    This article considers the repercussions of discharging youth from foster care at age 18 based on recent research demonstrating that youth at this age are not developmentally prepared to live independently and have a continued need for strong social scaffolding during emerging adulthood. Drawing upon recent research findings, we make…

  6. The Agelink Project Replication Manual: An Intergenerational School-Age Child-Care Program.

    ERIC Educational Resources Information Center

    Crites, Marsha; And Others

    Chapter 1 of this document introduces AgeLink, a 5-year model intergenerational child care project for school-age children. The project implemented after-school services that linked children with volunteer older adults in 17 western North Carolina counties. Ten sites participated in the project between 1984 and 1989, and 11 sites currently have…

  7. A Direction towards Sustainability? Australian Rural Communities and Care for the Aged.

    ERIC Educational Resources Information Center

    Lawrence, Geoffrey; Stehlik, Dani

    1996-01-01

    Rural elderly in Australia lack access to health and welfare services, compounded by an increasingly aging population and downsizing of services. Successful strategies can be found in U.S. retirement communities and the Australian Community Aged Care Package program. However, these strategies often compete with a drive toward cost-effectiveness.…

  8. Age equity in different models of primary care practice in Ontario

    PubMed Central

    Dahrouge, Simone; Hogg, William; Tuna, Meltem; Russell, Grant; Devlin, Rose Ann; Tugwell, Peter; Kristjansson, Elizabeth

    2011-01-01

    Abstract Objective To assess whether the model of service delivery affects the equity of the care provided across age groups. Design Cross-sectional study. Setting Ontario. Participants One hundred thirty-seven practices, including traditional fee-for-service practices, salaried community health centres (CHCs), and capitation-based family health networks and health service organizations. Main outcome measures To compare the quality of care across age groups using multilevel linear or logistic regressions. Health service delivery measures and health promotion were assessed through patient surveys (N = 5111), which were based on the Primary Care Assessment Tool, and prevention and chronic disease management were assessed, based on Canadian recommendations for care, through chart abstraction (N = 4 108). Results Older individuals reported better health service delivery in all models. This age effect ranged from 1.9% to 5.7%, and was larger in the 2 capitation-based models. Individuals aged younger than 30 years attending CHCs had more features of disadvantage (ie, living below the poverty line and without high school education) and were more likely than older individuals to report discussing at least 1 health promotion subject at the index visit. These differences were deemed an appropriate response to greater needs in these younger individuals. The prevention score showed an age-sex interaction in all models, with adherence to recommended care dropping with age for women. These results are largely attributable to the fact that maneuvers recommended for younger women are considerably more likely to be performed than other maneuvers. Chronic disease management scores showed an inverted U relationship with age in fee-for-service practices, family health networks, and health service organizations but not in CHCs. Conclusion The salaried model might have an organizational structure that is more conducive to providing appropriate care across age groups. The thrust toward

  9. Assessment of occupational radiation exposure among medical staff in health-care facilities in the Eastern Province, Kingdom of Saudi Arabia

    PubMed Central

    Salama, Khaled Fikry; AlObireed, Abdulrahman; AlBagawi, Mohammed; AlSufayan, Yuosef; AlSerheed, Mohammed

    2016-01-01

    Introduction: Radiation exposure poses hazards for health-care providers as well as patients in health-care facilities (HCFs). Radiographic imaging is extremely valuable as a diagnostic tool in medicine, but ionizing radiation and computed tomography (CT) scan carry well-known potential risks. Personnel and radiation safety monitoring is an important safety precaution in the practice of radiography. Aim: The study aimed to assess the occupational radiation exposure and safety protection among medical staff in HCFs in the Eastern Province, Kingdom of Saudi Arabia (KSA). Materials and Methods: Total of 4 HCFs with radiological services were randomly selected for the study in the period from January to April 2013. The radiation survey has been carried out by the measurement of radiation in the x-ray and CT-scan room at different points of the diagnostic, imaging, and waiting rooms of different hospitals. The radiation safety was assessed by using a questionnaire Results: The results of our study are surprising and alarming. Data revealed that there are a significant association between the levels of radiation exposure in all selected hospitals concerning imaging and waiting X-ray and CT-scan operating room (P < 0.01). For radiation safety, most hospitals have lead aprons and thyroid shields in place, but only about 50% have lead glasses and lead shields, showing that many hospitals still lack essential equipment. Moreover, actual utilization rate of radiation dosimeters are 57.7% and 68.9%, respectively. Conclusion: All medical staff as well as patients are at risk of exposure to x-ray and CT-scan radiation exposure, and the levels are exceeding the standard guidelines. Many hospitals still lack safety protection tools and there is a complete absence of radiation protection equipment. Further studies should be conducted to highlight different aspects of radiation exposure dose and safety protection tools. PMID:27390475

  10. Early child care and obesity at 12 months of age in the Danish National Birth Cohort

    PubMed Central

    Neelon, Sara E Benjamin; Andersen, Camilla Schou; Morgen, Camilla Schmidt; Kamper-Jørgensen, Mads; Oken, Emily; Gillman, Matthew W; Sørensen, Thorkild IA

    2014-01-01

    Background/Objectives Evidence suggests that the child care environment may be more obesogenic than the family home, and previous studies have found that child care use may be associated with obesity in children. Few studies, however, have focused on child care during infancy, which may be an especially vulnerable period. This study examined child care use in infancy and weight status at 12 months of age in a country where paid maternity leave is common and early child care is not as prevalent as in other developed countries. Subjects/Methods We studied 27821 children born to mothers participating in the Danish National Birth Cohort (DNBC), a longitudinal study of pregnant women enrolled between 1997 and 2002, who were also included in the Childcare Database, a national record of child care use in Denmark. The exposure was days in child care from birth to 12 months. The outcomes were sex-specific body mass index (BMI) z-score and overweight/obesity (BMI ≥85th percentile based on the World Health Organization classification) at 12 months. We conducted multivariable linear and logistic regression analyses examining child care use and weight outcomes. Results A total of 17721 (63.7%) children attended child care during their first year of life. After adjustment for potential confounders, a 30-day increment of child care was associated with a modestly higher BMI z-score at 12 months (0.03 units; 95% CI: 0.01, 0.05; p=0.003). Similarly, child care use was associated with increased odds of being overweight/obese at 12 months of age (OR 1.05; 95% CI: 1.01, 1.10; p=0.047). Conclusions Child care in the first year of life was associated with slightly higher weight at 12 months, suggesting that child care settings may be important targets for obesity prevention in infancy. PMID:25233894

  11. Differences in COPD Patient Care by Primary Family Caregivers: An Age-Based Study

    PubMed Central

    Hsiao, Peng-Ching; Chu, Chi-Ming; Sung, Pei-Yi; Perng, Wann-Cherng; Wang, Kwua-Yun

    2014-01-01

    Background Because Taiwan has the fastest aging rate among developed countries, care for the elderly is becoming more prominent in the country. Primary family caregivers play an important role in patient health and health promotion behavior. Chronic obstructive pulmonary disease (COPD), an age-related disease, is a major public health problem with high morbidity and mortality and can be a long-term burden for family members; however, little attention has been given to the differences in COPD care between elder caregivers and other caregivers. This study aimed to investigate the differences between elder family caregivers and non-elder family caregivers caring for COPD patients in Taiwan, including caring behavior, caregiver response, and caring knowledge. Methods This cross-sectional study was conducted between March 2007 and January 2008; 406 primary family caregivers of COPD patients from the thoracic outpatient departments of 6 hospitals in north-central Taiwan were recruited to answer questionnaires measuring COPD characteristics, care behavior, caregiver response, and COPD knowledge. All questionnaires, which addressed caregiver knowledge, care behaviors, and care reactions, were shown to have acceptable validity and reliability, and the data were analyzed using univariate and generalized linear model techniques. Results The elder caregivers group had 79 participants, and the non-elder caregivers comprised 327 participants. The COPD-related knowledge scale results were positively correlated with the family caregiver caring behavior scale, suggesting that better COPD-related knowledge among family caregivers may result in improved caring behavior. After adjusting for all possible confounding factors, the elder caregivers had significantly lower COPD-related knowledge than the non-elder caregivers (P<0.001). However, there were no significant differences in the family caregiver caring behavior scale or the caregiver reaction assessment scale between the two

  12. Integrating Telehealth Care-Generated Data With the Family Practice Electronic Medical Record: Qualitative Exploration of the Views of Primary Care Staff

    PubMed Central

    Davidson, Emma

    2013-01-01

    Background Telehealth care is increasingly being employed in the management of long-term illness. Current systems are largely managed via “stand-alone” websites, which require additional log-ons for clinicians to view their patients’ symptom records and physiological measurements leading to frustrating delays and sometimes failure to engage with the record. However, there are challenges to the full integration of patient-acquired data into family physicians’ electronic medical records (EMR) in terms of reliability, how such data can best be summarized and presented to avoid overload to the clinicians, and how clarity of responsibility is managed when multiple agencies are involved. Objective We aimed to explore the views of primary care clinicians on the acceptability, clinical utility, and, in particular, the benefits and risks of integrating patient-generated telehealth care data into the family practice EMR and to explore how these data should be summarized and presented in order to facilitate use in routine care. Methods In our qualitative study, we carried out semi-structured interviews with clinicians with experience of and naïve to telehealth care following demonstration of pilot software, which illustrated various methods by which data could be incorporated into the EMR. Results We interviewed 20 clinicians and found 2 overarching themes of “workload” and “safety”. Although clinicians were largely positive about integrating telehealth care data into the EMR, they were concerned about the potential increased workload and safety issues, particularly in respect to error due to data overload. They suggested these issues could be mitigated by good system design that summarized and presented data such that they facilitated seamless integration with clinicians’ current routine processes for managing data flows, and ensured clear lines of communication and responsibility between multiple professionals involved in patients’ care. Conclusions

  13. Interprofessional education in practice: Evaluation of a work integrated aged care program.

    PubMed

    Lawlis, Tanya; Wicks, Alison; Jamieson, Maggie; Haughey, Amy; Grealish, Laurie

    2016-03-01

    Health professional clinical education is commonly conducted in single discipline modes, thus limiting student collaboration skills. Aged care residential facilities, due to the chronic and complex health care needs of residents, provide an ideal placement to provide a collaborative experience. Interprofessional education is widely acknowledged as the pedagogical framework through which to facilitate collaboration. The aim of the evaluation was to assess student attitudes towards collaboration after active involvement in an interprofessional education program. Students studying nursing, occupational therapy, and aged care were invited to complete a version of the Readiness for Interprofessional Learning Scale before and after participating in a three-week pilot interprofessional program. A positive change in student attitudes towards other health professionals and the importance of working in interprofessional teams was reported with significant differences between two statements indicated: Learning with health-care students before qualifications would improve relationships after qualifications; and I learned a lot from the students from the other disciplines. The innovative pilot project was found to enhance student learning in interprofessional teams and the aged care environment. Further development of this and similar interprofessional programs is required to develop sustainable student projects that have health benefits for residents in aged care residential facilities. PMID:26733460

  14. Bridging the gap in ageing: Translating policies into practice in Malaysian Primary Care.

    PubMed

    Ambigga, Krishnapillai S; Ramli, Anis Safura; Suthahar, Ariaratnam; Tauhid, Norlaili; Clearihan, Lyn; Browning, Colette

    2011-01-01

    Population ageing is poised to become a major challenge to the health system as Malaysia progresses to becoming a developed nation by 2020. This article aims to review the various ageing policy frameworks available globally; compare aged care policies and health services in Malaysia with Australia; and discuss various issues and challenges in translating these policies into practice in the Malaysian primary care system. Fundamental solutions identified to bridge the gap include restructuring of the health care system, development of comprehensive benefit packages for older people under the national health financing scheme, training of the primary care workforce, effective use of electronic medical records and clinical guidelines; and empowering older people and their caregivers with knowledge, skills and positive attitudes to ageing and self care. Ultimately, family medicine specialists must become the agents for change to lead multidisciplinary teams and work with various agencies to ensure that better coordination, continuity and quality of care are eventually delivered to older patients across time and settings. PMID:21385446

  15. Bridging the gap in ageing: Translating policies into practice in Malaysian Primary Care

    PubMed Central

    2011-01-01

    Population ageing is poised to become a major challenge to the health system as Malaysia progresses to becoming a developed nation by 2020. This article aims to review the various ageing policy frameworks available globally; compare aged care policies and health services in Malaysia with Australia; and discuss various issues and challenges in translating these policies into practice in the Malaysian primary care system. Fundamental solutions identified to bridge the gap include restructuring of the health care system, development of comprehensive benefit packages for older people under the national health financing scheme, training of the primary care workforce, effective use of electronic medical records and clinical guidelines; and empowering older people and their caregivers with knowledge, skills and positive attitudes to ageing and self care. Ultimately, family medicine specialists must become the agents for change to lead multidisciplinary teams and work with various agencies to ensure that better coordination, continuity and quality of care are eventually delivered to older patients across time and settings. PMID:21385446

  16. Aging in Correctional Custody: Setting a Policy Agenda for Older Prisoner Health Care

    PubMed Central

    Stern, Marc F.; Mellow, Jeff; Safer, Meredith; Greifinger, Robert B.

    2012-01-01

    An exponential rise in the number of older prisoners is creating new and costly challenges for the criminal justice system, state economies, and communities to which older former prisoners return. We convened a meeting of 29 national experts in correctional health care, academic medicine, nursing, and civil rights to identify knowledge gaps and to propose a policy agenda to improve the care of older prisoners. The group identified 9 priority areas to be addressed: definition of the older prisoner, correctional staff training, definition of functional impairment in prison, recognition and assessment of dementia, recognition of the special needs of older women prisoners, geriatric housing units, issues for older adults upon release, medical early release, and prison-based palliative medicine programs. PMID:22698042

  17. Aging in correctional custody: setting a policy agenda for older prisoner health care.

    PubMed

    Williams, Brie A; Stern, Marc F; Mellow, Jeff; Safer, Meredith; Greifinger, Robert B

    2012-08-01

    An exponential rise in the number of older prisoners is creating new and costly challenges for the criminal justice system, state economies, and communities to which older former prisoners return. We convened a meeting of 29 national experts in correctional health care, academic medicine, nursing, and civil rights to identify knowledge gaps and to propose a policy agenda to improve the care of older prisoners. The group identified 9 priority areas to be addressed: definition of the older prisoner, correctional staff training, definition of functional impairment in prison, recognition and assessment of dementia, recognition of the special needs of older women prisoners, geriatric housing units, issues for older adults upon release, medical early release, and prison-based palliative medicine programs. PMID:22698042

  18. Aging skin is functionally anaerobic: importance of coenzyme Q10 for anti aging skin care.

    PubMed

    Prahl, S; Kueper, T; Biernoth, T; Wöhrmann, Y; Münster, A; Fürstenau, M; Schmidt, M; Schulze, C; Wittern, K-P; Wenck, H; Muhr, G-M; Blatt, T

    2008-01-01

    The functional loss of mitochondria represents an inherent part in modern theories trying to explain the cutaneous aging process. The present study shows significant age-dependent differences in mitochondrial function of keratinocytes isolated from skin biopsies of young and old donors. Our data let us postulate that energy metabolism shifts to a predominantly non-mitochondrial pathway and is therefore functionally anaerobic with advancing age. CoQ10 positively influences the age-affected cellular metabolism and enables to combat signs of aging starting at the cellular level. As a consequence topical application of CoQ10 is beneficial for human skin as it rapidly improves mitochondrial function in skin in vivo. PMID:19096122

  19. Critical action research applied in clinical placement development in aged care facilities.

    PubMed

    Xiao, Lily D; Kelton, Moira; Paterson, Jan

    2012-12-01

    The aim of this study was to develop quality clinical placements in residential aged care facilities for undergraduate nursing students undertaking their nursing practicum topics. The proportion of people aged over 65 years is expected to increase steadily from 13% in 2006 to 26% of the total population in Australia in 2051. However, when demand is increasing for a nursing workforce competent in the care of older people, studies have shown that nursing students generally lack interest in working with older people. The lack of exposure of nursing students to quality clinical placements is one of the key factors contributing to this situation. Critical action research built on a partnership between an Australian university and five aged care organisations was utilised. A theoretical framework informed by Habermas' communicative action theory was utilised to guide the action research. Multiple research activities were used to support collaborative critical reflection and inform actions throughout the action research. Clinical placements in eight residential aged care facilities were developed to support 179 nursing students across three year-levels to complete their practicum topics. Findings were presented in three categories described as structures developed to govern clinical placement, learning and teaching in residential aged care facilities. PMID:23134277

  20. Timely Access to Quality Health Care Among Georgia Children Ages 4 to 17 Years

    PubMed Central

    Ogbuanu, Chinelo; Goodman, David A.; Kahn, Katherine; Long, Cherie; Noggle, Brendan; Bagchi, Suparna; Barradas, Danielle; Castrucci, Brian

    2015-01-01

    We examined factors associated with children's access to quality health care, a major concern in Georgia, identified through the 2010 Title V Needs Assessment. Data from the 2007 National Survey of Children's Health were merged with the 2008 Area Resource File and Health Resources and Services Administration medically under-served area variable, and restricted to Georgia children ages 4–17 years (N = 1,397). The study outcome, access to quality health care was derived from access to care (timely utilization of preventive medical care in the previous 12 months) and quality of care (compassionate/culturally effective/family-centered care). Andersen's behavioral model of health services utilization guided independent variable selection. Analyses included Chi-square tests and multinomial logit regressions. In our study population, 32.8 % reported access to higher quality care, 24.8 % reported access to moderate quality care, 22.8 % reported access to lower quality care, and 19.6 % reported having no access. Factors positively associated with having access to higher/moderate versus lower quality care include having a usual source of care (USC) (adjusted odds ratio, AOR:3.27; 95 % confidence interval, 95 % CI 1.15–9.26), and special health care needs (AOR:2.68; 95 % CI 1.42–5.05). Lower odds of access to higher/moderate versus lower quality care were observed for non-Hispanic Black (AOR:0.31; 95 % CI 0.18–0.53) and Hispanic (AOR:0.20; 95 % CI 0.08–0.50) children compared with non-Hispanic White children and for children with all other forms of insurance coverage compared with children with continuous-adequate-private insurance. Ensuring that children have continuous, adequate insurance coverage and a USC may positively affect their access to quality health care in Georgia. PMID:23054451

  1. Do Effects of Early Child Care Extend to Age 15 Years? Results From the NICHD Study of Early Child Care and Youth Development

    PubMed Central

    Vandell, Deborah Lowe; Belsky, Jay; Burchinal, Margaret; Vandergrift, Nathan; Steinberg, Laurence

    2010-01-01

    Relations between nonrelative child care (birth to 4 ½ years) and functioning at age 15 were examined (N = 1364). Both quality and quantity of child care were linked to adolescent functioning. Effects were similar in size as those observed at younger ages. Higher quality care predicted higher cognitive-academic achievement at age 15, with escalating positive effects at higher levels of quality. The association between quality and achievement was mediated, in part, by earlier child care effects on achievement. Higher quality early child care also predicted youth reports of less externalizing behavior. More hours of nonrelative care predicted greater risk taking and impulsivity at age 15, relations that were partially mediated by earlier child care effects on externalizing behaviors. PMID:20573102

  2. Generational cohorts hold the key to understanding patients and health care providers: coming-of-age experiences influence health care behaviors for a lifetime.

    PubMed

    Berkowitz, Eric N; Schewe, Charles D

    2011-04-01

    The health care landscape is ever changing. Medical groups are experiencing challenges in recruiting staff, dealing with managing effective clinical teams, and tempering the growing tensions among partnerships and medical groups. Additionally, all clinicians report many patients are now approaching them differently than in the past. They come armed with medical information from the Internet and a more questioning attitude toward the clinician's directive for care. What accounts for these behavioral changes and management challenges within health care organizations? These issues may be best understood and addressed through generational cohort analysis. PMID:21590564

  3. Instrument development, data collection, and characteristics of practices, staff, and measures in the Improving Quality of Care in Diabetes (iQuaD) Study

    PubMed Central

    2011-01-01

    Background Type 2 diabetes is an increasingly prevalent chronic illness and an important cause of avoidable mortality. Patients are managed by the integrated activities of clinical and non-clinical members of primary care teams. This study aimed to: investigate theoretically-based organisational, team, and individual factors determining the multiple behaviours needed to manage diabetes; and identify multilevel determinants of different diabetes management behaviours and potential interventions to improve them. This paper describes the instrument development, study recruitment, characteristics of the study participating practices and their constituent healthcare professionals and administrative staff and reports descriptive analyses of the data collected. Methods The study was a predictive study over a 12-month period. Practices (N = 99) were recruited from within the UK Medical Research Council General Practice Research Framework. We identified six behaviours chosen to cover a range of clinical activities (prescribing, non-prescribing), reflect decisions that were not necessarily straightforward (controlling blood pressure that was above target despite other drug treatment), and reflect recommended best practice as described by national guidelines. Practice attributes and a wide range of individually reported measures were assessed at baseline; measures of clinical outcome were collected over the ensuing 12 months, and a number of proxy measures of behaviour were collected at baseline and at 12 months. Data were collected by telephone interview, postal questionnaire (organisational and clinical) to practice staff, postal questionnaire to patients, and by computer data extraction query. Results All 99 practices completed a telephone interview and responded to baseline questionnaires. The organisational questionnaire was completed by 931/1236 (75.3%) administrative staff, 423/529 (80.0%) primary care doctors, and 255/314 (81.2%) nurses. Clinical questionnaires were

  4. The Penna model for biological ageing on a lattice: spatial consequences of child-care

    NASA Astrophysics Data System (ADS)

    Sousa, A. O.; Moss de Oliveira, S.

    We introduce a square lattice into the Penna bit-string model for biological ageing and study the evolution of the spatial distribution of the population considering different strategies of child-care. Two of the strategies are related to the movements of a whole family on the lattice: in one case the mother cannot move if she has any child younger than a given age, and in the other case if she moves, she brings these young children with her. A stronger condition has also been added to the second case, considering that young children die with a higher probability if their mothers die, this probability decreasing with age. We show that a highly non uniform occupation can be obtained when child-care is considered, even for an uniform initial occupation per site. We also compare the standard survival rate of the model with that obtained when the spacial lattice is considered (without any kind of child-care).

  5. Design of Alarm Sound of Home Care Equipment Based on Age-related Auditory Sense

    NASA Astrophysics Data System (ADS)

    Shibano, Jun-Ichi; Tadano, Shigeru; Kaneko, Hirotaka

    A wide variety of home care equipment has been developed to support the independent lifestyle and care taking of elderly persons. Almost all of the equipment has an alarm designed to alert a care person or to sound a warning in case of an emergency. Due to the fact that aging human beings' senses physiologically, weaken and deteriorate, each alarm's sound must be designed to account for the full range of elderly person's hearing loss. Since the alarms are usually heard indoors, it is also necessary to evaluate the relationship between the basic characteristics of the sounds and living area's layout. In this study, we investigated the sounds of various alarms of the home care equipment based on both the age-related hearing characteristics of elderly persons and the propagation property of the sounds indoors. As a result, it was determined that the hearing characteristics of elderly persons are attuned to sounds which have a frequency from 700Hz to 1kHz, and it was learned that the indoor absorption ratio of sound is smallest when the frequency is 1kHz. Therefore, a frequency of 1kHz is good for the alarm sound of home care equipment. A flow chart to design the alarm sound of home care equipment was proposed, taking into account the extent of age-related auditory sense deterioration.

  6. Impediments to applying the 'dignity of risk' principle in residential aged care services.

    PubMed

    Ibrahim, Joseph E; Davis, Marie-Claire

    2013-09-01

    This discussion paper identifies four core factors currently impeding the application of the dignity of risk principle in residential aged care settings in Victoria, Australia: the fluctuating decision-making ability of residents; multiple participants in decision-making; discordance between espoused values and actions; and confusion and fear around legal responsibilities of care providers. Potential solutions identified include a conceptual shift in approach and consensus between key stakeholders, as well as more tangible solutions such as education and point-of-care decision support tools. PMID:24028460

  7. [Caring for healthy aging: building an educational process with rural women].

    PubMed

    Portella, M R

    1999-01-01

    This study analyses a proposal of nursing assistance. The project proposed has as its goal the construction of an educational process aiming a healthy aging among rural women. It is important to emphasize that these women's cultural health practices were taken into consideration in this research. The conceptual milestones adopted were drawn from Madeleine Leninger's concept of "cultural care" and Paulo Freire's pedagogical ideas. The educational process being proposed is based on the idea of caring/educating in which the nursing professional and the group share experiences through reflective dialog, and seek cultural health practices that can contribute on a healthy aging. PMID:12138632

  8. Older lesbians and work in the Australian health and aged care sector.

    PubMed

    Hughes, Mark; Kentlyn, Sujay

    2015-01-01

    While research has identified challenges lesbians face in the workplace, there is limited understanding of the particular experiences of older lesbians, especially those working in the health and aged care sector. This article draws on the stories of four women who participated in a narrative research project on lesbian and gay people's experiences of health and aged care. It highlights the need for future research to examine the complexity of identity expression and community affiliation, how people negotiate "coming out" in the workplace, the impact of discrimination, and the resources (such as friends) available to lesbians in the workplace. PMID:25575323

  9. Improving adjustments for older age in pre-hospital assessment and care.

    PubMed

    Rehn, Marius

    2013-01-01

    Population estimates projects a significant increase in the geriatric population making elderly trauma patients more common. The geriatric trauma patients experience higher incidence of pre-existing medical conditions, impaired age-dependent physiologic reserve, use potent drugs and suffer from trauma system related shortcomings that influence outcomes. To improve adjustments for older age in pre-hospital assessment and care, several initiatives should be implemented. Decision-makers should make system revisions and introduce advanced point-of-care initiatives to improve outcome after trauma for the elderly. PMID:23343340

  10. Keys to Quality in School-Age Child Care. Trainer's Guide for Using the Video and Viewer's Guides.

    ERIC Educational Resources Information Center

    Newman, Roberta L.

    Based on observations of hundreds of school-age child care programs across the nation and conversations with parents, children, and professionals in school-age care, this training guide is intended to help parents, caregivers, and interested citizens to develop quality school-age programs in their communities. The guide begins by summarizing an…

  11. In-house pureed food production in long-term care: perspectives of dietary staff and implications for improvement.

    PubMed

    Ilhamto, Nila; Anciado, Katrina; Keller, Heather H; Duizer, Lisa M

    2014-01-01

    Texture modification of foods to a pureed consistency is a common management approach for older adults with dysphagia. Long-term care (LTC) facilities commonly produce some pureed food in-house. This study investigated challenges and preferred practices associated with the production of pureed food in LTC facilities. Nutrition Managers (n = 27) and cooks (n = 26) from 25 Ontario LTC facilities were recruited for one-on-one, semistructured interviews. Interviews were digitally recorded, transcribed, and analyzed using inductive thematic analysis. Four themes arose from the data to exemplify challenges in production, including (a) difficulty in using standardized recipes, (b) varied interpretation of governmental guidelines, (c) lack of consistency in terminology and texture, and (d) wanting to improve the visual appeal. These challenges were reported to reduce the quality of in-house produced pureed food. Preferred practices to overcome these challenges were also provided by participants, such as involving cooks in pureed recipe improvements and tailoring to the specific needs of residents. Incorporation of these practices into pureed food production may help to shape and improve future practice and pureed food products. PMID:25105716

  12. The HIV Care Cascade Measured Over Time and by Age, Sex, and Race in a Large National Integrated Care System.

    PubMed

    Horberg, Michael Alan; Hurley, Leo Bartemeier; Klein, Daniel Benjamin; Towner, William James; Kadlecik, Peter; Antoniskis, Diana; Mogyoros, Miguel; Brachman, Philip Sigmund; Remmers, Carol Louise; Gambatese, Rebecca Claire; Blank, Jackie; Ellis, Courtney Georgiana; Silverberg, Michael Jonah

    2015-11-01

    HIV care cascades can evaluate programmatic success over time. However, methodologies for estimating cascade stages vary, and few have evaluated differences by demographic subgroups. We examined cascade performance over time and by age, sex, and race/ethnicity in Kaiser Permanente, providing HIV care in eight US states and Washington, DC. We created cascades for HIV+ members' age ≥13 for 2010-2012. We measured "linkage" (a visit/CD4 within 90 days of being diagnosed for new patients; ≥1 medical visit/year if established); "retention" (≥2 medical visits ≥60 days apart); filled ART (filled ≥3 months of combination ART); and viral suppression (HIV RNA <200 copies/mL last measured in year). The cascades were stratified by calendar year, sex, age, and race/ethnicity. We found men had statistically (p < 0.05) higher percent linkage, filled ART, and viral suppression for 2010 and 2011 but not for 2012. Women had significantly greater retention for all years. Annually, older age was associated (p < 0.05) with retention, filled ART, and viral suppression but not linkage. Latinos had greater (p < 0.05) retention than whites or blacks in all years, with similar retention comparing blacks and whites. Filled ART and viral suppression was increased (p < 0.05) for whites compared with all racial/ethnic groups in all years. Cascade methodology requiring success at upstream stages before measuring success at later stages (i.e., "dependent" methodology) underreported performance by up to 20% compared with evaluating each stage separately ("independent"). Thus, care results improved over time, but significant differences exist by patient demographics. Specifically, retention efforts should be targeted toward younger patients and blacks; women, blacks, and Latinos require greater ART prescribing. PMID:26505968

  13. Caring for Your School-Age Child: Ages 5 to 12. The Complete and Authorative Guide.

    ERIC Educational Resources Information Center

    Schor, Edward L., Ed.

    The middle years of childhood are challenging for both children and their parents, as children master skills and develop behaviors that will strongly influence their later health and well-being. This parenting manual offers up-to-date information and guidelines on key emotional, physical, and behavioral issues that parents of school-age children…

  14. Advance care planning for older people in Australia presenting to the emergency department from the community or residential aged care facilities.

    PubMed

    Street, Maryann; Ottmann, Goetz; Johnstone, Megan-Jane; Considine, Julie; Livingston, Patricia M

    2015-09-01

    The purpose of this retrospective, cross-sectional study was to determine the prevalence of advance care planning (ACP) among older people presenting to an Emergency Department (ED) from the community or a residential aged care facility. The study sample comprised 300 older people (aged 65+ years) presenting to three Victorian EDs in 2011. A total of 150 patients transferred from residential aged care to ED were randomly selected and then matched to 150 people who lived in the community and attended the ED by age, gender, reason for ED attendance and triage category on arrival. Overall prevalence of ACP was 13.3% (n = 40/300); over one-quarter (26.6%, n = 40/150) of those presenting to the ED from residential aged care had a documented Advance Care Plan, compared to none (0%, n = 0/150) of the people from the community. There were no significant differences in the median ED length of stay, number of investigations and interventions undertaken in ED, time seen by a doctor or rate of hospital admission for those with an Advance Care Plan compared to those without. Those with a comorbidity of cerebrovascular disease or dementia and those assessed with impaired brain function were more likely to have a documented Advance Care Plan on arrival at ED. Length of hospital stay was shorter for those with an Advance Care Plan [median (IQR) = 3 days (2-6) vs. 6 days (2-10), P = 0.027] and readmission lower (0% vs. 13.7%). In conclusion, older people from the community transferred to ED were unlikely to have a documented Advance Care Plan. Those from residential aged care who were cognitively impaired more frequently had an Advance Care Plan. In the ED, decisions of care did not appear to be influenced by the presence or absence of Advance Care Plans, but length of hospital admission was shorter for those with an Advance Care Plan. PMID:25443161

  15. IAServ: an intelligent home care web services platform in a cloud for aging-in-place.

    PubMed

    Su, Chuan-Jun; Chiang, Chang-Yu

    2013-11-01

    As the elderly population has been rapidly expanding and the core tax-paying population has been shrinking, the need for adequate elderly health and housing services continues to grow while the resources to provide such services are becoming increasingly scarce. Thus, increasing the efficiency of the delivery of healthcare services through the use of modern technology is a pressing issue. The seamless integration of such enabling technologies as ontology, intelligent agents, web services, and cloud computing is transforming healthcare from hospital-based treatments to home-based self-care and preventive care. A ubiquitous healthcare platform based on this technological integration, which synergizes service providers with patients' needs to be developed to provide personalized healthcare services at the right time, in the right place, and the right manner. This paper presents the development and overall architecture of IAServ (the Intelligent Aging-in-place Home care Web Services Platform) to provide personalized healthcare service ubiquitously in a cloud computing setting to support the most desirable and cost-efficient method of care for the aged-aging in place. The IAServ is expected to offer intelligent, pervasive, accurate and contextually-aware personal care services. Architecturally the implemented IAServ leverages web services and cloud computing to provide economic, scalable, and robust healthcare services over the Internet. PMID:24225647

  16. IAServ: An Intelligent Home Care Web Services Platform in a Cloud for Aging-in-Place

    PubMed Central

    Su, Chuan-Jun; Chiang, Chang-Yu

    2013-01-01

    As the elderly population has been rapidly expanding and the core tax-paying population has been shrinking, the need for adequate elderly health and housing services continues to grow while the resources to provide such services are becoming increasingly scarce. Thus, increasing the efficiency of the delivery of healthcare services through the use of modern technology is a pressing issue. The seamless integration of such enabling technologies as ontology, intelligent agents, web services, and cloud computing is transforming healthcare from hospital-based treatments to home-based self-care and preventive care. A ubiquitous healthcare platform based on this technological integration, which synergizes service providers with patients’ needs to be developed to provide personalized healthcare services at the right time, in the right place, and the right manner. This paper presents the development and overall architecture of IAServ (the Intelligent Aging-in-place Home care Web Services Platform) to provide personalized healthcare service ubiquitously in a cloud computing setting to support the most desirable and cost-efficient method of care for the aged-aging in place. The IAServ is expected to offer intelligent, pervasive, accurate and contextually-aware personal care services. Architecturally the implemented IAServ leverages web services and cloud computing to provide economic, scalable, and robust healthcare services over the Internet. PMID:24225647

  17. Planning for End-of-Life Care: Findings from the Canadian Study of Health and Aging

    ERIC Educational Resources Information Center

    Garrett, Douglas D.; Tuokko, Holly; Stajduhar, Kelli I.; Lindsay, Joan; Buehler, Sharon

    2008-01-01

    Steps involved in formalizing end-of-life care preferences and factors related to these steps are unclear in the literature. Using data from the third wave of the Canadian Study of Health and Aging (CSHA-3), we examined the relations between demographic and health predictors, on the one hand, and three outcomes, on the other (whether participants…

  18. Declines with Age in Childhood Asthma Symptoms and Health Care Use: An Adjustment for Evaluations

    ERIC Educational Resources Information Center

    Ko, Yi-An; Song, Peter X. K.; Clark, Noreen M.

    2014-01-01

    Rationale: Asthma is a variable condition with an apparent tendency for a natural decline in asthma symptoms and health care use occurring as children age. As a result, asthma interventions using a pre-post design may overestimate the intervention effect when no proper control group is available. Objectives: Investigate patterns of natural decline…

  19. Academic Achievement and Aging out of Care: Foster Parents' Perceptions

    ERIC Educational Resources Information Center

    Mack, Robert D.

    2012-01-01

    Foster children experience multiple barriers and challenges that, amongst other issues, prevent them from achieving academically. At the age of 18, foster youth are forced out of the Department of Children and Families care, leading many of them to become homeless or to return to the homes from which they were displaced. Scholarly literature and…

  20. Plotting Careers in Aged Care: Perspectives of Medical, Nursing, Allied Health Students and New Graduates

    ERIC Educational Resources Information Center

    Wray, Natalie; McCall, Louise

    2007-01-01

    The research reported in this article explored the impact of the undergraduate placement experience on medical, nursing, and allied health students' perceptions of careers in aged care. Data were collected from undergraduate students (48) and graduates (26) via individual (46) and group (7) interviews; data were thematically analyzed.…

  1. School-Age Child Care: Texas School District Involvement: A Report.

    ERIC Educational Resources Information Center

    Reid, Kristen; Temple, Judy

    With increasing numbers of parents at work or in training and education programs when children get out of school, the existence and quality of school-age child care (SACC) affects not only families, but the community as a whole. Texas school district involvement with SACC was examined, and qualities of model programs and barriers to developing…

  2. Development of a Typology of Dual-Earner Couples Caring for Children and Aging Parents

    ERIC Educational Resources Information Center

    Cullen, Jennifer C.; Hammer, Leslie B.; Neal, Margaret B.; Sinclair, Robert R.

    2009-01-01

    Using a national sample of 267 couples, the authors identify distinct profiles of dual-earner couples in the sandwiched generation (i.e., those caring for children and aging parents) using cluster analysis and then assess the relationship between these profiles and work-family conflict. The profiles are defined by characteristics of couples' child…

  3. Language, Literacy and Numeracy in National Training Packages: Case Studies in Aged Care and Hospitality.

    ERIC Educational Resources Information Center

    Haines, Christine; Brand, Jennie Bickmore

    The implementation and effectiveness of the inclusion of literacy and numeracy in industry training packages was examined in case studies of three programs in Western Australia. Two were certificate programs in cooking and food and beverage as specified in the hospitality training package, and the third was an aged care program based on the…

  4. Two-Dimensional Work: Workplace Literacy in the Aged Care and Call Centre Industries

    ERIC Educational Resources Information Center

    Waterhouse, Peter; Virgona, Crina

    2004-01-01

    A key challenge of Australia's vocational education and training (VET) system is to serve the broad needs of individuals, communities, and industries. This includes the provision of literacy and generic skills which meet the needs of all groups. This study investigates and documents workplace literacy in aged care facilities and call centres,…

  5. Deprescribing psychotropic medications in aged care facilities: the potential role of family members.

    PubMed

    Plakiotis, Christos; Bell, J Simon; Jeon, Yun-Hee; Pond, Dimity; O'Connor, Daniel W

    2015-01-01

    There is widespread concern in Australia and internationally at the high prevalence of psychotropic medication use in residential aged care facilities. It is difficult for nurses and general practitioners in aged care facilities to cease new residents' psychotropic medications when they often have no information about why residents were started on the treatment, when and by whom and with what result. Most existing interventions have had a limited and temporary effect and there is a need to test different strategies to overcome the structural and practical barriers to psychotropic medication cessation or deprescribing. In this chapter, we review the literature regarding psychotropic medication deprescribing in aged care facilities and present the protocol of a novel study that will examine the potential role of family members in facilitating deprescribing. This project will help determine if family members can contribute information that will prove useful to clinicians and thereby overcome one of the barriers to deprescribing medications whose harmful effects often outweigh their benefits. We wish to understand the knowledge and attitudes of family members regarding the prescribing and deprescribing of psychotropic medications to newly admitted residents of aged care facilities with a view to developing and testing a range of clinical interventions that will result in better, safer prescribing practices. PMID:25416108

  6. Status of School Age Child Care or Extended Day Programs in Minnesota Schools.

    ERIC Educational Resources Information Center

    Minnesota State Dept. of Education, St. Paul.

    This report is based upon survey responses from 139 school districts and 59 nonpublic schools in Minnesota that offer School Age Child Care (SACC), or extended day programs. The report presents data on public and private SACC programs related to: (1) administration and growth; (2) number of children served; (3) types of services offered; (4)…

  7. Latchkey Children and School-Age Child Care: A Background Briefing. Policy Issues.

    ERIC Educational Resources Information Center

    Fink, Dale B.

    This background briefing paper synthesizes current thinking and practice on the issue of latchkey children and school-age child care (SACC). The paper defines the problem of latchkey children; reviews related literature and programmatic responses to the problem; reports responses of four southern states; and points out implications for policy…

  8. School-Age Child Care: An Examination of Philosophical Priorities. Research in Early Childhood.

    ERIC Educational Resources Information Center

    Coleman, Mick; Wallinga, Charlotte; Toledo, Carlos

    1999-01-01

    School-age child care (SACC) is a relatively new social institution, and effective SACC programs must balance academic, recreational, and enrichment needs of child development. Outcomes of a study in two states to review program operations, staffing, activities, community involvement, and evaluation indicate that programs focus on academics and…

  9. Staff Development.

    ERIC Educational Resources Information Center

    Reusswig, James, Ed.; Ponzio, Richard, Ed.

    1980-01-01

    Eight essays are presented which reflect current problems, issues, and practices related to the development of teacher and administrator expertise. The authors are school district and public school administrators, faculty of schools of education, and a director of staff development in a state department of education. The topics treated are: (1)…

  10. Caring from Afar: Asian H1B Migrant Workers and Aging Parents.

    PubMed

    Lee, Yeon-Shim; Chaudhuri, Anoshua; Yoo, Grace J

    2015-09-01

    With the growth in engineering/technology industries, the United States has seen an increase in the arrival of highly skilled temporary migrant workers on H1B visas from various Asian countries. Limited research exists on how these groups maintain family ties from afar including caring for aging parents. This study explores the experiences and challenges that Asian H1B workers face when providing care from a distance. A total of 21 Chinese/Taiwanese, Korean, and Indian H1B workers participated in in-depth qualitative interviews. Key findings indicate that despite distance, caring relationships still continue through regular communications, financial remittances, and return visits, at the same time creating emotional, psychological, and financial challenges for the workers. Findings highlight the need for further research in understanding how the decline of aging parent's health impacts the migrants' adjustment and health in the United States. PMID:26267591

  11. Recruiting and Retaining Summer Staff.

    ERIC Educational Resources Information Center

    Crossen, Brian; Yerkes, Rita

    1998-01-01

    Recruiting of camp staff is challenged by economic and workplace restructuring, including business downsizing, part-time and temporary employment patterns, and generational attitude changes. Strategies for hiring and retaining staff include knowing what college-age workers want, marketing benefits, adopting new business strategies, and empowering…

  12. Educator Talk in Long Day Care Nurseries: How Context Shapes Meaning

    ERIC Educational Resources Information Center

    Torr, Jane; Pham, Lien

    2016-01-01

    Little is known about the quality and characteristics of the language used by childcare staff when interacting with infants in non-parental group care settings. This qualitative study analysed the manner in which staff used language when interacting with ten children aged between 9 and 20 months in four different long day care centres in Sydney,…

  13. A prospective study of long-term care institutionalization among the aged.

    PubMed

    Branch, L G; Jette, A M

    1982-12-01

    A statewide probability sample of 1,625 elders living in Massachusetts are studied prospectively to identify key determinants of long-term care (LTC) institutionalization. One-hundred forty-seven elders, 9 per cent of the original cohort, entered a LTC institution during the six-year investigation. Using logistic multiple regression, we examine the predictive power of 19 independent variables grouped into six categories: demographic characteristics, attitude, social context, long-term care needs, physical disability, and mental/emotional disability. Five variables are significantly related to institutionalization: advancing age, using ambulatory aids, mental disorientation, living alone, and using assistance to perform "instrumental" ADL (activities of daily living). These results may be helpful to those trying to target non-institutional services to elders for use as substitutes for institutional long-term care. They may also help explain why recent experimental tests of substituting non-institutional care for institutional services have been less than successful. PMID:6814269

  14. Multi-Age Caregiving. Beginnings Workshop.

    ERIC Educational Resources Information Center

    Katz, Lilian G.; Allison, Jeanette; Clark, Marty; Bergman, Roberta; Gainer, Sue

    1998-01-01

    Presents four articles on the benefits of multi-age child care settings as being similar to a natural family setting. The workshop titles are: "The Benefits of the Mix" (Katz); "Dealing with Staff and Parent Concerns" (Allison); "Multi-Age at Riverfield Country Day School" (Clark); and "Making Multi-Age Groups Work" (Bergman and Gainer). (LBT)

  15. Health care strategy for ensuring work ability in an aging Korea.

    PubMed

    Park, Jungsun; Park, Jong-Tae; Kim, Soo Geun; Yoo, Cheol-In; Son, Junseok; Yim, Jun; Kim, Dae-Seong; Rhee, Kyung Young; Kim, Yangho

    2016-01-01

    The rapid aging trend in South Korea will cause a growing shortage of labor and decreasing quality of the labor force. The purpose of this commentary is to recommend a health care strategy to maintain and promote the work ability of employees in an aging Korea. Strategies to promote the work ability require the collaboration of governmental agencies at the central and local levels. First, the common goal should be the reinforcement of follow-up measure in general medical examinations and the promotion of healthy lifestyles for workers. Second, collaborating activities should be performed among the Worker's Health Center, the Health Promotion Center, and community health centers. In conclusion, health care strategies for ensuring the work ability in an aging Korea require the collaboration of governmental agencies at the central and local levels. PMID:27610236

  16. Emerging issues on comprehensive hemophilia care: preventing, identifying, and monitoring age-related comorbidities.

    PubMed

    Coppola, Antonio; Santoro, Cristina; Franchini, Massimo; Mannucci, Caterina; Mogavero, Selene; Molinari, Angelo Claudio; Schinco, Piercarla; Tagliaferri, Annarita; Santoro, Rita Carlotta

    2013-10-01

    Life expectancy for persons with hemophilia (PWH) has considerably increased in the last decades as a direct result of the availability of modern therapies to control the clotting defect. Because their life expectancy now matches that of the general population, PWH are experiencing age-related comorbidities, such as, cardiovascular diseases, metabolic syndrome, renal diseases, sexuality issues, malignancies, and neurologic problems, that until recently have been rarely seen in this group of patients. In this article, we present a summary of the current knowledge on the aging PWH along with the clinical approaches that may be integrated into the routine comprehensive care of these patients for preventing, diagnosing, and monitoring age-related comorbidities. In general, patients with and without hemophilia should receive similar care, with close collaboration between the physician treating PWH and the specialty expert treating the comorbid disease. PMID:24014070

  17. Dental care for aging populations in Denmark, Sweden, Norway, United kingdom, and Germany.

    PubMed

    Holm-Pedersen, Poul; Vigild, Merete; Nitschke, Ina; Berkey, Douglas B

    2005-09-01

    This article reviews access to and financing of dental care for aging populations in selected nations in Europe. Old age per se does not seem to be a major factor in determining the use of dental services. Dentition status, on the other hand, is a major determinant of dental attendance. In addition to perceived need, a variety of social and behavioral factors as well as general health factors have been identified as determinants of dental service use. Frail and functionally dependent elderly have special difficulties in accessing dental care; private dental practitioners are hesitant to provide dental care to these patients. One reason may be that the fee for treating these patients is too low, considering high dental office expenses. Another reason may be problems related to management of medically compromised patients. This raises an important question: does inadequate training in geriatric dentistry discourage dentists from seeking opportunities to treat geriatric patients? Overall, the availability of dental services, the organization of the dental health care delivery system, and price subsidy for dental treatment are important factors influencing access to dental care among older people in Europe as well as in the United States. PMID:16141084

  18. Love stories: understanding the caring journeys of aged Greek-Australian carers.

    PubMed

    Horsfall, Debbie; Blignault, Ilse; Perry, Astrid; Antonopoulos, Penny

    2016-03-01

    This article documents the findings of a short-term longitudinal study that explored the caring journeys of aged Greek carers providing in-home care for their spouse. Through a deeper understanding of carers' decisions and decision-making and insights from service providers and community leaders, we aimed to inform policy makers, service managers and providers about how to develop and promote culturally appropriate support services, and negotiate them with carers and care recipients in a timely way. Initially, we conducted three focus groups and one follow-up forum with service providers and Greek community leaders. Then, over a 6-month period, we conducted two in-home interviews and two telephone interviews with 12 older Greek carers. We sought to understand factors influencing carers' decision-making regarding service uptake, and we provided information about services as required. Through our thematic analysis, we found that most carers wanted to remain as independent as possible and to avoid forced separation from the one they loved, through institutionalisation. They placed great value on their caring role which, while a struggle at times, gave them a sense of meaning, purpose and belonging. We also found that carers had great resourcefulness, strength and competence. They were all in long-term relationships, had negotiated coming to a foreign country and establishing themselves and were now in the process of negotiating old age and increasing frailty while at the same time providing care and support to family and friends. Our findings suggest that services need to be communicated in ways which support what carers value, not on outdated assumptions about cultural groups, otherwise providers will perpetuate exclusion. We propose an outreach in-home service model with an emphasis on ageing well and staying at home. This model of service provision is a model of care which emphasises relationships and community, and seeks to build social and cultural capital. PMID

  19. Age- and gender-related prevalence of multimorbidity in primary care: the swiss fire project

    PubMed Central

    2012-01-01

    Background General practitioners often care for patients with several concurrent chronic medical conditions (multimorbidity). Recent data suggest that multimorbidity might be observed more often than isolated diseases in primary care. We explored the age- and gender-related prevalence of multimorbidity and compared these estimates to the prevalence estimates of other common specific diseases found in Swiss primary care. Methods We analyzed data from the Swiss FIRE (Family Medicine ICPC Research using Electronic Medical Record) project database, representing a total of 509,656 primary care encounters in 98,152 adult patients between January 1, 2009 and July 31, 2011. For each encounter, medical problems were encoded using the second version of the International Classification of primary Care (ICPC-2). We defined chronic health conditions using 147 pre-specified ICPC-2 codes and defined multimorbidity as 1) two or more chronic health conditions from different ICPC-2 rubrics, 2) two or more chronic health conditions from different ICPC-2 chapters, and 3) two or more medical specialties involved in patient care. We compared the prevalence estimates of multimorbidity defined by the three methodologies with the prevalence estimates of common diseases encountered in primary care. Results Overall, the prevalence estimates of multimorbidity were similar for the three different definitions (15% [95%CI 11-18%], 13% [95%CI 10-16%], and 14% [95%CI 11-17%], respectively), and were higher than the prevalence estimates of any specific chronic health condition (hypertension, uncomplicated 9% [95%CI 7-11%], back syndrome with and without radiating pain 6% [95%CI 5-7%], non-insulin dependent diabetes mellitus 3% [95%CI 3-4%]), and degenerative joint disease 3% [95%CI 2%-4%]). The prevalence estimates of multimorbidity rose more than 20-fold with age, from 2% (95%CI 1-2%) in those aged 20–29 years, to 38% (95%CI 31-44%) in those aged 80 or more years. The prevalence estimates of

  20. Innovating team-based outpatient mental health care in the Veterans Health Administration: Staff-perceived benefits and challenges to pilot implementation of the Behavioral Health Interdisciplinary Program (BHIP).

    PubMed

    Barry, Catherine N; Abraham, Kristen M; Weaver, Kendra R; Bowersox, Nicholas W

    2016-05-01

    In the past decade, the demand for Veterans Health Administration (VHA) mental health care has increased rapidly. In response to the increased demand, the VHA developed the Behavioral Health Interdisciplinary Program (BHIP) team model as an innovative approach to transform VHA general outpatient mental health delivery. The present formative evaluation gathered information about pilot implementation of BHIP to understand the struggles and successes that staff experienced during facility transitions to the BHIP model. Using a purposive, nonrandom sampling approach, we conducted 1-on-1, semistructured interviews with 37 licensed and nonlicensed clinical providers and 13 clerical support staff assigned to BHIP teams in 21 facilities across the VHA. Interviews revealed that having actively involved facility mental health leaders, obtaining adequate staffing for teams to meet the requirements of the BHIP model, creating clear descriptions and expectations for team member roles within the BHIP framework, and allocating designated time for BHIP team meetings challenged many VHA sites but are crucial for successful BHIP implementation. Despite the challenges, staff reported that the transition to BHIP improved team work and improved patient care. Staff specifically highlighted the potential for the BHIP model to improve staff working relationships and enhance communication, collaboration, morale, and veteran treatment consistency. Future evaluations of the BHIP implementation process and BHIP team functioning focusing on patient outcomes, organizational outcomes, and staff functioning are recommended for fully understanding effects of transitioning to the BHIP model within VHA general mental health clinics and to identify best practices and areas for improvement. (PsycINFO Database Record PMID:27148949

  1. Age at adoption from institutional care as a window into the lasting effects of early experiences

    PubMed Central

    Julian, Megan M.

    2013-01-01

    One of the major questions of human development is how early experience impacts the course of development years later. Children adopted from institutional care experience varying levels of deprivation in their early life followed by qualitatively better care in an adoptive home, providing a unique opportunity to study the lasting effects of early deprivation and its timing. The effects of age at adoption from institutional care are discussed for multiple domains of social and behavioral development within the context of several prominent developmental hypotheses about the effects of early deprivation (cumulative effects, experience-expectant developmental programming, and experience-adaptive developmental programming). Age at adoption effects are detected in a majority of studies, particularly when children experienced global deprivation and were assessed in adolescence. For most outcomes, institutionalization beyond a certain age is associated with a step-like increase in risk for lasting social and behavioral problems, with the step occurring at an earlier age for children who experienced more severe levels of deprivation. Findings are discussed in terms of their concordance and discordance with our current hypotheses, and speculative explanations for the findings are offered. PMID:23576122

  2. An Institutional Staff Training and Self-Management Program for Developing Multiple Self-Care Skills in Severely/Profoundly Retarded Individuals.

    ERIC Educational Resources Information Center

    Kissel, Robert C.; And Others

    1983-01-01

    Staff were taught use of training and self-management skills through a sequence of written instructions, videotaped and live modeling, rehearsal, and videotaped feedback. Results indicated that staff learned to use the training skills appropriately and consistently, applied the skills in the generalization situations, and maintained skills with…

  3. Changing Care Staff Approaches to the Prevention and Management of Aggressive Behaviour in a Residential Treatment Unit for Persons with Mental Retardation and Challenging Behaviour.

    ERIC Educational Resources Information Center

    Allen, David; And Others

    1997-01-01

    Evaluation of a training procedure to improve staff skills in the preventative and reactive management of severely challenging behaviors in a small residential treatment unit found reduced (though not statistically significant) behavioral incidents, use of major reactive strategies (restraint and emergency medication), and staff and resident…

  4. Designing a Staff Development Program and Subsequent Handbook for Use at Woburn Nursing Center: A Long-Term Care Facility of Salter Healthcare Services.

    ERIC Educational Resources Information Center

    McKinnon, Cole; Capone, Martha

    Woburn Nursing Center (WNC), a private nursing home owned and operated by Salter Healthcare Services (SHS), developed an integrated, comprehensive staff development program and handbook. A literature review focused on staff needs, responsible agent, and handbook development. The following activities were undertaken: a review of ERIC documents,…

  5. Older adults' evaluations of middle-aged children's attempts to initiate discussion of care needs.

    PubMed

    Fowler, Craig; Fisher, Carla L; Pitts, Margaret J

    2014-01-01

    We explored how older adults evaluated the strategies used by an adult child to initiate discussion of future care needs, and subsequently, whether these judgments affected older adults' willingness to engage in discussions about eldercare if approached in a similar fashion by one of their own children. One hundred and thirty older adults were randomly assigned to read one of four scripts depicting efforts by a middle-aged daughter to raise the topic of future care needs with her mother by implementing a variety of facework behaviors. Scripts manipulated the degree to which the daughter conveyed respect for her mother's desires for autonomy (negative face) and connection (positive face). The daughter's facework significantly predicted older parents' evaluation of her as supportive, which in turn predicted their willingness to discuss future care needs with one of their own children if they were to approach the conversation in a similar way. PMID:24156501

  6. The elasticity of demand for health care in Burkina Faso: differences across age and income groups.

    PubMed

    Sauerborn, R; Nougtara, A; Latimer, E

    1994-06-01

    Like many other developing countries, Burkina Faso has been exploring how community resources can be tapped to co-finance health services. Although revenue generation is important for the viability of health services, effects on utilization and on equity of access to health care must also be considered. The authors present a logistic regression model to derive price elasticities of demand for health care based on cross-sectional survey data. While demand for health care appears inelastic overall (-0.79), subgroup analysis reveals differences in elasticity across age and income groups. Elasticities of demand for infants and children (-3.6 and -1.7) and for the lowest income quartile (-1.4) are substantially greater than overall elasticity. The method used is unusual in that it allows estimation of elasticities before the introduction of user fees. This increases the value of the information to policy makers. PMID:15726780

  7. Measuring the performance of electronic health records: a case study in residential aged care in Australia.

    PubMed

    Yu, Ping; Qian, Siyu; Yu, Hui; Lei, Jianbo

    2013-01-01

    Measuring the performance of electronic health records (EHR) is an important, yet un-resolved challenge. Various measurements have addressed different aspects of EHR success, yet a holistic, comprehensive measurement tool needs to be developed to capture the potential EHR success variables completely. A self-administered questionnaire survey instrument was developed based on the theoretical framework of the DeLone and McLean Information Systems Success Model. It measures nigh variables of EHR success: system quality, information quality, service quality, training, self efficacy, intention to use, use, user satisfaction and net benefits. The instrument was used to measure the performance of aged care EHR systems in three aged care organizations. The results suggest that the instrument was reliable. PMID:23920809

  8. Age and racial differences in the presentation and treatment of Generalized Anxiety Disorder in primary care.

    PubMed

    Brenes, Gretchen A; Knudson, Mark; McCall, W Vaughn; Williamson, Jeff D; Miller, Michael E; Stanley, Melinda A

    2008-10-01

    Despite the prevalence and impact of Generalized Anxiety Disorder (GAD) in the primary care setting, little is known about its presentation in this setting. The purpose of this study is to examine age and racial differences in the presentation and treatment of GAD in medical patients. Participants were recruited from one family medicine clinic and one internal medicine clinic. The prevalence of GAD was lowest for older adults. Age differences were found in the presentation of GAD, with young adults reporting greater cognitive symptoms of anxiety, negative affect, and depressive symptoms. African-Americans with GAD reported more positive affect and lower rates of treatment. The lower levels of negative affect and depressive symptoms reported among older adults may affect the recognition of GAD by primary care physicians. Further research is needed to better understand the causes of racial differences in treatment. PMID:18182275

  9. Medical care of children during the golden age of Islamic medicine.

    PubMed

    Modanlou, Houchang D

    2015-04-01

    During the Sassanid Empire in Persia (226-652 AD), there was a renaissance of humanistic sciences, including medicine, in the city of Gondi-Shapur. When the Islamic center of power moved to Baghdad in about 750 AD, physicians of Gondi-Shapur, including the dean of the medical school (a Nestorian Christian), gradually moved to Baghdad constructing hospitals and medical schools. Aided by the Persian and Nestorian Christians, the Islamic civilization ushered in what is considered to be the Golden Age of Islam from the 8th to 13th century AD. During this period, there were remarkable achievements in humanistic sciences including medicine by many physicians/authors whose medical textbooks were used for centuries in burgeoning medical schools in Europe. The medical texts written during the Golden Age of Islamic Medicine contain sections and chapters about the clinical conditions, diseases and medical care of children. It was during this era that the first treatise was written on the diseases of children and their care. This essay will describe, in brief, the writings about the conditions and diseases of children and their medical care, by three prominent Persian physicians of the Golden Age of Islamic Medicine: 1) Abubakr Muhammad Ibn Zakaria Razi, Rhazes (865-925 AD); 2) Ali ibn-al-Abbas al-Majusi or Haly Abbas (949-994 AD); and 3)  Abu Ali al-Husayn ibn Abd Allah ibn Sina or Avicenna (980-1037 AD). PMID:25841951

  10. How Do Early Childhood Education Teachers Perceive Their Expertise? A Qualitative Study of Child Care Providers in Lapland, Finland

    ERIC Educational Resources Information Center

    Happo, Iiris; Maatta, Kaarina; Uusiautti, Satu

    2013-01-01

    Every preschool age child in Finland has the right to child care. Well-educated staff consists of all-round experts who work in versatile contexts with various children in a multi-professional collaboration. This staff is one of the strengths of the Finnish child care system. The aim of this article is to clarify the expertise of those early…

  11. NICU staff

    MedlinePlus

    ... a professional who supports mothers and babies with breastfeeding and, in the NICU, supports mothers with expressing ... Pediatric Critical Care . 4th ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 1.

  12. Declines with Age in Childhood Asthma Symptoms and Health Care Use. An Adjustment for Evaluations

    PubMed Central

    Ko, Yi-An; Clark, Noreen M.

    2014-01-01

    Rationale: Asthma is a variable condition with an apparent tendency for a natural decline in asthma symptoms and health care use occurring as children age. As a result, asthma interventions using a pre-post design may overestimate the intervention effect when no proper control group is available. Objectives: Investigate patterns of natural decline over time with increasing age in asthma symptoms and health care use of children. Develop a statistical procedure that enables adjustment that accounts for expected declines in these outcomes and is useable when intervention evaluations must rely solely on pre-post data. Methods: Mixed-effects models with mixture distributions were used to describe the pattern of symptoms and health care use in 3,021 children aged 2 to 15 years in a combined sample from three controlled trials. An adaptive least squares estimation was used to account for overestimation of intervention effects and make adjustments for pre-post only data. Termed “Adjustment for Natural Declines in Asthma Outcomes (ANDAO),” the adjustment method uses bootstrap sampling to create control cohorts comparable to subjects in the intervention study from existing control subjects. ANDAO accounts for expected declines in outcomes and is beneficial when intervention evaluations must rely solely on pre-post data. Measurements and Main Results: Children under 10 years of age experienced 18% (95% confidence interval, 15–21%) fewer symptom days and 28% (95% confidence interval, 24–32%) fewer symptom nights with each additional year of age. The decline was less than 10% after age 10 years, depending on baseline asthma severity. Emergency department visits declined regardless of baseline symptom frequency (P = 0.02). The adjustment method corrected estimates to within 2.4% of true effects through simulations using control cohorts. Conclusions: Because of the declines in symptoms and health care use expected with increasing age of children with asthma, pre

  13. Age differences in treatment response to a collaborative care intervention for anxiety disorders*†

    PubMed Central

    Wetherell, Julie Loebach; Petkus, Andrew J.; Thorp, Steven R.; Stein, Murray B.; Chavira, Denise A.; Campbell-Sills, Laura; Craske, Michelle G.; Sherbourne, Cathy; Bystritsky, Alexander; Sullivan, Greer; Roy-Byrne, Peter

    2013-01-01

    Background Some data suggest that older adults with anxiety disorders do not respond as well to treatment as do younger adults. Aims We examined age differences in outcomes from the Coordinated Anxiety Learning and Management (CALM) study, an effectiveness trial comparing usual care to a computer-assisted collaborative care intervention for primary care patients with panic disorder, generalised anxiety disorder, post-traumatic stress disorder (PTSD), and/or social anxiety disorder. This is the first study to examine the efficacy of a collaborative care intervention in a sample that included both younger and older adults with anxiety disorders. We hypothesised that older adults would show a poorer response to the intervention than younger adults. Method We examined findings for the overall sample, as well as within each diagnostic category (clinicaltrials.gov identifier: NCT00347269). Results The CALM intervention was more effective than usual care among younger adults overall and for those with generalised anxiety disorder, panic disorder and social anxiety disorder. Among older adults, the intervention was effective overall and for those with social anxiety disorder and PTSD but not for those with panic disorder or generalised anxiety disorder. The effects of the intervention also appeared to erode by the 18-month follow-up, and there were no significant effects on remission among the older adults. Conclusions These results are consistent with the findings of other investigators suggesting that medications and psychotherapy for anxiety disorders may not be as effective for older individuals as they are for younger people. PMID:23580378

  14. Incorporating Palliative Care Concepts Into Nutrition Practice: Across the Age Spectrum.

    PubMed

    Schwartz, Denise Baird; Olfson, Kristina; Goldman, Babak; Barrocas, Albert; Wesley, John R

    2016-06-01

    A practice gap exists between published guidelines and recommendations and actual clinical practice with life-sustaining treatments not always being based on the patient's wishes, including the provision of nutrition support therapies. Closing this gap requires an interdisciplinary approach that can be enhanced by incorporating basic palliative care concepts into nutrition support practice. In the fast-paced process of providing timely and effective medical treatments, communication often suffers and decision making is not always reflective of the patient's quality-of-life goals. The current healthcare clinical ethics model does not yet include optimum use of advance directives and early communication between patients and family members and their healthcare providers about treatment choices, including nutrition support. A collaborative, proactive, integrated process in all healthcare facilities and across levels of care and age groups, together with measurable sustained outcomes, shared best practices, and preventive ethics, will be needed to change the culture of care. Implementation of a better process, including basic palliative care concepts, requires improved communication skills by healthcare professionals. Formalized palliative care consults are warranted early in complex cases. An education technique, as presented in this article, of how clinicians can engage in critical and crucial conversations early with patients and family members, by incorporating the patient's values and cultural and religious diversity in easily understood language, is identified as an innovative tool. PMID:26888858

  15. The prevention and management of constipation in older adults in a residential aged care facility.

    PubMed

    Grieve, Jennifer

    2006-03-01

    The need to implement programs for developing leadership and practice improvement skills using an evidence-based practice approach to practice change is becoming more apparent in the health and aged care services. This is no more apparent than in high care residential health and aged care services, where health professionals are increasingly required to provide care for older people with multifocal and complex healthcare needs. This paper describes one of the projects undertaken as part of the Joanna Briggs Institute Commonwealth Department of Health and Ageing Clinical Aged Care Fellowship program from February 2005 to June 2005. This purpose of this particular project was twofold. First it sought to improve the local practice in the prevention and management of constipation and that this practice was performed according to the best available evidence. Second to use the Joanna Briggs Institute Practical Application of Clinical Guidance (PACES) program to implement a process of audit and feedback as a strategy to improve practice. The project was designed to link in with the facility's existing quality improvement program and better practice continence management project. The project was conducted over 6 months and was divided into six stages involving the identification of evidence-based standards of care, an initial audit to determine appropriate sample size, a clinical audit across the facility, planning of the implementation process, implementation of the action plan and re-audit to assess practice change. Overall, the results were extremely positive and demonstrated a real improvement in practice relating to constipation in the project facility. This success, however, needs to be seen in the context of the benefits of having the support of senior management, an existing quality improvement and continence management better practice project, and a culture of clinical review. Although there will always be more work to be done, the success of this project can be

  16. Improving staff selection processes.

    PubMed

    Cerinus, Marie; Shannon, Marina

    2014-11-11

    This article, the second in a series of articles on Leading Better Care, describes the actions undertaken in recent years in NHS Lanarkshire to improve selection processes for nursing, midwifery and allied health professional (NMAHP) posts. This is an area of significant interest to these professions, management colleagues and patients given the pivotal importance of NMAHPs to patient care and experience. In recent times the importance of selecting staff not only with the right qualifications but also with the right attributes has been highlighted to ensure patients are well cared for in a safe, effective and compassionate manner. The article focuses on NMAHP selection processes, tracking local, collaborative development work undertaken to date. It presents an overview of some of the work being implemented, highlights a range of important factors, outlines how evaluation is progressing and concludes by recommending further empirical research. PMID:25370266

  17. A Systematic Approach to Child Care Regulatory Review, Policy Evaluation and Planning To Promote Health and Safety of Children in Child Care: A Manual for State and Local Child Care and Maternal and Child Health Agency Staff.

    ERIC Educational Resources Information Center

    Griffin, Abbey; Fiene, Richard

    This manual is written for state and local administrators and statewide child care and child health organizations looking for ways to improve the efficiency and effectiveness of their child care regulatory review, rule-making process, and enforcement system. Data collection procedures and a review team process, state administrators can identify…

  18. Parental perspectives regarding primary-care weight-management strategies for school-age children.

    PubMed

    Turer, Christy Boling; Mehta, Megha; Durante, Richard; Wazni, Fatima; Flores, Glenn

    2016-04-01

    To identify parental perspectives regarding weight-management strategies for school-age children, focus groups were conducted of parents of overweight and obese (body mass index ≥ 85th percentile) 6-12-year-old children recruited from primary-care clinics. Questions focused on the role of the primary-care provider, effective components of weight-management strategies and feasibility of specific dietary strategies. Focus groups were recorded, transcribed and analysed using margin coding and grounded theory. Six focus groups were held. The mean age (in years) for parents was 32, and for children, eight; 44% of participants were Latino, 33%, African-American and 23%, white. Parents' recommendations on the primary-care provider's role in weight management included monitoring weight, providing guidance regarding health risks and lifestyle changes, consistent follow-up and using discretion during weight discussions. Weight-management components identified as key included emphasising healthy lifestyles and enjoyment, small changes to routines and parental role modelling. Parents prefer guidance regarding healthy dietary practices rather than specific weight-loss diets, but identified principles that could enhance the acceptability of these diets. For dietary guidance to be feasible, parents recommended easy-to-follow instructions and emphasising servings over counting calories. Effective weight-management strategies identified by parents include primary-care provider engagement in weight management, simple instructions regarding healthy lifestyle changes, parental involvement and deemphasising specific weight-loss diets. These findings may prove useful in developing primary-care weight-management strategies for children that maximise parental acceptance. PMID:24720565

  19. Comparison of patients’ age receiving therapeutic services in a cleft care team in Isfahan

    PubMed Central

    Soheilipour, Saeed; Soheilipour, Fatemeh; Derakhshandeh, Fatemeh; Hashemi, Hedieh; Memarzadeh, Mehrdad; Salehiniya, Hamid; Soheilipour, Fahimeh

    2016-01-01

    Background: Due to numerous difficulties in patients suffering from varieties of cleft lip and palate, their therapeutic management involves interdisciplinary teamwork. This study was conducted to compare the age of commencing treatments such as speech therapy, secondary palate and alveolar bone grafting and orthodontics between those who sought treatment early and late. Materials and Methods: In this retrospective study, 260 files of patients with cleft lip and palate based on their age at the time of admission to a cleft care team were divided into two groups: The early admission and late admission. Both groups compared based on four variables including the mean age of beginning speech therapy, palatal secondary surgery, alveolar bone grafting, and receiving orthodontics using t-test. Results: Based on the results, among 134 patients admitted for speech therapy, the mean age of initiating speech therapy in early clients was 3.3 years, and in the late ones was 9 years. Among 47 patients with secondary surgery, the mean age in early clients was 3.88 years, and in the late clients was 15.7 years. Among 17 patients with alveolar bone grafting, the mean age in the first group was 9 years, and in the other was 16.69 years. Among 24 patients receiving orthodontic services, the mean age in early clients was 7.66 years, and in the second group was 17.05 years. Conclusion: There was a significant difference between the age of performing secondary surgery and alveolar bone grafting and the age of beginning speech therapy and receiving orthodontic services in early references and late references to the team. PMID:27274350

  20. Differences in selected medical care parameters in rheumatic disease ward patients of different ages of life

    PubMed Central

    Pobrotyn, Piotr; Susło, Robert; Milczanowski, Piotr; Drobnik, Jarosław

    2016-01-01

    Introduction Rheumatic diseases are becoming more and more common in Poland with the ageing of the population. Nearly 18% of the total hospital admissions in Poland result from rheumatic diseases, which was equivalent to 350 thousand cases in the year 2008. These diseases tend to last for many decades, decreasing both the quality of life and income of the patients as well as increasing the medical institutions’ workload and society's financial burden. The aim of the study was to determine whether the medical care parameters in a rheumatic disease hospital ward show any significant differences among different patient age groups – especially such that would support taking them into account as a basis for adjusting the financial coverage level of medical services. Material and methods Data on hospitalizations at the Rheumatic Diseases Ward of Wroclaw University Hospital in Wroclaw in the years 2009–2015 were analyzed, taking into account the age groups, number of hospital admissions, their duration and causes. Relevant statistical data analysis was performed. Discussion The study revealed that the number of old patients hospitalized at the rheumatic diseases ward increased over the last 6 years and that such statistically significant differences do exist: on average the old patients not only tend to stay much longer at the hospital, but also suffer from a different and more diverse spectrum of diseases in comparison to their younger counterparts. Conclusions The detected differences in medical care parameters support the need for more individualized medical care and increased cost of the hospital stay in the case of older patients. Consequently, those factors justify the necessity to increase the value of medical services in the case of old patients, possibly also taking into account the variation between age subgroups. PMID:27407280

  1. An alternate technique of care using silver fluoride followed by stannous fluoride in the management of root caries in aged care.

    PubMed

    Deutsch, Alan

    2016-03-01

    An alternate technique of care to prevent, arrest and manage root caries using aqueous silver fluoride followed by stannous fluoride (AgF+SnF2 ) in aged care is demonstrated by three case studies. With increasing age, the inability to maintain ones own oral care from dementia, illness or frailty and polypharmacy induced salivary gland hypofunction will result in dental caries becoming a progessively greater burden for the elderly. Future generations of elders will live longer and need to maintain many more teeth longer than earlier generations. Both silver diamine fluoride (SDF)and AgF+SnF2 arrest and prevent caries and are easy to use in residential aged care facilities. Clinical differences between SDF and AgF+SnF2 are discussed. However, in aged care, AgF+SnF2 may offer advantages over SDF. AgF+SnF2 used to arrest and prevent caries in children can be modified to provide effective but minimally invasive care for an ageing and frail population. These techniques are rapid, inexpensive and nonthreatening suited to treat frail elders, dementia patients exhibiting challenging behaviours and patients with multiple rapidly progressing decay. Silver fluoride, applied before placing glass-ionomer cement (GIC) restorations is an important adjunct to the atraumatic restorative technique and may retard caries reactivation more than GIC used alone. PMID:26687774

  2. The Impact of Age on Retention in Care and Viral Suppression

    PubMed Central

    Yehia, Baligh R.; Rebeiro, Peter; Althoff, Keri N.; Agwu, Allison L.; Horberg, Michael A.; Samji, Hasina; Napravnik, Sonia; Mayer, Kenneth; Tedaldi, Ellen; Silverberg, Michael J.; Thorne, Jennifer E.; Burchell, Ann N.; Rourke, Sean B.; Rachlis, Anita; Mayor, Angel; Gill, M. John; Zinski, Anne; Ohl, Michael; Anastos, Kathryn; Abraham, Alison G.; Kitahata, Mari M.; Moore, Richard D.; Gebo, Kelly A.

    2014-01-01

    Background Retention in care is important for all HIV-infected persons and is strongly associated with initiation of antiretroviral therapy and viral suppression. However, it is unclear how retention in care and age interact to effect viral suppression. We evaluated whether the association between retention and viral suppression differed by age at entry into care. Methods Cross-sectional analysis (2006-2010) involving 17,044 HIV-infected adults in 14 clinical cohorts across the U.S. and Canada. Patients contributed one year of data during their first full calendar year of clinical observation. Poisson regression examined associations between retention measures [U.S. National HIV/AIDS Strategy (NHAS), U.S. Department of Health and Human Services (DHHS), 6-month gap, and 3-month visit constancy] and viral suppression (HIV RNA ≤200 copies/mL) by age group: 18-29, 30-39, 40–49, 50–59, and ≥60 years old. Results Overall, 89% of patients were retained in care using the NHAS measure, 74% with the DHHS indicator, 85% did not have a 6-month gap, and 62% had visits in 3-4 quarters of the year; 54% achieved viral suppression. For each retention measure, the association with viral suppression was significant for only the younger age groups (18-29 and 30-39 years): 18-29 [adjusted prevalence ratio (APR)=1.33, 95% confidence interval (CI)=1.03-1.70]; 30-39 (APR=1.23, CI=1.01-1.49); 40-49 (APR=1.06, CI=0.90-1.22); 50-59 (APR=0.92, CI=0.75-1.13); ≥60 years (APR=0.99, CI=0.63-1.56) using the NHAS measure as a representative example. Conclusions These results have important implications for improving viral control among younger adults, emphasizing the crucial role retention in care plays in supporting viral suppression in this population. PMID:25559604

  3. Future challenges for clinical care of an ageing population infected with HIV: a modelling study

    PubMed Central

    Smit, Mikaela; Brinkman, Kees; Geerlings, Suzanne; Smit, Colette; Thyagarajan, Kalyani; Sighem, Ard van; de Wolf, Frank; Hallett, Timothy B

    2015-01-01

    Summary Background The population infected with HIV is getting older and these people will increasingly develop age-related non-communicable diseases (NCDs). We aimed to quantify the scale of the change and the implications for HIV care in the Netherlands in the future. Methods We constructed an individual-based model of the ageing HIV-infected population, which followed patients on HIV treatment as they age, develop NCDs—including cardiovascular disease (hypertension, hypercholesterolaemia, myocardial infarctions, and strokes), diabetes, chronic kidney disease, osteoporosis, and non-AIDS malignancies—and start co-medication for these diseases. The model was parameterised by use of data for 10 278 patients from the national Dutch ATHENA cohort between 1996 and 2010. We made projections up to 2030. Findings Our model suggests that the median age of HIV-infected patients on combination antiretroviral therapy (ART) will increase from 43·9 years in 2010 to 56·6 in 2030, with the proportion of HIV-infected patients aged 50 years or older increasing from 28% in 2010 to 73% in 2030. In 2030, we predict that 84% of HIV-infected patients will have at least one NCD, up from 29% in 2010, with 28% of HIV-infected patients in 2030 having three or more NCDs. 54% of HIV-infected patients will be prescribed co-medications in 2030, compared with 13% in 2010, with 20% taking three or more co-medications. Most of this change will be driven by increasing prevalence of cardiovascular disease and associated drugs. Because of contraindications and drug–drug interactions, in 2030, 40% of patients could have complications with the currently recommended first-line HIV regimens. Interpretation The profile of patients in the Netherlands infected with HIV is changing, with increasing numbers of older patients with multiple morbidities. These changes mean that, in the near future, HIV care will increasingly need to draw on a wide range of medical disciplines, in addition to evidence

  4. Population ageing and wellbeing: lessons from Japan's long-term care insurance policy.

    PubMed

    Tamiya, Nanako; Noguchi, Haruko; Nishi, Akihiro; Reich, Michael R; Ikegami, Naoki; Hashimoto, Hideki; Shibuya, Kenji; Kawachi, Ichiro; Campbell, John Creighton

    2011-09-24

    Japan's population is ageing rapidly because of long life expectancy and a low birth rate, while traditional supports for elderly people are eroding. In response, the Japanese Government initiated mandatory public long-term care insurance (LTCI) in 2000, to help older people to lead more independent lives and to relieve the burdens of family carers. LTCI operates on social insurance principles, with benefits provided irrespective of income or family situation; it is unusually generous in terms of both coverage and benefits. Only services are provided, not cash allowances, and recipients can choose their services and providers. Analysis of national survey data before and after the programme started shows increased use of formal care at lower cost to households, with mixed results for the wellbeing of carers. Challenges to the success of the system include dissatisfaction with home-based care, provision of necessary support for family carers, and fiscal sustainability. Japan's strategy for long-term care could offer lessons for other nations. PMID:21885099

  5. Integrating Web-Based Applications into Aged Care: Two Case Studies and Discussion.

    PubMed

    Rehm, Imogen C; Musić, Selma; Carlsson, Anthony; Scanlan, Faye; Silver, Mark; Bhar, Sunil S

    2016-09-01

    In anticipation of the growing need for adequate mental health care for older adults in residential aged care facilities, psychologists are challenged to overcome several barriers that impede the uptake and delivery of their services in such settings. Information and communication technologies (ICT) have strong potential to overcome some of these barriers by supporting the delivery of evidence-based psychosocial treatments for common psychogeriatric issues. This paper presents two case studies that illustrate when and how psychologists can use various ICT applications (e.g., tablet devices, web-based applications) integrated with cognitive behavioural and reminiscence-based therapies. Both case studies demonstrate that ICT can effectively support the therapeutic alliance, enhance therapeutic engagement, and individualize treatment delivery to accommodate the needs of elderly patients. It is hoped that these case studies will encourage clinicians to consider using ICT to augment therapy with their elderly patients. PMID:27073103

  6. Inequities in health care utilization by people aged 50+: evidence from 12 European countries.

    PubMed

    Terraneo, Marco

    2015-02-01

    The aim of this study is to describe the magnitude of educational inequities in the use of health care services, by people aged 50+, in 12 European countries, controlling for country-level heterogeneity. We consider four services: having seen or talked to 1) a general practitioner (GP) or 2) specialist, 3) having been hospitalized, and 4) having visited a dentist (only for prevention). Data derived from the SHARE (Survey of Health, Ageing and Retirement in Europe) project, a cross-national panel that collects information from individuals aged 50 and over. A Fixed Effects approach is applied, which is a valuable alternative to the application of conventional multilevel models in country-comparative analysis. The main findings of this study confirm that there is substantial educational inequity in the use of health care, although relevant differences arise between services. A clear pro-educated gradient is found for specialists and dentist visits, whereas no evidence of educational disparities was found for GP use. On the other hand, less clear results emerge regarding hospitalizations. However, the analysis shows that micro-level dimensions, i.e. individual needs and predisposing and enabling population characteristics, and macro level factors, i.e. health care system and welfare regime, interact to determine people's use of health services. It can be concluded that people with more education level have more resources (cognitive, communicative, relational) that allow them to make more informed choices and take more effective actions for their health goals, however, the institutional context may modify this relationship. PMID:25562311

  7. Aging effects on oropharyngeal swallow and the role of dental care in oropharyngeal dysphagia.

    PubMed

    Logemann, J A; Curro, F A; Pauloski, B; Gensler, G

    2013-11-01

    Difficulty with oropharyngeal swallow requires careful diagnosis and treatment from a team of professionals including the patients' physicians and the speech-language pathologist specializing in dysphagia. The dentist can be a critical team member in prevention, early identification, and management of oropharyngeal dysphagia. This manuscript reviews the physiology of normal oropharyngeal swallow and the effects of normal aging on this physiology. Typical etiologies for oropharyngeal dysphagia are defined as is the most commonly used physiologic diagnostic procedure, the modified barium swallow (MBS). The critical role of the dentist in identifying risk of oropharyngeal dysphagia, making appropriate referrals, and improving oral hygiene to prevent aspiration pneumonia in the elderly is discussed. PMID:23574512

  8. School-Age NOTES, 1999.

    ERIC Educational Resources Information Center

    Scofield, Richard T., Ed.

    1999-01-01

    This document is comprised of the 12 monthly issues of a newsletter providing support and information for providers of child care for school-age children. The featured articles for each month are: (1) "Tips for New and Old for the New School Year" (September); (2) "Train Them and Retain Them: Keeping Quality Staff" (October); (3) "What Older Kids…

  9. The Effects of a School-Based Atopy Care Program for School-Aged Children.

    PubMed

    Ryu, Hosihn; Lee, Youngjin

    2015-08-01

    The aim of the present study was to evaluate the effectiveness of a school-based atopy care program (SACP) for children with atopic dermatitis (AD). The program is administered by health teachers who are also school nurses. The study compared groups using a pre- and post-test design. Participants were children with AD and their parents (98 dyads; 32 in the test group and 66 in the control group) sampled from four elementary schools in Seoul. After completing the SACP, parents in the test group had significantly increased knowledge of AD (p = .04) and a greater sense of parental efficacy (p = .02) when compared with the control group. This study derived guidelines that elementary health teachers can use in practice for school-aged children with AD. We concluded that there is sufficient evidence of effectiveness for the SACP to be used as a model for chronic disease management in school-aged children. PMID:24942774

  10. Consumer-directed personal care: comparing aged and non-aged adult recipient health-related outcomes among those with paid family versus non-relative providers.

    PubMed

    Newcomer, Robert; Kang, Taewoon; Faucett, Julia

    2011-10-01

    Risk factors associated with the incidence of recipient injuries, bedsores and contractures, and health care use (i.e., emergency department and hospital use) among aged and non-aged adult personal care recipients are investigated. Data are from a statewide survey of aged and non-aged adult personal assistance service (PAS) recipients (n = 913) in California's In-Home Supportive Services (IHSS) program. This is a consumer-directed PAS program. Outcomes among recipients using relatives (other than spouses or parents) as paid providers are compared with those of recipients having non-relatives as providers. No differences were found by provider-recipient relationships. Non-aged recipients, those in poorer health, those with more than three activities of daily living (ADL) limitations, and those changing providers during the year were all at greater risk for adverse health outcomes. African American, Hispanic, and Asian recipients were at lower risk for injuries and hospital stays than were White recipients. PMID:22106901

  11. Taking Each Day as It Comes: Staff Experiences of Supporting People with Down Syndrome and Alzheimer's Disease in Group Homes

    ERIC Educational Resources Information Center

    Iacono, T.; Bigby, C.; Carling-Jenkins, R.; Torr, J.

    2014-01-01

    Background: Disability staff are being increasingly required to support adults with Down syndrome who develop Alzheimer's disease. They have little understanding of the nature of care required, and may lack input from aged care and dementia services, which lack knowledge of intellectual disability. The aim of this study was to report on the…

  12. Women's health: marketing challenges for the 21st century. The future of women's health care reflects demographic, social, and economic trends. MHS staff.

    PubMed

    2000-01-01

    The notion of a separate "women's health" component within the U.S. health care system emerged in the 1980s as many health care organizations recognized the opportunities offered by this market. While originally addressed traditional women's needs such as OB services, the 1990s witnessed as expansion of the scope of women's services as baby-boom women became a driving force for consumerism. For health care marketers, the female market is in many THE market for health care for the future and health care organizations have responded to this opportunity in a variety of ways. Demographic, social, and economic trends will only serve to increase the importance of women as health care consumers. For both providers of care and marketers, the women's market is clearly a force to be reckoned with as health care enters the 21st century. PMID:11185874

  13. A Population-based Study of Age Inequalities in Access to Palliative Care Among Cancer Patients

    PubMed Central

    Burge, Frederick I.; Lawson, Beverley J.; Johnston, Grace M.; Grunfeld, Eva

    2013-01-01

    Background Inequalities in access to palliative care programs (PCP) by age have been shown to exist in Canada and elsewhere. Few studies have been able to provide greater insight by simultaneously adjusting for multiple demographic, health service, and socio-cultural indicators. Objective To re-examine the relationship between age and registration to specialized community-based PCP programs among cancer patients and identify the multiple indicators contributing to these inequalities. Methods This retrospective, population-based study was a secondary data analysis of linked individual level information extracted from 6 administrative health databases and contextual (neighborhood level) data from provincial and census information. Subjects included all adults who died due to cancer between 1998 and 2003 living within 2 District Health Authorities in the province of Nova Scotia, Canada. The relationship between registration in a PCP and age was examined using hierarchical nonlinear regression modeling techniques. Identification of potential patient and ecologic contributing indicators was guided by Andersen’s conceptual model of health service utilization. Results Overall, 66% of 7511 subjects were registered with a PCP. Older subjects were significantly less likely than those <65 years of age to be registered with a PCP, in particular those aged 85 years and older (adjusted odds ratio: 0.4; 95% confidence interval: 0.3–0.5). Distance to the closest cancer center had a major impact on registration. Conclusions Age continues to be a significant predictor of PCP registration in Nova Scotia even after controlling for the confounding effects of many new demographic, health service, and ecologic indicators. PMID:19300309

  14. Managing reliance on temporary agency staff.

    PubMed

    Nicholson, Maria

    2016-03-01

    Amid spiralling agency staff costs, in November 2015 Monitor and the Trust Development Authority placed caps on the hourly rate that NHS trusts can pay agency staff, and informed all NHS and foundation trusts that they are required to procure agency staff through approved frameworks. This article suggests ways in which management can maintain these requirements while ensuring safe staffing levels and high-quality care delivery. PMID:26927789

  15. [The limit of pediatric age in primary health care. A problem to be solved].

    PubMed

    Salazar Rodríguez, A; Sánchez de Rojas de las Heras, C; Garrido Romera, A

    1992-08-01

    The true definition of the term Pediatrics, implies comprehensive care up to the end of adolescence; in practice, however, treatment is usually only available up to the age of seven. In this study, the medical records of children born between 1976 and 1983 were examined with respect to the four areas of General Practice covered by a pediatrician. The characteristics of this conurbation and the nature of medical advice sought were also studied. A survey of the situation in the remainder of the country was also carried out by means of telephone conversations with pediatricians nationwide. Of the 519 children considered, 150 did not consult their doctor during 1990. Those that did seek medical attention did so on 802 occasions, which represents 3.6% of all consultations by general practitioners. However, it would have amounted to 25.3% of the visits to pediatricians. Raising the age limit of pediatric patients, as an isolated measure, would therefore overload pediatric offices and thus lead to a lower standard of medical care. Such a measure should not be implemented hastily. PMID:1416534

  16. Update on age-appropriate preventive measures and screening for Canadian primary care providers

    PubMed Central

    Shimizu, Tawnya; Bouchard, Manon; Mavriplis, Cleo

    2016-01-01

    Abstract Objective To summarize the best available age-appropriate, evidence-based guidelines for prevention and screening in Canadian adults. Quality of evidence The Canadian Task Force on Preventive Health Care recommendations are the primary source of information, supplemented by relevant US Preventive Services Task Force recommendations when a Canadian task force guideline was unavailable or outdated. Leading national disease-specific or specialty-specific organizations’ guidelines were also reviewed to ensure the most up-to-date evidence was included. Main message Recommended screening maneuvers by age and sex are presented in a summary table highlighting the quality of evidence supporting these recommendations. An example of a template for use with electronic medical records or paper-based charts is presented. Conclusion Whether primary care providers use a dedicated preventive health visit or opportunistic preventive counseling and screening in their patient encounters, this summary of evidence-based recommendations can help maximize efficiency and prevent important omissions and unnecessary screening. PMID:26884526

  17. Clinical and Financial Effects of Psychoeducational Care Provided by Staff Nurses to Adult Surgical Patients in the Post-DRG Environment.

    ERIC Educational Resources Information Center

    Devine, Elizabeth C.; And Others

    1988-01-01

    A three-hour, two-stage workshop for staff nurses on providing education and psychological support to 148 patients who had abdominal surgery. After the workshop the patients used fewer sedatives or antiemetics, fewer hypnotics, and were discharged from the hospital on the average half a day sooner. (Author/BJV)

  18. THE FEASIBILITY OF TRAINING NON-SKILLED PERSONNEL TO ASSIST PROFESSIONAL STAFF IN THE CARE AND TREATMENT OF MENTALLY RETARDED CHILDREN, A CHILD WELFARE DEMONSTRATION PROJECT. FINAL REPORT.

    ERIC Educational Resources Information Center

    Retarded Infants Services, Inc., New York, NY.

    A 12-WEEK TRAINING PROGRAM WAS DEVELOPED TO PREPARE NONPROFESSIONAL PERSONNEL TO SERVE MENTAL RETARDATES IN THE AREAS OF HOMEMAKING AND CHILD CARE, PHYSICAL MEDICINE AND NURSING CARE, SPEECH THERAPY, PLAY ACTIVITY, AND AUXILIARY MATERNAL CARE. RECRUITMENT WAS THROUGH NEWSPAPER ANNOUNCEMENT, THE RETARDED INFANTS SERVICE REFERRAL AGENCIES, POVERTY…

  19. Study protocol: translating and implementing psychosocial interventions in aged home care the lifestyle engagement activity program (LEAP) for life

    PubMed Central

    2013-01-01

    Background Tailored psychosocial activity-based interventions have been shown to improve mood, behaviour and quality of life for nursing home residents. Occupational therapist delivered activity programs have shown benefits when delivered in home care settings for people with dementia. The primary aim of this study is to evaluate the effect of LEAP (Lifestyle Engagement Activity Program) for Life, a training and practice change program on the engagement of home care clients by care workers. Secondary aims are to evaluate the impact of the program on changes in client mood and behaviour. Methods/design The 12 month LEAP program has three components: 1) engaging site management and care staff in the program; 2) employing a LEAP champion one day a week to support program activities; 3) delivering an evidence-based training program to care staff. Specifically, case managers will be trained and supported to set meaningful social or recreational goals with clients and incorporate these into care plans. Care workers will be trained in and encouraged to practise good communication, promote client independence and choice, and tailor meaningful activities using Montessori principles, reminiscence, music, physical activity and play. LEAP Champions will be given information about theories of organisational change and trained in interpersonal skills required for their role. LEAP will be evaluated in five home care sites including two that service ethnic minority groups. A quasi experimental design will be used with evaluation data collected four times: 6-months prior to program commencement; at the start of the program; and then after 6 and 12 months. Mixed effect models will enable comparison of change in outcomes for the periods before and during the program. The primary outcome measure is client engagement. Secondary outcomes for clients are satisfaction with care, dysphoria/depression, loneliness, apathy and agitation; and work satisfaction for care workers. A process

  20. Early Childhood Staff and Families' Perceptions: Diverse Views about Important Experiences for Children Aged 3-5 Years in Early Childhood Settings

    ERIC Educational Resources Information Center

    Hadley, Fay

    2012-01-01

    There is a growing body of literature about the potential for early childhood settings to serve as community hubs to develop relationships with families. However, there is limited information about the ways in which families and early childhood staff interface in defining what constitutes "quality" within settings. Researchers have rarely studied…

  1. [Medical care support intervention to the patient and family who has chosen a terminal care at home - an influence of satisfactory experience on the culture of terminal care].

    PubMed

    Sugimoto, Kaoru; Ishikawa, Mariko; Kouketsu, Nobuko; Ozaki, Mitsuyo; Tomita, Ikue; Hong, Youngjae; Miura, Hisayuki; Nishikawa, Mitsunori; Yokoe, Yuriko; Nakashima, Kazumitsu

    2010-12-01

    The National Center for Geriatrics and Gerontology in Japan implemented a home medical care support system for aged patients in April 2009. In this study, we report a case of terminal care system where a medical care intervention was carried out by a close coordination of visiting nurses and other staffs with a "at-home terminal care" brochure on hand, and we discussed how this system was brought forward satisfactory and how it affected this culture. PMID:21368543

  2. Ecological Influences of the Home and the Child-Care Center on Preschool-Age Children's Literacy Development

    ERIC Educational Resources Information Center

    Weigel, Daniel J.; Martin, Sally S.; Bennett, Kymberley K.

    2005-01-01

    Based on ecological theory, this study examined how four components of children's home and child-care literacy environments, and the connections between these environments, were associated with preschool-age children's literacy and language development. Interview and standardized assessment data were collected from 85 preschool-age children, their…

  3. Older Workers' Perspectives on Training and Retention of Older Workers: Victorian Aged Care Workers Survey. Support Document

    ERIC Educational Resources Information Center

    Lundberg, David; Marshallsay, Zariah

    2007-01-01

    Older workers' perspectives are examined in a national survey of the finance sector and case studies of aged care and construction workers. The majority of older workers intend to work beyond retirement age, to achieve a better lifestyle. With training, older workers could mentor younger workers. This support document includes a national survey of…

  4. Older Workers' Perspectives on Training and Retention of Older Workers: South Australian Aged Care Workers Study. Support Document

    ERIC Educational Resources Information Center

    Lundberg, David; Marshallsay, Zariah

    2007-01-01

    Older workers' perspectives are examined in a national survey of the finance sector and case studies of aged care and construction workers. The majority of older workers intend to work beyond retirement age, to achieve a better lifestyle. With training, older workers could mentor younger workers. This support document includes a national survey of…

  5. Nursing Students' Intentions to Work in Dementia Care: Influence of Age, Ageism, and Perceived Barriers

    ERIC Educational Resources Information Center

    McKenzie, Ellen L.; Brown, Patricia M.

    2014-01-01

    Given a projected threefold increase in people living with dementia globally by 2050 (World Health Organization, 2012), attracting nurses to work in this area will be critical to meet demand. This study examined the role of age, positive ageism, negative ageism, and aged-care placement completion in predicting nursing students' intentions to…

  6. ERIC/EECE Digests Related to the Education and Care of Children from Birth through 12 Years of Age.

    ERIC Educational Resources Information Center

    ERIC Clearinghouse on Early Childhood Education, Champaign, IL.

    The ERIC/EECE Digests in this compilation focus on different aspects of the education and care of children from birth through 12 years of age. The four digests produced in 1989 concern the escalating kindergarten curriculum, involvement of parents in the education of their children, mixed-age groups in early childhood education, and praise in the…

  7. Joint Modelling of Survival and Emergency Medical Care Usage in Spanish Insureds Aged 65+

    PubMed Central

    2016-01-01

    Background We study the longevity and medical resource usage of a large sample of insureds aged 65 years or older drawn from a large health insurance dataset. Yearly counts of each subject's emergency room and ambulance service use and hospital admissions are made. Occurrence of mortality is also monitored. The study aims to capture the simultaneous dependence between their demand for healthcare and survival. Methods We demonstrate the benefits of taking a joint approach to modelling longitudinal and survival processes by using a large dataset from a Spanish medical mutual company. This contains historical insurance information for 39,137 policyholders aged 65+ (39.5% men and 60.5% women) across the eight-year window of the study. The joint model proposed incorporates information on longitudinal demand for care in a weighted cumulative effect that places greater emphasis on more recent than on past service demand. Results A strong significant and positive relationship between the exponentially weighted demand for emergency, ambulance and hospital services is found with risk of death (alpha = 1.462, p < 0.001). Alternative weighting specifications are tested, but in all cases they show that a joint approach indicates a close connection between health care demand and time-to-death. Additionally, the model allows us to predict individual survival curves dynamically as new information on demand for services becomes known. Conclusions The joint model fitted demonstrates the utility of analysing demand for medical services and survival simultaneously. Likewise, it allows the personalized prediction of survival in advanced age subjects. PMID:27073868

  8. HIV, Aging, and Advance Care Planning: Are We Successfully Planning for the Future?

    PubMed Central

    Allshouse, Amanda A.; Duong, Syki; MaWhinney, Samantha; Kohrt, Wendy M.; Campbell, Thomas B.

    2012-01-01

    Abstract Introduction Studies of advance care planning (ACP) completion rates in HIV-infected persons pre-date the “graying” of the HIV epidemic. We sought to examine current ACP completion rates and factors influencing completion among HIV-infected persons. Methods HIV-1-seropositive persons aged 45–65 years on effective antiretroviral therapy for a minimum of 6 months were enrolled in a cross-sectional survey. Likelihood of ACP was assessed by demographic and clinical characteristics, tested with odds ratios (OR) and 95% Wald confidence intervals (CI), and adjusted for gender. Results Of 238 participants, 112 (47%) completed ACP. Persons ≥55 years of age (OR 2.8; CI 1.6,5.0; p<0.001), males (OR 4.1; CI 1.8,9.3; p=0.004), and persons with higher education (OR 2.2; CI 1.3,4.0; p=0.007) were more likely to have completed ACP. Persons with a cardiac event were more likely to have completed ACP (OR 5.5; CI 1.6,25; p=0.03), although this effect was diminished after adjusting for gender (OR 4.5; CI 0.95,21.4; p=0.06). HIV infection diagnosed for greater than 5 years was not associated with ACP completion (OR 1.3; CI 0.7,2.7; p=0.4). Current CD4+ cell counts were similar between those completing and not completing documentation (588 cells/μL and 604 cells/μL, respectively; p=0.7). The likelihood of ACP did not significantly differ with other comorbidities. Discussion Less than 50% of middle-aged patients in HIV care had documented ACP. In particular, women and those with lower education were at greatest risk of non-completion and may need interventions to improve ACP. PMID:22694717

  9. Feasibility and benefits of group-based exercise in residential aged care adults: a pilot study for the GrACE programme

    PubMed Central

    Henwood, Timothy; Climstein, Mike; Keogh, Justin William Leslie

    2016-01-01

    The objective of the study was to examine the feasibility and benefits of a group resistance training exercise programme for improving muscle function in institutionalised older adults. A feasibility and acceptability study was designed for a residential aged care (RAC) facility, based on the Gold Coast, Australia. Thirty-seven adults, mean age 86.8 ± 6.1 years (30 females) living in a RAC facility. Participants were allocated into an exercise (n = 20) or control (n = 17) group. The exercise group, the Group Aged Care Exercise (GrACE) programme, performed 12 weeks of twice weekly resistance exercises. Feasibility was measured via recruitment rate, measurement (physiological and surveys) completion rate, loss-to-follow-up, exercise session adherence, adverse events, and ratings of burden and acceptability. Muscle function was assessed using gait speed, sit-to-stand and handgrip strength assessments. All intervention participants completed pre- and post-assessments, and the exercise intervention, with 85% (n = 17) of the group attending ≥ 18 of the 24 sessions and 15% (n = 3) attending all sessions. Acceptability was 100% with exercise participants, and staff who had been involved with the programme strongly agreed that the participants “Benefited from the programme.” There were no adverse events reported by any participants during the exercise sessions. When compared to the control group, the exercise group experienced significant improvements in gait speed (F(4.078) = 8.265, p = 0.007), sit to stand performance (F(3.24) = 11.033, p = 0.002) and handgrip strength (F(3.697) = 26.359, p < 0.001). Resistance training via the GrACE programme is feasible, safe and significantly improves gait speed, sit-to-stand performance and handgrip strength in RAC adults. PMID:27231652

  10. Depression, self-esteem, diabetes care and self-care behaviors among middle-aged and older Mexicans☆

    PubMed Central

    Rivera-Hernandez, Maricruz

    2016-01-01

    Aims Examine the associations of depression and self-esteem on self-care activities and care received among Mexicans with diabetes. Methods Using data from the Mexican Nutrition and Health Survey 2012, logistic regression models were fit to test the associations between each self-care activity and diabetes care, and self-esteem and depression. Results People with low self-esteem were less likely to follow a diet, but no other associations were found. Contrary to what was expected, there were no relationships between depression and quality of care received or self-care behaviors. Conclusion Current findings support the importance of looking at mental health and emotional state among older adults with diabetes. Future studies should explore the relationship between different psychological barriers to proper diabetes management. PMID:24846446

  11. Periodontal Care as a Fundamental Step for an Active and Healthy Ageing

    PubMed Central

    Cafiero, Carlo; Matarasso, Marco; Marenzi, Gaetano; Iorio Siciliano, Vincenzo; Bellia, Loredana; Sammartino, Gilberto

    2013-01-01

    In the industrialized part of the world, an increasing number of people live the old age without too many restrictions due to illness or physiological impairment. This group is known as the young elderly. On the contrary, a consistent part of seniors develops a greater number of medical conditions and become more and more dependent, these are the old elderly. The first cause of tooth lost in industrialized word is periodontitis that generally strikes people older than 40 years and determines serious detriment of the stomatognatic organ. Smoking and stress are risk factors for periodontitis that are common and shared between young, adult, and older age. Diabetes mellitus, obesity, and osteoporosis are very frequent pathological situations in older age. They have been identified as cofactors in the progression of periodontitis. Many dental associations recognize the importance of continued research on oral fluids diagnostics and welcome the development of rapid point-of-care tests providing accurate measurements of clinically validated biomarkers. At present, well-studied molecules associated with host response factors and with derived tissue destruction mediators have been proposed as diagnostic biomarkers for periodontitis detected in the oral fluids. PMID:24453788

  12. Identifying how age and gender influence prescription drug use in a primary health care environment in Catalonia, Spain

    PubMed Central

    Fernández-Liz, Eladio; Modamio, Pilar; Catalán, Arantxa; Lastra, Cecilia F; Rodríguez, Teresa; Mariño, Eduardo L

    2008-01-01

    Aims To determine the prevalence and usage patterns of prescription drugs according to patients' age and gender, and to identify their relative importance in the prescription costs, in primary health care within the Catalan Health Institute. Methods This was a cross-sectional study using computerized pharmacy dispensing records for 5 474 274 members registered, during 2002. Twenty age-gender categories were established. Use of a drug group was defined as filling at least one prescription. The variables studied were age, gender, number of prescriptions and net cost. The prevalence of use, the number of prescriptions and cost issued to each age category were reported. Results The overall prevalence of drug use was 74.53% (women 80.93%, men 67.84%). This was higher in the group of 0–4 year-olds, and in the ≥ 55 year-olds. Age (P < 0.001) produced a statistically more significant effect than gender (P < 0.05). The most used therapeutic groups were analgesics, nonsteroidal anti-inflammatory drugs, antiulcer drugs, anxiolytics, expectorants and mucolytics. The number of prescriptions and costs per patient rose with age and showed great variation in the use of these groups for patients in different age groups. The risk of prescription in women was 23% higher than in men (RR 1.23, 95% CI 1.11, 1.37, P < 0.001). Conclusions The majority of subjects were exposed to one or more drugs. The variability in the number of prescriptions and in the prescribing cost per patient between the different age groups suggests that adjustments should be made for age in practitioners' prescription evaluation processes in primary health care in Catalonia. What is already known about this subject Knowledge of prescription patterns in primary health care is an important tool in rational drug therapy.Age and gender are the principal determining factors of cost variability between medical practices, due to drug prescriptions.Age and gender are the principal determining factors of cost

  13. [Age-related macular degeneration – a challenge for public health care].

    PubMed

    Mantel, Irmela

    2016-01-01

    Age-related macular degeneration (AMD) is the predominant cause of legal blindness in the population over 50 years of age. The disorder shows exponentially increasing prevalence with age, and the late forms with their vision threatening evolution are found in approximately one third of cases. The late AMD may be purely atrophic and so far untreatable. Or it may be neovascular and exudative, for which medical treatment is available, consisting of repetitive intravitreous injections of Anti-VEGF molecules. The treatment is highly effective in blocking the growth of the pathological vessels and allowing resolution of the accompanying edema. Visual improvement is variable but often very meaningful for the patients. However, the final visual level depends mostly on early intervention. Thus, screening for the first signs of neovascular AMD is crucial for the endresult. However, the repetitive intraocular injections are an important burden for the patients. Due to the high patient numbers, the chronic care management with steadily adding new patients is a major challenge for treating institutions. Limited resources may put patients at risk of undertreatment with resulting visual loss. Various strategies have been developed to cope with the burden. In addition, the financial cost is high for the health care system. On the other hand, timely and ongoing treatment is the best investment to achieve meaningful visual improvement, which is extremely important for the quality of life and autonomy of the patients. Side effects of the treatment are limited and mostly procedure related. Systemic side effects are possible but despite the large studies not conclusive. However, care must be taken in cases of high cardiovascular risk, as thromboembolic risk increase may rarely happen. So far unsolved problems include the long term visual results, the degree of reversibility of neovascularization, and the missing treatment options of atrophic AMD. Basic and clinical research on various

  14. Framing the issue of ageing and health care spending in Canada, the United Kingdom and the United States.

    PubMed

    Gusmano, Michael K; Allin, Sara

    2014-07-01

    Political debates about the affordability of health care programmes in high-income countries often point to population ageing as a threat to sustainability. Debates in the United States, in particular, highlight concerns about intergenerational equity, whereby spending on older people is perceived as a threat to spending on the young. This paper compares how the problem of health spending is defined in Canada, the United Kingdom and the United States by presenting the results of a content analysis of print media during the period 2005-2010. We found that population ageing was cited as an important source of health care cost increases in all three countries but was cited less frequently in Canadian newspapers than in the UK or US papers. Direct claims about intergenerational equity are infrequent among the articles we coded, but newspaper articles in the United States were more likely than those in Canada and the United Kingdom to claim that of high health care spending on older people takes resources away from younger people. In Canada a much larger percentage of articles in our sample either claimed that high health care spending is crowding out other types of government expenditure. Finally, we found that almost no articles in the United States challenged the view that population ageing causes health care spending, whereas in both Canada and the United Kingdom a small, but steady stream of articles challenged the idea that population ageing is to blame for health care spending increases. PMID:24759155

  15. Improving Nutrition in a Day Care Program through a Multidimensional Approach.

    ERIC Educational Resources Information Center

    Mohanty, Pranoti S.

    This practicum project sought to improve nutrition in a day care program serving children ages 2 through 14 years by increasing staff, student, and parent knowledge about nutrition. The primary goal was to increase knowledge and interest in nutrition and its relation to wellness of students, staff, and parents. The second goal was to provide…

  16. The Impact of Electronic Health Records on Risk Management of Information Systems in Australian Residential Aged Care Homes.

    PubMed

    Jiang, Tao; Yu, Ping; Hailey, David; Ma, Jun; Yang, Jie

    2016-09-01

    To obtain indications of the influence of electronic health records (EHR) in managing risks and meeting information system accreditation standard in Australian residential aged care (RAC) homes. The hypothesis to be tested is that the RAC homes using EHR have better performance in meeting information system standards in aged care accreditation than their counterparts only using paper records for information management. Content analysis of aged care accreditation reports from the Aged Care Standards and Accreditation Agency produced between April 2011 and December 2013. Items identified included types of information systems, compliance with accreditation standards, and indicators of failure to meet an expected outcome for information systems. The Chi-square test was used to identify difference between the RAC homes that used EHR systems and those that used paper records in not meeting aged care accreditation standards. 1,031 (37.4%) of 2,754 RAC homes had adopted EHR systems. Although the proportion of homes that met all accreditation standards was significantly higher for those with EHR than for homes with paper records, only 13 RAC homes did not meet one or more expected outcomes. 12 used paper records and nine of these failed the expected outcome for information systems. The overall contribution of EHR to meeting aged care accreditation standard in Australia was very small. Risk indicators for not meeting information system standard were no access to accurate and appropriate information, failure in monitoring mechanisms, not reporting clinical incidents, insufficient recording of residents' clinical changes, not providing accurate care plans, and communication processes failure. The study has provided indications that use of EHR provides small, yet significant advantages for RAC homes in Australia in managing risks for information management and in meeting accreditation requirements. The implication of the study for introducing technology innovation in RAC in

  17. Managing the wandering behaviour of people living in a residential aged care facility.

    PubMed

    Hodgkinson, Brent; Koch, Susan; Nay, Rhonda; Lewis, Matthew

    2007-12-01

    Background  Wandering behaviour is frequently seen in older people with cognitive impairment. The prevalence of patients exhibiting wandering behaviour has been estimated to be 11.6% on traditional units and 52.7% on Alzheimer's units. Wandering is one of the core behavioural characteristics that impact on familial carers and is likely to influence the decision to place a family member in an aged care environment. Considering the possible risks associated with wandering behaviour, the successful identification and management of wandering is essential. Wandering is also a problem for caregivers in the institutionalised setting, in terms of containment, usually being addressed by securing the environment. There has been some research conducted to assist in the understanding and management of wandering behaviour; however, the findings have been diverse resulting in a level of confusion about the best approaches to take. Objectives  This review aims to present the best available evidence on the management of wandering in older adults who reside in an aged care facility (both high and low care). Search strategy  An extensive search of keywords contained in the title and abstract, and relevant MeSH headings and descriptor terms was performed on the following databases: MEDLINE, CINAHL, PsychINFO, AGELINE, Cochrane Library, Embase, APAIS Health, Current Contents, Dare, Dissertation Abstracts, Personal Communication, Social Science Index. Selection criteria  Papers were selected if they focused on the treatment of wandering in an institutional setting. Some studies were not specifically examining wanderers over the age of 65 years as per the protocol requirements, but were included as it was felt that their findings could be applied to this age group. Data collection and analysis  Study design and quality were tabulated and relative risks, odds ratios, mean differences and associated 95% confidence intervals were calculated from individual comparative studies

  18. Changing Attitudes Toward Care of Aging Parents: The Influence of Education, International Travel, and Gender

    PubMed Central

    Compernolle, Ellen

    2015-01-01

    Population aging is a key public health issue facing many nations, and is particularly pronounced in many Asian countries. At the same time, attitudes toward filial obligation are also rapidly changing, with a decreasing sense that children are responsible for caring for elderly parents. This investigation blends the family versus nonfamily mode of social organization framework with a life course perspective to provide insight into the processes of ideational change regarding filial responsibility, highlighting the influence of education and international travel. Using data from a longitudinal study in Nepal—the Chitwan Valley Family Study—results demonstrate that education and international travel are associated with a decrease in attitudes toward filial obligation. However, findings further reveal that the impact of education and international travel vary both across the life course and by gender. PMID:25866415

  19. Physical and psychosocial function in residential aged-care elders: effect of Nintendo Wii Sports games.

    PubMed

    Keogh, Justin W L; Power, Nicola; Wooller, Leslie; Lucas, Patricia; Whatman, Chris

    2014-04-01

    This mixed-methods, quasi-experimental pilot study examined whether the Nintendo Wii Sports (NWS) active video game (exergame) system could significantly improve the functional ability, physical activity levels, and quality of life of 34 older adults (4 men and 30 women, 83 ± 8 yr) living in 2 residential aged-care (RAC) centers. Change score analyses indicated the intervention group had significantly greater increases in bicep curl muscular endurance, physical activity levels, and psychological quality of life than the control group (p < .05). Analysis of the quotes underlying the 3 themes (feeling silly, feeling good; having fun; and something to look forward to) suggested that intervention group participants developed a sense of empowerment and achievement after some initial reluctance and anxiousness. They felt that the games were fun and provided an avenue for greater socialization. These results add some further support to the utilization of NWS exergames in the RAC context. PMID:23752164

  20. Health Care Cost Containment: Are America's Aged Protected? Hearing before the Select Committee on Aging. House of Representatives, Ninety-Ninth Congress, First Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Select Committee on Aging.

    This document contains testimony and prepared statements from the Congressional hearing examining the impact on the elderly of the federal health care cost containment measure. Correspondence between the Select Committee on Aging and the Department of Health and Human Services, concerning the government restrictions' harmful effects on the…