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Sample records for aged care staff

  1. 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…

  2. The needs, current knowledge, and attitudes of care staff toward the implementation of palliative care in old age homes.

    PubMed

    Lo, Raymond S K; Kwan, Bonnie H F; Lau, Kay P K; Kwan, Cecilia W M; Lam, L M; Woo, Jean

    2010-06-01

    This study aims to explore in depth the needs, current knowledge, and attitudes of all ranks of old age home staff. A large-scale qualitative study with 13 semistructured focus groups was conducted in Hong Kong. Key themes were extracted by framework analysis. Three major themes were extracted, including role as a service provider, current knowledge, and attitude toward palliative care. There was a marked difference in familiarity with the concept of ''palliative care'' between different groups of staff, yet both shared the motivation for enhancement. The biggest concerns for the staff were elderly residents' readiness to accept palliative care, manpower, and resources. Care staff, regardless of rank, seemed to welcome and be ready to adopt a palliative care approach in caring for old age home residents, though not without worries and concerns. PMID:19959840

  3. Aged Patients in Long-Term Care Facilities: A Staff Manual.

    ERIC Educational Resources Information Center

    Goldfarb, Alvin I.

    This document represents transcripts of a series of workshops presented for the staff of a long-term care facility for aged patients. A specialist in geriatric psychiatry leads the discussions, which cover topics such as the definition of brain syndrome; testing procedures; emotional and behavioral problems; and the optimal environment for the…

  4. '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

  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. Sexuality & Dementia: An eLearning Resource to Improve Knowledge and Attitudes of Aged-Care Staff

    ERIC Educational Resources Information Center

    Jones, Cindy; Moyle, Wendy

    2016-01-01

    Expression of sexuality by older people, particularly those with dementia, can be challenging and confronting for aged-care staff. Education on this topic is often a low priority area for aged-care organizations, and there appears to be limited training programs available. Results from our study highlighted the value of an eLearning education…

  7. 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

  8. Staff members' negotiation of power in client engagement: analysis of practice within an Australian aged care service.

    PubMed

    Petriwskyj, Andrea; Gibson, Alexandra; Webby, Glenys

    2015-04-01

    With increasing focus on client control and active client roles in aged care service provision, client engagement is highlighted as fundamental to contemporary care practice. Client engagement itself, however, is complex and is impacted by a range of issues including the relationships and power dynamics inherent in the care context. These dynamics do not simply reflect the roles that are available to or taken up by clients; just as important are the roles and positions that staff of aged care services are offered, and take up, in client engagement. This paper presents the findings of a study that explored client engagement practice within a large Australian service provider. Analysis of interview and focus group discussions addressed the ways in which staff were positioned - by both themselves and by clients - in terms of the roles that they hold within engagement practice and the power relations inherent within these. Analysis of power from the dominant policy perspective of choice and control, and the alternative perspective of an ethic of care suggests that power relations within the care context are dynamic, complex and involve on-going negotiation and regulation by clients and staff members in aged care. The use of these two contrasting perspectives reveals a more dynamic and complex understanding of power in care practice than dominant uni-dimensional approaches to critique suggest.

  9. Supporting Staff to Identify Residents in Pain: A Controlled Pretest-Posttest Study in Residential Aged Care.

    PubMed

    Douglas, Clint; Haydon, Deborah; Wollin, Judy

    2016-02-01

    Practical strategies are needed to improve pain awareness among aged care staff and promote a systematic approach to pain identification using evidence-based tools. The purpose of this study was to evaluate a pain identification tool for use by nursing and nonprofessional staff in residential aged care facilities (RACFs). A controlled pretest-posttest intervention design was conducted in two RACFs in Brisbane, Australia. Completed surveys were returned by 216 staff and 74 residents at baseline and 218 staff and 94 residents at 3-month follow-up. Chart audits were conducted on 308 residents at baseline and 328 at follow-up. Groups were compared on: (1) staff knowledge and attitudes regarding pain, perceived confidence and skills for pain assessment, and perceived quality of pain management; (2) frequency of pain assessments and use of pain interventions; and (3) residents' perceptions of the quality of pain management. Both groups had high knowledge scores and reported high levels of confidence, skills, and perceived quality of pain management at baseline and follow-up. The intervention group showed significant improvement in routine pain assessment and use of nonpharmacological pain interventions. However, due to unexpected changes in control group conditions, both groups increased episodic pain assessment. Overall, staff believed the intervention was clinically useful and fostered a team approach to pain assessment. We found the introduction of pain identification resources with implementation strategies to support frontline staff was partially effective in improving staff and resident outcomes. Nonetheless, our findings confirm the need for change and importance of translational pain research in RACFs. PMID:26700721

  10. 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…

  11. Patchwork Quilt or Seamless Day? Parent, Teacher and Child Care Staff Views on Early Childhood Education Programs for Kindergarten-Age Children in Canada.

    ERIC Educational Resources Information Center

    Johnson, Laura C.

    2003-01-01

    Examined parent, teacher, and child care staff views on coordination between part-day school and child care. Found some key differences among the groups in priorities for programs for kindergarten-age children. Devised arguments in favor of small-scale demonstration programs to expand provision of child care services and for rigorous evaluation of…

  12. 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)

  13. 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

  14. "The Red Dress or the Blue?": How Do Staff Perceive That They Support Decision Making for People With Dementia Living in Residential Aged Care Facilities?

    PubMed

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

    2016-02-01

    Respect for a person's right to make choices and participate in decision making is generally seen as central to quality of life and well-being. When a person moves into a residential aged care facility (RACF), however, decision making becomes more complicated, particularly if the person has a diagnosis of dementia. Little is known about how staff in RACFs perceive that they support decision making for people with dementia within their everyday practice, and this article seeks to address this knowledge gap. The article reports on the findings of a qualitative study conducted in the states of Victoria and Queensland, Australia with 80 direct care staff members. Findings revealed that the participants utilized a number of strategies in their intention to support decision making for people with dementia, and had an overall perception that "a little effort goes a long way."

  15. Staff empowerment in Finnish intensive care units.

    PubMed

    Suominen, T; Leino-Kilpi, H; Merja, M; Doran, D I; Puukka, P

    2001-12-01

    The purpose of this study was to describe staff empowerment in Finnish intensive care units. The data were collected with a questionnaire comprising demographic background and empowerment items. The concept of empowerment was divided into three components: behavioural, verbal and outcome empowerment. The questionnaire was sent to all registered nurses at Finnish intensive care units (ICUs). Eight hundred and fourteen replied, giving a response rate of 77%. The ICU nurses demonstrated confidence in their own skills and competencies, although least so in the domain of outcome empowerment. Experience of behavioural, verbal and outcome empowerment increased linearly with age. The length of nursing experience was positively associated with behavioural, verbal and outcome empowerment. Experience in ICU nursing correlated positively with verbal and outcome empowerment. Motivation, job satisfaction, respect of job autonomy and the fact that the job of ICU nurses commanded respect in society were associated with behavioural, verbal, and outcome empowerment.

  16. 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)

  17. '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.

  18. Staff experiences within the implementation of computer-based nursing records in residential aged care facilities: a systematic review and synthesis of qualitative research

    PubMed Central

    2014-01-01

    Background Since the introduction of electronic nursing documentation systems, its implementation in recent years has increased rapidly in Germany. The objectives of such systems are to save time, to improve information handling and to improve quality. To integrate IT in the daily working processes, the employee is the pivotal element. Therefore it is important to understand nurses’ experience with IT implementation. At present the literature shows a lack of understanding exploring staff experiences within the implementation process. Methods A systematic review and meta-ethnographic synthesis of primary studies using qualitative methods was conducted in PubMed, CINAHL, and Cochrane. It adheres to the principles of the PRISMA statement. The studies were original, peer-reviewed articles from 2000 to 2013, focusing on computer-based nursing documentation in Residential Aged Care Facilities. Results The use of IT requires a different form of information processing. Some experience this new form of information processing as a benefit while others do not. The latter find it more difficult to enter data and this result in poor clinical documentation. Improvement in the quality of residents’ records leads to an overall improvement in the quality of care. However, if the quality of those records is poor, some residents do not receive the necessary care. Furthermore, the length of time necessary to complete the documentation is a prominent theme within that process. Those who are more efficient with the electronic documentation demonstrate improved time management. For those who are less efficient with electronic documentation the information processing is perceived as time consuming. Normally, it is possible to experience benefits when using IT, but this depends on either promoting or hindering factors, e.g. ease of use and ability to use it, equipment availability and technical functionality, as well as attitude. Conclusions In summary, the findings showed that members

  19. Selected methods of measuring workload among intensive care nursing staff.

    PubMed

    Kwiecień, Katarzyna; Wujtewicz, Maria; Mędrzycka-Dąbrowska, Wioletta

    2012-06-01

    Intensive care units and well-qualified medical staff are indispensable for the proper functioning of every hospital facility. Due to demographic changes and technological progress having extended the average life expectancy, the number of patients hospitalized in intensive care units increases every year [9,10]. Global shortages of nursing staff (including changes in their age structure) have triggered a debate on the working environment and workload the nursing staff are exposed to while performing their duties. This paper provides a critical review of selected methods for the measurement of the workload of intensive care nurses and points out their practical uses. The paper reviews Polish and foreign literature on workload and the measurement tools used to evaluate workload indicators.

  20. Staff training and computers in respiratory care.

    PubMed

    Walker, David H

    2004-05-01

    The respiratory therapists' (RTs') knowledge base is among a hospital's greatest assets. RTs routinely use advanced medical technologies and must understand the patient's physiology, anatomy, and condition to deliver safe and effective treatment with those technologies, especially within critical care environments. Also RTs often must educate patients and patients' families, which requires thorough understanding of the operation of medical equipment. RT education must include both tacit and explicit knowledge, so RT education can be complex, which may present challenges to clinical educators. RTs must have continuing education, and computer-based education can help meet education challenges, promote safe and effective patient care, improve patient outcomes, and improve employee satisfaction, which may improve RT recruitment and retention, while decreasing the cost of staff training. However, since computer-based education is relatively new to health care, RT educators should learn from other industries that have extensive experience with computer-based staff education.

  1. Staff perceptions of caring: the importance of a supportive environment.

    PubMed

    Sikma, Suzanne K

    2006-06-01

    Five themes of caring interventions emerged from the perspective of staff caregivers-valuing personhood and the work, belonging, knowing, acting together, and promoting quality. Three themes of caring organizational conditions identified by participants included communicating, providing resources, and trusting. The research-based Model of Caring in the Organizational Environment can be used to assess and improve the caring environment of nursing homes as well as to develop caring managers and staff. Organizational well-being for nursing homes is everyone's responsibility and requires formal and informal leaders who can create supportive caring organizational conditions, engage in caring interventions with staff, and inspire the synergy of caring. PMID:16773860

  2. Staff perceptions of caring: the importance of a supportive environment.

    PubMed

    Sikma, Suzanne K

    2006-06-01

    Five themes of caring interventions emerged from the perspective of staff caregivers-valuing personhood and the work, belonging, knowing, acting together, and promoting quality. Three themes of caring organizational conditions identified by participants included communicating, providing resources, and trusting. The research-based Model of Caring in the Organizational Environment can be used to assess and improve the caring environment of nursing homes as well as to develop caring managers and staff. Organizational well-being for nursing homes is everyone's responsibility and requires formal and informal leaders who can create supportive caring organizational conditions, engage in caring interventions with staff, and inspire the synergy of caring.

  3. 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…

  4. Increasing Day Care Staff Members' Interactions during Caregiving Routines.

    ERIC Educational Resources Information Center

    Venn, Martha L.; Wolery, Mark

    1992-01-01

    Four paraprofessional staff members in a mainstreamed day care program were trained to engage in positive interactive behaviors during diaper changing. Results indicated that staff increased frequency of game playing and other interactive behaviors during diapering, but increases were not generalized to feeding routines. (Author/JDD)

  5. When Staff Members Sexually Abuse Children in Residential Care.

    ERIC Educational Resources Information Center

    Bloom, Robert B.

    1992-01-01

    Presents practical suggestions for managing a protective service agency for children when one of its staff members is accused of sexually abusing a child in residential care. The agency must balance the tasks of protecting the child, supporting the staff, and maintaining the integrity and reputation of the agency. (GLR)

  6. Self-care project for faculty and staff of future health care professionals: Case report.

    PubMed

    MacRae, Nancy; Strout, Kelley

    2015-01-01

    Self-care among health care providers is an important component of their ability to provide quality health care to patients. Health care institutions have programs in place for students that emphasize health and wellness, but few programs are available for faculty and staff. To address this gap and facilitate modeling health and wellness strategies for students, a New England institution that educates health care practitioners began a pilot self-care project for faculty and staff. Both quantitative and qualitative data were collected. The template used for this project could be used as a stepping-stone for future wellness self-care program in higher education for faculty, staff, and students.

  7. 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…

  8. 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

  9. 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.

  10. Staff costs of hospital-based outpatient care of patients with cystic fibrosis

    PubMed Central

    2011-01-01

    Background This study identified per patient resource use and staff costs at a cystic fibrosis (CF) outpatient unit from the health care provider's perspective. Methods Personnel cost data were prospectively collected for all CF outpatients (n = 126) under routine conditions at the Charité Medical School Berlin in Germany over a six month study period. Patients were grouped according to age, sex and two severity categories. Ordinary least squares regression analysis was performed to determine the impact of various independent variables on personnel costs. Results The mean staff costs were €142.3 per patient over six months of outpatient service. Services provided by physicians were the biggest contributor to staff costs. Patient age correlated significantly and negatively with mean total costs per patient. Conclusions Age of patient is a significant determinant of staff costs for CF outpatient care. For a cost-covering remuneration of outpatient treatment it seems plausible to create separate reimbursement rates for two or three age groups and to consider additional costs due to tasks carried out by physicians without direct patient contact. The relatively low staff costs identified by our study reflect a staffing level not sufficient for specialist CF outpatient care. PMID:22828269

  11. Barriers to Care for Depressed Older People: Perceptions of Aged Care among Medical Professionals

    ERIC Educational Resources Information Center

    McCabe, Marita P.; Davison, Tanya; Mellor, David; George, Kuruvilla

    2009-01-01

    The current study evaluated barriers to detection of depression among older people. Focus groups were conducted with 21 professional carers, 4 nurses, 10 general practitioners, and 7 aged care managers. The results demonstrated that care for older people is primarily focused on physical care. Further, staff resources, a lack of continuity of care,…

  12. 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…

  13. 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…

  14. Inadequate care in Norwegian nursing homes--as reported by nursing staff.

    PubMed

    Malmedal, Wenche; Ingebrigtsen, Oddbjørn; Saveman, Britt-Inger

    2009-06-01

    Studies have shown that inadequate care, also referred to as abuse, violence, neglect and maltreatment occur in nursing homes in many countries. The aim of this study was to describe the frequency and types of inadequate care committed by staff in nursing homes. Another aim was to investigate if nursing staff reported differently depending on age, education level and years of experience working at nursing homes. A questionnaire survey was conducted among nursing staff (n = 616) in 16 nursing homes in the central part of Norway. Twenty items concerned staff behaviour in forms of acts of inadequate care. The respondents were asked to report how often they had observed colleagues commit acts and how often they themselves had committed such acts. The response rate was 79%. All in all, 91% of the nursing staff reported that they had observed at least one act of inadequate care and 87% reported that they had committed at least one act of inadequate care. Acts of negligent and emotional character were most frequently reported, both as observed and committed. Depending on the higher educational level that the nursing staff had more acts of all types were observed and committed. The oldest staff and those with longest experience at the present nursing home reported more observed and committed acts of physical character than did the others. The extent of inadequate care confirms that this is a common part of activities in nursing homes. Because emotional and negligent acts can be just as harmful as physical acts, more knowledge is needed about the reasons in order to take preventive actions.

  15. Sensory rooms in psychiatric inpatient care: Staff experiences.

    PubMed

    Björkdahl, Anna; Perseius, Kent-Inge; Samuelsson, Mats; Lindberg, Mathilde Hedlund

    2016-10-01

    There is an increased interest in exploring the use of sensory rooms in psychiatric inpatient care. Sensory rooms can provide stimulation via sight, smell, hearing, touch and taste in a demand-free environment that is controlled by the patient. The rooms may reduce patients' distress and agitation, as well as rates of seclusion and restraint. Successful implementation of sensory rooms is influenced by the attitudes and approach of staff. This paper presents a study of the experiences of 126 staff members who worked with sensory rooms in a Swedish inpatient psychiatry setting. A cross-sectional descriptive survey design was used. Data were collected by a web based self-report 12-item questionnaire that included both open- and closed-ended questions. Our findings strengthen the results of previous research in this area in many ways. Content analyses revealed three main categories: hopes and concerns, focusing on patients' self-care, and the room as a sanctuary. Although staff initially described both negative and positive expectations of sensory rooms, after working with the rooms, there was a strong emphasis on more positive experiences, such as letting go of control and observing an increase in patients' self-confidence, emotional self-care and well-being. Our findings support the important principals of person-centred nursing and recovery-oriented mental health and the ability of staff to implement these principles by working with sensory rooms.

  16. Enabling hospital staff to care for people with dementia.

    PubMed

    Bray, Jennifer; Evans, Simon; Bruce, Mary; Carter, Christine; Brooker, Dawn; Milosevic, Sarah; Thompson, Rachel; Woods, Catherine

    2015-12-01

    This is the fourth and final article in a short series that presents case study examples of the positive work achieved by trusts who participated in the Royal College of Nursing's development programme to improve dementia care in acute hospitals. Dementia training in hospitals is often inadequate and staff do not always have sufficient knowledge of dementia to provide appropriate care. It can also be difficult for them to identify when patients with dementia are in pain, especially when their communication skills deteriorate. The case studies presented illustrate how two NHS trusts have worked to ensure that their staff are fully equipped to care for people with dementia in hospital. Basildon and Thurrock University Hospitals NHS Foundation Trust in Essex made dementia training a priority by including dementia awareness in staff induction across a range of roles and providing additional training activities tailored to meet staff needs. Nottingham University Hospitals NHS Trust focused on pain assessment, aiming to standardise its approach for patients with dementia. The pain assessment in advanced dementia tool was chosen and piloted, and is being implemented across the trust after a positive response.

  17. A residential aged care end-of-life care pathway (RAC EoLCP) for Australian aged care facilities.

    PubMed

    Reymond, Liz; Israel, Fiona J; Charles, Margaret A

    2011-08-01

    The objective of this study was to develop, implement and evaluate an end-of-life (terminal) care pathway and associated infrastructure suitable for Australian residential aged care facilities that improves resident and health system outcomes. The residential aged care end-of-life care pathway was developed by a multidisciplinary collaboration of government and non-government professionals and incorporated best clinical management for dying residents to guide care and increase palliative care capacity of generalist staff. Implementation included identifying and up-skilling Link Nurses to champion the pathway, networking facilities with specialist palliative care services, delivering education to generalists and commencing a Palliative Care Medication Imprest System in each facility. The primary outcome measure for evaluation was transfer to hospital; secondary measures included staff perceived changes in quality of palliative care provided and family satisfaction with care. Results indicated that the pathway, delivered within a care framework that guides provision of palliative care, resulted in improved resident outcomes and decreased inappropriate transfers to acute care settings. PMID:21871198

  18. 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

  19. 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…

  20. Family-centred care: review of opinions among staff.

    PubMed

    McLaughlin, Kieran; Melby, Vidar; Coates, Vivien

    2013-02-01

    The sudden admission to an emergency department (ED) of a patient requiring resuscitation can be a traumatic experience for families, who often require a great deal of support from ED staff. The needs of such staff must be considered too, if the care of patients and families during resuscitation attempts is to be improved. This article discusses the findings of a systematic review of the literature on family-centred care during and after resuscitation attempts, and reveals that, although families appear to favour witnessed resuscitation, the practice remains controversial among healthcare professionals. Chaotic workloads, time restraints, lack of education and poor coping abilities all appear to affect wider implementation of the practice in EDs.

  1. 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. ...

  2. Resident-Directed Long-Term Care: Staff Provision of Choice During Morning Care

    PubMed Central

    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 included 73 long-stay residents in 2 facilities. Research staff conducted observations for 4 consecutive morning hours during targeted care activities (transfer out of bed, incontinence, dressing, and dining location). Observations were conducted weekly for 12 consecutive weeks. Staff–resident interactions were measured related to staff offers of choice and residents’ responses. Results: Interrater agreement was achieved for measures of staff offers of choice (kappa = .83, p < .001), type of choice provided (kappa = .75, p < .001), and resident requests related to choice (kappa = .72, p < .001). Observations over 2,766 care episodes during 4 aspects of morning care showed that staff offered residents choice during 18% of the episodes. Most observations (70%) were coded as staff offering “no choice.” Implications: Nursing home staff can use a simplified version of this standardized observational tool to reliably measure staff–resident interactions related to choice during morning care provision as a first step toward improving resident-directed care practice. PMID:21719629

  3. 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

  4. 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.

  5. Oral care for frail elders: knowledge, attitudes, and practices of long-term care staff.

    PubMed

    Dharamsi, Shafik; Jivani, Khairun; Dean, Charmaine; Wyatt, Chris

    2009-05-01

    The University of British Columbia Geriatric Dentistry Program (GDP) offers dental services and provides a comprehensive in-service education program for nursing and residential care-aide (RCA) staff in the provision of daily mouth care for elders in various long-term care (LTC) facilities in Vancouver. This study examined the general impact of the education initiative at one LTC site. A survey (N=90), semi-structured open-ended interviews (N=26), and product audits were conducted to 1) examine the impact of the GDP education initiative on the level of knowledge, attitudes, and practices of RCAs and nursing staff regarding the provision of daily mouth care; 2) identify the enablers and barriers that influenced the provision of daily mouth care practices, policies, and protocols using the PRECEDE-PROCEED model of health promotion research; and 3) assess the self-perceptions of RCAs and nursing staff members regarding their oral health. A knowledge gap was evident in some key areas pertaining to prevention of dental diseases. Twenty-five percent of residents were missing toothbrushes and toothpaste for daily mouth care. Residents who exhibit resistance to mouth care tended not to receive regular care, while issues such as time, increased workload, limited staff, and the lack of an accountability structure are disenabling factors for provision of daily mouth care. Results suggest that the impact of educational interventions is affected by the quality of in-service education, an absence of identified predisposing, reinforcing, and enabling factors, and a strong commitment among LTC staff to the provision of daily mouth care for frail elders.

  6. Role of emergency care staff in managing acute stroke.

    PubMed

    Watkins, Caroline; Anderson, Craig; Forshaw, Denise; Lightbody, Liz

    2014-09-01

    In June, the University of Central Lancashire opened its clinical trials unit, where staff will run complex intervention trials in a range of care areas, including stroke, musculoskeletal health, public health and mental health. One of the first trials looks at how hospital nursing policies in the first 24 hours after patients have had stroke affect their subsequent survival and disabilities. Known as HeadPoST, the study will recruit 20,000 patients globally, with the 6,000 UK research participants managed by Lancashire. This article explores the role of emergency nurses in supporting the research.

  7. [Psychic crisis care in the emergency room nursing staff's view].

    PubMed

    Borges, Leandro da Rosa; de Pinho, Leandro Barbosa; Lacchini, Annie Jeanninne Bisso; Schneider, Jacó Fernando

    2012-09-01

    This study was aimed at finding out the nursing staff's view about psychic crisis care in an emergency room unit. This is a qualitative study that used the application of semi-structured interviews as data collecting technique. Five nursing professionals that worked in the emergency room during the morning and afternoon shifts participated in the research. Data analysis was conducted based on the discussion of the following categories: concept of crisis for the emergency room team and the different suffering expressions and therapeutic resources to face and minimize the crisis' burdens. Professionals usually justify their difficulties on treating a psychic crisis due to lack of time, space and proper training.

  8. Wage and Benefits Survey of Child Care Center Staff in Montgomery County.

    ERIC Educational Resources Information Center

    Montgomery County Dept. of Family Resources, Rockville, MD. Div. of Program Development and Planning.

    In this study of child care center wages, benefits, and working conditions, questionnaires were completed by directors and senior staff at 129 centers in Montgomery County, Maryland. Survey findings on staff education and experience indicated that 34 percent of staff had a bachelor's degree or higher. A typical staff member had 5.5 years of…

  9. 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…

  10. Use of Warning Signs for Dengue by Pediatric Health Care Staff in Brazil

    PubMed Central

    Hökerberg, Yara Hahr Marques; de Oliveira, Raquel de Vasconcellos Carvalhaes; Barros, Danielle Martins de Souza; Alexandria, Helenara Abadia Ferreira; Daumas, Regina Paiva; de Andrade, Carlos Augusto Ferreira; Passos, Sonia Regina Lambert; Brasil, Patrícia

    2016-01-01

    Objective The aim of this study was to describe the use of dengue warning signs by pediatric healthcare staff in the Brazilian public health care system. Methods Cross-sectional study (2012) with physicians, nurses, and nurse technicians assisting children in five health care facilities. Participants reported the use and importance of dengue warning signs in pediatrics clinical practice through a structured questionnaire. Differences in the use of signs (chi-square test) and in the ranking assigned to each of them (Kruskal-Wallis) were assessed according to health care occupation and level of care (p<0.05). Results The final sample comprised 474 participants (97%), mean age of 37 years (standard deviation = 10.3), mainly females (83.8%), physicians (40.1%) and from tertiary care (75.1%). The majority (91%) reported using warning signs for dengue in pediatrics clinical practice. The most widely used and highly valued signs were major hemorrhages (gastrointestinal, urinary), abdominal pain, and increase in hematocrit concurrent or not with rapid decrease in platelet count. Persistent vomiting as well as other signs of plasma leakage such as respiratory distress and lethargy/restlessness were not identified as having the same degree of importance, especially by nurse technicians and in primary or secondary care. Discussion Although most health care staff reported using dengue warning signs, it would be useful to extend the training for identifying easily recognizable signs of plasma leakage that occur regardless of bleeding. PMID:27716812

  11. 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

  12. 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.

  13. 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…

  14. 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.

  15. 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…

  16. Staff Group Unanimity in the Care of Juveniles in Institutional Treatment: Routines, Rituals, and Relationships

    ERIC Educational Resources Information Center

    Ahonen, Lia; Degner, Jurgen

    2013-01-01

    One prerequisite for effective institutional care is that staff agree on how to deliver treatment and have a unified view of how to achieve change--in other words, to have staff group unanimity (SGU). This study used the Correctional Program Assessment Inventory (CPAI) 2000, interviews with key staff, and observations of daily activities to…

  17. A family perspective of family/staff interaction in long-term care facilities.

    PubMed

    Gladstone, J; Wexler, E

    2000-01-01

    This article explores the ways that families perceive their relationships with the staff in long-term care facilities. Qualitative interviews were conducted with 27 families who had elder members in two facilities in Ontario, Canada. The families identified the staff characteristics that they valued and the ways they developed relationships with staff members.

  18. 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

  19. Hospital staff's perceptions of risk associated with the discharge of elderly people from acute hospital care.

    PubMed

    Macmillan, M S

    1994-02-01

    As part of the exploratory work for a project on discharge planning of elderly people (75+ years of age) from acute care, the concept of risk was discussed with a sample of consultants; ward sisters; staff nurses; a social worker; occupational therapist; pharmacist; and some physiotherapists. The factors which they identified as being relevant to 'risky discharges' were organized under seven headings: medical factors; mobility; social surroundings; personality; habits; social support; and external factors. These findings are presented within the context of a review of relevant literature and some conclusions are drawn.

  20. Discipline in School-Age Care: Control the Climate, Not the Children.

    ERIC Educational Resources Information Center

    Fink, Dale Borman

    This book is addressed to school-age care staff and suggests they rethink their attitudes about the behavior of the children under their care. Ideas were generated by workshop participants about ways to promote misbehavior, as a way of gaining insights into encouraging positive behaviors. The following six key elements of a school-age care program…

  1. An evaluation of perceived education and training needs of staff nurses and care officers.

    PubMed

    Brennan, Michael

    2006-01-01

    This study was carried out to ascertain the specific education and training needs of nursing and care officer staff working at the Central Mental Hospital (CMH) in Dublin, Ireland, which provides national forensic psychiatric services. This is the first time an education and training needs analysis was conducted for all nursing and care officer staff.

  2. 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…

  3. 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

  4. 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…

  5. 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.

  6. When staff members sexually abuse children in residential care.

    PubMed

    Bloom, R B

    1992-01-01

    When an agency staff member is accused of sexually abusing a client, the administration is faced with the Solomonic task of balancing the necessity of protecting the child, supporting the staff, and maintaining the integrity and reputation of the agency. This article presents practical suggestions for managing the agency through such a crisis. PMID:1638902

  7. Positive effects of experience in terminal care on nursing home staff in Japan.

    PubMed

    Abe, Koji; Ohashi, Akira

    2011-09-01

    This study aimed to examine the psychological effects of terminal care experience on nursing home staff and analyze the differences between staff who are experienced and those who are inexperienced in providing terminal care. A mailed survey was conducted in 2007. A total of 37% (N = 72) of the participants had experience in terminal care in nursing homes. Analysis of variance (ANOVA) revealed that the professional efficacy (a subscale of the Maslach Burnout Inventory-General Survey [MBI-GS]) and tenure (duration of service) of the experienced staff were significantly higher than those of the inexperienced staff. The high professional efficacy noted among the experienced staff suggests that the provision of terminal care in nursing homes does not necessarily lead to burnout among caregivers and may in fact serve as an important motivational factor.

  8. Managing risk in cancer presentation, detection and referral: a qualitative study of primary care staff views

    PubMed Central

    Cook, Neil; Thomson, Gillian; Dey, Paola

    2014-01-01

    Objectives In the UK, there have been a number of national initiatives to promote earlier detection and prompt referral of patients presenting to primary care with signs and symptoms of cancer. The aim of the study was to explore the experiences of a range of primary care staff in promoting earlier presentation, detection and referral of patients with symptoms suggestive of cancer. Setting Six primary care practices in northwest England. Participants: 39 primary care staff from a variety of disciplines took part in five group and four individual interviews. Results The global theme to emerge from the interviews was ‘managing risk’, which had three underpinning organising themes: ‘complexity’, relating to uncertainty of cancer diagnoses, service fragmentation and plethora of guidelines; ‘continuity’, relating to relationships between practice staff and their patients and between primary and secondary care; ‘conflict’ relating to policy drivers and staff role boundaries. A key concern of staff was that policymakers and those implementing cancer initiatives did not fully understand how risk was managed within primary care. Conclusions Primary care staff expressed a range of views and opinions on the benefits of cancer initiatives. National initiatives did not appear to wholly resolve issues in managing risk for all practitioners. Staff were concerned about the number of guidelines and priorities they were expected to implement. These issues need to be considered by policymakers when developing and implementing new initiatives. PMID:24928585

  9. Grief After Patient Death: Direct Care Staff in Nursing Homes and Homecare

    PubMed Central

    Boerner, Kathrin; Burack, Orah R.; Jopp, Daniela S.; Mock, Steven E.

    2014-01-01

    Context Patient death is common in long-term care. Yet, little attention has been paid to how direct care staff members, who provide the bulk of daily long-term care, experience patient death and to what extent they are prepared for this experience. Objectives To 1) determine how grief symptoms typically reported by bereaved family caregivers are experienced among direct care staff, 2) explore how prepared staff members were for the death of their patients, and 3) identify characteristics associated with their grief. Methods This was a cross-sectional study of direct care staff experiencing recent patient death. Participants were 140 certified nursing assistants and 80 homecare workers. Standardized assessments and structured questions addressed staff (e.g., preparedness for death), institutional (e.g., support availability), and patient/relational factors (e.g., relationship quality). Data analyses included bivariate group comparisons and hierarchical regression. Results Grief reactions of staff reflected many of the core grief symptoms reported by bereaved family caregivers in a large-scale caregiving study. Feelings of being “not at all prepared” for the death and struggling with “acceptance of death” were prevalent among staff. Grief was more intense when staff-patient relationships were closer, care was provided for longer, and staff felt emotionally unprepared for the death. Conclusion Grief symptoms like those experienced by family caregivers are common among direct care workers following patient death. Increasing preparedness for this experience via better training and support is likely to improve the occupational experience of direct care workers, and ultimately allow them to provide better palliative care in nursing homes and homecare. PMID:24996033

  10. Reducing Direct-Care Staff Absenteeism: Effects of a Combined Reinforcement and Punishment Procedure.

    ERIC Educational Resources Information Center

    Briggs, Renee M.

    1990-01-01

    Absenteeism of 130 direct-care staff in a residential facility for developmentally disabled persons was reduced by 27 percent through positive reinforcement for reliable attendance and punishment (progressive discipline) for attendance abuse. Reduced absenteeism was maintained for 12 months and overtime was reduced, but staff turnover increased.…

  11. Continuing Education for Staff in Long-Term Care Facilities: Corporate Philosophies and Approaches.

    ERIC Educational Resources Information Center

    Ross, Margaret M.; Carswell, Anne; Dalziel, William B.; Aminzadeh, Faranak

    2001-01-01

    Interviews with 10 administrators in 9 long-term care facilities revealed a commitment to staff continuing education and recognition of the escalating need, but also an emphasis on individual responsibility. Lack of fiscal and human resources and diversity of staff hampered the ability to provide continuing education. (SK)

  12. Handbook of Policies and Procedures for Before-and-After-School Child Care Staff.

    ERIC Educational Resources Information Center

    1991

    This handbook, which is provided by the Adel-Desoto Community School District for new staff members, covers all aspects of the before-and-after-school child care program, including: (1) the school itself (facilities and equipment); (2) the staff (employment qualifications, requirements, and classifications; policies regarding conduct, appearance,…

  13. 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…

  14. 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

  15. Joining the Quality Circle: Developmentally Appropriate Practice in School-Age Care.

    ERIC Educational Resources Information Center

    Albrecht, Kay

    1993-01-01

    Describes characteristics of a high-quality school-age care program: resourceful, caring staff; recognition of the importance of peers; opportunities for mixed- and same-age grouping; children's selection of activities and experiences; guidance for children's social and emotional development; and environments that encourage a wide variety of…

  16. [Constipation in the hospital. Ethical reflection on its care by the nursing staff].

    PubMed

    Berger, Valérie; Durand, Luc; Grocq, Martine

    2010-12-01

    The intestinal elimination of the hospitalized patients is a function insufficiently taken into account by the nursing staff from a preventive point of view. Nevertheless, numerous patients present transit disorders which are mostly translated into a diagnosis of constipation requiring therapeutic prescriptions and sometimes even aggressive and expensive medical examinations. The objective of this work is to lead an ethical reflection on the care of intestinal elimination by the nursing staff. Through a questionnaire, we wish to answer 3 questions: how come the nursing staff have difficulties taking care of the intestinal elimination of the hospitalized patients? What are the determiners which influence the care of the intestinal elimination by the nursing staff? Does training prepare the nursing staff to take care of the intestinal elimination of the hospitalized patients? The questionnaire was distributed to doctors, male and female nurses, nursing auxiliaries and students in care of the sick working in medicine, surgery and intensive care of the same hospital. This survey allowed to question 130 persons among whom 36 doctors, 37 male and female nurses, 30 nursing auxiliaries and 27 students. We were able to confirm that the care of the intestinal elimination is insufficiently taken into account in a preventive way, because 56 % of the people interviewed explain that the problem of intestinal elimination is not approached before the complaint of the patient Several determiners make that the nursing staff are not in a preventive approach. This care does not meet much interest, is experienced as devaluing, taboo and the relation nursing staff-patient is hindered because everyone has difficulties to speak about it. Institutional difficulties are also discussed, such as the lack of coordination of the nursing staff and the lack of time. Another point of this survey shows that work experience is not an element which facilitates this care because the more the nursing

  17. The differential influence of culture change models on long-term care staff empowerment and provision of individualized care.

    PubMed

    Caspar, Sienna; O'Rourke, Norm; Gutman, Gloria M

    2009-06-01

    With this study we set out to determine if differences exist across culture change models (CCM) in relation to formal caregivers' perceived access to empowerment structures and reported provision of individualized care. We recruited staff working in facilities that had implemented the Eden Alternative, GentleCare, Facility Specific Social Models of Care (FSSMOC), or no CCM. Multivariate analyses of variance (MANOVA) compared these constructs by CCM for each of three caregiver groups (Registered Nurses, Licensed Practical Nurses, and care aides). Results suggest that considerable differences exist between formal caregivers and by CCM. The greater caregivers' day-to-day contact with residents, the more CCMs appear to affect perceived empowerment and reported provision of individualized care. Findings suggest the greatest benefits existed for staff working in facilities with a FSSMOC. Conversely, in only one instance did responses from staff in Eden Alternative facilities differ from those in facilities with no CCM. PMID:19860975

  18. [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.

  19. 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

  20. 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)

  1. Choosing a model of care for patients in alternate level care: caregiver perspectives with respect to staff injury.

    PubMed

    Ostry, Aleck S; Tomlin, Katrina M; Cvitkovich, Yuri; Ratner, Pamela A; Park, Il Hyeok; Tate, Robert B; Yassi, Annalee

    2004-03-01

    The population of alternate level care (ALC) patients utilizing acute-care hospital resources inappropriate to their needs is growing. The purpose of this study was to explore how the care of ALC patients was managed at 4 acute-care facilities in the Canadian province of British Columbia and to examine how this care impacts on outcomes of staff injury. Interviews were conducted to identify and characterize the different models of ALC. Injury outcomes for all caregivers were obtained (n = 2,854) and logistic regression conducted to compare staff injuries across ALC models. Injured workers were surveyed regarding their perceptions of injury risk and ALC. Five ALC models were identified: low-mix, high-mix, dedicated ALC units, extended care units, and geriatric assessment units. The risk for caregiver injuries was lowest on dedicated ALC units. These findings suggest that acute-care facilities faced with a growing ALC population should consider creating dedicated ALC units.

  2. 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

  3. Occupational conditions of ward staff and quality of residential care for individuals with mental retardation.

    PubMed

    Duker, P C; Seys, D; van Leeuwe, J; Prins, L W

    1991-01-01

    Effects of occupational conditions of ward staff on the quality of residential care for individuals with mental retardation was assessed. Three questions were asked: (a) Does type of contract under which staff members are employed differentially affect their distribution of activities? (b) Does length of duty have an effect on their distribution of activities? (c) Does the number of staff members present on the living group influence quality of care? Over a 40-week period, data were collected on 30 ward staff members who were responsible for 39 residents with severe and profound mental retardation. Results show that staff differentially distributed their activities, especially with respect to organizational activities and the amount of custodial care, depending on the type of contract they were employed under and the number of consecutive days they worked. Number of staff present on the living group appeared to be a major factor in terms of distribution of activities. Implications for staff managers and administrators of residential facilities were discussed. PMID:2003908

  4. 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,…

  5. [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.

  6. [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

  7. 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…

  8. Elder Care Comes of Age.

    ERIC Educational Resources Information Center

    Herndon, Mary D.

    1995-01-01

    A discussion of elder care looks at the extent to which government and employers are addressing the issue, how elder care affects the work performance of and productivity of employed caregivers, and how human resource professionals can respond effectively to the needs of both employee and employer as these needs relate to the issue of elder care.…

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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.

  14. 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.

  15. Presence and availability: staff conceptions of nursing leadership on an intensive care unit.

    PubMed

    Rosengren, Kristina; Athlin, Elsy; Segesten, Kerstin

    2007-07-01

    A demand for high quality care has drawn attention to leadership issues. The nurse managing role has changed over the years and become more complex with a high burden of work. Few studies describe the perspective of 'those being lead'. The aim of this study was to describe staff conceptions about nursing leadership on an intensive care unit. Ten members of staff were interviewed and analysed according to a phenomenographical approach, focusing variations in how informants experience nursing leadership and make sense of the world around them. The findings show that nursing leadership was considered to be 'being present and available in daily work', 'supporting everyday practice', 'facilitating professional acknowledgement' and to 'improve care both as individuals and as a team'. Transformational leadership seemed to be suitable to meet the staff perspective. In such leadership communicative skills is a core to work with strong professionals by being present and available. PMID:17576250

  16. [Verbal aggression against health-care staff: results of a qualitative study].

    PubMed

    Richter, D

    2014-09-01

    Verbal aggression against health-care staff can induce considerable stress. Compared to physical aggression, systematic studies on verbal aggression are lacking.A qualitative focus group study was conducted in several clinical settings in north-western Germany: acute mental health care, forensic mental health care, children and adolescent psychiatry, residential care for mentally ill persons, general hospital, and nursing home. 74 staff members from various professions participated in 8 focus groups.Various forms of verbal aggression were reported, from verbal abuse over threats to non-compliant behaviour. Backgrounds for verbal aggression by patients were usually non-satisfaction with the situation or the treatment, organisational problems, and mental disorders. Staff reported about various coping strategies such as ignorance and rationalisation, but also helplessness. Compared to physical aggression, the severity of verbal aggression was rated non-uniformly. A clear boundary between verbal aggression and 'normal' speech acts could not be drawn, as subjective and individual factors play an important role while interpreting aggressive acts.Verbal aggression is a relevant stressor for health-care staff which has been widely neglected in care institutions. Prevention efforts may include situational coping (e. g., communication training) and psychological coping (e. g., resilience enhancement).

  17. 25 CFR 900.199 - Does FTCA coverage extend to health care practitioners to whom staff privileges have been...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 2 2013-04-01 2013-04-01 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...

  18. 25 CFR 900.199 - Does FTCA coverage extend to health care practitioners to whom staff privileges have been...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 2 2014-04-01 2014-04-01 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...

  19. 25 CFR 900.199 - Does FTCA coverage extend to health care practitioners to whom staff privileges have been...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 2 2011-04-01 2011-04-01 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...

  20. 25 CFR 900.199 - Does FTCA coverage extend to health care practitioners to whom staff privileges have been...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 2 2012-04-01 2012-04-01 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...

  1. The patient care development programme: organisational development through user and staff involvement.

    PubMed

    Hill, P; O'Grady, A; Millar, B; Boswell, K

    2000-01-01

    A number of approaches have been developed in recent years to try effectively to engage service users in the process of planning and delivering health-care services. The consumerist methodology for the strategy described in this paper was designed to maximise staff involvement in capturing user views, in order to develop services at a district general hospital. This strategy--the Patient Care Development Programme (PCDP)--provides a framework for both staff and patient involvement in shaping and influencing the development of health-care services. Uses the findings from applying the strategy to modify care packages, roles, skills, layouts, protocols and procedures, in response to both the "shortfalls" and the service strengths that the patient's view uncovers. Discusses the results of an evaluation of the programme which has been replicated in another part of the UK. The PCDP now forms part of a clinical governance framework and is being used to develop multi-agency integrated care pathways.

  2. Leadership and management in the aged care sector: a narrative synthesis.

    PubMed

    Jeon, Yun-Hee; Merlyn, Teri; Chenoweth, Lynn

    2010-06-01

    The aim of this study is to examine the issues and the progress being made in leadership and management with relevance for the residential aged care workforce. A systematic review was conducted using scientific journal databases, hand searching of specialist journals, Google, snowballing and suggestions from experts. After a seven-tiered culling process, we conducted a detailed review of 153 papers relevant to leadership and management development in aged care. Strong, effective leadership and management promotes staff job satisfaction and retention, high care quality and the well-being of care recipients, and reduces associated costs. Good leadership and effective management also play a key role in bringing about a successful change to a positive workplace culture through innovative programs and research projects. Organisational investment in improving leadership and management skills and capabilities can only improve outcomes for staff stability and productivity, care quality and budgets, and better prepare the aged care sector. PMID:20553534

  3. Catch a Glimpse of Me: The development of staff videos to promote person-centered care.

    PubMed

    Gendron, Tracey L; King Seymour, Lindsay; Welleford, E Ayn

    2016-09-01

    Catch a Glimpse of Me is an ongoing project that uses video to help staff deliver more person-centered care for people with dementia living in long-term care. Focus groups consisting of residents, family and staff members were conducted to develop a template for the development of the videos. The five themes they identified as being important to include are: family; interests and hobbies; memories and moments; life space and getting personal. The article describes the process of developing the videos and discusses the ongoing potential of the Catch a Glimpse of Me project.

  4. 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

  5. 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

  6. 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.

  7. 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

  8. 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…

  9. Job satisfaction among nursing staff in a military health care facility.

    PubMed

    Allgood, C; O'Rourke, K; VanDerslice, J; Hardy, M A

    2000-10-01

    Job satisfaction in the workplace affects absenteeism, turnover, and performance. We conducted a cross-sectional study of 201 nursing personnel to assess satisfaction among nursing staff at a military hospital in the southwestern United States. Participants completed a self-administered survey in which they rated professional status, autonomy, pay, organizational policies, task requirements, and interaction by importance and satisfaction. Autonomy, professional status, and pay were the most important factors and organizational policies was the least important factor. Military staff were slightly more satisfied with staff interactions than civilian staff. Nursing personnel working in specialty care units were significantly more satisfied with interactions and professional status, but they valued organizational policies less than those working in general units. Professionals were significantly more satisfied with pay and autonomy, whereas nonprofessionals were more satisfied with task requirements and professional status. PMID:11050873

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

    PubMed

    Reinholdz, Hanna; Bendtsen, Preben; Spak, Fredrik; Müssener, Ulrika

    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

  11. 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

  12. 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

  13. 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…

  14. Parent Involvement in Day Care: Its Impact on Staff and Classroom Environments

    ERIC Educational Resources Information Center

    Shapiro, Sylvia

    1977-01-01

    A large-scale study of the extent of parent involvement on boards in preschool day care indicates that intensity of involvement, rather than the number of parents involved, is the key factor. The impact of parent involvement on staff and classroom environment also is examined. (MS)

  15. Parent Involvement in Day Care: Its Impact on Staff and Classroom Environments.

    ERIC Educational Resources Information Center

    Shapiro, Sylvia

    In this large scale study, the extent of parent involvement in preschool day care and its impact on staff and on classroom environments in child-centered and adult-centered situations were assessed. Subjects were 15 directors, 30 teachers, 524 children in 30 classrooms. Interview schedules and a classroom observation scale were the two instruments…

  16. 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)

  17. 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.…

  18. Recruitment & Selection of Staff: A Guide for Managers of Preschool & Child Care Programs.

    ERIC Educational Resources Information Center

    Administration for Children, Youth, and Families (DHHS), Washington, DC.

    Intended for managers of child care programs, this brochure lists the basic components of a clearly defined personnel policy. The guide is based on the personnel practices and experiences of more than 1,200 Head Start programs serving over 442,000 children nationwide. Emphasis is given to staff recruitment, screening, and the selection process.…

  19. Supervisory Intervention: Improving Data Reporting by Direct-Care Staff at a Child Services Program

    ERIC Educational Resources Information Center

    Flood, William A.; Luiselli, James K.

    2012-01-01

    We report a study that addressed behavior data recording by direct-care staff at a child services program. In response to a decreasing percentage of daily data recording in two community-based group homes, a supervisory intervention was implemented, consisting of a revised data recording form and providing performance feedback to the direct-care…

  20. Creating a Healthy Camp Community: Health Care Staff Can Provide Training and Guidance.

    ERIC Educational Resources Information Center

    McMillan, Nancy S.

    2001-01-01

    Camp health care staff can give basic health education to counselors, covering daily hygiene for young children, basic understanding of common chronic illnesses, observational skills to detect illnesses, elementary public health tutoring, and OSHA medical standards. Health personnel should be included in planning precamp and in-service counselor…

  1. Career Development Potential and Validity of a Competency Based Credential for Child Care Staff. Final Report.

    ERIC Educational Resources Information Center

    Pettygrove, Willa Bowman

    A credential called the Child Development Associate (CDA) was the focus of this study. Based on the competence of child care staff, it offers two benefits: it may be fair and accurate without resorting to impractical requirements of education and experience, and its recognition may benefit workers' careers. Credentialed and noncredentialed groups…

  2. Identifying Child-Staff Ratios That Promote Peer Skills in Child Care

    ERIC Educational Resources Information Center

    Iluz, Reli; Adi-Japha, Esther; Klein, Pnina S.

    2016-01-01

    Research Findings: Early child care policy and practice are grounded in a growing understanding of the importance of the first years of life. In earlier studies, associations between child-staff ratios and peer skills yielded inconsistent findings. The current study used data from the National Institute of Child Health and Human Development Study…

  3. 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…

  4. Examining the role of information exchange in residential aged care work practices-a survey of residential aged care facilities

    PubMed Central

    2012-01-01

    Background The provision of residential aged care is underpinned by information, and is reliant upon systems that adequately capture and effectively utilise and communicate this information. The aim of this study was to explicate and quantify the volume and method by which information is collected, exchanged within facilities and with external providers, and retrieved from facility information systems and hospitals. Methods A survey of staff (n = 119), including managers, health informatics officers (HIOs), quality improvement staff, registered nurses (RNs), enrolled nurses (ENs)/endorsed enrolled nurses (EENs) and assistants in nursing (AINs) was carried out in four residential aged care facilities in New South Wales and Victoria, Australia. Sites varied in size and displayed a range of information technology (IT) capabilities. The survey investigated how and by whom information is collected, retrieved and exchanged, and the frequency and amount of time devoted to these tasks. Descriptive analysis was performed using SPSS, and open responses to questions were coded into key themes. Results Staff completed a median of six forms each, taking a median of 30 min per shift. 68.8% of staff reported transferring information from paper to a computer system, which took a median of 30 min per shift. Handover and face-to-face communication was the most frequently used form of information exchange within facilities. There was a large amount of faxing and telephone communication between facility staff and General Practitioners and community pharmacists, with staff reporting sending a median of 2 faxes to pharmacy and 1.5 faxes to General Practitioners, and initiating 2 telephone calls to pharmacies and 1.5 calls to General Practitioners per shift. Only 38.5% of respondents reported that they always had information available at the point-of-care and only 35.4% of respondents reported that they always had access to hospital stay information of residents after hospital

  5. 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

  6. “They can do whatever they want”: Meanings of receiving psychiatric care based on a common staff approach

    PubMed Central

    Enarsson, Per; Sandman, Per-Olof; Hellzén, Ove

    2011-01-01

    This study deepens our understanding of how patients, when cared for in a psychiatric ward, experience situations that involve being handled according to a common staff approach. Interviews with nine former psychiatric in-patients were analyzed using a phenomenological–hermeneutic method to illuminate the lived experience of receiving care based on a common staff approach. The results revealed several meanings: discovering that you are as subjected to a common staff approach, becoming aware that no one cares, becoming aware that your freedom is restricted, being afflicted, becoming aware that a common staff approach is not applied by all staff, and feeling safe because someone else is responsible. The comprehensive understanding was that the patient's understanding of being cared for according to a common staff approach was to be seen and treated in accordance with others' beliefs and valuations, not in line with the patients' own self-image, while experiencing feelings of affliction. PMID:21383956

  7. Violation of the patient's integrity, seen by staff in long-term care.

    PubMed

    Kihlgren, M; Thorsén, H

    1996-01-01

    The aim of the study was to describe the views held by staff (n = 233) in long-term care on what they regard as a violation of patient's integrity and to define the concept "integrity" in simple terms. The design of the investigation was inductive. The answers were coded into 775 items. Agreement was reached between the authors on 770 of the items when sorted into 13 categories: the unique personality, autonomous self, personal opinions, secret self, personal competence, professional self, family self, cultural self, information self, personal properties, private territory, corporal self, and ridiculing. The number of categories shows a great variation in the ordinary language definitions given by staff. It was also shown in two other ways: the difference in the level of abstraction in the items, and the fact that integrity referred to the patient, directly or indirectly. Our conclusion is that integrity by the staff reflects an ethical value and not a personal trait. If the staff have to violate the patient's integrity, because other vital values are involved, it is absolutely essential that they consider the ethical aspects of the situation carefully. Such violation demands that they preserve their respect for the patient to the greatest extent possible. It seems important in the training of different staff groups to show the complexity in the concept "integrity" and the ethical dilemmas that arise, especially in the interaction with vulnerable patients who are not able to protect and maintain their own integrity.

  8. 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...

  9. 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.

  10. 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

  11. Who's Who in School-Age Care

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    2006-01-01

    In the field of school-age care, there are three organizations that have been instrumental in the development of the profession: (1) School-Age "NOTES"; (2) National Institute on Out-of-School Time; and (3) National AfterSchool Association. In recent years many new players have been effective in promoting the field. In this article, the author…

  12. Reducing direct-care staff absenteeism: effects of a combined reinforcement and punishment procedure.

    PubMed

    Briggs, R M

    1990-06-01

    Absenteeism of 130 direct-care staff was reduced by 27% through a mixed consequence procedure consisting of positive reinforcement for reliable attendance and punishment (progressive discipline) for attendance abuse. Reduced rates of absenteeism were maintained over a 12-month period. A 17% reduction in overtime and an increase in annual staff turnover from 34% to 45% also occurred. Results extend the findings of mixed consequence procedures to residential facilities for persons with developmental disabilities. Development of a more powerful positive reinforcement component was discussed.

  13. 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

  14. 76 FR 74834 - Interim Staff Guidance on Aging Management Program for Steam Generators

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-01

    ... using Revision 3 of the Nuclear Energy Institute's (NEI) document, NEI 97-06, ``Steam Generator Program... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Interim Staff Guidance on Aging Management Program for Steam Generators AGENCY: Nuclear...

  15. 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

  16. 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

  17. 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.

  18. Primary Care of Women Aging with HIV

    PubMed Central

    Womack, Julie A.; Brandt, Cynthia A.; Justice, Amy C.

    2016-01-01

    Women are living longer with HIV infection, but their life expectancy is shorter than for women in the general population. How best to manage the multiple comorbidities and polypharmacy that are common in HIV infected individuals has not been studied. This paper explores areas where the primary care of women with HIV may differ from that of aging women in the general population. We also discuss aspects of care that may not commonly be considered in those under the age of 65, specifically multimorbidity and polypharmacy. Incorporating a gerontologic approach in the care of these women may optimize outcomes until research provides more definitive answers as to how best to collaborate with women with HIV to provide them with optimal care. PMID:25782848

  19. Impact of the Relocation of a Long-term Residential Care Facility on Staff.

    PubMed

    Kearney, Anne J; Grainger, Patricia; Compton, Glenda; Morgan, Arthur F

    2015-01-01

    This article describes the relocation of residents and staff of a long-term residential care facility into a new state-of-the-art building in a Canadian province. All staff were surveyed about their perceptions of the moving process 2 months after the move occurred using a newly created 51-item questionnaire containing both open-ended and closed questions (5-point Likert scale). The results were positive for the 3 subscales of the survey, with average scores for premove, midmove, and postmove items of 3.67, 3.94, and 3.66, respectively. There was no significant difference in the means when comparing staff position, years of employment, or assignment to 1 or more units. Staff were very positive about the move itself, the orientation provided and overall planning, and support from coworkers and management. Some concerns were raised about staffing shortages, involvement of residents, and preparedness of the units and building. In addition, it is evident that relocation is an ongoing process, with many supports required in the months after the move. This article describes a very well planned and executed relocation of a long-term residential care facility and can provide guidance and lessons learned to assist other administrators who are planning a similar endeavor.

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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…

  6. 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…

  7. 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... been extended in contractor health care facilities operated under a self-determination contract on...

  8. Education and Training. Do They "Really, Really" Want It? A Comparative Study of Care Home Staff in England and Germany.

    ERIC Educational Resources Information Center

    Eyers, Ingrid

    2000-01-01

    Comparison of residential care staff in England and Germany showed that, in the care industry, England has a training framework that is not yet widely used. Despite its strong vocational policies, Germany has none. Care assistants are not expected to have formal skills and rarely participate in training. "Emotional labor" is undervalued in both…

  9. Ethical issues in palliative care. Views of patients, families, and nonphysician staff.

    PubMed Central

    Towers, Anna; MacDonald, Neil; Wallace, Ellen

    2003-01-01

    OBJECTIVE: Much of what we know about ethical issues in palliative care comes from the perceptions of physicians and ethicists. In this study our goal was to hear other voices and to gain first-hand knowledge of the possibly contrasting views of patients, their families, nurses, volunteers, and other team members on end-of-life issues. DESIGN: Qualitative study using semistructured interviews. SETTING: Inpatient and consultation palliative care service of the Royal Victoria Hospital in Montreal, Que. PARTICIPANTS: Of 113 people interviewed, 13 were patients, 43 were family members, 32 were volunteers, 14 were nurses, and 11 were other staff. METHOD: Interviewers elicited subjects' perspectives on ethical issues. Content analysis was used to identify, code, and categorize themes in the data. MAIN FINDINGS: Communication difficulties and insufficient resources and staff were the most frequently mentioned problems in this palliative care setting. CONCLUSION: The findings of this study will help guide policy decisions and setting of educational priorities in end-of-life care, particularly regarding the importance of adequate communication. PMID:14708928

  10. 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.

  11. Gentle persuasive approaches: introducing an educational program on an orthopaedic unit for staff caring for patients with dementia and delirium.

    PubMed

    Pizzacalla, Anne; Montemuro, Maureen; Coker, Esther; Martin, Lori Schindel; Gillies, Leslie; Robinson, Karen; Pepper, Heather; Benner, Jeff; Gusciora, Joanna

    2015-01-01

    Gentle Persuasive Approaches in Dementia Care (GPA), a curriculum originally designed for long-term care, was introduced into an acute care setting. This person-centered approach to supporting and responding to persons with behaviors associated with dementia was shown to be applicable for staff on an orthopaedic surgery unit where they had reported significant challenges and care burdens when faced with behaviors such as shouting, explosiveness, and resistance to care. Staff confidence in their ability to care for persons with behaviors increased after attending the 1-day GPA workshop, and they reported being highly satisfied with the curriculum, found it to be applicable to their practice, indicated that it was also useful for patients with delirium, and would recommend it to others. Some of the staff on the orthopaedic unit became certified GPA coaches. The passion of those champions, along with demonstrated success of the program on their unit, contributed to its spread to other units, including rehabilitation and acute medicine.

  12. Ethical dilemmas for house staff physicians. The care of critically ill and dying patients.

    PubMed

    Winkenwerder, W

    1985-12-27

    Winkenwerder describes a disagreement about proper management of a critically ill patient that arose during his tenure as a house staff physician. Despite the attending physician's consideration of the family's wishes and the best interests of the patient, the resident was uneasy with the decision to continue life-prolonging treatment and the role he was to play in implementing such procedures. The author argues that ethical decisions within the group of physicians caring for a patient, especially one who is terminally ill, are not always resolved to everyone's satisfaction. What then are the rights and duties of residents to refuse further participation in care? Winkenwerder suggests dealing with conflicts through recognizing value differences, increasing formal ethics teaching, using consultants, and maximizing communication among members of patient care teams.

  13. Preparing staff to care for veterans in a way they need and deserve.

    PubMed

    Conard, Patricia L; Allen, Patricia E; Armstrong, Myrna L

    2015-03-01

    More than 2.5 million military veterans have been deployed for service in Iraq and/or Afghanistan, whereas another 20 million veterans currently reside in the United States. For various reasons, increasing numbers of military and associated personnel from various wars could go to civilian population-based care facilities for their rest-of-life health care. Therefore, educational activities are important to prepare nursing staff for the culturally sensitive care that veterans, their dependents, and civilian contractor personnel need. This article (a) provides rationale for veterans' admissions, (b) summarizes some common health situations that veterans are likely to encounter, (c) stresses major educational goals, and (d) emphasizes the use of the universal assessment question: Have you ever served in the military? Several educational implications and challenges are discussed, including war zone physiology, reintegration, military culture and pride, ethical challenges, educational speakers, simulation, veteran individuality, and compassion fatigue. Available resources to accompany this content are provided.

  14. 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

  15. Preparing staff to care for veterans in a way they need and deserve.

    PubMed

    Conard, Patricia L; Allen, Patricia E; Armstrong, Myrna L

    2015-03-01

    More than 2.5 million military veterans have been deployed for service in Iraq and/or Afghanistan, whereas another 20 million veterans currently reside in the United States. For various reasons, increasing numbers of military and associated personnel from various wars could go to civilian population-based care facilities for their rest-of-life health care. Therefore, educational activities are important to prepare nursing staff for the culturally sensitive care that veterans, their dependents, and civilian contractor personnel need. This article (a) provides rationale for veterans' admissions, (b) summarizes some common health situations that veterans are likely to encounter, (c) stresses major educational goals, and (d) emphasizes the use of the universal assessment question: Have you ever served in the military? Several educational implications and challenges are discussed, including war zone physiology, reintegration, military culture and pride, ethical challenges, educational speakers, simulation, veteran individuality, and compassion fatigue. Available resources to accompany this content are provided. PMID:25723332

  16. 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

  17. 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

  18. 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

  19. 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…

  20. Status Report #1 on School-Age Care.

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    1993-01-01

    Provides an overview of issues and trends in school-age care. Topics discussed include (1) the population that needs care; (2) the providers of care; (3) challenges to providing care that relate to facility space, funding, affordability, staffing, and competition among providers; and (4) the future of school-age care. (HOD)

  1. School-Age Care and After-School Programs: Developing a Responsive Curriculum--Revisited 25 Years Later

    ERIC Educational Resources Information Center

    Scofield, Rich

    2004-01-01

    In 1979 and 1980 "Child Care Information Exchange" ran a series of five articles about what was then called school-age day care: "Getting It Off the Ground," "Designing an Effective Structure," "Developing a Responsive Curriculum," "Selecting and Motivating Staff," and "Managing the Money." These articles from 25 years ago captured the essence of…

  2. Evaluating the barriers to point-of-care documentation for nursing staff.

    PubMed

    Kohle-Ersher, Angela; Chatterjee, Pooja; Osmanbeyoglu, Hatice Ulku; Hochheiser, Harry; Bartos, Christa

    2012-03-01

    Point-of-care documentation has been identified as a patient safety measure for improving accuracy and timeliness of data. To evaluate the barriers that nurses and nurse aide/clinical technicians encounter for electronic point-of-care documentation, we conducted surveys on a telemetry unit at a southwestern Pennsylvania community hospital. Our first survey revealed that the location of the in-room computers, perceived lack of in-room computer reliability, Health Insurance Portability and Accountability Act/privacy concerns, and perceptions of the patients' response to charting on computers in patient rooms were all barriers to point-of-care documentation. Our second survey revealed that workflow priority issues were also a barrier to point-of-care documentation, as staff members did not rate documentation as a high priority in terms of delivering timely medical care. Changes in both nursing practices and hospital infrastructure may be needed if these barriers to point-of-care documentation are to be overcome.

  3. 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…

  4. 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.

  5. The professional development needs of registered nurses in residential aged care.

    PubMed

    Hunter, Sharyn; McMillan, Margaret; Conway, Jane

    2007-04-01

    This paper reports on research which used a multiple-case study approach to investigate the responses of aged care nurses to changes in Australian health care policy following the introduction of the Aged Care Act 1997. Significant fiscal, social and environmental issues for Residential Aged Care (RAC) are the: need to respond to policy changes emphasizing efficiency in RAC facilities, nature of the needs of residents with increasing acuity, impact of decreasing numbers of Registered Nurses (RNs) working in the RAC environment, changing composition of the care team and RAC RN functions. The study explored the phenomenon of the contemporary practice of (RNs) within six RAC settings, focusing on changes in the practice of RNs. As a result of the research a number of issues pertinent to staff and role development of RNs were identified. PMID:17679262

  6. 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)

  7. [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.

  8. Staff-related access deficit and antenatal care coverage across the NUTS level 1 regions of Turkey.

    PubMed

    Yardim, Mahmut S

    2010-01-01

    At the heart of each health system, the workforce is central to advancing health. The World Health Organization has identified a threshold in workforce density below which high coverage of essential interventions, including those necessary to meet the health-related Millennium Development Goals (MDGs), is very unlikely. The International Labor Organization (ILO) has launched a similar indicator -staff related access deficit- using Thailand's health care professional density as a benchmark. The aim of this study is to assess the staff-related access deficit of the population across the 12 NUTS 1 level regions of Turkey. The main hypothesis is that staff-related access deficit has a correlation with and predicts the gap in antenatal care coverage (percentage of women unable to access to antenatal care) across different regions. Staff-related access deficit, as a threshold indicator, seems to have a linear relationship with the antenatal care coverage gap. The known inequalities in the distribution of the health care workforce among different regions of Turkey were put forward once more in this study using the SRA indicator. The staff-related access deficit indicator can be easily used to monitor the status of distributional inequalities of the health care workforce at different sub-national levels in the future. PMID:21375148

  9. 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

  10. 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,…

  11. 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

  12. 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.

  13. 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

  14. 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

  15. Knowing versus doing: education and training needs of staff in a chronic care hospital unit for individuals with dementia.

    PubMed

    Marx, Katherine A; Stanley, Ian H; Van Haitsma, Kimberly; Moody, Jennifer; Alonzi, Dana; Hansen, Bryan R; Gitlin, Laura N

    2014-12-01

    Hospital clinical staff routinely confront challenging behaviors in patients with dementia with limited training in prevention and management. The authors of the current article conducted a survey of staff on a chronic care hospital unit concerning knowledge about dementia, perceived educational needs, and the care environment. The overall mean score for a 27-item knowledge scale was 24.08 (SD = 2.61), reflecting high level of disease knowledge. However, staff indicated a need for more information and skills, specifically for managing behaviors nonpharmacologically (92.3%), enhancing patient safety (89.7%), coping with care challenges (84.2%), and involving patients in activities (81.6%). Although most staff (i.e., nurses [80%] and therapists [86.4%]) believed their care contributed a great deal to patient well-being, approximately 75% reported frustration and being overwhelmed by dementia care. Most reported being hit, bitten, or physically hurt by patients (66.7%), as well as disrespected by families (53.8%). Findings suggest that staff have foundational knowledge but lack the "how-to" or hands-on skills necessary to implement nonpharmacological behavioral management approaches and communicate with families.

  16. 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...

  17. Helping students survive institutionalized patients and burn-out in staff in chronic psychiatric care facilities.

    PubMed

    Bissell, B P; Feather, R B; Ryan, D M

    1984-01-01

    In summary, we have discussed the problem of institutionalized patients and burn-out in staff as well as the effect they both have on nursing students during their mental health-psychiatric nursing rotation. The stages in which specific student behaviors occur during the psychiatric nursing rotation as a result of the students' perceptions, and the interventions faculty members can employ in decreasing the subjective aspects of these perceptions have also been presented. We conclude that nursing students will emerge from their experience with better understanding of institutionalization and burn-out, and better equipped to cope with reality shock if they are introduced to these concepts early in the lecture series and are sent to a variety of psychiatric care facilities for observational experience. The facilities selected should be those in which patients are coping with less chronic behavior problems than found in state hospitals and where observable behavioral changes in patients are measured in weeks or months, rather than years. Facilities such as outpatient clinics and crisis intervention centers where clients may be more stabilized, less overwhelming, and have more resources available to them would meet these criteria. Finally, we recommend that instructors be made more aware than they are of the institutionalization and burn-out process early in their teaching responsibilities; that faculty group discussions on institutionalization as maladaptive behavior be held; and that the faculty encourage an open atmosphere where students can discuss their reactions to institutionalization in patients and burn-out in staff freely.

  18. Special report on medical staff relationships. Handling "impaired" health care professionals.

    PubMed

    Paine, S J

    1991-06-01

    Applying the doctrine of corporate negligence, courts will, in appropriate circumstances, deem hospitals and other institutional health care providers responsible for the quality of patient care in their institutions and for the consequences of negligent physician performance that could have been discovered and prevented. See, e.g., Darling v. Charleston Community Memorial Hosp., 33 Ill. 2d 326 (1965), cert, denied, 383 U.S. 946 (1966); Johnson v. Misericordia Community Hosp., 99 Wis. 2d 709 (1981); Elam v. College Park Hosp., 132 Cal. App. 3d 332 (1982). In such a climate, and with Data Bank reporting now a reality, neither institutional providers nor health care professionals on their medical staffs can afford to ignore problems of practitioner impairment. Recognizing this reality, some state laws now mandate an organized approach--such as the establishment of an impaired practitioners committee--to problems of professional impairment. However, whether state-mandated or not, providers must have policies and procedures in place to insure not only that impaired professionals are referred to available treatment programs, but that they fully participate in and complete such programs, and achieve rehabilitation, before they return to practice at the institution. The earlier detection and treatment are initiated, preferably before peer review action becomes necessary, the better for patients, institutions, and practitioners themselves. PMID:10111959

  19. 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.

  20. 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

  1. 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

  2. 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

  3. State Developments in Child Care, Early Education, and School-Age Care, 2001.

    ERIC Educational Resources Information Center

    Ewen, Danielle; Blank, Helen; Hart, Katherine; Schulman, Karen

    This report provides highlights and updates regarding state actions on child care, early education, and school-age care issues during 2001. It is intended to serve as a supplement to "State Developments in Child Care, Early Education, and School-Age Care 2000" and various reports published on this issue between 1997 and 1999. Information in the…

  4. 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…

  5. 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.

  6. Parents: the best experts in child health care? Viewpoints from parents and staff concerning child health services.

    PubMed

    Hallberg, A C; Lindbladh, E; Råstam, L; Håkansson, A

    2001-08-01

    The aim was to describe what parents and staff think about child health care, to identify agreements and disagreements. A qualitative study was made with semi-structured interviews based on a phenomenographic approach. Sixty parents, 14 nurses and six doctors from southern Sweden were interviewed. Parents and staff emphasized two tasks as being of particular importance: support and check-ups. There was a conflict between parents' need for security versus integrity. Individual nurses experienced a conflict between what they wanted to do and what they felt that they had to do. The parents viewed parental education as a chance to exchange experiences with other parents and receive support from other adults, while the staff mainly saw it as an opportunity to inform parents and strengthen them in their parental role. The study gives grounds for reflection about how the work of child health care can be changed in the future.

  7. 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

  8. 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…

  9. 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…

  10. [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.

  11. [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

  12. Acceptance and commitment therapy-based self-management versus psychoeducation training for staff caring for clients with a personality disorder: a randomized controlled trial.

    PubMed

    Clarke, Sue; Taylor, Georgina; Lancaster, Joanna; Remington, Bob

    2015-04-01

    People diagnosed with a personality disorder (PD) are often a stigmatized patient group. This can affect the care they receive, their progression, and the well-being of staff caring for them. Interventions targeted at health care professionals that aim to improve attitudes toward these patients and improve staff well-being do exist; however, evidence for their effectiveness is limited. The present study compared a self-management, Acceptance and Commitment Therapy-based training intervention (ACTr) with a Psychoeducation Training (PETr) intervention in their effectiveness in improving attitudes toward PD patients, staff-patient relations, and staff well-being. Both interventions were successful at improving attitudes and measures of staff-patient relations up to 6 months after training; however, staff well-being did not change for either group. The implications for staff training and future research are discussed.

  13. A Survey of the Salaries, Benefits, and Working Conditions for California Child Care Resource and Referral Staff.

    ERIC Educational Resources Information Center

    Kinley, Gary J.; And Others

    This document reports the results of a survey of resource and referral programs and their parent agencies. All the agencies were members of the California Child Care Resource and Referral Network. The survey instrument was a 96-item questionnaire divided into four sections: (1) staff salaries and qualifications; (2) working conditions; (3)…

  14. 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…

  15. 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…

  16. 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…

  17. Knowledge of Staff Members of Residential Care Facilities for Individuals with Intellectual Disability on Medication Administration via Enteral Feeding Tube

    ERIC Educational Resources Information Center

    Joos, E.; Mehuys, E.; Van Bocxlaer, J.; Remon, J. P.; Van Winckel, M.; Boussery, K.

    2016-01-01

    Background: Guidelines for the safe administration of drugs through enteral feeding tube (EFT) are an important tool to minimise the risk of errors. This study aimed to investigate knowledge of these guidelines among staff of residential care facilities (RCF) for people with ID. Method: Knowledge was assessed using a 13-item self-administered…

  18. 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…

  19. 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…

  20. 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

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

    PubMed

    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."

  2. 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,…

  3. 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.…

  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.

  5. 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

  6. 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

  7. State unit on aging involvement with continuing care retirement community (CCRC) legislation.

    PubMed

    Netting, F E; Wilson, C C; Stearns, L R; Branch, L G

    1992-09-01

    State units on aging (SUAs) from 29 states with continuing care retirement community (CCRC) legislation were surveyed to (a) assess staff familiarity with CCRC legislation, (b) examine interdepartmental working relationships surrounding such legislation and ask what role(s) ombudspersons are playing in CCRC oversight, (c) determine what role(s) aging units have had in developing legislation, and (d) gain insights regarding legislative impact. Results indicate that SUAs have been active in legislative development but vary greatly in the intensity of their involvement with the implementation and enforcement of CCRC regulation and in their perception of legislative impact.

  8. Differences by age groups in health care spending.

    PubMed

    Fisher, C R

    1980-01-01

    This paper presents differences by age in health care spending by type of expenditure and by source of funds through 1978. Use of health care services generally increases with age. The average health bill reached $2,026 for the aged in 1978, $764 for the intermediate age group, and $286 for the young. Biological, demographic, and policy factors determine each age group's share of health spending. Public funds financed over three-fifths of the health expenses of the aged, with Medicare and Medicaid together accounting for 58 percent. Most of the health expenses of the young age groups were paid by private sources. PMID:10309224

  9. Psychosocial effects of SARS on hospital staff: survey of a large tertiary care institution

    PubMed Central

    Nickell, Leslie A.; Crighton, Eric J.; Tracy, C. Shawn; Al-Enazy, Hadi; Bolaji, Yemisi; Hanjrah, Sagina; Hussain, Ayesha; Makhlouf, Samia; Upshur, Ross E.G.

    2004-01-01

    Background The outbreak of SARS in 2003 had a dramatic effect on the health care system in Toronto. The main objective of this study was to investigate the psychosocial effects associated with working in a hospital environment during this outbreak. Methods Questionnaires were distributed to all willing employees of Sunnybrook and Women's College Health Sciences Centre between Apr. 10 and 22, 2003. The survey included questions regarding concern about SARS, precautionary measures, personal well-being and sociodemographic characteristics; a subsample also received the 12-item version of the General Health Questionnaire (GHQ-12). Results Of the 4283 questionnaires distributed, 2001 (47%) were returned, representing 27% of the total hospital employee population of 7474. The proportions of respondents who were allied health care professionals, nurses and doctors and who worked in areas other than patient care were representative of the hospital staff population as a whole. Of the 2001 questionnaires, 510 contained the GHQ-12. Two-thirds of the respondents reported SARS-related concern for their own or their family's health. A total of 148 respondents (29%) scored above the threshold point on the GHQ-12, indicating probable emotional distress; the rate among nurses was 45%. Masks were reported to be the most bothersome infection control precaution. Logistic regression analysis identified 4 factors as being significantly associated with increased levels of concern for personal or family health: perception of a greater risk of death from SARS (adjusted odds ratio [OR] 5.0, 95% confidence interval [CI] 2.6–9.6), living with children (adjusted OR 1.8, 95% CI 1.5–2.3), personal or family lifestyle affected by SARS outbreak (adjusted OR 3.3, 95% CI 2.5–4.3) and being treated differently by people because of working in a hospital (adjusted OR 1.6, 95% CI 1.2–2.1). Four factors were identified as being significantly associated with the presence of emotional distress

  10. 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…

  11. Patient care in a technological age.

    PubMed

    Dragon, Natalie

    2006-07-01

    In this electronically wired world of the 21 st century, the health care system has tapped into technology available at the touch of a button. Scientific discoveries, high-tech equipment, electronic medical records, Smarticards, and long distance diagnosis using telehealth technology have all been embraced. But Natalie Dragon asks, what are the implications for nurses and the outcomes on patient care?

  12. 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.

  13. 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.…

  14. 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.

  15. 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

  16. Evaluation of care for the aged: a multipurpose guide.

    PubMed

    Bergman, R; Golander, H

    1982-05-01

    There is a growing recognition of the need to evaluate quality of care. As the aged are a particularly vulnerable group, often dependent on care-givers for their remaining years, it is important to control related services. An interdisciplinary workgroup prepared a tool which lists cues to be considered in determining the quality of care for the age in ambulatory services, home care programmes, short-and long-term institutions. The cues fall into six domains: physical environment, psychosocial environment, basic personal care, health care, family involvement and manpower. The tool can be used by clients and families for selecting placement for care; by caregivers in choosing or remaining in a place of work; by those administratively responsible for care, such as supervisors, or licensing bodies for controlling performance and policy; and by other involved persons, such as educators, researchers, volunteers or funding agencies for their specific purposes. PMID:6811642

  17. 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

  18. 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

  19. [The voluntary medical care during the First World War. The work of the nursing staff in the military field hospitals on the eastern and western frontlines].

    PubMed

    Stölzle, Astrid

    2012-01-01

    The voluntary medical care consisted of civilians who were provided to the medical corps in the First World War for the first time in this great dimension. The nursing staff on the eastern and the western German frontlines were sending letters back home, some of them were drafting diaries due to the special event or recorded their experiences after the war. Besides the narratives of their private impressions, these documents are reflecting their nursing work, which the nursing staff had to achieve. An important factor was, that the patients were soldiers. Conflicts in the cooperation with the medical staff and among the nurses did not seem to have influenced a good quality of care, however it facilitated a harmonic coexistence and above all, it helped to sustain behind the fronts. The study of the nursing care and the relationship with patients and among the staff reflects on the meaning of nursing care for the staff.

  20. 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

  1. 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

  2. Masterful care of the aging triathlete.

    PubMed

    Wright, Vonda J

    2012-12-01

    Current endurance champions are turning in winning performances in their late 30s and 40s. These masters-age athletes present a special challenge to Sport Medicine practitioners who in previous decades have simply advised masters-aged athletes to stop competing to prevent or treat injury. The fact is, many of the physical changes commonly attributed to aging alone are actually due to the rages of sedentary aging. Recently a body of literature emerged which begins to define what we are capable of with chronic high-level exercise and guides masters-age athletes to train and rehab smarter to stay competitive. The factors influencing the relative declines in overall performance in the various sports include both physiological and lifestyle changes. The following review summarizes age and sex-related changes in triathlon performance, the biology of aging as it relates to endurance sport and factors that affect performance in the masters athletes.

  3. Low back pain among care workers working at newly-built nursing homes for the aged.

    PubMed

    Tomioka, Kimiko

    2008-05-01

    The aim of this study was to investigate the association between severe low back pain (LBP) and work load for care workers (CWs) who were working at newly-built special nursing homes, because it has long been known that LBP is very common among CWs, and we consider that measures to reduce serious LBP should be the top priority. A total of 258 questionnaires were distributed to all CWs employed at 7 nursing homes. There were 214 replies, a response rate of 82.9%. The average age of respondents was 28.8 years old. A total of 212 (59 males and 153 females) completed questionnaires were analyzed. The results of factor analysis were based on 22 original questions about physical and mental care work load. Sixteen questions and 5 subscales were explored. Factor 1 was characteristics and ADL of care receivers; Factor 2, violence by care receivers; Factor 3, communication with staff at workplace; Factor 4, problems with work environment; and Factor 5, communication with care receivers. Severe LBP was defined as a subject who had always suffered from LBP in the last one month. Multiple logistic regression analysis was performed to estimate the relationship of severe LBP and care work load. Adjustments were made for sex and job tenure. In Factor 1, "characteristics and ADL of care receivers", heavy weight showed significant association, with adjusted Odds Ratios of 6.63 (95%CI: 1.71-25.75). Therefore, to prevent LBP of CWs, it is necessary to make staff assignments and to provide assistive devices based on careful considerations of the characteristics and ADL of care receivers. PMID:18434702

  4. 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.

  5. 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

  6. 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

  7. 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

  8. Do Child Care Centers Have to Pay Staff for Time Spent in Training?

    ERIC Educational Resources Information Center

    Pekow, Charles

    1996-01-01

    Notes the different labor acts and policies that create confusion over whether centers must pay staff for training time if such training is required by law. Also notes state variations on this matter. (MOK)

  9. 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

  10. Social climate of acute old age psychiatry inpatient units: staff perceptions within the context of patient aggression.

    PubMed

    McCann, T; Baird, J; Muir-Cochrane, E C

    2015-03-01

    Patient aggression occurs in old age psychiatry and is contrary to their recovery and to the well-being of staff. A favourable social climate can contribute to a reduction in aggression. The aim of this study was to examine the perceptions of clinical staff about the social climate of acute old age psychiatry inpatient units. Eighty-five clinicians were recruited from these facilities. They completed a survey questionnaire about the social climate or ward atmosphere of inpatient units. The findings showed that, to some extent, respondents' perceived patient cohesion and mutual support were evident, units were perceived somewhat positively as safe environments for patients and staff, and the ward climate helped meet patients' therapeutic needs. Overall, clinicians were somewhat positive about the social climate of the units, and this has implications for the perception of aggression in old age psychiatry inpatient settings. As there is a direct relationship between social climate and aggression, clinicians should consider adopting a broad-based, person-centred approach to the promotion of a favourable social climate in old age psychiatry inpatient settings.

  11. 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

  12. 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.

  13. Staff Counselling in Education.

    ERIC Educational Resources Information Center

    Gray, H. L.

    One aspect of staff development that has not received much attention is staff counseling. In fact, the general pastoral care of the teaching staff is largely neglected. Since most problems of teachers have a personal nature, what is needed is a specially trained staff within the institution to offer personal counseling. This counseling could focus…

  14. Advance care planning for residents in aged care facilities: what is best practice and how can evidence-based guidelines be implemented?

    PubMed

    Lyon, Cheryl

    2007-12-01

    Background  Advance care planning in a residential care setting aims to assist residents to make decisions about future healthcare and to improve end-of-life care through medical and care staff knowing and respecting the wishes of the resident. The process enables individuals and others who are important to them, to reflect on what is important to the resident including their beliefs/values and preferences about care when they are dying. This paper describes a project conducted as part of the Joanna Briggs Institute Clinical Aged Care Fellowship Program implemented at the Manningham Centre in metropolitan Melbourne in a unit providing services for 46 low and high care residents. Objectives  The objectives of the study were to document implementation of best practice in advance care planning in a residential aged care facility using a cycle of audit, feedback and re-audit cycle audit with a clinical audit software program, the Practical Application of Clinical Evidence System. The evidence-based guidelines found in 'Guidelines for a Palliative Approach in Residential Aged Care' were used to inform the process of clinical practice review and to develop a program to implement advance care planning. Results  The pre-implementation audit results showed that advance care planning practice was not based on high level evidence as initial compliance with five audit criteria was 0%. The barriers to implementation that became apparent during the feedback stage included the challenge of creating a culture where advance care planning policy, protocols and guidelines could be implemented, and advance care planning discussions held, by adequately prepared health professionals and carers. Opportunities were made to equip the resident to discuss their wishes with family, friends and healthcare staff. Some residents made the decision to take steps to formally document those wishes and/or appoint a Medical Enduring Power of Attorney to act on behalf of the resident when they

  15. Age differences in health care spending, fiscal year 1977.

    PubMed

    Gibson, R M; Fisher, C R

    1979-01-01

    This report of health care spending in fiscal year 1977 reveals that of the $142.6 billion spent by the Nation for personal health care in fiscal year 1977, 29 percent was spent for those aged 65 or older, 59 percent for those aged 19-64, and 13 percent for those below age 19. The average health bill reached $1,745 for the aged, $661 for the intermediate age group, and $253 for the young. Public funds financed 67 percent of the health expenses of the aged, with Medicare and Medicaid together accounting for 61 percent. More than two-thirds of the health expenses of the young and 71 percent of the expenses of those aged 19-64 were paid by private sources. Third-party payments met 68 percent of the health expenditures of all those under age 65. PMID:107600

  16. 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…

  17. Influences on Case-Managed Community Aged Care Practice.

    PubMed

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

    2016-10-01

    Case management has been widely implemented in the community aged care setting. In this study, we aimed to explore influences on case-managed community aged care practice from the perspectives of community aged care case managers. We conducted 33 semistructured interviews with 47 participants. We drew these participants from a list of all case managers working in aged care organizations that provided publicly funded case management program(s)/packages in Victoria, Australia. We used a multilevel framework that included such broad categories of factors as structural, organizational, case manager, client, and practice factors to guide the data analysis. Through thematic analysis, we found that policy change, organizational culture and policies, case managers' professional backgrounds, clients with culturally and linguistically diverse backgrounds, and case management models stood out as key influences on case managers' practice. In the future, researchers can use the multilevel framework to undertake implementation research in similar health contexts. PMID:26318797

  18. 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 ...

  19. 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

  20. 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.

  1. Psychosocial work environment, stress factors and individual characteristics among nursing staff in psychiatric in-patient care.

    PubMed

    Hanna, Tuvesson; Mona, Eklund

    2014-01-20

    The psychosocial work environment is an important factor in psychiatric in-patient care, and knowing more of its correlates might open up new paths for future workplace interventions. Thus, the aims of the present study were to investigate perceptions of the psychosocial work environment among nursing staff in psychiatric in-patient care and how individual characteristics--Mastery, Moral Sensitivity, Perceived Stress, and Stress of Conscience--are related to different aspects of the psychosocial work environment. A total of 93 nursing staff members filled out five questionnaires: the QPSNordic 34+, Perceived Stress Scale, Stress of Conscience Questionnaire, Moral Sensitivity Questionnaire, and Mastery scale. Multivariate analysis showed that Perceived Stress was important for Organisational Climate perceptions. The Stress of Conscience subscale Internal Demands and Experience in current units were indicators of Role Clarity. The other Stress of Conscience subscale, External Demands and Restrictions, was related to Control at Work. Two types of stress, Perceived Stress and Stress of Conscience, were particularly important for the nursing staff's perception of the psychosocial work environment. Efforts to prevent stress may also contribute to improvements in the psychosocial work environment.

  2. Becoming-Worker: Vocational Training for Workers in Aged Care

    ERIC Educational Resources Information Center

    Somerville, Margaret

    2006-01-01

    Women's care work sits on the boundary between unpaid work in the private domain and poorly paid, low-status work in the public sphere. It continues to be a site for the expression of complex, high-level knowledge and skills, and of ongoing gender oppression. The aged-care industry is a particularly salient example of such work. It is a…

  3. 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…

  4. Casemix in the Islamic Republic of Iran: current knowledge and attitudes of health care staff.

    PubMed

    Ghaffari, S; Doran, C M; Wilson, A

    2008-01-01

    Casemix is a tool that classifies patients according to their clinical similarity and the homogeneity of resources required. A descriptive study was conducted to assess the level of knowledge and attitude toward the casemix-based funding system among staff working in the Iranian Social Security Organization in Tehran. The survey showed that knowledge of casemix and diagnosis-related groups (DRG) was poor among the study group and any attempt to implement the casemix system--which about three-quarters of high-level staff had never heard of--would be likely to fail. This highlights the necessity for creating awareness of the casemix and DRG systems among the hospital staff before any action takes place. PMID:19166177

  5. Animal-assisted therapy in the intensive care unit. A staff nurse's dream comes true.

    PubMed

    Cole, K M; Gawlinski, A

    1995-09-01

    This article presents an example of how one staff nurse was able to implement change in clinical practice on the basis of research. After reviewing the literature on AAT, I was able to implement this therapy for critically ill patients and families. Patient satisfaction surveys indicate that patients have benefited from this change. Patients report feelings of increased happiness, calmness, more feelings of love, and less loneliness. This example shows how staff nurses, a highly motivated and knowledgeable group, provide a fertile arena for bridging the research-practice gap.

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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.

  11. 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…

  12. [Quality of working life and burnout among nursing staff in Intensive Care Units].

    PubMed

    Schmidt, Denise Rodrigues Costa; Paladini, Márcia; Biato, Cleonice; Pais, Juliana Domingues; Oliveira, Adelaine Rodrigues

    2013-01-01

    This descriptive-correlational and cross-sectional study aimed to evaluate the quality of working life (QWL) and the presence of burnout among nursing professionals working at Intensive Care Units. The sample was composed of 53 nursing professionals from a university hospital located in the city of Londrina-PR, Brazil. Three instruments were used for data collection: socio-demographic and professional characterization, Visual Analogue Scale for QWL and Maslach Burnout Inventory. Data was collected from April to August, 2009. Among the participants, most were auxiliary nurses (52.8%), women (66.0%) and married (67.9%). The average age was of 42.4 years. Regarding assessment of QWL, the average score obtained for the total sample was 71.1 (SD=15.5), showing that workers were satisfied with their QWL. The average for Emotional Exhaustion, Depersonalization and Personal Accomplishment dimensions was 11.4 (SD=7.7), 4.6 (SD=4.1) and 25.0 (SD=5.9), respectively. The QWL for the total sample showed significant association only with Emotional Exhaustion (p=0.000). PMID:23681373

  13. The black aged: implications for mental health care.

    PubMed

    Carter, J H

    1982-01-01

    Some of the problems associated with providing quality mental health care for aged blacks are discussed. It is postulated that treatment should be used selectively, not in terms of simplistic formulas or part-truths about aged blacks, but on the bases of clinical indications in differential diagnosis. The essence of improved mental health for blacks, regardless of sex or age, entails an unrelenting struggle by mental health professionals toward the removal of all vestiges of racism.

  14. 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

  15. Age differences in health care spending, fiscal year 1976.

    PubMed

    Gibson, R M; Mueller, M S; Fisher, C R

    1977-08-01

    Of the $120.4 billion spent by the Nation for personal health care in fiscal year 1976, 29% was spent for those aged 65 or older, 15% for those under age 19, and the remaining 56% for those aged 19-64. The average health bill reached $1,521 for the aged, $547 for the intermediate age group, and $249 for the young. Public funds financed 68% of the health expenses of the aged with Medicare and Medicaid together accounting for 59%. Private sources paid 74% of the health expenses of the young and 70% of the expenses of those aged 19-64. Third-party payments met 65% of the health expenditures of all those under age 65. PMID:408934

  16. An exploratory, interview study of oncology patients' and health-care staff experiences of discussing resuscitation.

    PubMed

    Cox, Karen; Wilson, E; Jones, L; Fyfe, D

    2007-11-01

    There is little research about how patients and their families would like discussions surrounding resuscitation to take place. The purpose of this exploratory study was to investigate the experience of a discussion of resuscitation from the perspective of the participants. In-depth interviews were undertaken with 21 patients, of whom nine were interviewed together with a relative and 14 staff in an oncology setting. Data were analysed using a constant comparative method and coded using NVIVO qualitative data analysis software. Patients appeared to be accepting resuscitation discussions as necessary and important. A minority felt that the timing of the discussion could have been better, particularly if they were newly diagnosed or had recently commenced treatment. Relatives generally found the discussions more difficult and felt that discussions should take place much closer to death. Patients identified that they needed time and privacy during the discussion. Staff identified a need to present a sensitive and individualised discussion which took into account the key elements of timing, place, space, manner and pace. Patients acknowledged that the resuscitation discussion enabled them to begin to address issues relating to dying and end of life. For staff on-going communication skills training and support in this area were seen as important but often overlooked parts of the process.

  17. 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

  18. 'I love nursing, but..'- qualitative findings from Australian aged-care nurses about their intrinsic, extrinsic and social work values.

    PubMed

    Tuckett, Anthony; Parker, Deborah; Eley, Robert M; Hegney, Desley

    2009-12-01

    Aim.  The aim of this qualitative analysis - a component of a larger survey study, was to provide insights and understandings about intrinsic and extrinsic work values for nurses in aged-care. Background.  Intrinsic and extrinsic work values impact on nurses' job satisfaction and ultimately nursing retention. This study contributes further to knowledge development in this area by building on a previous work values study in aged-care nursing. Methods.  This paper presents the qualitative research findings from the final open-ended question from a survey of nurses employed in the aged-care sector in the State of Queensland, Australia in 2007. Data from a cohort of 105 aged care sector nurses was analysed relying on deductive content analysis. Findings.  Two intrinsic work values emerged - low morale and images of nursing and two extrinsic work values emerged - remuneration and working conditions. The work value 'working conditions' comprised four aspects of aged-care work, specifically staff turnover, workplace violence, care team membership specifically the Assistants-in-Nursing and paperwork. A single social workplace value 'support by management' is discussed as identified as important to these nurses. Conclusion.  Qualitative insights into aged-care nurses' intrinsic and extrinsic work values suggest that work satisfaction is low. Workforce policy makers and employers of nurses in aged-care need to comprehend the relationship between job satisfaction, retention and work values. Relevance to clinical practice.  These findings have implications for recruitment, retention and workforce planning within the aged-care environment. PMID:20925856

  19. “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

  20. “We’ll Get to You When We Get to You”: Exploring Potential Contributions of Health Care Staff Behaviors to Patient Perceptions of Discrimination and Satisfaction

    PubMed Central

    Cherrington, Andrea L.; Andreae, Lynn; Prince, Candice; Holt, Cheryl L.; Halanych, Jewell H.

    2015-01-01

    Objectives. We qualitatively assessed patients’ perceptions of discrimination and patient satisfaction in the health care setting specific to interactions with nonphysician health care staff. Methods. We conducted 12 focus-group interviews with African American and European American participants, stratified by race and gender, from June to November 2008. We used a topic guide to facilitate discussion and identify factors contributing to perceived discrimination and analyzed transcripts for relevant themes using a codebook. Results. We enrolled 92 participants: 55 African Americans and 37 European Americans, all of whom reported perceived discrimination and lower patient satisfaction as a result of interactions with nonphysician health care staff. Perceived discrimination was associated with 2 main characteristics: insurance or socioeconomic status and race. Both verbal and nonverbal communication style on the part of nonphysician health care staff were related to individuals’ perceptions of how they were treated. Conclusions. The behaviors of nonphysician health care staff in the clinical setting can potentially contribute to patients’ perceptions of discrimination and lowered patient satisfaction. Future interventions to reduce health care discrimination should include a focus on staff cultural competence and customer service skills. PMID:26270291

  1. Psychosocial Work Environment, Stress Factors and Individual Characteristics among Nursing Staff in Psychiatric In-Patient Care

    PubMed Central

    Hanna, Tuvesson; Mona, Eklund

    2014-01-01

    The psychosocial work environment is an important factor in psychiatric in-patient care, and knowing more of its correlates might open up new paths for future workplace interventions. Thus, the aims of the present study were to investigate perceptions of the psychosocial work environment among nursing staff in psychiatric in-patient care and how individual characteristics—Mastery, Moral Sensitivity, Perceived Stress, and Stress of Conscience—are related to different aspects of the psychosocial work environment. A total of 93 nursing staff members filled out five questionnaires: the QPSNordic 34+, Perceived Stress Scale, Stress of Conscience Questionnaire, Moral Sensitivity Questionnaire, and Mastery scale. Multivariate analysis showed that Perceived Stress was important for Organisational Climate perceptions. The Stress of Conscience subscale Internal Demands and Experience in current units were indicators of Role Clarity. The other Stress of Conscience subscale, External Demands and Restrictions, was related to Control at Work. Two types of stress, Perceived Stress and Stress of Conscience, were particularly important for the nursing staff’s perception of the psychosocial work environment. Efforts to prevent stress may also contribute to improvements in the psychosocial work environment. PMID:24448633

  2. 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

  3. A virtual aged care system: when health informatics and spatial science intersect.

    PubMed

    Robertson, Hamish; Nicholas, Nick; Rosenfeld, Tuly; Georgiou, Andrew; Johnson, Julie; Travaglia, Joanne

    2014-01-01

    Healthcare systems are increasingly adapting to address the issues associated with population ageing. The shift to chronic diseases and a rise in neuroepidemiological conditions, associated with rising life expectancies, means that continued change and accommodation will be required of our health and social support systems. Current social policy environments developed out of early approaches to state-supported health and welfare service provision, most now a century or more old. A feature of these systems has often been a formal separation between them, into silos, that does not and cannot effectively address the issues raised by a growing population of older people. This is especially true in the context of community-based care where the majority of older people currently live and where governments hope to keep more elderly people living into the future. This objective will require a far more sophisticated and responsive approach to the health information environment than is currently the case. One strategy for improving this scenario is the development of augmented and virtual environments that collect and analyse real-time data on which health professionals and support staff can act in a timely manner. In this paper we explore some aspects of a virtualised aged care system and provide some examples of how this would enhance our current strategies for aged care.

  4. Poor uptake of hepatitis B immunization amongst hospital-based health care staff.

    PubMed

    Burden, A D; Whorwell, P J

    1991-03-01

    The uptake of hepatitis B vaccine was assessed amongst 100 medical and 100 nursing staff in a teaching hospital with a policy of recommending to those at risk that they should seek immunization from their general practitioners. Sixteen per cent of nurses and 31% of doctors had completed a course of immunization with confirmation of seroconversion. An additional 9% and 18% respectively had been immunized without post-immunization serology. Ninety three per cent of nurses and 61% of doctors who had not been immunized would like to receive the vaccine. The commonest reasons for non-immunization amongst nurses were fear of vaccine and lack of advice, and amongst doctors, apathy and difficulty in obtaining the vaccine. Eighty seven per cent of medical staff and 57% of nurses had a history of needle stick injury. The low rates of vaccine uptake in this study combined with the high incidence of needle stick injury calls for a reappraisal of present hepatitis B vaccination programmes in hospitals. In particular the abrogation of responsibility for immunization to general practitioners is probably a major disincentive to potential vaccines.

  5. [Main concepts of preventive health care for the air staff of sea-based aviation].

    PubMed

    Mel'nik, S G; Chulaevskiĭ, A O

    2013-08-01

    The authors researched the air-stuff and complex of adverse factors uncharacteristic for the air-staff of land-based aircraft. It was determined that adverse factors affect the air-staff foremost in 4-5 months of a blue-water sailing, except cardiovascular system diseases. In a month of a blue-water sailing was registered a hypotonic state. Systolic blood pressure varied from 100-105 mm Hg and lower, dystolic blood pressure varied from 60-65 mm Hg and lower. The lowest ranges of blood pressure were registered in three months after the beginning of the sailing. In the following, the hypotonic state, registered during the monthly medical examinations, remained till the end of the sailing. Normal averages of blood pressure were restored in two weeks after the end of sailing. Low red cell count (for more than 1100 points) was registered in 61.5% of patients, (for more than 550 points) in 38.4% of patients. Low white cell count (for more than 4800 points) was registered in 33.3% of patients, (for more than 3300 points) in 41% of patients, (for more than 1330 points) in 25% of patients. Input data was: red cell count--4250 points, white cell count--7300 points in 1 ml of blood. After the sailing haematological indices were restored. The authors suggested guidelines for primary and secondary disease prevention.

  6. [Intervention in situations of psychic crisis: challenges and suggestions of a prehospital care staff].

    PubMed

    Almeida, Alexsandro Barreto; do Nascimento, Eliane Regina Pereira; Rodrigues, Jeferson; Schweitzer, Gabriela

    2014-01-01

    A qualitative and descriptive research, aimed at knowing how the pre-hospital care professionals perceive the interventions towards people in mental crisis. The study was developed in Santa Catarina with four teams of basic life support units of the Department of Mobile Emergency Care, during April to June 2011. The Collective Subject Discourse was used as the method of analysis. Two themes emerged: Awareness of the difficulties in meeting a person in mental crisis and Suggestions in the search for a closer attention to the person in mental crisis. The difficulties mentioned were related to the lack of training and a local to forward the patients, suggesting a better training and systematization of care. We conclude that it is necessary to invest in the educational process, based on new care strategies guided by the principles of SUS and of the psychosocial paradigm, and revisit the strategy of protocols as guidelines and not as standardizing systems.

  7. 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

  8. Effects of Prenatal Care on Child Health at Age 5

    PubMed Central

    Noonan, Kelly; Corman, Hope; Schwartz-Soicher, Ofira; Reichman, Nancy E.

    2012-01-01

    Objectives The broad goal of contemporary prenatal care is to promote the health of the mother, child, and family through the pregnancy, delivery, and the child’s development. Although the vast majority of mothers giving birth in developed countries receive prenatal care, past research has not found compelling evidence that early or adequate prenatal care has favorable effects on birth outcomes. It is possible that prenatal care confers health benefits to the child that do not become apparent until after the perinatal period. Methods Using data from a national urban birth cohort study in the U.S., we estimate the effects of prenatal care on four markers of child health at age 5—maternal-reported health status, asthma diagnosis, overweight, and height. We implement a number of different strategies to address the issue of potential omitted variables bias as well as a large number of specification checks to validate the findings. Results and Conclusions Prenatal care, defined a number of different ways, does not appear to have any effect on the outcomes examined. The findings are robust and suggest that routine health care encounters during the prenatal period could potentially be used more effectively to enhance children’s health trajectories. However, future research is needed to explore the effects of prenatal care on additional child health and developmental outcomes as well as the effects of preconceptional and maternal lifetime helathcare on child health. PMID:22374319

  9. 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

  10. 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…

  11. [Caring for the aging and institutionalized disabled person].

    PubMed

    Trungel-Legay, Patricia

    2014-05-01

    The French national group of public social and medical-social institutions (GEPSO) has for several years been studying the issue of the ageing of disabled people. These people need more complex care and can present a loss of autonomy requiring changes to their day-to-day life.

  12. 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

  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. 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…

  15. [The interface of nursing care with the aged attention policies].

    PubMed

    Darder, Juan José Tirado; Carvalho, Zuila Maria de Figueiredo

    2012-01-01

    The objective was to make an explanation on the interface of nursing care with the elder care policies. It is presented the aging phenomenon as a global reality and a victory of modern society; the situation of elderly people and the social consequences of aging in Spain; the dependence and assistance needs; the situation of elderly people in Brazil; comparison between Spain and Brazil; dependency levels; and the solutions that nurses provide and home care as a basis for a better future. The considerations given are: meeting the dependency must be addressed immediately, considering the failures in other countries, to avoid the same mistakes, and to urge the elder population to maintain their independence with health promotion. PMID:23338574

  16. The effect on staff of essential oil burners in extended care settings.

    PubMed

    Tysoe, P

    2000-04-01

    Because hospital wards may be associated with smells, such as chemicals, food, and people and their produce, essential oils in burners were considered a way of improving the ward atmosphere for staff. A study was conducted in three parts. A questionnaire covering a period of 1 month; lavender oil in burners for a 3-month period; and a second questionnaire. A significant number of respondents (88%) indicated in the first questionnaire their belief that the use of essential oil would have a positive effect on the workplace. Eighty-five per cent of respondents to the second questionnaire believed that there had been an improvement in the work environment following the use of the lavender oil burners. PMID:11111496

  17. Care staff training in residential homes for managing behavioural and psychological symptoms of dementia based on differential reinforcement procedures of applied behaviour analysis: a process research.

    PubMed

    Noguchi, Dai; Kawano, Yoshiyuki; Yamanaka, Katsuo

    2013-06-01

    Previous studies of care staff training programmes for managing behavioural and psychological symptoms of dementia (BPSD) based on the antecedent-behaviour-consequence analysis of applied behaviour analysis have not included definite intervention strategies. This case study examined the effects of such a programme when combined with differential reinforcement procedures. We examined two female care home residents with dementia of Alzheimer's type. One resident (C) exhibited difficulty in sitting in her seat and made frequent visits to the restroom. The other resident (D) avoided contact with others and insisted on staying in her room. These residents were cared for by 10 care staff trainees. Using an original workbook, we trained the staff regarding the antecedent-behaviour-consequence analysis with differential reinforcement procedures. On the basis of their training, the staff implemented individual care plans for these residents. This study comprised a baseline phase and an intervention phase (IN) to assess the effectiveness of this approach as a process research. One month after IN ended, data for the follow-up phase were collected. In both residents, the overall frequency of the target behaviour of BPSD decreased, whereas the overall rate of engaging in leisure activities as an alternative behaviour increased more during IN than during the baseline phase. In addition, the overall rate of staff actions to support residents' activities increased more during IN than during the baseline phase. However, the frequency of the target behaviour of BPSD gradually increased during IN and the follow-up phase in both residents. Simultaneously, the rate of engaging in leisure activities and the staff's treatment integrity gradually decreased for C. The training programme was effective in decreasing BPSD and increasing prosocial behaviours in these two cases. However, continuous support for the staff is essential for maintaining effects.

  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

    Hongwei Wan; Fang Yu; Kolanowski, Ann

    2008-04-01

    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.

  20. 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…

  1. The impact of a hospital-wide experiential learning educational program on staff's knowledge and misconceptions about aging.

    PubMed

    Karner, K J; Rheinheimer, D C; DeLisi, A M; Due, C

    1998-01-01

    The increased use of health care services by older adults has prompted an interest in preparing health care workers to better deal with the special needs of older adults. Aging education is one method of sensitizing health care personnel to these special needs, but the effectiveness of such educational programs needs to be established. The purpose of this study was to examine the impact of the knowledge and attitudes of hospital personnel of their participation in an experiential learning educational program concerning older adults. Each of nine groups of hospital employees attended a 2-hour workshop. Each group completed a pretest and posttest using Palmore's Facts on Aging Quiz. A significant increase in scores was found in all groups after the workshop experience, and some groups had a greater increase in scores than others. PMID:9652262

  2. 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…

  3. A game-based strategy for the staff development of home health care nurses.

    PubMed

    Popil, Inna; Dillard-Thompson, Darlene

    2015-05-01

    This article describes gaming, an interactive teaching strategy that promotes active learning. An evaluation study conducted with home health care nurses tested the use of a game as a teaching tool. The study evaluated learning outcomes and learners' level of engagement and satisfaction with an educational game as a teaching method. PMID:25955422

  4. Mental Health Consultation in Child Care: Transforming Relationships among Directors, Staff, and Families

    ERIC Educational Resources Information Center

    Johnston, Kadija; Brinamen, Charles

    2006-01-01

    As babies, toddlers, and preschoolers spend more and more time in child care programs, those programs have an increasingly significant effect on their healthy social and emotional development. The impact and quality of caregivers' relationships with children contribute to the quality of young children's mental health. A mental health consultant…

  5. A Training Program in Infant Education for Paraprofessional Staff of Day Care Centers.

    ERIC Educational Resources Information Center

    Segner, Leslie; Patterson, Charlotte

    As part of an early child care program for migrant children in Colorado, 2-day workshops were held to train migrant women--mostly Spanish-speaking Mexican Americans--as teachers and aides for 25 infant education centers operated in public schools throughout the summer of 1969. Major goals were 1) to change attitudes toward the importance of…

  6. Considerations on Caring for Caregivers in an Aging Society.

    PubMed

    Sinha, Dr Samir K

    2015-01-01

    While it is anticipated that healthcare systems around the world will continue to rely heavily on family members and friends to provide unpaid care especially to meet the needs of our aging population, current assumptions and issues around caregivers need to be challenged and addressed if we are to expect their future support. This paper builds on Williams et al's assertion that many current assumptions and issues around caregivers need to be challenged and addressed if we are to expect their future support. Indeed, with the pool of available caregivers expected to actually shrink in the future, this paper therefore examines four key policy issues in greater depth that we can address to enable individuals to age in place and others to maintain and take on caregiving roles. Through the establishment of policies that support robust and longterm capacity planning; make clear what care recipients and caregivers can expect to receive in the form of government supports; appreciate the increasing diversity that is occurring among those taking on caregiving roles and those requiring care; and recognize the need to invest in strategies that combat social isolation, we may not only improve our future health and well-being but ensure we are also enabled to care for ourselves as we age.

  7. Is There Sufficient Training of Health Care Staff on Noise Reduction in Neonatal Intensive Care Units? a Pilot Study From Neonoise Project.

    PubMed

    Carvalhais, Carlos; Santos, Joana; da Silva, Manuela Vieira; Xavier, Ana

    2015-01-01

    Evidence indicates that exposure to high levels of noise adversely affects human health, and these effects are dependent upon various factors. In hospitals, there are many sources of noise, and high levels exert an impact on patients and staff, increasing both recovery time and stress, respectively. The goal of this pilot study was to develop, implement, and evaluate the effectiveness of a training program (TP) on noise reduction in a neonatal intensive care unit (NICU) by comparing the noise levels before and after the implementation of the program. In total, 79 health professionals participated in the study. The measurements of sound pressure levels took into account the layout of the unit and locations of the main sources of noise. General results indicated that LAeq levels before implementation of the training program were often excessive, ranging from 48.7 ± 2.94 dBA to 71.7 ± 4.74 dBA, exceeding international guidelines. Similarly, following implementation of the training program, noise levels remained unchanged (54.5 ± 0.49 dBA to 63.9 ± 4.37 dBA), despite a decrease in some locations. There was no significant difference before and after the implementation of TP. However, a significant difference was found for Lp,Cpeak, before and after training staff, suggesting greater care by health care professionals performing their tasks. Even recognizing that a TP is quite important to change behaviors, this needs to be considered in a broader context to effectively control noise in the NICU.

  8. Complexity in caring for an ageing heart failure population: concomitant chronic conditions and age related impairments.

    PubMed

    De Geest, Sabina; Steeman, Els; Leventhal, Marcia E; Mahrer-Imhof, Romy; Hengartner-Kopp, Beatrice; Conca, Antoinette; Bernasconi, Arlette T; Petry, Heidi; Brunner-La Rocca, Hanspeter

    2004-12-01

    The complexity of caring for the ageing heart failure (HF) population is further complicated by concomitant chronic conditions (i.e., polypharmacy, depression), age related impairments (i.e., hearing, visual and cognitive impairments, impairments in activities of daily living (ADL/IADL), and other issues (e.g., health illiteracy, lack of social support). This paper provides an overview of these risk factors, outlines how they individually and in interplay endanger favourable outcome by putting patients at risk for poor self-management. Moreover, suggestions are made on how these issues could be addressed and integrated in heart failure management by applying gerontological care principles in caring for the ageing heart failure population.

  9. 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

  10. Medication safety in residential aged-care facilities: a perspective.

    PubMed

    Wilson, Nicholas M; March, Lyn M; Sambrook, Philip N; Hilmer, Sarah N

    2010-10-01

    Medication safety must be tailored to the distinctive issues in residential aged-care facilities (RACFs). The health and functional characteristics of their residents are different to those of hospital inpatients and community-dwelling older adults, and there are unique staffing and management issues. Understanding the aetiology and epidemiology of drug-related problems is vital in developing methods to improve patient safety. In this perspective review, we discuss tools that are used to quantify exposure to 'high-risk' medications and their evaluation in residential aged-care settings. Drug withdrawal interventions are described as a potential way to reduce adverse drug events in RACFs. Multidisciplinary professional interventions, education programs and improved communication between health professionals have been shown to improve medication safety in RACFs. Technological advances and other administrative strategies may also improve resident safety. This perspective addresses issues in medication safety facing RACFs and methods to improve the safety of medicines for their residents.

  11. Critical care at extremes of temperature: effects on patients, staff and equipment.

    PubMed

    Hindle, Elise M; Henning, J D

    2014-12-01

    Modern travel and military operations have led to a significant increase in the need to provide medical care in extreme climates. Presently, there are few data on what happens to the doctor, their drugs and equipment when exposed to these extremes. A review was undertaken to find out the effects of 'extreme heat or cold' on anaesthesia and critical care; in addition, subject matter experts were contacted directly. Both extreme heat and extreme cold can cause a marked physiological response in a critically ill patient and the doctor treating these patients may also suffer a decrement in both physical and mental functioning. Equipment can malfunction when exposed to extremes of temperature and should ideally be stored and operated in a climatically controlled environment. Many drugs have a narrow range of temperatures in which they remain useable though some have been shown to remain effective if exposed to extremes of temperature for a short period of time. All personnel embarking on an expedition to an extreme temperature zone should be of sufficient physical robustness and ideally should have a period of acclimatisation which may help mitigate against some of the physiological effects of exposure to extreme heat or extreme cold. Expedition planners should aim to provide climatic control for drugs and equipment and should have logistical plans for replenishment of drugs and medical evacuation of casualties.

  12. Ethical constraints on rationing medical care by age.

    PubMed

    Jecker, N S; Pearlman, R A

    1989-11-01

    In a statement published in this issue, the Public Policy Committee of the American Geriatrics Society endorses the view that chronological age should not be a criterion for exclusion of individuals from medical care. This article aims to amplify the Committee's position by placing it within a broader context and identifying its justification in ethical argument. The paper is divided into three parts. The first part clarifies the difference between allocation (the distribution of funds between categories) and rationing (the distribution of funds within a single category). It is argued that given the current allocation of funds to medical care, some form of rationing is unavoidable. As others have noted, rationing is already occurring in an informal and piecemeal fashion. However, ethically sound rationing requires publicly debated and defensible policies. The second section of the paper reviews a number of arguments advanced in favor of rationing medical care on the basis of age. Objections to these arguments are carefully set out. The final part of the paper details and defends a series of positive arguments establishing special duties to the elderly. The paper concludes that to the extent that scarcity forces rationing, older persons should not be excluded because they are old.

  13. Development of two measures of client engagement for use in home aged care.

    PubMed

    Baker, Jess Rose; Harrison, Fleur; Low, Lee-Fay

    2016-05-01

    The aim of the study was to develop and validate measures of client engagement in aged homecare. The Homecare Measure of Engagement-Staff questionnaire (HoME-S) is a self-complete measure of six dimensions of client engagement: client acceptance, attention, attitude, appropriateness, engagement duration and passivity. The Homecare Measure of Engagement-Client/Family report (HoME-CF) is a researcher-rated interview which obtains client and/or family perspectives regarding frequency and valence of conversational and recreational engagement during care worker visits. Care workers (n = 84) completed the HoME-S and a measure of relationship bond with client. Researchers interviewed clients (n = 164) and/or their family (n = 117) and completed the HoME-CF, and measures of agitation, dysphoria, apathy and cognitive functioning. The HoME-S and HoME-CF demonstrated good test-retest and inter-rater reliability, and showed significant negative correlations with apathy, agitation and non-English-speaking background. Controlling for client and care service characteristics, a stronger care worker-client relationship bond and English-speaking background were independently associated with higher HoME-S scores, and apathy was independently associated with higher HoME-CF scores. In conclusion, the HoME-S and HoME-CF are psychometrically sound engagement measures for use in homecare. Clients who are apathetic or from non-English-speaking backgrounds may be less responsive to traditional care worker engagement strategies. Engagement may be augmented in clients who have stronger relationships with their care workers.

  14. Managed care implications of age-related ocular conditions.

    PubMed

    Cardarelli, William J; Smith, Roderick A

    2013-05-01

    The economic costs of age-related ocular diseases and vision loss are increasing rapidly as our society ages. In addition to the direct costs of treating age-related eye diseases, elderly persons with vision loss are at significantly increased risk for falls and fractures, experiencing social isolation, and suffering from an array of comorbid medical conditions compared with individuals with normal vision. Recent studies estimate the total economic burden (direct and indirect costs) of adult vision impairment in the United States at $51.4 billion. This figure is expected to increase as the baby boomer generation continues to age. While a number of highly effective new therapies have caused a paradigm shift in the management of several major age-related ocular diseases in recent years, these treatments come at a substantial cost. This article reviews the economic burdens and treatment-related costs of 4 major ocular diseases of aging-glaucoma, age-related macular degeneration, diabetic retinopathy, and dry eye disease-and the implications for managed care.

  15. Family, caring and ageing in the United Kingdom.

    PubMed

    Gilbert, Tony; Powell, Jason L

    2005-03-01

    This paper provides a critical exploration of the assumptions and narratives underpinning the development of social policy initiatives targeting caring relationships based upon family ties. Using a narrative approach attention is drawn to the ways in which family identities are open to a far greater range of negotiation than is assumed by policy. Drawing on the United Kingdom as a case example, questions are posed about intergenerational relations and the nature of late life citizenship. The comparatively recent invention of narratives supporting 'informal care' and the link with neo-liberal and 'third way' notions of active citizenship are explored. As is the failure of policy developments to take into account the diversity of care giving styles and the complexity of caring relationships. It is argued that the uneven and locally specific ways in which policy develops enables the co-existence of a complex range of narratives about family, caring and ageing which address diverse aspects of the family life of older people in often contradictory ways.

  16. 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

  17. 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.

  18. 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…

  19. 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…

  20. End-of-Life Care and Dying: Issues Raised by Staff Supporting Older People with Intellectual Disability in Community Living Services

    ERIC Educational Resources Information Center

    Wiese, Michele; Stancliffe, Roger J.; Balandin, Susan; Howarth, Glennys; Dew, Angela

    2012-01-01

    Background: The aim of this study was to explore the current status of end-of-life care and dying of people with intellectual disability based on the experiences of staff in community living services. Materials and Methods: Focus groups and individual interviews were conducted, guided by grounded theory methodology. Results: The current status of…

  1. 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

  2. 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…

  3. 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

  4. 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

  5. [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.

  6. Schwartz Center Rounds. A Staff Dialogue on Caring for an Intensely Spiritual Patient: Psychosocial Issues Faced By Patients, Their Families, and Caregivers.

    PubMed

    Lintz; Penson; Chabner; Lynch

    1998-01-01

    The Schwartz Center Rounds are a monthly multidisciplinary forum, at Massachusetts General Hospital (MGH), in which caregivers discuss a specific patient with cancer and the important psychosocial issues faced by the patient, family, and caregivers. This forum allows caregivers to reflect on their experiences with patients and to gain support and insight from their fellow staff members. The following case discussion was addressed at the September 1997 Schwartz Center Rounds. M.R. was a 45-year-old woman who developed ovarian carcinoma and was subsequently treated at MGH. She was a deeply religious woman and believed that God would cure her cancer. Her religious views profoundly influenced her decisions related to further care and her ability to accept what staff felt to be a realistic assessment of her condition and progress. At the rounds, staff members struggled with many issues, including whether M.R. should continue her treatment at MGH or return home to Puerto Rico. Staff found it challenging to discuss a sensitive topic-such as spirituality-with a patient, especially when the patient was from a different cultural background. One of the most striking outcomes of the rounds was the diversity of staff views regarding how they advocated addressing spirituality with a patient. Staff concluded that discussion of spirituality-while challenging-can meaningfully enhance the caregiver-patient relationship.

  7. 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

  8. 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

  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.

  10. 4-H and School-Age Care: A Great Combination! Point of View.

    ERIC Educational Resources Information Center

    Vandenbergh, Barbara D.

    1999-01-01

    Discusses the positive relationship between 4-H programs and school-age care programs, advocating the use of 4-H programs as a model for care, or as a source of care, caregiver training, or curriculum. Notes the role of the Cooperative Extension System in training and supporting school-age care providers. (JPB)

  11. School-Age Child Care Arrangements. Research-to-Policy Connections No. 4

    ERIC Educational Resources Information Center

    Lawrence, Sharmila; Kreader, J. Lee

    2006-01-01

    School-age children ages 5 through 12 years spend their out-of-school time in many different types of arrangements. In addition to parental care, these include relative care, non-relative care (either in their own or another family's home), center- or school-based programs, sports and extracurricular activities, summer activities, and self-care.…

  12. 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…

  13. 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…

  14. 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…

  15. Desired social distance from people who have hepatitis C virus: an exploration among staff in health care, dentistry, drug treatment, and tattoo/body piercing.

    PubMed

    Suarez, Alicia Elena; Redmond, Deidre

    2014-03-01

    Staff who work in facilities such as health care, dentistry, drug treatment, and tattoo/body piercing are likely to encounter persons with hepatitis C virus (HCV) and be privy to their HCV status. The purpose of this paper is to assess staff comfort with varying levels of intimacy (i.e., social distance) with people who have HCV. We examine how previous contact with persons with HCV and knowledge of HCV including HCV specific training affect desire for social distance. Data are from a 2007 sample of 82 individuals working in health care, dentistry, drug treatment, or tattoo/body-piercing studios located in the Pacific Northwest region of the United States. Multivariate analyses indicate that staff desire social distance from persons with HCV, but contact of certain types reduce desire for social distance. We discuss how the findings have implications for people employed in these fields, as they point to the need to dispel myths and reduce fear among staff working in facilities that may serve persons with HCV. PMID:24224774

  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. 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

  18. Client Incentives versus Contracting and Staff Incentives: How Care Continuity Interventions in Substance Abuse Treatment can improve Residential to Outpatient Transition

    PubMed Central

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

    2013-01-01

    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 30 days 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% vs 52% in UC) and immediacy (1.0 vs 3.9 days) of appointment scheduling. This study supports use of CSI for improving rates of transition between residential and outpatient continuing care treatment. PMID:23375361

  19. The Burden of Aging: A Theoretical Framework for Understanding the Shifting Balance of Caregiving and Care Receiving as Cohorts Age.

    ERIC Educational Resources Information Center

    Uhlenberg, Peter

    1996-01-01

    Develops a theoretical framework that explicates factors determining the level of care given and care received by cohorts moving through different stages of later life. Specifies four proximate determinants of caregiving and three proximate determinants of care receiving. Focuses on social changes that could reduce the burden of aging. (RJM)

  20. 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

  1. '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

  2. '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.

  3. 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.

  4. Coping with Violence in Mental Health Care Settings: Patient and Staff Member Perspectives on De-escalation Practices.

    PubMed

    Berring, Lene Lauge; Pedersen, Liselotte; Buus, Niels

    2016-10-01

    This multiple case study explored de-escalation processes in threatening and violent situations based on patients and staff members perspectives. Our post hoc analysis indicated that de-escalation included responsive interactions influenced by the perspectives of both patients and staff members. We assembled their perspectives in a mental model consisting of three interdependent stages: (1) memories and hope, (2) safety and creativity and (3) reflective moments. The data indicated that both patients and staff strived for peaceful solutions and that a dynamic and sociological understanding of de-escalation can foster shared problem solving in violent and threatening situations.

  5. Coping with Violence in Mental Health Care Settings: Patient and Staff Member Perspectives on De-escalation Practices.

    PubMed

    Berring, Lene Lauge; Pedersen, Liselotte; Buus, Niels

    2016-10-01

    This multiple case study explored de-escalation processes in threatening and violent situations based on patients and staff members perspectives. Our post hoc analysis indicated that de-escalation included responsive interactions influenced by the perspectives of both patients and staff members. We assembled their perspectives in a mental model consisting of three interdependent stages: (1) memories and hope, (2) safety and creativity and (3) reflective moments. The data indicated that both patients and staff strived for peaceful solutions and that a dynamic and sociological understanding of de-escalation can foster shared problem solving in violent and threatening situations. PMID:27654228

  6. 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)

  7. Dying in a rural residential aged care facility: an action research and reflection project to improve end-of-life care to residents with a non-malignant disease.

    PubMed

    Rowley, Joanne; Taylor, Beverley

    2011-12-01

    This article describes a qualitative research project that explored issues around end-of-life care provided to residents dying from non-malignant diseases in two, rural Australian, residential aged care facilities. Reflective processes and action research were combined to work in collaboration with 14 aged nurses, associated staff and relatives of dying residents. Reflection featured in the research and included group reflection on practice stories, critical reflection during thematic analysis and reflection on action research cycles. Themes and subthemes emerged, indicating that aspects of end-of-life care needed further improvement. Major thematic concerns were prioritized for action and included the need for better pain management practices which will be discussed. Identifying these clinical issues was an important step in creating, implementing and evaluating actions. Participants reported varying degrees of success in attempting to improve end-of-life care.

  8. Knowledge, attitudes, and practices of OB/GYN nurses and auxiliary staff in the care of pregnant women living with HIV.

    PubMed

    Farley, Jason E; Hayat, Matthew J; Murphy, Jeanne; Sheridan-Malone, Eileen; Anderson, Jean; Mark, Hayley

    2014-01-01

    The purpose of this study was to explore the knowledge, attitudes, and practices (KAP) of health care workers caring for HIV-infected pregnant women. A KAP survey was formulated in order to achieve this goal. Obstetric and gynecological (OB/GYN) health care workers (n = 121) in both inpatient and outpatient settings in an academic and an affiliated community-based hospital in a large urban academic medical center in the northeastern United States were surveyed. Findings suggest that KAP requires further improvement among OB/GYN staff, particularly in the areas of prevention of HIV and psychosocial care of patients with HIV. Further research is needed to determine the best strategies to improve clinical practice for pregnant women living with HIV. PMID:23876818

  9. Extrinsic high-effort and low-reward conditions at work among institutional staff caring for people with intellectual disabilities in Taiwan.

    PubMed

    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 in 2006. Conditions at work were measured using Siegrist's Effort-Reward Imbalance (ERI) model, the questionnaire included 23 Likert scaled items and it divided into three scales: effort, reward and overcommitment. Multiple logistic regression modeling was conducted for extrinsic high-effort/low-reward status in relation to staff and working environmental factors. We found that 15.1% staff were in the low-effort/low-reward group, 35.9% was in the low-effort/high-reward group, 17.9% belonged to the high-effort/high-reward group and 31.1% was included in the high-effort/low-reward group. Controlling for many personal demographic and organizational characteristics, the factors of perceived job support (OR=0.91; 95% CI=0854-0.97), job control (OR=0.954, 95% CI=0.934-0.974), job demand (OR=1.155, 95% CI=1.109-1.203) and job stress (felt sometimes stressful compare to no stress at all, OR=2.305, 95% CI=1.161-4.575) of the staff were significantly correlated to the extrinsic high effort/low reward at work in the multiple logistic regression model. The present study highlights that the service providers need to be aware and understand the experiences that their staff encounters in the organizational, interpersonal and personal level regarding unfair working conditions such as high effort/low reward to improve the positive health of the staff.

  10. 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

  11. 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.

  12. Extrinsic high-effort and low-reward conditions at work among institutional staff caring for people with intellectual disabilities in Taiwan.

    PubMed

    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 in 2006. Conditions at work were measured using Siegrist's Effort-Reward Imbalance (ERI) model, the questionnaire included 23 Likert scaled items and it divided into three scales: effort, reward and overcommitment. Multiple logistic regression modeling was conducted for extrinsic high-effort/low-reward status in relation to staff and working environmental factors. We found that 15.1% staff were in the low-effort/low-reward group, 35.9% was in the low-effort/high-reward group, 17.9% belonged to the high-effort/high-reward group and 31.1% was included in the high-effort/low-reward group. Controlling for many personal demographic and organizational characteristics, the factors of perceived job support (OR=0.91; 95% CI=0854-0.97), job control (OR=0.954, 95% CI=0.934-0.974), job demand (OR=1.155, 95% CI=1.109-1.203) and job stress (felt sometimes stressful compare to no stress at all, OR=2.305, 95% CI=1.161-4.575) of the staff were significantly correlated to the extrinsic high effort/low reward at work in the multiple logistic regression model. The present study highlights that the service providers need to be aware and understand the experiences that their staff encounters in the organizational, interpersonal and personal level regarding unfair working conditions such as high effort/low reward to improve the positive health of the staff. PMID:18534817

  13. 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

  14. The selection of anterior teeth appropriate for the age and sex of the individual. How variable are dental staff in their choice?

    PubMed

    Sellen, P N; Jagger, D C; Harrison, A

    2002-09-01

    As part of the development of a guide to aid the undergraduate in the selection of artificial teeth, the aim of this study was to investigate the variability in choice of dental staff to select teeth appropriate to the age and sex of the individual with the aid of a series of three-dimensional guides. Four three-dimensional guides were produced for use in the study. Fifty dentists were asked to complete a questionnaire designed to assess the variability in selection of anterior teeth appropriate for the age and sex of an individual. From this study it can be concluded that there was little consistency in the selection of the shade, mould and arrangement of anterior teeth appropriate for the age and sex of the individual by qualified dental staff. The development and implementation of an aesthetic proforma to guide dental staff, dental undergraduates and patients through the process of choosing tooth mould, shade and arrangement based on age and sex may be helpful.

  15. AgedCare+GP: description and evaluation of an in-house model of general practice in a residential aged-care facility.

    PubMed

    Pain, Tilley; Stainkey, Lesley; Chapman, Sue

    2014-01-01

    This paper describes a medical model to provide in-house GP services to residents of aged-care facilities. Access to GP services for aged-care residents is decreasing, partially due to the changing demographic of the Australian GP workforce. The model we have developed is an in-house GP (AgedCare+GP) trialled in a publicly funded residential aged-care facility (RACF). The service model was based on the GP cooperative used in our after-hours general practice (AfterHours+GP). Briefly, the service model involves rostering a core group of GPs to provide weekly sessional clinics at the RACF. Financial contributions from appropriate Medicare Benefits Schedule (MBS) items for aged-care planning (including chronic conditions) provided adequate funds to operate the clinic for RACF residents. Evaluation of the service model used the number of resident transfers to the local emergency department as the primary outcome measure. There were 37 transfers of residents in the 3 months before the commencement of the AgedCare+GP and 11 transfers over a 3-month period at the end of the first year of operation; a reduction of almost 70%. This project demonstrates that AgedCare+GP is a successful model for GP service provision to RACF residents, and it also reduces the number of emergency department transfers. PMID:24134857

  16. 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 ...

  17. 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…

  18. Responding to a "window of opportunity": the detection and management of aged abuse in an acute and subacute health care setting.

    PubMed

    Joubert, Lynette; Posenelli, Sonia

    2009-01-01

    Aged abuse can manifest as physical harm, sexual assault, intimidation, blackmail, and social deprivation, misappropriation of funds or property, and neglect. The extent of the problem is difficult to assess in health settings due to underreporting and the fragility and reluctance of the elderly in being able to discuss the issue with health care providers. This appears to be related to the fact that perpetrators are frequently family members with resulting issues of aged dependency, family loyalty, and fear of the consequences of reporting. Of equal importance is a general lack of community understanding of aged abuse, including health professionals who frequently lack the confidence in screening and management to respond appropriately when aged abuse is suspected. Staff knowledge and skills emerge as a deficit in the detection of elder abuse and staff education has been identified as an effective means of improving the recognition of the abused elderly person in acute hospital settings. In addition, there remains a need for effective screening protocols. The aim of this study was to explore the recognition of aged abuse in an acute and subacute hospital setting. This has implications for effective management and community linkage as well as strengthening the knowledge base of issues related to this vulnerable group. The study included a survey and interview with hospital staff to explore their response to aged abuse over a retrospective twelve-month period. PMID:20182983

  19. 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.

  20. 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

  1. Preventing the development of metabolic syndrome in people with psychotic disorders--difficult, but possible: experiences of staff working in psychosis outpatient care in Sweden.

    PubMed

    Bergqvist, Anette; Karlsson, Maria; Foldemo, Anniqa; Wärdig, Rikard; Hultsjö, Sally

    2013-05-01

    The aim of this study was to explore mental health staffs' experiences of assisting people with psychotic disorders to implement lifestyle changes in an effort to prevent metabolic syndrome. Qualitative interviews were conducted with 12 health care professionals working in psychosis outpatient care in Sweden. Data were analysed using a qualitative content analysis. The results illustrate that implementation of lifestyle changes among people with psychotic disorders was experienced as difficult, but possible. The greatest obstacles experienced in this work were difficulties due to the reduction of cognitive functions associated with the disease. Guidelines available to staff in order to help them identify and prevent physical health problems in the group were not always followed and the content was not always relevant. Staff further described feelings of uncertainty about having to motivate people to take anti-psychotic medication while simultaneously being aware of the risks of metabolic deviations. Nursing interventions focusing on organising daily routines before conducting a more active prevention of metabolic syndrome, including information and practical support, were experienced as necessary. The importance of healthy eating and physical activity needs to be communicated in such a way that it is adjusted to the person's cognitive ability, and should be repeated over time, both verbally and in writing. Such efforts, in combination with empathic and seriously committed community-based social support, were experienced as having the best effect over time. Permanent lifestyle changes were experienced as having to be carried out on the patient's terms and in his or her home environment.

  2. Continuing in Foster Care Beyond Age 18: How Courts Can Help. Issue Brief 116

    ERIC Educational Resources Information Center

    Peters, Clark; Bell, Katie S. Claussen; Zinn, Andrew; Goerge, Robert M.; Courtney, Mark E.

    2008-01-01

    Research has found that foster youth who remain in care beyond age 18 are more likely to participate in services and tend to have better outcomes than those who do not. However, not all youth eligible to remain in care beyond age 18 do so. This study examines Illinois, one of the few states that extends care up to age 21, to identify the major…

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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

  8. 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 ...

  9. 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

    ... published in the Federal Register on June 22, 2010 (75 FR 35510). The NRC staff developed LR-ISG-2011-03 to..., 2012, (77 FR 14446) the NRC requested public comments on draft LR-ISG-2011-03 (ADAMS Accession No... noticed on April 11, 2012 (77 FR 21813) and given that the comment period had closed on April 9, 2012,...

  10. Sex as a Bona Fide Occupational Qualification for Direct Care Staff in Residences for Mentally Retarded People.

    ERIC Educational Resources Information Center

    Rotegard, Lisa L.; And Others

    1983-01-01

    Court rulings and legislation are cited in a discussion of institutionalized mentally retarded persons' rights to privacy. The authors emphasize the need to restructure job responsibilities and/or descriptions to ensure appropriate resident-staff relations for dressing, bathing, toileting, and other private activities. (CL)

  11. Implementation of a scheduled toileting program in a long term care facility: evaluating the impact on injury risk to caregiving staff.

    PubMed

    Engst, Chris; Chhokar, Rahul; Robinson, Dan; Earthy, Ann; Tate, Robert B; Yassi, Annalee

    2004-10-01

    This study evaluated the impact of a scheduled toileting program on the risk of injury to caregivers and on resident agitation or aggressive behaviors. Injury data, ergonomic assessments, staff questionnaires, and resident agitation checklists were used to evaluate the program in a 75 bed unit, with a similar unit acting as a comparison. The program resulted in an increased percentage of residents toileted regularly in the intervention unit, while aggressive incidents declined in both groups. Staff in the intervention unit reported a significantly lower perceived risk of injury to the head and neck than the comparison group. Although the program resulted in increased workload to manage multitasking, monitor an additional aspect of scheduled care, and perform more toileting transfers, overall risk of physical injury was reduced. The toileting program, a shift toward resident focused care, and enhanced agitation awareness combined to reduce resident handling injuries and resident agitation expressed as verbal behaviors or emotional upset, but not as physical behaviors. Clear communication, mentoring, and monitoring were important for successfully changing care practices.

  12. Population aging and its impacts: strategies of the health-care system in Taipei.

    PubMed

    Lin, Ming-Hsien; Chou, Ming-Yueh; Liang, Chih-Kuang; Peng, Li-Ning; Chen, Liang-Kung

    2010-11-01

    Taiwan is one of the fastest aging countries in the world. As such, the government has developed various strategies to promote an age-friendly health-care system. Health services are supported by National Health Insurance (NHI), which insures over 97% of citizens and over 99% of health-care institutes. The current health-care system has difficulties in caring for older patients with multiple comorbidities, complex care needs, functional impairments, and post-acute care needs. Taipei, an international metropolis with a well-preserved tradition of filial piety in Chinese societies, has developed various strategies to overcome the aforementioned barriers to an age-friendly health-care system. These include an emphasis on general medical care and a holistic approach in all specialties, development of a geriatrics specialty training program, development of post-acute services, and strengthening of linkages between health and social care services. Despite achievements thus far, challenges still include creating a more extensive integration between medical specialties, promotion of an interdisciplinary care model across specialties and health-care settings, and integration of health and social care services. The experiences of Taipei in developing an age-friendly health-care service system may be a culturally appropriate model for other Chinese and Asian communities.

  13. Limited family members/staff communication in intensive care units in the Czech and Slovak Republics considerably increases anxiety in patients ´ relatives – the DEPRESS study

    PubMed Central

    2014-01-01

    Background Symptoms of anxiety and depression are common among family members of ICU patients and are culturally dependent. The aim of the study was to assess the prevalence of symptoms of anxiety and depression and associated factors in family members of ICU patients in two Central European countries. Methods We conducted a prospective multicenter study involving 22 ICUs (250 beds) in the Czech and Slovak Republics. The Hospital Anxiety and Depression Scale (HADS) was used to assess symptoms of anxiety and depression in family members of ICU patients. Family member understanding of the patient’s condition was assessed using a structured interview and a questionnaire was used to assess satisfaction with family member/ICU staff communication. Results Twenty two intensive care units (both adult and pediatric) in academic medical centers and community hospitals participated in the study. During a 6 month period, 405 family members of 293 patients were enrolled. We found a high prevalence of anxiety and depression symptoms – 78% and 54%, respectively. Information leaflets distributed to family members did not lower incidences of anxiety/depression. Family members with symptoms of depression reported higher levels of satisfaction according to the modified Critical Care Family Needs Inventory. Extended contact between staff and family members was the only related factor associated with anxiety reduction (p = 0.001). Conclusion Family members of ICU patients in East European countries suffer from symptoms of anxiety and depression. We identified limited family member/ICU staff communication as an important health care professional-related factor associated with a higher incidence of symptoms of anxiety. This factor is potentially amenable to improvement and may serve as a target for proactive intervention proactive intervention. PMID:24467834

  14. 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

  15. 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.

  16. 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…

  17. Aging, social capital, and health care utilization in Canada.

    PubMed

    Laporte, Audrey; Nauenberg, Eric; Shen, Leilei

    2008-10-01

    This paper examines relationships between aging, social capital, and healthcare utilization. Cross-sectional data from the 2001 Canadian Community Health Survey and the Canadian Census are used to estimate a two-part model for both GP physicians (visits) and hospitalization (annual nights) focusing on the impact of community- (CSC) and individual-level social capital (ISC). Quantile regressions were also performed for GP visits. CSC is measured using the Petris Social Capital Index (PSCI) based on employment levels in religious and community-based organizations [NAICS 813XX] and ISC is based on self-reported connectedness to community. A higher CSC/lower ISC is associated with a lower propensity for GP visits/higher propensity for hospital utilization among seniors. The part-two (intensity model) results indicated that a one standard deviation increase (0.13%) in the PSCI index leads to an overall 5% decrease in GP visits and an annual offset in Canada of approximately $225 M. The ISC impact was smaller; however, neither measure was significant in the hospital intensity models. ISC mainly impacted the lower quantiles in which there was a positive association with GP utilization, while the impact of CSC was strongest in the middle quantiles. Each form of social capital likely operates through a different mechanism: ISC perhaps serves an enabling role by improving access (e.g. transportation services), while CSC serves to obviate some physician visits that may involve counseling/caring services most important to seniors. Policy implications of these results are discussed herein.

  18. Should we educate care staff to improve the oral health and oral hygiene of people with intellectual disability in residential care? Real world lessons from a randomized controlled trial.

    PubMed

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

    2015-01-01

    This study assessed the impact of a multitiered oral health educational program on the oral health and oral hygiene of people with intellectual disabilities (ID). In a controlled pretest, posttest trial, with cluster randomization, a pyramidal training program was delivered to residential staff who cared for a randomly allocated, purposively stratified intervention group of people with ID living in community care homes. A control group lived in centers where staff received no training. Clinical measures were carried out pre- and posttest. Difference in Modified Gingival Index (MGI) and Plaque Index (PI) was measured posttest using ANCOVA. Seventy-six participants took part, representing 49.0% of the invited sample (n = 155). Fourteen did not receive clinical examination. There was one dropout 6-9 months later. A 10.5% and 8.5% reduction in mean MGI and PI was evident at posttest but did not show statistically significant difference, when controlling for baseline covariates (p > 0.05, ANCOVA). Mean MGI and PI scores were not significantly different among people with ID whose care staff had and had not received oral health training. Limitations are discussed. The results indicate that this program failed to significantly improve oral health or oral hygiene, despite the intervention being "educationally" successful. More research is needed.

  19. The effect of foot massage on long-term care staff working with older people with dementia: a pilot, parallel group, randomized controlled trial

    PubMed Central

    2013-01-01

    Background Caring for a person with dementia can be physically and emotionally demanding, with many long-term care facility staff experiencing increased levels of stress and burnout. Massage has been shown to be one way in which nurses’ stress can be reduced. However, no research has been conducted to explore its effectiveness for care staff working with older people with dementia in long-term care facilities. Methods This was a pilot, parallel group, randomized controlled trial aimed at exploring feasibility for a larger randomized controlled trial. Nineteen staff, providing direct care to residents with dementia and regularly working ≥ two day-shifts a week, from one long-term care facility in Queensland (Australia), were randomized into either a foot massage intervention (n=9) or a silent resting control (n=10). Each respective session lasted for 10-min, and participants could receive up to three sessions a week, during their allocated shift, over four-weeks. At pre- and post-intervention, participants were assessed on self-report outcome measures that rated mood state and experiences of working with people with dementia. Immediately before and after each intervention/control session, participants had their blood pressure and anxiety measured. An Intention To Treat framework was applied to the analyses. Individual qualitative interviews were also undertaken to explore participants’ perceptions of the intervention. Results The results indicate the feasibility of undertaking such a study in terms of: recruitment; the intervention; timing of intervention; and completion rates. A change in the intervention indicated the importance of a quiet, restful environment when undertaking a relaxation intervention. For the psychological measures, although there were trends indicating improvement in mood there was no significant difference between groups when comparing their pre- and post- scores. There were significant differences between groups for diastolic blood

  20. 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

  1. 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

  2. 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…

  3. Addressing the Need for School Age Child Care: A Guide for Philadelphia Elementary School Principals.

    ERIC Educational Resources Information Center

    Mintzer, Janet L.

    The Delaware Valley Child Care Council (DVCCC) developed this booklet to help Philadelphia school principals plan and develop privately run after-school centers in their schools. First, an executive summary documents the need for school-age day care nationwide and in the Philadelphia area. Section I offers guidance on planning a school-age child…

  4. What Is the Need for School-Age Care? Lessons from Two Communities.

    ERIC Educational Resources Information Center

    Nagle, Ami

    In 2001, Arizona's Children's Action Alliance (CCA) developed a resource for community groups interested in exploring the need for care for school-age children. Titled "School-Age Care Tool Kit: A Guide for Measuring Needs in Your Community," the resource provided step-by-step advice to community organizations on how to identify the need for…

  5. 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…

  6. Long-term care of the aging population with intellectual and developmental disabilities.

    PubMed

    Kim, Nae-Hwa; Hoyek, Georges El; Chau, Diane

    2011-05-01

    The aging population with intellectual and developmental disabilities (I/DD) deserves appropriate health care and social support. This population poses unique medical and social challenges to the multidisciplinary team that provides care. In the past, long-term care (LTC) facilities played an essential role in the livelihood of this population. The likelihood that the geriatric LTC system must prepare for adequately caring for this population is high. This article conveys the need to prepare for the inclusion of the growing aging population with I/DD into long-term care with the general elderly population in the near future.

  7. Critical thinking: Reported enhancers and barriers by nurses in long-term care: implications for staff development.

    PubMed

    Raterink, Ginger

    2011-01-01

    Nursing acknowledges critical thinking as an important guide to clinical decision making. Agreement on how to define, teach, and evaluate this skill is lacking. The purpose of this study was to evaluate critical thinking in practice using a survey that asked nurses to evaluate work-related factors that enhance or pose barriers to the use of critical thinking in practice. Results indicated that enhancers and barriers to practice included teamwork, staffing patterns, and staff and administrator support. A relationship with patients was the most satisfying factor, whereas paperwork was the least. Staff development educators must consider the work environment aspects that affect performance and create the life long learning needed for increased competency in practice. PMID:21602631

  8. 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

  9. 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.

  10. 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)

  11. 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.

  12. Medical innovation and age-specific trends in health care utilization: findings and implications.

    PubMed

    Wong, Albert; Wouterse, Bram; Slobbe, Laurentius C J; Boshuizen, Hendriek C; Polder, Johan J

    2012-01-01

    Health care utilization is expected to rise in the coming decades. Not only will the aggregate need for health care grow by changing demographics, so too will per capita utilization. It has been suggested that trends in health care utilization may be age-specific. In this paper, age-specific trends in health care utilization are presented for different health care sectors in the Netherlands, for the period 1981-2009. For the hospital sector we also explore the link between these trends and the state of medical technology. Using aggregated data from a Dutch health survey and a nationwide hospital register, regression analysis was used to examine age-specific trends in the probability of utilizing health care. To determine the influence of medical technology, the growth in age-specific probabilities of hospital care was regressed on the number of medical patents while adjusting for confounders related to demographics, health status, supply and institutional factors. The findings suggest that for most health care sectors, the trend in the probability of health care utilization is highest for ages 65 and up. Larger advances in medical technology are found to be significantly associated with a higher growth of hospitalization probability, particularly for the higher ages. Age-specific trends will raise questions on the sustainability of intergenerational solidarity in health care, as solidarity will not only be strained by the ageing population, but also might find itself under additional pressure as the gap in health care utilization between elderly and non-elderly grows over time. For hospital care utilization, this process might well be accelerated by advances in medical technology.

  13. Impediments to community-based care for people ageing with intellectual disability in rural New South Wales.

    PubMed

    Wark, Stuart; Hussain, Rafat; Edwards, Helen

    2014-11-01

    The emerging phenomenon of ageing with an intellectual disability has become subject to an increasing research focus in recent years. However, there remains little knowledge regarding the specific impediments that community workers face in supporting this cohort. The aims of the current study were to identify the major factors that, direct care staff believe, have most impact upon individuals ageing with an intellectual disability in the community. A three-round Delphi project was conducted across rural areas of New South Wales in Australia with 31 disability support workers to gain their perspectives on the main impediments facing a person ageing with intellectual disability. The 2010 study identified that the issue of ageing with an intellectual disability was presenting significant problems for community-based service delivery to this group of people. The panel identified 25 different impediments to the provision of support. A thematic analysis of the items indicated three main themes of 'funding', 'training' and 'access to services'. By identifying these impediments to supporting people ageing with an intellectual disability in the community, both services and government funding bodies have the ability to plan to overcome both current and future problem areas. This identification of impediments may facilitate individuals to receive more appropriate assistance, which in turn may lead to an improved quality of life and maintenance of a community-based placement rather than premature admission to the congregate-care system. This study is particularly timely, given that Australia is in the midst of implementing a National Disability Insurance Scheme, and is an opportunity for all levels of government to agree on the mechanisms to appropriately assist individuals with an intellectual disability to continue to be supported in the community as they age.

  14. Impediments to community-based care for people ageing with intellectual disability in rural New South Wales.

    PubMed

    Wark, Stuart; Hussain, Rafat; Edwards, Helen

    2014-11-01

    The emerging phenomenon of ageing with an intellectual disability has become subject to an increasing research focus in recent years. However, there remains little knowledge regarding the specific impediments that community workers face in supporting this cohort. The aims of the current study were to identify the major factors that, direct care staff believe, have most impact upon individuals ageing with an intellectual disability in the community. A three-round Delphi project was conducted across rural areas of New South Wales in Australia with 31 disability support workers to gain their perspectives on the main impediments facing a person ageing with intellectual disability. The 2010 study identified that the issue of ageing with an intellectual disability was presenting significant problems for community-based service delivery to this group of people. The panel identified 25 different impediments to the provision of support. A thematic analysis of the items indicated three main themes of 'funding', 'training' and 'access to services'. By identifying these impediments to supporting people ageing with an intellectual disability in the community, both services and government funding bodies have the ability to plan to overcome both current and future problem areas. This identification of impediments may facilitate individuals to receive more appropriate assistance, which in turn may lead to an improved quality of life and maintenance of a community-based placement rather than premature admission to the congregate-care system. This study is particularly timely, given that Australia is in the midst of implementing a National Disability Insurance Scheme, and is an opportunity for all levels of government to agree on the mechanisms to appropriately assist individuals with an intellectual disability to continue to be supported in the community as they age. PMID:25252081

  15. 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.

  16. 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

  17. Eating buckwheat cookies is associated with the reduction in serum levels of myeloperoxidase and cholesterol: a double blind crossover study in day-care centre staffs.

    PubMed

    Wieslander, Gunilla; Fabjan, Nina; Vogrincic, Maja; Kreft, Ivan; Janson, Christer; Spetz-Nyström, Ulrike; Vombergar, Blanka; Tagesson, Christer; Leanderson, Per; Norbäck, Dan

    2011-01-01

    Buckwheat food is a good source of antioxidants, e.g. rutin, and other beneficial substances. Here we investigated the effects of the intake of common buckwheat (low rutin content) and tartary buckwheat cookies (high rutin content) on selected clinical markers. A double blind crossover study was performed among female day-care centre staffs (N = 62) from five day-care centres. Participants were randomly divided into two groups. The first group initially consumed four common buckwheat cookies per day (16.5 mg rutin equivalents/day) for two weeks, while the second group consumed four tartary buckwheat cookies per day (359.7 mg rutin equivalents/day). Then the groups switched their type of cookies and consumed them for another two weeks. We monitored selected clinical markers related to cardiovascular disease and lower airway inflammation, lung function, and subjective breathing difficulties in the staffs. Intake of tartary buckwheat cookies reduced the serum level of myeloperoxidase (MPO) by a factor 0.84 (p = 0.02). When grouping the two types of buckwheat cookies together, there was a reduction of total serum cholesterol (p < 0.001) and HDL-cholesterol (p < 0.001) during the study period, with improved lung vital capacity (p < 0.001). The degree of reduction in total and HDL cholesterol levels was similar in staffs with low and high body mass index (cut off 25). In conclusion, intake of tartary buckwheat cookies with high level of the antioxidant rutin may reduce levels of MPO, an indicator of inflammation. Moreover, intake of both types of buckwheat cookies may lower cholesterol levels.

  18. 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.

  19. 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

  20. Operational research in primary health care planning: a theoretical model for estimating the coverage achieved by different distributions of staff and facilities

    PubMed Central

    Kemball-Cook, D.; Vaughan, J. P.

    1983-01-01

    This report outlines a basic operational research model for estimating the coverage achieved by different distributions of primary health care staff and facilities, using antenatal home visiting as an illustrative example. Coverage is estimated in terms of the average number of patient contacts achieved per annum. The model takes into account such features as number of facilities and health workers per 10 000 population, the radius of the health facility area, the overall population density in the region, the number of working days in the year, and the health worker's travelling time and work rate. A theoretical planning situation is also presented, showing the application of the model in defining various possible strategies, using certain planning norms for new levels of staff and facilities. This theoretical model is presented as an example of the use of operational research in primary health care, but it requires to be tested and validated in known situations before its usefulness can be assessed. Some indications are given of the ways in which the model could be adapted and improved for application to a real planning situation. PMID:6602666

  1. 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…

  2. 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…

  3. Strategies for School-Age Child Care in Texas.

    ERIC Educational Resources Information Center

    Baker, Nancy A.

    This manual was designed to assist Texas school districts in their efforts to implement Senate Bill (SB) 913 and to serve as a guide for organizing child care programs in the schools. Chapter 1 provides a summary of SB 913, a bill that requires school districts with more than 5,000 students to hold annual public hearings on out-of-school care for…

  4. A prospective observational study of quality of diabetes care in a shared care setting: trends and age differences (ZODIAC-19)

    PubMed Central

    van Hateren, Kornelis J J; Drion, Iefke; Kleefstra, Nanne; Groenier, Klaas H; Houweling, Sebastiaan T; van der Meer, Klaas; Bilo, Henk J G

    2012-01-01

    Objective The Zwolle Outpatient Diabetes project Integrating Available Care (ZODIAC) study was initiated in 1998 to investigate the effects of shared care for patients with type 2 diabetes mellitus (T2DM) in the Netherlands, and to reduce the number of diabetes-related complications. Benchmarking the performance of diabetes care was and is an important aspect of this study. We aimed to investigate trends in diabetes care, within the ZODIAC study for a wide variety of quality indicators during a long follow-up period (1998–2008), with special interest for different age groups. Design Prospective observational cohort study. Setting Primary care, Zwolle, The Netherlands. Participants Patients with T2DM. Methods A dataset of quality measures was collected annually during the patient's visit to the practice nurse or general practitioner. Linear time trends from 1998 to 2008 were estimated using linear mixed models in which we adjusted for age and gender. Age was included in the model as a categorical variable: for each follow-up year all participants were categorised into the categories <60, 60–75 and >75 years. Differences in trends between the age categories were investigated by adding an interaction term to the model. Results The number of patients who were reported to participate increased in the period 1998–2008 from 1622 to 27 438. All quality indicators improved in this study, except for body mass index. The prevalence albuminuria decreased in an 11-year-period from 42% to 21%. No relevant differences between the trends for the three age categories were observed. During all years of follow-up, mean blood pressure and body mass index were the lowest and highest, respectively, in the group of patients <60 years (data not shown). Conclusions Quality of diabetes care within the Dutch ZODIAC study, a shared care project, has considerably improved in the period 1998–2008. There were no relevant differences between trends across various age categories

  5. Comparing Aging in Place to Home Health Care: Impact of Nurse Care Coordination On Utilization and Costs.

    PubMed

    Popejoy, Lori L; Galambos, Colleen; Stetzer, Frank; Popescu, Mihail; Hicks, Lanis; Khalilia, Mohammed A; Rantz, Marilyn J; Marek, Karen D

    2015-01-01

    The goal of this study was to compare utilization and cost outcomes of patients who received long-term care coordination in an Aging in Place program to patients who received care coordination as a routine service in home health care. This research offered the unique opportunity to compare two groups of patients who received services from a single home health care agency, using the same electronic health record, to identify the impact of long-term and routine care coordination on utilization and costs to Medicare and Medicaid programs. This study supports that long-term care coordination supplied by nurses outside of a primary medical home can positively influence functional, cognitive, and health care utilization for frail older people. The care coordinators in this study practiced nursing by routinely assessing and educating patients and families, assuring adequate service delivery, and communicating with the multidisciplinary health care team. Care coordination managed by registered nurses can influence utilization and cost outcomes, and impact health and functional abilities.

  6. 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.

  7. Informing policy and service development at the interfaces between acute and aged care.

    PubMed

    Howe, Anna L

    2002-01-01

    This paper argues that policies to address the interfaces between acute care and aged care should view older people as members of the wider Australian population entitled to a range of health services under Medicare rather than focusing only on supposed "bed blockers". In seeking to explain the current level of policy interest in this area, three areas are canvassed: pressures on acute hospital care, particularly those attributed to population ageing; shrinking provision of residential aged care; and the proliferation of post acute services. If policy development is to maintain a wider rather than narrower perspective, attention needs to be given to improving collection and analysis of critical data that are currently unavailable, to developing system-wide funding arrangements for post acute care, and to reassessing what constitutes appropriate hospital activity for younger and older age groups alike. PMID:12536863

  8. Caring for an aging society: cohort values and eldercare services.

    PubMed

    Karner, T X

    2001-01-01

    Understanding the impact of cohort values is important in trying to project future aging service needs. The cultural characteristics of cohorts yet to reach the age of 65 are compared with those already "old," with specific focus on the Baby Boomers. Aging policies (and available services) reflect the cultural notions of age and aging held as normative during the historical era in which they are enacted. Previous research into lifestyle preferences, consumer practices, and key characteristics is drawn upon to investigate the values of Baby Boomers in light of their projected needs for eldercare services. Cohort research and generational marketing practices offer a promising foundation for exploring how best to develop, target, and deliver aging services that most effectively utilize our social resources.

  9. 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

  10. 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

  11. Work satisfaction and intention to leave among direct care workers in community and residential aged care in Australia.

    PubMed

    King, Debra; Wei, Zhang; Howe, Anna

    2013-01-01

    Turnover in the Australian aged-care workforce is lower than in the United States but is still of concern. This research examined the effects of worker satisfaction, worker characteristics, work conditions, and workplace environment on intention to leave, using data from a 2007 national census of the aged-care workforce. A probit model was used to estimate the probability of care workers leaving their jobs in the next 12 months. While workers were satisfied, overall, with their work, improving some components of satisfaction and converting casual contracts to permanent work would reduce intention to leave. To these ends, a shift in focus is required away from worker characteristics and the nature of care work to job conditions and organizational matters amenable to management and policy action.

  12. 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

  13. 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

  14. The Care Of The Aged: A Responsibility & Challenge For The Family Physician

    PubMed Central

    de Buda, Yvonne

    1979-01-01

    The population increase in the over 65 age group creates a challenge and responsibility for family physicians in the continuing and comprehensive care of the aged. Family physicians have to assess the medical, psychological and social needs of the elderly and provide them with the best care available by utilizing local facilities, community resources, health care personnel, and whenever possible, the cooperation of the patient's family. Medical students, family practice trainees and other health professionals require the appropriate training. New trends in the care of the elderly and medical education geared towards this task are discussed. PMID:20469307

  15. 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

  16. 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.

  17. 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).

  18. 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

  19. The emotional overlay: older person and carer perspectives on negotiating aging and care in rural Ontario.

    PubMed

    Herron, Rachel V; Skinner, Mark W

    2013-08-01

    This paper extends the burgeoning interest in emotion, health and place by investigating the emotionally complex experiences of aging and care in rural settings. Featuring a thematic analysis of 44 semi-structured interviews and two focus groups with older people and their carers in rural Ontario (Canada) we examine the importance and implications of emotions within and across multiple scales at which care relationships, expectations and responsibilities are negotiated. With the aim of broadening the discussion surrounding geographical dimensions of ethical care, our approach draws on feminist care ethics to understand the multifaceted ways in which emotions shape and are shaped by experiences of aging and caring at the interpersonal, household and community scales. The findings reveal how emotions are central, yet often-overlooked and even hidden within care relationships among older rural people and their carers. We argue that ethical care is contingent on recognizing and valuing the situated emotions involved in doing care work, sustaining care relationships and asking for care. In doing so, we demonstrate how qualitative research on the emotional geographies of care can contribute to the development of informed policies that are contextually sensitive and, ultimately, have the potential to build more ethical rural conditions of care.

  20. Population ageing and its implications on aggregate health care demand: empirical evidence from 22 OECD countries.

    PubMed

    Palangkaraya, Alfons; Yong, Jongsay

    2009-12-01

    Recent evidence indicates that the relationship between age and health care expenditure is not as straightforward as it appears. In fact, micro-level studies find that time to death, rather than ageing, is possibly the main driver of the escalating health care costs in developed countries. Unfortunately, the evidence at the macro level is less clear and often depends on the specification of the empirical model used. We use an aggregate demand framework to assess whether health expenditure is more likely to be driven by ageing per se or proximity to death. Using panel data from 22 OECD countries from the first half of the 1990s, we find population ageing to be negatively correlated with health expenditure once proximity to death is accounted for. This suggests that the effects of ageing on health expenditure growth might be overstated while the effects of the high costs of medical care at the end of life are potentially underestimated. With respect to the latter, our finding highlights the importance of long-term and hospice care management. An expanded long-term care program may not only improve patient welfare, but also reduce costs of care by reducing the duration of hospital care for terminally ill patients. If expensive medical treatment for patients near the end of life can be controlled for, health expenditure growth resulting from population ageing is unlikely to present a most serious problem.

  1. Targeting Expanded Care to the Aged: Early SHMO Experience.

    ERIC Educational Resources Information Center

    Leutz, Walter; And Others

    1988-01-01

    Describes targeting policies of four Social Health Maintenance Organization sites which deliver integrated, prepaid, acute, and chronic care to Medicare beneficiaries. Analyzes complexities of operationalizing targeting systems in four different settings. Notes that selection criteria for targeting expanded benefits and their implementation affect…

  2. 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…

  3. 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)

  4. 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…

  5. 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.

  6. 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

  7. Health care decision making: cross-cultural analysis of the shift from the autonomous to the relational staff.

    PubMed

    Joseph Tham, S; Letendre, Marie Catherine

    2014-01-01

    This paper addresses three factors that have contributed to shifts in decision making in health care. First, the notion of patient autonomy, which has changed due to the rise of patient-centred approaches in contemporary health care and the re-conceptualization of the physician-patient relationship. Second, the understanding of patient autonomy has broadened to better engage patient participation. Third, the need to develop cross-cultural health care ethics. Our paper shows that the shift in the West from the individual to the relational self indicates an important change in the understanding of autonomy through the lens of culture. Practices that recognize the notion of the relational self allow for a more balanced view of autonomy and a richer conception of moral agency.

  8. Ethnic aged discrimination and disparities in health and social care: a question of social justice.

    PubMed

    Johnstone, Megan-Jane; Kanitsaki, Olga

    2008-09-01

    Older overseas-born Australians of diverse cultural and language backgrounds experience significant disparities in their health and social care needs and support systems. Despite being identified as a 'special needs' group, the ethnic aged in Australia are generally underserved by local health and social care services, experience unequal burdens of disease and encounter cultural and language barriers to accessing appropriate health and social care compared to the average Australian-born population. While a range of causes have been suggested to explain these disparities, rarely has the possibility of cultural racism been considered. In this article, it is suggested that cultural racism be named as a possible cause of ethnic aged disparities and disadvantage in health and social care. It is further suggested that unless cultural racism is named as a structural mechanism by which ethnic aged disparities in health and social care have been created and maintained, redressing them will remain difficult.

  9. How patient and staff experiences affect outcomes.

    PubMed

    Churchill, Neil; Warden, Ruth

    Exploring patient and staff experiences is a new discipline but is providing key insights into the quality of care patients receive. This article explores how patient and staff experiences are measured and how this information is used to change practice.

  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. Autonomous staff selection teams.

    PubMed

    Mills, J; Oie, M

    1992-12-01

    Although some other organizations encourage staff input into employee selection, the advanced care department at Bellin Hospital in Green Bay, Wisconsin has taken this concept to a new level by implementing an autonomous interview team. This team is empowered to make hiring decisions for all positions within the department without management influence or interference.

  12. 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

  13. 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

  14. 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…

  15. 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…

  16. 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…

  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 Data-Feedback Method Used by Staff in Day-Care Centres to Improve the Quality of Their Work.

    ERIC Educational Resources Information Center

    Hedin, Anna; Ekholm, Bodil

    1989-01-01

    A data feedback method based on observations of daily activities was tested in 11 Swedish day care centers. Advantages and disadvantages of the use of data collectors from different organizational levels were studied. Hindrances to the change process are discussed. (NH)

  19. 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…

  20. 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…

  1. 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

  2. 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.

  3. 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

  4. 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

  5. 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…

  6. The feasibility of developing a standards rating system for all Australian government aged care homes.

    PubMed

    Koch, Susan; Nay, Rhonda; McAuliffe, Linda; Koch, Bill

    2008-06-01

    Aims and objectives.  The main objective of this project was to investigate the likelihood of creating an easily understood rating system for all aged care homes. A secondary objective was to canvas the feasibility of alternative systems that could better inform aged care consumers. Background.  Standards rating systems are used internationally to enable comparisons in healthcare. In Australia, the performance of numerous services and products are measured according to the star system of ratings, yet despite their widespread use, star ratings remain absent from the healthcare industry. Methods.  A National Consultative Group (NCG) consisting of key stakeholder representatives was consulted, and a literature review performed on existing standards (or 'star') rating systems. Telephone interviews were conducted with representatives from aged care homes, as well as consumers. Results.  A standards rating system for aged care homes was not found to be feasible in the current climate. However, an alternative system that emphasises empowering aged care consumers, such as one that allows consumers to search for an aged care home using their own criteria of preference, was considered more feasible. Conclusion.  The need for information to assist consumer choice - limited as it may be - is real. Ways of providing more consumer friendly, useful information need to be further explored and developed. Recommendations are made for future work in this area.

  7. Professional carers' knowledge and response to depression among their aged-care clients: the care recipients' perspective.

    PubMed

    Mellor, David; Davison, Tanya; McCabe, Marita; George, Kuruvilla

    2008-05-01

    Depression is an under-diagnosed disorder among the elderly, even in those who are in receipt of aged-care services. One factor associated with this under diagnosis has been identified as a reluctance amongst the elderly to discuss their mood and emotions with their medical practitioners. The current study focused on why depression is not recognised and acted on by those providing residential or home-based care to older people. We interviewed 15 elderly people residing in high-level or low-level aged-care facilities, and three elderly people who were receiving personal care in their homes. All participants had been identified by their care agencies as depressed. Participants reported their perceptions of their personal carers' knowledge and practices in managing the residents' depression. Although the participants described their carers in positive terms, they were critical of their knowledge and skills in recognising depression, and indicated that the communication between personal carers and care recipients about depressive symptomatology was seriously flawed. Training for personal carers in these areas, and efforts to change organisational culture are recommended. PMID:18728953

  8. Professional carers' knowledge and response to depression among their aged-care clients: the care recipients' perspective.

    PubMed

    Mellor, David; Davison, Tanya; McCabe, Marita; George, Kuruvilla

    2008-05-01

    Depression is an under-diagnosed disorder among the elderly, even in those who are in receipt of aged-care services. One factor associated with this under diagnosis has been identified as a reluctance amongst the elderly to discuss their mood and emotions with their medical practitioners. The current study focused on why depression is not recognised and acted on by those providing residential or home-based care to older people. We interviewed 15 elderly people residing in high-level or low-level aged-care facilities, and three elderly people who were receiving personal care in their homes. All participants had been identified by their care agencies as depressed. Participants reported their perceptions of their personal carers' knowledge and practices in managing the residents' depression. Although the participants described their carers in positive terms, they were critical of their knowledge and skills in recognising depression, and indicated that the communication between personal carers and care recipients about depressive symptomatology was seriously flawed. Training for personal carers in these areas, and efforts to change organisational culture are recommended.

  9. Income Inequities in Health Care Utilization among Adults Aged 50 and Older.

    PubMed

    Penning, Margaret J; Zheng, Chi

    2016-03-01

    Equitable access to and utilization of health services is a primary goal for many health care systems, particularly in countries with universal publicly funded systems. Despite concerns regarding potentially adverse implications of the 1990s' health care policy and other reforms, whether and how income inequalities in service utilization changed remains unclear. This study addressed the impact of income on physician and hospital utilization from 1992-2002 among adults aged 50 and older in British Columbia. Those with lower incomes were found less likely to access general practitioner and specialist services but more likely to access hospital services. Income-related disparities in physician care increased over time; hospital care declined. Volume of GP and hospital care was inversely associated with income; these differences increased regarding GP services only. Findings of declines in hospital-care access, accompanied by increasing income-related disparities in physician-services access, show that inequities are increasing within Canada's health care system.

  10. Income Inequities in Health Care Utilization among Adults Aged 50 and Older.

    PubMed

    Penning, Margaret J; Zheng, Chi

    2016-03-01

    Equitable access to and utilization of health services is a primary goal for many health care systems, particularly in countries with universal publicly funded systems. Despite concerns regarding potentially adverse implications of the 1990s' health care policy and other reforms, whether and how income inequalities in service utilization changed remains unclear. This study addressed the impact of income on physician and hospital utilization from 1992-2002 among adults aged 50 and older in British Columbia. Those with lower incomes were found less likely to access general practitioner and specialist services but more likely to access hospital services. Income-related disparities in physician care increased over time; hospital care declined. Volume of GP and hospital care was inversely associated with income; these differences increased regarding GP services only. Findings of declines in hospital-care access, accompanied by increasing income-related disparities in physician-services access, show that inequities are increasing within Canada's health care system. PMID:26757886

  11. Maternal care, mother-offspring aggregation and age-dependent coadaptation in the European earwig.

    PubMed

    Gómez, Y; Kölliker, M

    2013-09-01

    Benefits and costs of parental care are expected to change with offspring development and lead to age-dependent coadaptation expressed as phenotypic (behavioural) matches between offspring age and parental reproductive stage. Parents and offspring interact repeatedly over time for the provision of parental care. Their behaviours should be accordingly adjusted to each other dynamically and adaptively, and the phenotypic match between offspring age and parental stage should stabilize the repeated behavioural interactions. In the European earwig (Forficula auricularia), maternal care is beneficial for offspring survival, but not vital, allowing us to investigate the extent to which the stability of mother-offspring aggregation is shaped by age-dependent coadaptation. In this study, we experimentally cross-fostered nymphs of different age classes (younger or older) between females in early or late reproductive stage to disrupt age-dependent coadaptation, thereby generating female-nymph dyads that were phenotypically matched or mismatched. The results revealed a higher stability in aggregation during the first larval instar when care is most intense, a steeper decline in aggregation tendency over developmental time and a reduced developmental rate in matched compared with mismatched families. Furthermore, nymph survival was positively correlated with female-nymph aggregation stability during the early stages when maternal care is most prevalent. These results support the hypothesis that age-related phenotypically plastic coadaptation affects family dynamics and offspring developmental rate.

  12. Health care leadership in an age of change.

    PubMed

    Farrell, Maureen

    2003-01-01

    This study examined the leadership practices of a sample of network and hospital administrators in metropolitan Victoria, Australia. It was undertaken in the mid-1990s when the State Liberal-National (Coalition) Government in Victoria established Melbourne's metropolitan health care networks. I argue that leadership, and the process of leading, contributes significantly to the success of the hospital in a time of turmoil and change. The sample was taken from the seven health care networks and consisted of 15 network and hospital administrators. Bolman and Deal's frames of leadership--structural, human resource, political and symbolic--were used as a framework to categorize the leadership practices of the administrators. The findings suggest a preference for the structural frame--an anticipated result, since the hospital environment is more conducive to a style of leadership that emphasizes rationality and objectivity. The human resource frame was the second preferred frame, followed by the political and symbolic. These findings suggest that network and hospital administrators focus more on intellectual than spiritual development, and perhaps this tendency needs to be addressed when educating present and future hospital leaders.

  13. 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

  14. 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

  15. The lifestyle questionnaire for school-aged children: a tool for primary care.

    PubMed

    VanAntwerp, C A

    1995-01-01

    The Lifestyle Questionnaire for School-Aged Children can be used by nurse practitioners in the primary care setting to enhance assessment and focus health teaching. A survey of 75 school-aged children seen for well child examinations is highlighted, illustrating how nurse practitioners can use the Lifestyle Questionnaire to assess lifestyle patterns and promote healthy behaviors and habits.

  16. 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…

  17. [The availability of particular types of medical social care to persons of elderly and senile age].

    PubMed

    Shigabutdinov, A F

    2012-01-01

    The article presents the results of sociological survey of respondents of elderly and senile age living with their families or in senior centers. The comparative analysis was applied to availability of particular types of medical social care of contingent of interest depending on place of its residence. The age and ability of self-support of respondents were taken into account.

  18. The impact of electronic health records on client safety in aged care homes.

    PubMed

    Jiang, Tao; Yu, Ping

    2014-01-01

    This study collects and critically reviews the published literature to synthesize the risk factors for client safety in residential aged care and the potential contributions of electronic health records to reducing these risks. Three major types of risk factors for client safety were identified: risk factors related to the person's health; those related to the health and aged care system serving the person and those related to human error. Multiple strategies at all levels of an aged care organization are needed to reduce risks and improve client safety. Electronic health records can be one of the effective organizational mechanisms because it improves access to better information and integrates intelligent functions to support point-of-care decision making.

  19. Nurse practitioners in aged care: documentary analysis of successful project proposals.

    PubMed

    Clark, Shannon J; Parker, Rhian M; Davey, Rachel

    2014-11-01

    Meeting the primary health care needs of an aging population is an increasing challenge for many Western nations. In Australia, the federal government introduced a program to develop, test, and evaluate nurse practitioner models in aged care settings. In this article, we present a documentary analysis of 32 project proposals awarded funding under the Nurse Practitioner-Aged Care Models of Practice Program. Successfully funded models were diverse and were operated by a range of organizations across Australia. We identified three key priorities as underlying the proposed models: "The right care," "in the right place," and "at the right time." In this article, we explore how these priorities were presented by different applicants in different ways. Through the presentation of their models, the program's applicants identified and proposed to address current gaps in health services. Applicants contrasted their proposed models with available services to create persuasive and competitive applications for funding.

  20. 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

  1. Long-term care insurance and integrated care for the aged in Japan

    PubMed Central

    Matsuda, Shinya; Yamamoto, Mieko

    2001-01-01

    Abstract By the introduction of a public, mandatory program of Long-Term Care Insurance (LTCI) on April 1, 2000, Japan has moved towards a system of social care for the frail and elderly. The program covers care that is both home-based and institutional. Fifty percent of the insurance is financed from the general tax and the other fifty percent from the premiums of the insured. The eligibility process begins with the individual or his/her family applying to the insurer (usually municipal government). A two-step assessment process to determine the limit of benefit follows this. The first step is an on-site assessment using a standardised questionnaire comprising 85 items. These items are analysed by an official computer program in order to determine either the applicant's eligibility or not. If the applicant is eligible it determines which of 6 levels of dependency is applicable. The Japanese LTCI scheme has thus formalised the care management process. A care manager is entrusted with the entire responsibility of planning all care and services for individual clients. The introduction of LTCI is introducing two fundamental structural changes in the Japanese health system; the development of an Integrated Delivery System (IDS) and greater informatisation of the health system. PMID:16896410

  2. Primary care presentations at emergency departments: rates and reasons by age and sex.

    PubMed

    Siminski, Peter; Bezzina, Andrew J; Lago, Luise P; Eagar, Kathy

    2008-11-01

    Primary care presentations at emergency departments (EDs) have been the subject of much attention in recent years. This paper is a demographic analysis using administrative data from the Emergency Department Information System (EDIS) for 2005 of such presentations in New South Wales EDs and of self-reported reasons for presentation. Age and sex differences in the reasons given by patients for such presentations are analysed using data from a survey of patients conducted in a subset of EDs in 2004. The rate of "potential primary care" presentations varies greatly with age and to a lesser extent with sex. Almost half (47%) of these presentations are made by people under 25 years of age. Children aged 0-4 years account for 14% of the total. The pattern is distinctly different to the corresponding rate of ED presentations that do not fit the "potential primary care" definition. Reasons given for "potential primary care" presentations are consistent across all age groups, reflecting self-assessed urgency, access to diagnostics and self-assessed complexity. Older "primary care" patients are particularly unlikely to give reasons associated with GP affordability or availability for their presentations. Young adults' responses are consistent with the overall population, and children under the age of five seem most susceptible to availability issues.

  3. Hepatitis B and workers in institutions for the mentally retarded: risk of infection for staff in patient care.

    PubMed

    Livengood, J R; Miller, G E; Coulter, D; Foster, L R

    1989-01-01

    In the fall of 1982, we conducted a serosurvey of 920 of 933 employees in a large residential institution for the mentally retarded in Salem, Oregon. This survey demonstrated an overall prevalence of 10% for antibody to hepatitis B core antigen (anti-HBc), a marker of present or previous hepatitis B virus infection. Antibody positivity was significantly associated with a history of ever having worked in a position involving direct patient care (adjusted odds ratio = 3.1, 95% confidence interval 2.6-4.2). The length of time employed at the institution was significantly associated with an increasing prevalence of anti-HBc positivity among those persons who had ever worked in direct patient care (chi 2 for linear trend = 19.3, P less than .00001, one tail), but not among those employees who had never worked in patient contact. This evidence supports the Immunization Practices Advisory Committee (ACIP) recommendation of hepatitis B virus screening and, where appropriate, vaccinations for those workers in institutions for the mentally retarded who work closely with patients. PMID:2787161

  4. 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

  5. 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

  6. [Health Care Insurance in France: its impact on income distribution between age and social groups].

    PubMed

    Fourcade, N; Duval, J; Lardellier, R

    2013-08-01

    Our study, based on microsimulation models, evaluates the redistributive impact of health care insurance in France on income distribution between age and social groups. This work sheds light on the debate concerning the respective role of the public health care insurance (PHI) and the private supplemental health care insurance (SHI) in France. The analysis points out that the PHI enables the lowest-income households and the pensioners a better access to health care than they would have had under a complete private SHI. Due to the progressivity of taxes, low-income households contribute less to the PHI and get higher benefits because of a weaker health. Pensioners have low contributions to public health care finance but the highest health care expenditures.

  7. Incorporating Age-Specific Plans of Care to Achieve Optimal Perioperative Outcomes.

    PubMed

    Mower, Juliana

    2015-10-01

    When developing a nursing plan of care, a perioperative nurse identifies nursing diagnoses during the preoperative patient assessment. The ability to identify age-specific outcomes (ie, infant/child, adolescent, adult, elderly adult) in addition to those that are universally applicable is a major responsibility of the perioperative RN. Having an individualized plan of care is one of the best ways to determine whether desired patient outcomes have been successfully attained. Nursing care plans address intraoperative and postoperative risks and allow for a smooth transfer of care throughout the perioperative experience. A good nursing care plan also includes education for the patient and his or her caregiver. Within an overall plan of care, the use of methods such as a concept or mind map can visually demonstrate the relationships between systems, nursing diagnoses, nursing interventions, and desirable outcomes.

  8. 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

  9. 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.

  10. 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

  11. 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

  12. [The nurse as an action tool in care for the aged].

    PubMed

    Brum, Ana Karine Ramos; Tocantins, Florence Romijn; Silva, Teresinha de Jesus do Espírito Santo da

    2005-01-01

    This study approaches nursing care as related to the aged. The studied situation involved health care needs of hospitalized persons, using the following central question: which is the meaning of nurses' actions when attending hospitalized aged patients without expectation of recovery and when technology is no longer that important? We aimed to reflect about hospitalized elders' needs in nursing reality. Comprehensive Sociology was used as a theoretical-methodological framework. The study was carried out at an Intensive Care Service of a Municipal Hospital in the city of Rio de Janeiro-Brazil. The subjects were nurses who attend hospitalized aged persons without any expectation of recovery, who were approached through a phenomenological interview. Through a comprehensive analysis, we identified care by being together, providing at the same time physical comfort and well-being to cope with the situation as typical of nursing actions. This study indicates some contributions for nursing care, assistance, teaching and research, aimed at strengthening nurses' attitude as an action tool in care for aged patients.

  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. Financing care for aging women in the U.S.: international perspectives.

    PubMed

    Neuman, P H; Rice, D P; Hussey, P S

    2000-04-01

    The aging of the U.S. population presents challenges in financing care and meeting the health and long-term care needs of older Americans. Women, who constitute a majority of the older adult population and a disproportionate share of those with low incomes, chronic conditions and long-term care needs, have much at stake in the future direction of health programs for aging Americans. This paper examines the status of older women in 12 industrialized nations to assess how the U.S. compares to other countries in terms of its aging female population. We find that women across the 12 industrialized countries have a longer life expectancy than men at ages 65 and 80, underscoring the universality of aging as a "women's issue". With respect to age composition, the U.S. lags behind many industrialized nations in the share of its elderly female population; by 2030, the proportion of women aged 65 and older, and 80 and older, will be lower in the U.S. than in any of the industrialized nations compared in this paper. Against this backdrop, the paper examines the characteristics of older adult women in the U.S., considers the role of Medicare in meeting the needs of aging women, and identifies gaps in coverage, primarily prescription drug and long-term care, that disproportionately affect older women. The paper concludes by considering how other nations provide and finance prescription drug and long-term care services for older adults, suggesting useful models for the U.S. to consider as it struggles to meet the demands of its aging population. PMID:10902056

  15. The effects of age, gender, and crash types on drivers' injury-related health care costs.

    PubMed

    Shen, Sijun; Neyens, David M

    2015-04-01

    There are many studies that evaluate the effects of age, gender, and crash types on crash related injury severity. However, few studies investigate the effects of those crash factors on the crash related health care costs for drivers that are transported to hospital. The purpose of this study is to examine the relationships between drivers' age, gender, and the crash types, as well as other crash characteristics (e.g., not wearing a seatbelt, weather condition, and fatigued driving), on the crash related health care costs. The South Carolina Crash Outcome Data Evaluation System (SC CODES) from 2005 to 2007 was used to construct six separate hierarchical linear regression models based on drivers' age and gender. The results suggest that older drivers have higher health care costs than younger drivers and male drivers tend to have higher health care costs than female drivers in the same age group. Overall, single vehicle crashes had the highest health care costs for all drivers. For males older than 64-years old sideswipe crashes are as costly as single vehicle crashes. In general, not wearing a seatbelt, airbag deployment, and speeding were found to be associated with higher health care costs. Distraction-related crashes are more likely to be associated with lower health care costs in most cases. Furthermore this study highlights the value of considering drivers in subgroups, as some factors have different effects on health care costs in different driver groups. Developing an understanding of longer term outcomes of crashes and their characteristics can lead to improvements in vehicle technology, educational materials, and interventions to reduce crash-related health care costs.

  16. 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

  17. 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

  18. Conflict of roles: a conflict of ideas? The unsettled relations between care team staff and independent mental health advocates.

    PubMed

    McKeown, Mick; Ridley, Julie; Newbigging, Karen; Machin, Karen; Poursanidou, Konstantina; Cruse, Kaaren

    2014-10-01

    Drawing on a national study of independent mental health advocacy, we explored the social relations of independent advocacy. The study was commissioned by the Department of Health (England), and involved a case study design covering eight different geographies and service configurations, and interviews or focus groups with a total of 289 stakeholders across two phases of inquiry. This paper focused on the analysis of qualitative data relevant to the relationship between mental health-care services and independent advocacy services, drawn from interviews with 214 participants in phase two of the study. Discussion of these particular findings affords insights into the working relations of independent advocacy within mental health services beset by reorganizational change and funding cuts, and increasing levels of legally-sanctioned compulsion and coercion. We offer a matrix, which accounts for the different types of working relationships that can arise, and how these are associated with various levels of understanding of independent advocacy and appreciation for the value of advocacy. The discussion is framed by the wider literature on advocacy and the claims by practitioners, such as nurses, for an advocacy role as part of their professional repertoire.

  19. 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.

  20. 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…

  1. Faculty Participation in Staff Selection.

    ERIC Educational Resources Information Center

    Maguire, John W.

    1979-01-01

    This article describes a process for staff involvement in the selection of secondary school teachers. Special attention is given to determining teacher selection criteria which will contribute to staff balance--the optimum mix of faculty by age, sex, race, and other variables. (SJL)

  2. Improving staff nurse conflict resolution skills.

    PubMed

    Baker, K M

    1995-01-01

    As health care organizations restructure their organizations based on a team-managed philosophy, staff nurses will need new skills to function successfully in this type of environment. Specifically, staff nurses will need improved conflict resolution skills. Training and nurse managers' modeling of effective resolution techniques are key elements in developing improved conflict resolution skills among staff nurses. PMID:7566208

  3. Aging, health and place in residential care facilities in Beijing, China.

    PubMed

    Cheng, Yang; Rosenberg, Mark W; Wang, Wuyi; Yang, Linsheng; Li, Hairong

    2011-02-01

    In recent years, residential care has become an alternative option for elder care in Beijing, China. Little is known, however, about the well-being of elderly residents and the relationship between their health and living in residential care facilities (RCFs). Hence this research aims to understand the well-being of elderly residents in RCFs and how the environment of RCFs affects elderly people's everyday activities and health. The concepts of therapeutic landscapes, active aging, and well-being contribute to understanding the relationships among aging, health, and environment within RCF settings. Qualitative data from 46 in-depth semi-structured interviews with RCF managers, elderly residents, and family members in Beijing were transcribed and analysed using the constant comparative method. The results show that most of the elderly residents are satisfied with their lives in RCFs, but a few of them feel isolated and depressed after their relocation. Each RCF, as a place with its unique physical and social environment, has a significant influence on the elderly residents' physical and psychological well-being. Individual factors such as characteristics of elderly residents, their attitudes on aging and residential care, and family support also play important roles in their adaptation and well-being after relocation from home to RCFs. Although this study focuses on residential care at the local level, it sheds light on future research on geographical and socio-cultural meanings of elder care at local, regional, and national levels in China. PMID:21109338

  4. 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

  5. Comparison of Informal Care Time and Costs in Different Age-Related Dementias: A Review

    PubMed Central

    Costa, Nadège; Ferlicoq, Laura; Derumeaux-Burel, Hélène; Rapp, Thomas; Garnault, Valérie; Gillette-Guyonnet, Sophie; Andrieu, Sandrine; Vellas, Bruno; Lamure, Michel; Grand, Alain; Molinier, Laurent

    2013-01-01

    Objectives. Age-related dementia is a progressive degenerative brain syndrome whose prevalence increases with age. Dementias cause a substantial burden on society and on families who provide informal care. This study aims to review the relevant papers to compare informal care time and costs in different dementias. Methods. A bibliographic search was performed on an international medical literature database (MEDLINE). All studies which assessed the social economic burden of different dementias were selected. Informal care time and costs were analyzed in three care settings by disease stages. Results. 21 studies met our criteria. Mean informal care time was 55.73 h per week for Alzheimer disease and 15.8 h per week for Parkinson disease (P = 0.0076), and the associated mean annual informal costs were $17,492 versus $3,284, respectively (P = 0.0393). Conclusion. There is a lack of data about informal care time and costs among other dementias than AD or PD. Globally, AD is the most costly in terms of informal care costs than PD, $17,492 versus $3,284, respectively. PMID:23509789

  6. Exploring the limitations of age-based models for health care planning.

    PubMed

    Mason, Thomas; Sutton, Matt; Whittaker, William; Birch, Stephen

    2015-05-01

    Health care decision makers are required to make planning decisions over a medium to long term planning horizon. Whilst population ageing is an important consideration for planners, age-stratified demographic models may produce misleading estimates of future resource requirements if the actual relationship between age and health is not fixed. We present a methodology which tests whether the assumption of a fixed age-health relationship is valid and estimate the magnitude of planning errors using a long time-series of measures of chronic health and service utilisation (N = 2419) taken from the Great British General Household Survey (1980-2008). We find that age-only models contain significant omitted variable bias, and that the relationship between age and health varies significantly across birth cohorts. Chronic sickness has fallen across birth cohorts born between 1890 and 2008, particularly before birth year 1930. Generational health improvements have mitigated the effects of population ageing, meaning that the population rate of sickness fell between 1980 and 2008. Planning based only on age leads to overestimation of the population level of health care need if successive cohorts are becoming healthier. Many alternative approaches exist which allow planners to relax the assumption of a fixed relationship between age and health. PMID:25780858

  7. Age-friendly primary health care: an assessment of current service provision for older adults in Hong Kong.

    PubMed

    Woo, Jean; Mak, Benise; Yeung, Fannie

    2013-01-01

    There has been no study evaluating whether primary care services are sufficiently oriented towards the older population in Hong Kong, particularly those with increasing frailty. Since primary care is a key first interface in promotion and maintenance of health in older people, an assessment of the age-friendliness of service provisions is of critical importance in optimizing the health of aging populations. The age-friendliness of primary care services for older people was assessed using focus groups of elderly people and also of service providers who care for them. Discussion content was based on the WHO guidelines for age-friendly primary care in the following areas: Information, education and training, community-based health care management systems, and the physical environment. Desirable improvements were identified in all domains. The findings underscore the need for wider dissemination of health care needs of older people in the primary care setting.

  8. 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…

  9. Family Day Care Check-In Program: After-School Care for Children Aged 10-14. [Introduction and Guide to Operation.

    ERIC Educational Resources Information Center

    Osborne, Linda B., Ed.

    The Family Day Care Check-In Program is designed to offer working parents convenient, affordable after school care for their children aged 10 to 14. It provides children with flexible supervision by caring, trained adults and gives them opportunities to grow into responsible, independent teens by planning and participating in activities on their…

  10. 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.

  11. [A Study on problems associated with a patient's death during home care, based on the duration of home care and patient's age-why terminal home care is difficult for a patient's family].

    PubMed

    Ohara, Hiroo; Okabe, Hiromi; Tsuchiya, Kumiko; Kikuchi, Kana

    2012-12-01

    When a patient receives home care, an important factor is how the family accepts the patient's death. In this study, we observed that the number of long-term in-home terminal care cases increased, as well as the number of short-term in-home care cases. Moreover, the number of cancer cases among the young population is also increasing. Consequently, how to acceptance of a patient's death varies among their family. When tending to patients, suitable support from the medical staff is required. Additionally, various options need to be provided for terminal care. PMID:23268913

  12. 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

  13. 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,…

  14. 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…

  15. 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…

  16. What Are the School-Age Child Care Needs of Families in Rural Communities?

    ERIC Educational Resources Information Center

    Hobbs, Beverly B.; Chang, Joyce I.

    During 1994 and 1995, the Commissions on Children and Families in six rural Oregon counties joined with local elementary schools and the Oregon State University Extension Service to conduct surveys to determine the school-age child care needs of local families. Data were collected and analyzed, and individual reports were prepared by county. The…

  17. 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.…

  18. 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,…

  19. 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…

  20. Standards, Regulation and Development of School-Age Day Care and "Open Door" Services.

    ERIC Educational Resources Information Center

    Petrie, Pat

    1996-01-01

    Describes research on "open door" play and day care services for school-age children, which provided data on standards of such services when they became subject to registration and inspection under Children Act 1989. Identifies shortcomings in material resources and practice. Uses case studies to describes problems of local authorities in carrying…

  1. 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…

  2. 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…

  3. The effect of age and time to death on primary care costs: the Italian experience.

    PubMed

    Atella, Vincenzo; Conti, Valentina

    2014-08-01

    A large body of literature shows that time to death (TTD) is by far a better predictor of health spending than age. In this paper, we investigate if this finding holds true also in presence of primary care costs (pharmaceuticals, diagnostic tests and specialist visits) in Italy, where they represent an important share (about 30%) of the total health care expenditure (HCE). Our analysis is based on a large sample of the Italian population (about 750,000 individuals), obtained from the Health Search-SiSSI database, which contains patient-level data collected routinely by General Practitioners in Italy since 2002. We study individuals aged 19 and older, over the period 2006-2009. By means of a two-part model which accounts for the presence of zero expenditure, our findings show that age represents the most important driver of primary care costs in Italy, although TTD remains a good predictor. These results suggest that age and TTD can have a different role in shaping health care costs according to the component of health expenditure examined. Therefore, our advice to policy makers is to use disaggregated models to better disentangle these contributions and to produce more reliable health spending forecasts.

  4. 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

  5. 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.

  6. NICU staff

    MedlinePlus

    ... reviewed and approved by a doctor. NEONATAL INTENSIVE CARE UNIT (NICU) NURSE This type of nurse has received special training ... Saunders; 2015:chap 95. Levin DL, Todres ID. History of pediatric critical care. In: Fuhrman BP, Zimmerman JJ, eds. Pediatric Critical ...

  7. 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,…

  8. 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…

  9. 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

  10. 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.

  11. Age at adoption from institutional care as a window into the lasting effects of early experiences.

    PubMed

    Julian, Megan M

    2013-06-01

    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.

  12. 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

  13. Norovirus epidemiology in community and health care settings and association with patient age, Denmark.

    PubMed

    Franck, Kristina T; Fonager, Jannik; Ersbøll, Annette K; Böttiger, Blenda

    2014-07-01

    Norovirus (NoV) is a major cause of gastroenteritis. NoV genotype II.4 (GII.4) is the predominant genotype in health care settings but the reason for this finding is unknown. Stool samples containing isolates with a known NoV genotype from 2,109 patients in Denmark (patients consulting a general practitioner or outpatient clinic, inpatients, and patients from foodborne outbreaks) were used to determine genotype distribution in relation to age and setting. NoV GII.4 was more prevalent among inpatients than among patients in community settings or those who became infected during foodborne outbreaks. In community and health care settings, we found an association between infection with GII.4 and increasing age. Norovirus GII.4 predominated in patients ≥ 60 years of age and in health care settings. A larger proportion of children than adults were infected with NoV GII.3 or GII.P21. Susceptibility to NoV infection might depend on patient age and infecting NoV genotype. Cohort studies are warranted to test this hypothesis.

  14. Norovirus Epidemiology in Community and Health Care Settings and Association with Patient Age, Denmark

    PubMed Central

    Fonager, Jannik; Ersbøll, Annette K.; Böttiger, Blenda

    2014-01-01

    Norovirus (NoV) is a major cause of gastroenteritis. NoV genotype II.4 (GII.4) is the predominant genotype in health care settings but the reason for this finding is unknown. Stool samples containing isolates with a known NoV genotype from 2,109 patients in Denmark (patients consulting a general practitioner or outpatient clinic, inpatients, and patients from foodborne outbreaks) were used to determine genotype distribution in relation to age and setting. NoV GII.4 was more prevalent among inpatients than among patients in community settings or those who became infected during foodborne outbreaks. In community and health care settings, we found an association between infection with GII.4 and increasing age. Norovirus GII.4 predominated in patients ≥60 years of age and in health care settings. A larger proportion of children than adults were infected with NoV GII.3 or GII.P21. Susceptibility to NoV infection might depend on patient age and infecting NoV genotype. Cohort studies are warranted to test this hypothesis. PMID:24960024

  15. 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.

  16. The Status of School-Age Child Care in Florida: An Oversight Report Prepared for the Education K-12 Committee.

    ERIC Educational Resources Information Center

    Florida House of Representatives, Tallahassee. Committee on Education, K-12.

    This comprehensive report provides current information on the status of school age child care in Florida, an overview of Florida Statutes, a summary of benefits and problems with state involvement, and recommendations for action. An estimated 138,000 children ages 5 to 13 in Florida may be without care every day after school. Florida's school…

  17. Spirituality and caring in old age and the significance of religion - a hermeneutical study from Norway.

    PubMed

    Rykkje, Linda L R; Eriksson, Katie; Raholm, Maj-Britt

    2013-06-01

    Spirituality is an important part of caring for the whole human being. However, there is lack of consensus about the concept parameter, and there is an ongoing discussion in nursing regarding the relation between religion and spirituality. Spirituality and religion is found to support health and well-being in old age, and this article portrays how older Norwegians understand religion and religious support as part of spirituality and caring. The theoretical framework in this study is Eriksson's caritative caring theory, and the research aim is to broaden the understanding of spirituality from a caring science perspective. The methodology is hermeneutical according to Gadamer. The study is based upon qualitative content analysis of 30 interviews with 17 participants above 74 years, six men and 11 women. The findings portray connectedness with a Higher power, including how Christianity has influenced upon the philosophy of life of the participants, wonders about the end of life/afterlife, and the meaning of religious symbols and rituals. The study also portrays how religious support may foster dignity, especially near the end of life, and experiences and opinions regarding support from nursing personnel. The study concludes that religiousness cannot be separated from spirituality, and that nurses should be able to provide spiritual care to a certain extent. Spiritual care including religious support according to patients' desires may foster health and preserve human dignity. PMID:22724432

  18. Spirituality and caring in old age and the significance of religion - a hermeneutical study from Norway.

    PubMed

    Rykkje, Linda L R; Eriksson, Katie; Raholm, Maj-Britt

    2013-06-01

    Spirituality is an important part of caring for the whole human being. However, there is lack of consensus about the concept parameter, and there is an ongoing discussion in nursing regarding the relation between religion and spirituality. Spirituality and religion is found to support health and well-being in old age, and this article portrays how older Norwegians understand religion and religious support as part of spirituality and caring. The theoretical framework in this study is Eriksson's caritative caring theory, and the research aim is to broaden the understanding of spirituality from a caring science perspective. The methodology is hermeneutical according to Gadamer. The study is based upon qualitative content analysis of 30 interviews with 17 participants above 74 years, six men and 11 women. The findings portray connectedness with a Higher power, including how Christianity has influenced upon the philosophy of life of the participants, wonders about the end of life/afterlife, and the meaning of religious symbols and rituals. The study also portrays how religious support may foster dignity, especially near the end of life, and experiences and opinions regarding support from nursing personnel. The study concludes that religiousness cannot be separated from spirituality, and that nurses should be able to provide spiritual care to a certain extent. Spiritual care including religious support according to patients' desires may foster health and preserve human dignity.

  19. Roles of Medical Record and Statistic Staff on Research at the Tawanchai Center.

    PubMed

    Pattaranit, Rumpan; Chantachum, Vasana; Lekboonyasin, Orathai; Pradubwong, Suteera

    2015-08-01

    The medical record and statistic staffs play a crucial role behind the achievements of treatment and research of physicians, nurses and other health care professionals. The medical record and statistic staff are in charge of keeping patient medical records; creating databases; presenting information; sorting patient's information; providing patient medical records and related information for various medical teams and researchers; Besides, the medical record and statistic staff have collaboration with the Center of Cleft Lip-Palate, Khon Kaen University in association with the Tawanchai Project. The Tawanchai Center is an organization, involving multidisciplinary team which aims to continuing provide care for patients with cleft lip and palate and craniofacial deformities who need a long term of treatment since newborns until the age of 19 years. With support and encouragement from the Tawanchai team, the medical record and statistic staff have involved in research under the Tawanchai Centre since then and produced a number of publications locally and internationally.

  20. [Habermas' and Giddens' modernization theories applied to homes for the aged and to somatic nursing homes. The long road toward greater equivalence between residents and staff].

    PubMed

    Belderok, J J

    1997-12-01

    The situation in homes for the elderly and nursing homes is for the residents both alarming and tragic. Recent Dutch legislation supports the movement towards more self-determination and autonomy for the residents. The staff are dedicated to making the living situation as good as possible for the residents. Nevertheless many publications describe how the dependence and helplessness of the residents stil continue. In this paper this helplessness is placed within the broader framework of modern society by application of Habermas' theory of communicative action and Giddens' structuration theory. Both theories show that the key to improve dependent making structures should be sought principally in the behaviour of both staff and residents. Habermas offers a perspective to more equivalent communicative action between residents and staff. Giddens draws attention to the knowledgeability of residents, with which they should be able to interact on an equal basis with professionals. This presupposes much dedication of both staff and residents.