scholarly journals An evaluation of telehealth expansion in U.S. nursing homes

2020 ◽  
Author(s):  
Gregory L Alexander ◽  
Kimberly R Powell ◽  
Chelsea B Deroche
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Organizational Characteristics ◽  
Limited Resources ◽  
Protective Equipment ◽  
Resident Evaluation ◽  
Significant Relationships ◽  
Wide Range ◽  
Home Telehealth ◽  
Score Range

Abstract Objective This research brief contains results from a national survey about telehealth use reported in a random sample of U.S. nursing homes. Methods and Materials The sample includes nursing homes (N = 664) that completed surveys about information technology maturity, including telehealth use, beginning January 1, 2019, and ending August 4, 2020. A pre/post design was employed to examine differences in nursing home telehealth use for nursing homes completing surveys prior to and after telehealth expansion, on March 6, 2020. We calculated a cumulative telehealth score using survey data from 6 questions about extent of nursing home telehealth use (score range 0-42). We calculated proportions of nursing homes using telehealth and used logistic regression to look for differences in nursing homes based on organizational characteristics and odds ratios. Results Significant relationships were found between nursing home characteristics and telehealth use, and specifically, larger metropolitan homes reported greater telehealth use. Ownership had little effect on telehealth use. Nursing homes postexpansion used telehealth applications for resident evaluation 11.24 times more (P < .01) than did nursing homes pre-expansion. Discussion Administrators completing our survey reported a wide range of telehealth use, including approximately 16% having no telehealth use and 5% having the maximum amount of telehealth use. Mean telehealth use scores reported by the majority of these nursing homes is on the lower end of the range. Conclusions One solution for the current pandemic is to encourage the proliferation of telehealth with continued relaxed regulations, which can reduce isolation and preserve limited resources (eg, personal protective equipment) while maintaining proper distancing parameters.

scholarly journals ORGANIZATIONAL CHARACTERISTICS OF HIGHLY PERSON-CENTERED UNITS IN SWEDISH NURSING HOME

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S700-S701
Author(s):  
Anders B Sköldunger ◽  
Annica Backman
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Organizational Context ◽  
Organizational Characteristics ◽  
Direct Care ◽  
Cross Sectional ◽  
Care Services ◽  
Individualized Care ◽  
Private And Public ◽  
Institutional Model

Abstract The movement from an institutional model of care towards a person-centred care as the gold standard of practice is now guiding the provision of care services in nursing homes around the world. The organizational context of care has been described as a determining factor for the extent to which staff can offer person-centred care. However, few studies have empirically investigated which factors that defines nursing home units as being person-centred. Providing information about organizational characteristics would therefor provide insight into an organizational context with capacity to enhance a person-centred care. Thus, the aim was to explore factors of nursing homes with high vs. low person-centred care with focus on organizational variables. The study was based on a cross-sectional national survey, and data on 4831 residents, 3605 staff, and facility variables were collected in 2014. Descriptive statistics and regression modelling were used to analyze the data. The preliminary results showed that characteristics of highly person-centred units were; dementia specific units and units with fewer number of beds. No significant differences were seen between private and public nursing homes in terms of degree of person-centred care. Person-centred units was characterized by managers supporting staff to provide individualized care based on the resident’s needs, as well as staff receiving supervision of a reg. nurse in the direct care. These findings can be seen as facilitators ’ for person-centred care, suggesting several contextual and organizational elements of significance for enhancing person-centred practice.

Sleep and agitation in nursing home residents with and without dementia

2015 ◽  
Vol 27 (12) ◽  
pp. 1945-1955 ◽  
Author(s):  
Donnamay T. Brown ◽  
Juanita L. Westbury ◽  
Benjamin Schüz
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Poor Sleep ◽  
Moderation Effect ◽  
Significant Relationships ◽  
Study Results ◽  
Hypnotic Medication ◽  
Benzodiazepine Use ◽  
The Relationship

ABSTRACTBackground:The prevalence of dementia in Australian nursing homes is high. A large proportion of residents express themselves through agitated behaviors, with substantial interpersonal and day-to-day variance. One factor that may increase agitation is poor sleep. The current study aimed to determine if sleep influences symptoms of agitation in nursing home residents, and whether this effect differed by dementia status. As benzodiazepines are used widely as hypnotic medication, their impact was also considered.Methods:Actigraph devices worn on residents’ non-dominant wrists for three days were used to obtain objective measures of sleep. Symptoms of agitation were assessed using staff responses to two standardized questionnaires – the Cohen-Mansfield Agitation Inventory (CMAI) and the Neuropsychiatric Inventory – nursing home version (NPI-NH). Presence of dementia and benzodiazepine use were obtained from resident medical charts.Results:Forty-nine residents (mean age: 85.57 years) from four nursing homes in Tasmania were included in the study. Results indicated that residents were in bed for an average of 11.04 h and slept for 10.14 h per day. Significant relationships between sleep and verbal as well as non-aggressive agitation were found. No relationships between sleep and aggressive agitation were detected. A significant moderation effect of dementia was found, in which residents without dementia expressed verbal agitation when obtaining less sleep, but not residents with dementia. Benzodiazepine use did not result in significantly more sleep.Conclusions:These results suggest that sleep could play an important role in explaining agitation, but more research is needed to explore the relationship between sleep and benzodiazepines in nursing home residents.

scholarly journals Characterization of COVID-19 outbreaks in three nursing homes during the first wave in Berlin, Germany

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alexandra Roth ◽  
Silke Feller ◽  
Andreas Ruhnau ◽  
Lena Plamp ◽  
Ute Viereck ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Facility Management ◽  
Protective Equipment ◽  
Course Of Disease ◽  
Healthcare Facilities ◽  
Health Authorities ◽  
Cluster Strategy ◽  
Close Cooperation

AbstractSevere Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) belongs to the coronavirus family and is characterized by its high transmission competence. Elderly COVID-19 patients are at significantly higher risk of severe course of disease and death. Therefore, outbreaks in nursing homes are particularly challenging for facility managers and health authorities. Here, we report three outbreaks of COVID-19 related to nursing homes (NH01.a, NH02 and NH03) with almost 1000 affected individuals during the first COVID-19 wave in Berlin, Germany. The occurrence of cases and the measures taken were analyzed retrospectively. In all three outbreaks, the index persons were nursing home employees or volunteers. Measures taken were quarantine of contacts, close-meshed tests, separation of the affected housing unit, suspension of admission, ban on visiting, and equipping staff with personal protective equipment, of which there was a shortage in Germany at the beginning of the pandemic. A court-ordered quarantine became necessary for three residents of NH01.a due to cognitive disabilities. In total, 61 persons were tested positive for SARS-CoV-2 in NH01.a, ten persons in NH02, and sixteen persons in NH03. Seventeen patients (27.9%) of NH01.a and three patients (18.8%) of NH03 were referred to hospital. Of all confirmed cases, thirteen (21.3%) related to NH01.a and four (25.0%) related to NH03 died as a result of the infection. Besides one 82 year old volunteer, all deceased persons were residents aged between 66 and 98. Our results emphasize the importance of a previously developed containment and cluster strategy for nursing homes. Due to the particular vulnerability of the residents, immediate action, close cooperation and communication between the facility management, residents, visitors and the health authorities are essential in the case of confirmed COVID-19 cases in healthcare facilities.

How to avoid and prevent coercion in nursing homes

2013 ◽  
Vol 20 (6) ◽  
pp. 632-644 ◽  
Author(s):  
Elisabeth Gjerberg ◽  
Marit Helene Hem ◽  
Reidun Førde ◽  
Reidar Pedersen
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Focus Group Interviews ◽  
Alternative Strategies ◽  
Nursing Home Staff ◽  
Alternative Interventions ◽  
Persuasive Strategies ◽  
Organization Of Care ◽  
Wide Range ◽  
Group Interviews

In many Western countries, studies have demonstrated extensive use of coercion in nursing homes, especially towards patients suffering from dementia. This article examines what kinds of strategies or alternative interventions nursing staff in Norway used when patients resist care and treatment and what conditions the staff considered as necessary to succeed in avoiding the use of coercion. The data are based on interdisciplinary focus group interviews with nursing home staff. The study revealed that the nursing home staff usually spent a lot of time trying a wide range of approaches to avoid the use of coercion. The most common strategies were deflecting and persuasive strategies, limiting choices by conscious use of language, different kinds of flexibility and one-to-one care. According to the staff, their opportunities to use alternative strategies effectively are greatly affected by the nursing home’s resources, by the organization of care and by the staff’s competence.

scholarly journals Exploring the N95 and Surgical Mask Supply in U.S. Nursing Homes During COVID-19

2020 ◽  
pp. 073346482096901
Author(s):  
Yumeng Li ◽  
Fang Fang ◽  
Mengying He
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Health Care Facilities ◽  
Protective Equipment ◽  
County Level ◽  
Multivariate Logistic Regression ◽  
For Profit ◽  
Not For Profit ◽  
Surgical Masks ◽  
Care Facilities

U.S. health care facilities have been encountering a recurrence of medical supply shortage since COVID-19 exploded in March 2020. There is an urgent need for important Personal Protective Equipment (PPE) such as N95 and surgical masks. This project examined the factors that were associated with nursing homes’ N95 and surgical mask supply. We analyzed data from the Nursing Home COVID-19 Public File and conducted a multivariate logistic regression estimating the association between nursing home characteristics and county-level demographic parameters with mask supply. We found that a high number of resident COVID-19 cases contributed to the supply of N95, but not surgical masks, whereas a high number of staff cases did not lead to an adequate supply of either N95 or surgical masks. Compared with not-for-profit (NFP) facilities, for-profit (FP) nursing homes were less likely to get enough masks. A better supply distribution plan is needed to prepare for future possible PPE shortage.

Does Competition Improve Service Quality? The Case of Nursing Homes Where Public and Private Payers Coexist

2021 ◽  
Author(s):  
Susan Feng Lu ◽  
Konstantinos Serfes ◽  
Gerard Wedig ◽  
Bingxiao Wu
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Service Quality ◽  
Repeated Game ◽  
Healthcare Management ◽  
Quality Improvements ◽  
Rent Extraction ◽  
Public And Private ◽  
Market Structures ◽  
Wide Range

Competition plays an ambiguous role in nursing home markets where public and private payers coexist. Using U.S. nursing home data with a wide range of market structures, we find a U-shaped relationship between competition and service quality when nursing homes serve a mix of public and private segments, and a monotonically increasing relationship when nursing homes mostly serve the public, price-regulated, segment. The outcomes can be explained by the interplay of two opposing effects of competition: the reputation-building effect, whereby competing firms choose high quality to build a good reputation, and the rent-extraction effect, whereby competition hinders investment for quality improvements by lowering price premia. These observations are consistent with a repeated game model that incorporates public and private-payer segments. This paper was accepted by Stefan Scholtes, healthcare management.

Quality in Nursing Homes

2019 ◽  
Author(s):  
Matteo Lippi Bruni ◽  
Irene Mammi ◽  
Rossella Verzulli
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Developed Countries ◽  
Poor Quality ◽  
Nursing Home Care ◽  
Future Research ◽  
Term Care ◽  
Nursing Home Quality ◽  
Wide Range ◽  
The Impact

In developed countries, the role of public authorities as financing bodies and regulators of the long-term care sector is pervasive and calls for well-planned and informed policy actions. Poor quality in nursing homes has been a recurrent concern at least since the 1980s and has triggered a heated policy and scholarly debate. The economic literature on nursing home quality has thoroughly investigated the impact of regulatory interventions and of market characteristics on an array of input-, process-, and outcome-based quality measures. Most existing studies refer to the U.S. context, even though important insights can be drawn also from the smaller set of works that covers European countries. The major contribution of health economics to the empirical analysis of the nursing home industry is represented by the introduction of important methodological advances applying rigorous policy evaluation techniques with the purpose of properly identifying the causal effects of interest. In addition, the increased availability of rich datasets covering either process or outcome measures has allowed to investigate changes in nursing home quality properly accounting for its multidimensional features. The use of up-to-date econometric methods that, in most cases, exploit policy shocks and longitudinal data has given researchers the possibility to achieve a causal identification and an accurate quantification of the impact of a wide range of policy initiatives, including the introduction of nurse staffing thresholds, price regulation, and public reporting of quality indicators. This has helped to counteract part of the contradictory evidence highlighted by the strand of works based on more descriptive evidence. Possible lines for future research can be identified in further exploration of the consequences of policy interventions in terms of equity and accessibility to nursing home care.

scholarly journals Disparities in COVID-19 Mortality in High-Minority Nursing Homes

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 523-524
Author(s):  
Robert Weech-Maldonado ◽  
Justin Lord ◽  
Ganisher Davlyatov ◽  
Akbar Ghiasi ◽  
Gregory Orewa
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Resource Availability ◽  
Negative Binomial ◽  
Ethnic Disparities ◽  
Organizational Characteristics ◽  
Term Care ◽  
Facility Level ◽  
The Relationship ◽  
Racial Ethnic

Abstract Racial/ethnic disparities in healthcare have been highlighted by the recent COVID-19 pandemic. Minorities continue to utilize nursing home services at a higher rate than White residents, contributing to existing health inequity concerns. This study examined the relationship between nursing home racial/ethnic mix and COVID-19 resident mortality using the CMS Nursing Home COVID-19 Public File. As of October 25, 2020, high minority nursing homes reported 6.5 COVID-19 deaths as compared to 2.6 deaths for nursing homes that had no racial/ethnic minorities. Four nested sequential negative binomial regressions were used to model the relationship between racial/ethnic disparities in COVID-19 deaths and the separate contributions of facility-level resident characteristics (percent of females, percent of residents 65 years and older, percent of residents with congestive heart failure, hypertension, and obesity, and the average level of residents’ acuity), resource availability (nursing homes’ payer-mix, occupancy rate, county-level Social Deprivation Index, and nursing home location), and other organizational characteristics (nursing home for-profit status, chain affiliation, and self-reported nursing, clinical, aides, and other staff shortages). After controlling for interstate differences, facility-level resident characteristics, resource availability, and organizational characteristics, high-minority nursing homes had 61% more COVID-19 deaths (Incidence Rate Ratio [IRR] = 1.61; p < 0.001) as compared to nursing facilities with no minorities. From a policy perspective, nursing homes, that serve primarily minority populations, may need additional resources, such as, funding for staffing and equipment in the face of the pandemic. The COVID-19 pandemic has sharpened the focus on healthcare disparities and societal inequalities in the long-term care.

A Review on Methods of Face Masks Sterilization for Reuse Owing To Crisis During COVID-19

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1240-1243
Author(s):  
Pradyuman Singh Rajput ◽  
Asish Kumar Saha ◽  
Insiya Gangardiwala ◽  
Anand Vijayakumar Palur Ramakrishnan
Keyword(s):  
Healthcare Workers ◽  
Health Hazard ◽  
Capital City ◽  
Limited Resources ◽  
Protective Equipment ◽  
First Line ◽  
Republic Of China ◽  
Enormous Amount ◽  
The Face ◽  
The Common

The COVID-19 pandemic initially started from the Wuhan capital city of Hubei Province in the People's Republic of China had now led to a severe public health hazard across the globe, the recorded death is approximately 958 thousand globally and counting. With the enormous amount of spread of the disease, a severe crisis for Personal Protective Equipment (PPE) is being noticed across the globe. Face masks being the first line of defence for all the healthcare workers as well for the common public. It became mandatory to wear face masks before entering the patient care area. The countries who are not manufacturing it locally had to depend on other countries for the procurement. As there is a severe supply chain disruption due to the lockdown measures taken by all the countries to contain the disease, so it had become difficult to procure the face masks from the manufacturing countries. The price for these PPEs is also rising at an alarming rate with the increase in the COVID-19 cases and the huge rate of consumption by the healthcare and other sectors. Therefore, with limited resources, the hospital has to run its services. The CDC, WHO and ICMR have released several guidelines from time to time for sterilization and reuse of face masks. This article will discuss the various methods that can be utilized to sterilize the face masks and reuse of it.

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