scholarly journals Increasing the Frequency and Timeliness of Pain Assessment and Management in Long-Term Care: Knowledge Transfer and Sustained Implementation

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Thomas Hadjistavropoulos ◽  
Jaime Williams ◽  
Sharon Kaasalainen ◽  
Paulette V. Hunter ◽  
Maryse L. Savoie ◽  
...  
Keyword(s):  
Pain Assessment ◽  
Large Scale ◽  
Management Practices ◽  
Long Term Care ◽  
Future Research ◽  
Clinical Practices ◽  
Term Care ◽  
Staff Members ◽  
Before And After

Background. Although feasible protocols for pain assessment and management in long-term care (LTC) have been developed, these have not been implemented on a large-scale basis.Objective. To implement a program of regular pain assessment in two LTC facilities, using implementation science principles, and to evaluate the process and success of doing so.Methods. The implementation protocol included a pain assessment workshop and the establishment of a nurse Pain Champion. Quality indicators were tracked before and after implementation. Focus groups and interviews with staff were also conducted.Results. The implementation effort was successful in increasing and regularizing pain assessments. This was sustained during the follow-up period. Staff members reported enthusiasm about the protocol at baseline and positive results following its implementation. Despite the success in increasing assessments, we did not identify changes in the percentages of patients reported as having moderate-to-severe pain.Discussion. It is our hope that our feasibility demonstration will encourage more facilities to improve their pain assessment/management practices.Conclusions. It is feasible to implement regular and systematic pain assessment in LTC. Future research should focus on ensuring effective clinical practices in response to assessment results, and determination of longer-term sustainability.

Efficacy of Psychosocial Treatments for Noisemaking in Severe Dementia

1997 ◽  
Vol 9 (4) ◽  
pp. 405-422 ◽  
Author(s):  
Colleen Doyle ◽  
Tania Zapparoni ◽  
Daniel O'Connor ◽  
Susannah Runci
Keyword(s):  
Management Practices ◽  
Long Term Care ◽  
Psychosocial Interventions ◽  
Care Staff ◽  
Future Research ◽  
Severe Dementia ◽  
Term Care ◽  
Standard Management ◽  
Environmental Stimulation

Noisemaking is one of the most disturbing behavior disorders associated with dementia. Standard management practices, including pharmacological interventions, are not very successful in treating the behavior. Very little research has been carried out to evaluate innovative treatments or to determine the etiology of noisemaking. In this article, we report on a series of 12 case studies in which we tested the efficacy of some psychosocial interventions in reducing the frequency of noisemaking in long-term-care residents with severe dementia. Interventions were contingent reinforcement of quiet behavior and environmental stimulation tailored to individual preferences. Of the 12 patients recruited into the study, 2 died during the course of observations, 3 were not observed to be as noisy as reported by staff, and 3 showed a clear reduction in noise during the intervention period. Four patients did not show any overall reduction in noisemaking during psychosocial interventions. Future research could differentiate between types of interventions in successful cases and attempt to control further for the consistent application of interventions by long-term-care staff.

Coping with the Intermingling of the Lucid and Confused

1988 ◽  
Vol 1 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Louis J. Novick
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Professional Staff ◽  
Term Care ◽  
Homogeneous Groups ◽  
Long Term Care Facility ◽  
Staff Members ◽  
Before And After ◽  
Staff Psychiatrist

The issue of intermingling mentally lucid individuals and confused patients with behaviour problems has been a serious concern for the long-term care facility from the standpoints of the resident, relatives and staff. Efforts at Maimonides Hospital Geriatric Centre in Montreal have included “relationship therapy” (i.e., the relationship between the resident and staff members) to preserve the resident's self-esteem. Also, homogeneous groups of lucid and confused residents have been formed to help each take part in appropriate social activities. Lucid residents also are encouraged to attend weekly meetings with both professional and non-professional staff working on their floor. A staff psychiatrist experienced in psycho-pharmacology has significantly improved the problems created by intermingling these two groups. The psychiatrist also has helped staff reduce the stress caused by intermingling. In addition, staff members meet with relatives before and after admission of applicants to alleviate and discuss their concerns. Nevertheless, Maimonides and other long-term care institutions face the problem of how to reduce the damage of intermingling these two groups of residents.

Communication Disordered: Program Implementation in Long-Term Care

2016 ◽  
Vol 1 (15) ◽  
pp. 64-67
Author(s):  
George Barnes ◽  
Joseph Salemi
Keyword(s):  
Program Implementation ◽  
Long Term Care ◽  
Family Satisfaction ◽  
Regulatory Compliance ◽  
Care Staff ◽  
Term Care ◽  
Staff Members ◽  
Change Policy

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.

“They don't just disappear”: Acknowledging death in the long-term care setting

2012 ◽  
Vol 10 (4) ◽  
pp. 241-247 ◽  
Author(s):  
Janine Maitland ◽  
Kevin Brazil ◽  
Bill James-Abra
Keyword(s):  
Long Term Care ◽  
Emotional Health ◽  
Family Members ◽  
Care Facility ◽  
Term Care ◽  
Long Term Care Facility ◽  
Qualitative Research Study ◽  
Staff Members

AbstractObjective:The purpose of this study was to describe the value of a formal room blessing ritual held within a long-term care facility, from the perspectives of staff, residents, and family members.Method:A qualitative research study involving interviews with staff, residents, and family members was conducted to examine the perceived value of a room blessing ritual.Results:Twenty-four room blessing attendees participated in the study (nine staff, eight residents, and seven family members). Attendees felt that the room blessing provided an opportunity to formally acknowledge the death of the resident and their grief; the majority felt that this was a positive experience and that it provided an element of closure. Staff members and residents expressed their appreciation for the opportunity to connect with family members of the deceased to express their condolences during the ritual. Participants also identified the inclusivity of the ritual (i.e., an open invitation to all staff, residents, and family members) as a positive aspect that served as a reminder that others shared in their grief. Staff members felt that blessing the room for the new resident was an important component of the ritual, helping to bridge the gap between mourning and welcoming a new person. Staff, residents, and family members felt that the room blessing positively reflected the mission and values of the facility. The most highly valued aspect of the ritual for all attendees was the sharing of stories about the deceased to celebrate that person's life.Significance of results:Long-term care facilities need to recognize that formal supports to manage the bereavement needs of staff and residents, such as a room blessing ritual, should be incorporated into their model for managing end-of-life care, given the relationship between the emotional health of staff and the quality of care provided for residents.

Changing the Culture of Long-Term Care: Combating Heterosexism

2015 ◽  
Vol 20 (2) ◽  
Author(s):  
Susan Schwinn ◽  
Shirley Dinkel
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Holistic Care ◽  
Culturally Competent ◽  
Sexual Diversity ◽  
Term Care ◽  
Culturally Competent Care ◽  
Staff Members ◽  
Unique Position

The purpose of this article is to describe how heterosexism impedes the provision of culturally competent care for lesbian, gay, bisexual, transgender, and queer (LGBTQ) residents in long-term care (LTC) facilities. LTC facilities continue to employ staff members who lack an understanding of sexuality and sexual diversity in the elderly. In this article, we identify the heterosexual assumption, namely heterosexism, as the primary issue surrounding the holistic care of the LGBTQ elder in LTC. We first review the literature related to LGBTQ elders in LTC facilities, identifying the themes that emerged from the review, specifically the definitions of homophobia and heterosexism; perceptions of LGBTQ elders as they consider placement in LTC facilities; and staff knowledge of and biases toward sexuality and sexual diversity in LTC settings. Then, we suggest approaches for changing the culture of LTC to one in which LGBTQ elders feel safe and valued, and conclude by considering how facility leaders are in a unique position to enable LGBTQ elders to flourish in what may be their last home.

The vulnerability of nursing home residents to the Covid-19 pandemic

2020 ◽  
Vol 23 (2-3) ◽  
pp. 57-60 ◽  
Author(s):  
Edward H Wagner
Keyword(s):  
Nursing Home ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Nursing Assistants ◽  
Nursing Home Care ◽  
Term Care ◽  
Staff Members ◽  
Care Facilities

Residents in nursing homes and other long-term care facilities comprise a large percentage of the deaths from Covid 19. Is this inevitable or are there problems with NHs and their care that increase the susceptibility of their residents. The first U.S. cluster of cases involved the residents, staff, and visitors of a Seattle-area nursing home. Study of this cluster suggested that infected staff members were transmitting the disease to residents. The quality of nursing home care has long been a concern and attributed to chronic underfunding and resulting understaffing. Most NH care is delivered by minimally trained nursing assistants whose low pay and limited benefits compel them to work in multiple long-term care settings, increasing their risk of infection, and work while ill. More comparative studies of highly infected long-term care facilities with those organizations that were able to better protect their residents are urgently needed. Early evidence suggests that understaffing of registered nurses may increase the risk of larger outbreaks.

scholarly journals Developing Capabilities From the Scope of Emotional Intelligence as Part of the Soft Skills Needed in the Long-Term Care Sector: Presentation of Pilot Study and Training Methodology

2020 ◽  
Vol 11 ◽  
pp. 215013272090627
Author(s):  
Yasen Dimitrov ◽  
Tanja Vazova
Keyword(s):  
Emotional Intelligence ◽  
Conflict Management ◽  
Long Term Care ◽  
Soft Skills ◽  
Training Design ◽  
Soft Skill ◽  
Term Care ◽  
Before And After ◽  
And Control

The article presents the results of the preliminary survey and pilot application of the methodological toolkit for the improvement of certain competencies, which are part of the soft skills of professionals in the long-term care sector in Bulgaria. Based on the survey the authors define 2 target competencies, namely conflict management and empathic interaction. These skills are considered a part of the scope of emotional intelligence and its constituent dimensions and authors use Daniel Goleman’s ability-based model as a base for their conceptual frame and theoretical explanations. In order to present their thesis, the authors perform a soft skill analysis of the long-term care sector; define the construct emotional intelligence and justify their choice of a theoretical model for the subsequent survey. On this basis, they develop a training design for the development of these skills and present the results achieved through its pilot application. The study includes 62 participants randomly divided into a test and control groups. The level of targeted skills is measured (before and after) and the authors report a significant increase in those skills (empathic interaction, net effect 1.87; conflict management, net effect 1.75). In conclusion, the authors open a discussion on the importance of emotional management as an essential part of any profession related to health care and underline its importance for the quality of caregiving services.

Suspected transmission of norovirus in eight long-term care facilities attributed to staff working at multiple institutions

2011 ◽  
Vol 140 (9) ◽  
pp. 1702-1709 ◽  
Author(s):  
L. M. NGUYEN ◽  
J. P. MIDDAUGH
Keyword(s):  
Long Term Care ◽  
Control Measures ◽  
Regulatory Agencies ◽  
Term Care ◽  
Staff Members ◽  
Care Facilities ◽  
Stool Specimens ◽  
Polymerase Chain ◽  
And Control

SUMMARYThis study reports on gastroenteritis outbreaks suspected of being norovirus infections in eight long-term care facilities. A descriptive epidemiological investigation was used to depict sources of infections and control measures. Outbreaks affected 299 (31%) of 954 residents and 95 (11%) of 843 staff. Attack rates were higher in residents (range 17–55%) than staff (range 3–35%). Person-to-person spread was suspected. The case-hospitalization rate was 2·5%, and no death occurred. Eight staff members were employed at multiple affected facilities and may have introduced disease into three facilities. Thirty-two stool specimens were positive for norovirus by real-time reverse transcriptase–polymerase chain reaction or enzyme immunoassay. Sequenced specimens were closely related to GII.4 New Orleans. A concurrent Clostridium difficile outbreak was also detected at one facility. Staff members who work at multiple facilities may transmit norovirus between them. Regulatory agencies should consider precluding ill staff from working in multiple facilities during outbreaks. Guidelines to control norovirus must be applied promptly and meticulously by facilities.

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