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

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.

2016 ◽  
Vol 24 (7) ◽  
pp. 778-788 ◽  
Author(s):  
Vibeke Lohne ◽  
Bente Høy ◽  
Britt Lillestø ◽  
Berit Sæteren ◽  
Anne Kari Tolo Heggestad ◽  
...  

Background: Physical impairment and dependency on others may be a threat to dignity. Research questions: The purpose of this study was to explore dignity as a core concept in caring, and how healthcare personnel focus on and foster dignity in nursing home residents. Research design: This study has a hermeneutic design. Participants and research context: In all, 40 healthcare personnel from six nursing homes in Scandinavia participated in focus group interviews in this study. Ethical considerations: This study has been evaluated and approved by the Regional Ethical Committees and the Social Science Data Services in the respective Scandinavian countries. Findings: Two main themes emerged: dignity as distinction (I), and dignity as influence and participation (II). Discussion: A common understanding was that stress and business was a daily challenge. Conclusion: Therefore, and according to the health personnel, maintaining human dignity requires slow caring in nursing homes, as an essential approach.


2015 ◽  
Vol 23 (3) ◽  
pp. 253-264 ◽  
Author(s):  
Elisabeth Gjerberg ◽  
Lillian Lillemoen ◽  
Reidar Pedersen ◽  
Reidun Førde

Background: Studies have demonstrated the extensive use of coercion in Norwegian nursing homes, which represents ethical, professional as well as legal challenges to the staff. We have, however, limited knowledge of the experiences and views of nursing home patients and their relatives. Objectives: The aim of this study is to explore the perspectives of nursing home patients and next of kin on the use of coercion; are there situations where the use of coercion can be defended, and if so, under which circumstances? Methods: The data are based on individual interviews with 35 patients living in six nursing homes and seven focus group interviews with 60 relatives. Ethical considerations: Participation was based on written informed consent, and the study was approved by the Regional Committees for Medical and Health Research Ethics. Results: More than half of the patients and the majority of the relatives accepted the use of coercion, trusting the staff to act in the patient’s best interest. However, the acceptance of coercion is strongly related to the patients’ lack of understanding, to prevent health risks and to preserve the patient’s dignity. Conclusion: The majority of nursing home patients and relatives accepted the use of coercion in specific situations, while at the same time they emphasised the need to try alternative strategies first. There is still a need for good qualitative research on the use of coercion in nursing homes, especially with a closer focus on the perspectives and experiences of nursing home patients.


Dementia ◽  
2015 ◽  
Vol 16 (7) ◽  
pp. 930-947 ◽  
Author(s):  
Daniela Lillekroken ◽  
Solveig Hauge ◽  
Åshild Slettebø

Research literature in the dementia field lacks examples of ‘best-practices’ demonstrating concretely how it is possible to support the sense of coherence in people with dementia. The purpose of this study was to elucidate the nurses’ views concerning a caring approach that may support the sense of coherence in people with dementia. The data were collected through participant observation and focus group interviews during a four-month period in 2011. Sixteen registered nurses recruited from two Norwegian nursing homes participated in this study. The data were interpreted using a phenomenological-hermeneutical method. Three themes were identified: ‘being in the moment’, ‘doing one thing at a time’, and ‘creating joy and contentment’. An overall interpretation of these themes is described by the metaphor ‘slow nursing’, a caring approach that may lead to supporting the sense of coherence in people with dementia.


2014 ◽  
Vol 9 (2) ◽  
pp. 42
Author(s):  
Aud Berit Fossøy ◽  
Solveig Hauge ◽  
Ellen Karine Grov

<p><strong>Grindagutar at nursing home: Employees experience with cultural project.</strong><em><br />Background: Culture activity contributes to holistic care for nursing home residents, and the employees are key personnel for success.<br />Aim: Explore the employees’ experience putting culture projects into life in a nursing home.<br />Methods: The material, based on four focus group interviews with employees in the nursing home, is categorized and analyzed through text condensation.<br />Results: The culture projects created activity and were sources for thriving. However, not participating directly in the activity, the employees let the artists in, were available for them, and watched the patients during the performances. Their function as “door-openers/-keepers” resulted in hosting responsibility, leading to a position of confusion regarding the role as protectors for the patients. Main challenges were how to give feedback regarding whether the patients liked/disliked the performance, and the feeling of being trapped in a position as bystander rather than making the culture activity a common happening for the patients and the employees. </em><strong></strong></p>


2016 ◽  
Vol 145 (4) ◽  
pp. 739-745 ◽  
Author(s):  
R. D. VAN GAALEN ◽  
H. A. HOPMAN ◽  
A. HAENEN ◽  
C. VAN DEN DOOL

SUMMARYA recent countrywide MRSA spa-type 1081 outbreak in The Netherlands predominantly affected nursing homes, generating questions on how infection spreads within and between nursing homes despite a low national prevalence. Since the transfer of residents between nursing homes is uncommon in The Netherlands, we hypothesized that staff exchange plays an important role in transmission. This exploratory study investigated the extent of former (last 2 years) and current staff exchange within and between nursing homes in The Netherlands. We relied on a questionnaire that was targeted towards nursing-home staff members who had contact with residents. We found that 17·9% and 12·4% of the nursing-home staff formerly (last 2 years) or currently worked in other healthcare institutes besides their job in the nursing home through which they were selected to participate in this study. Moreover, 39·7% of study participants worked on more than one ward. Our study shows that, in The Netherlands, nursing-home staff form a substantial number of links between wards within nursing homes and nursing homes are linked to a large network of healthcare institutes through their staff members potentially providing a pathway for MRSA transmission between nursing homes and throughout the country.


2020 ◽  
Vol 24 (3) ◽  
pp. 184-195
Author(s):  
Elisabeth Finnbakk ◽  
Kirsti Skovdahl ◽  
Sigrid Wangensteen ◽  
Lisbeth Fagerström

Nurses' clinical competence is crucial to ensure that elderly, frail patients in nursing homes are met with high-quality nursing care. Thus, this study aimed to disclose the essential meaning of registered nurses' experiences as related to their clinical competence when caring for elderly patients with complex health needs in nursing homes. Focus group interviews and a phenomenological hermeneutical analysis were conducted revealing that the nurses balanced between being and striving to be competent. The utterance “It's not for amateurs!” symbolized that if nurses are not clinically competent or hindered from acting competently, they may be at risk for moral distress.


2005 ◽  
Vol 9 (3) ◽  
pp. 31-37 ◽  
Author(s):  
Theris A. Touhy, ◽  
Wendy Strews ◽  
Cynthia Brown

Nursing as caring (Boykin & Schoenhofer, 1993, 2001) was utilized as the framework for design of a model of healthcare delivery in a nursing home that is intentionally grounded in caring. The article presents themes emerging from a qualitative analysis of interview data in which participants were asked what was most important when caring for a resident or family member and to share an experience that best represented caring. Suggestions are offered for creating a model of culture change in nursing homes that honors and values expressions of caring as lived by staff, families, and residents.


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260055
Author(s):  
Rachel L. Snyder ◽  
Laura E. Anderson ◽  
Katelyn A. White ◽  
Stephanie Tavitian ◽  
Lucy V. Fike ◽  
...  

Background A large portion of COVID-19 cases and deaths in the United States have occurred in nursing homes; however, current literature including the frontline perspective of staff working in nursing homes is limited. The objective of this qualitative assessment was to better understand what individual and facility level factors may have contributed to the impact of COVID-19 on Certified Nursing Assistants (CNAs) and Environmental Services (EVS) staff working in nursing homes. Methods Based on a simple random sample from the National Healthcare Safety Network (NHSN), 7,520 facilities were emailed invitations requesting one CNA and/or one EVS staff member for participation in a voluntary focus group over Zoom. Facility characteristics were obtained via NHSN and publicly available sources; participant demographics were collected via SurveyMonkey during registration and polling during focus groups. Qualitative information was coded using NVIVO and Excel. Results Throughout April 2021, 23 focus groups including 110 participants from 84 facilities were conducted homogenous by participant role. Staffing problems were a recurring theme reported. Participants often cited the toll the pandemic took on their emotional well-being, describing increased stress, responsibilities, and time needed to complete their jobs. The lack of consistent and systematic guidance resulting in frequently changing infection prevention protocols was also reported across focus groups. Conclusions Addressing concerns of low wages and lack of financial incentives may have the potential to attract and retain employees to help alleviate nursing home staff shortages. Additionally, access to mental health resources could help nursing home staff cope with the emotional burden of the COVID-19 pandemic. These frontline staff members provided invaluable insight and should be included in improvement efforts to support nursing homes recovering from the impact of COVID-19 as well as future pandemic planning.


2019 ◽  
Author(s):  
Haneen Ali ◽  
Huiyang Li

Abstract Background and Objectives: The call light system is one of the major communication technologies that links the nursing home staff to the needs of the residents. By providing residents with the ability to request assistance, the system becomes an indispensable resource for patient-focused healthcare. However, there is little known about how the call light systems are being used in nursing homes and how the system contributes to the safety and the quality of care for seniors. Therefore, the aims of this study are to understand the nursing home staff experience while using the call light systems and to uncover the usability issues associated with the implemented systems. Method: A mix of 150 hours of hypothetic-deductive (unstructured) and 90 hours of standard-procedure (structured) observational study were conducted in four different nursing homes. The data collected includes insights into the nursing homes work system and the process of locating and responding to call lights. Results: The data shows that the highest alarm rate is before and after meal times. The nursing staff exceeded the allotted time set by administration 50% of the time. Additionally, the staff canceled 10% of the call lights and did not immediately assist residents due to high workloads. Further, the staff forgot to come back to assist residents over 3% of the time. Usability issues such as broken parts, lack of feedback, lack of prioritization, and low/no discriminability are contributing to the long response time. More than 8% of the time, residents notified the staff about call lights after they waited for a long time, as these residents were left unattended. Conclusion: Nursing homes that are still using old call light systems risk the continuation of usability issues that can affect performance of the staff and contribute to a decline in staff and resident outcomes. While the healthcare industry has been at the forefront of technological advancements and implementation, it is important to recognize the influence of technology in the quality of service delivery for the elderly population in nursing homes and to the nursing homes staff working conditions.


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