scholarly journals Taking In-Service Learning Technologies into Nursing Homes: The Duke Endowment Supports Patient Care Simulator Training in North Carolina Skilled Nursing Facilities

2010 ◽  
Vol 71 (2) ◽  
pp. 180-181
Author(s):  
Gordon H. DeFriese ◽  
Polly Godwin Welsh
Keyword(s):  
North Carolina ◽  
Nursing Homes ◽  
Service Learning ◽  
Patient Care ◽  
Learning Technologies ◽  
Skilled Nursing Facilities ◽  
Simulator Training ◽  
Nursing Facilities ◽  
Skilled Nursing

scholarly journals A Qualitative Study of Antibiotic Stewardship Implementation at Arizona Skilled Nursing Facilities

2020 ◽  
Vol 41 (S1) ◽  
pp. s101-s101
Author(s):  
Theresa LeGros ◽  
Connor Kelley ◽  
James Romine ◽  
Katherine Ellingson
Keyword(s):  
Nursing Homes ◽  
Antibiotic Stewardship ◽  
Population Level ◽  
Skilled Nursing Facilities ◽  
Care Transition ◽  
Antibiotic Prescribing ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
The Core ◽  
Core Elements

Background: The CDC Core Elements of Antibiotic Stewardship (AS) include 7 evidence-based best practices adapted for a variety of healthcare settings, including nursing homes. We aimed to identify barriers and facilitators related to AS implementation in skilled nursing facilities (SNFs) within 18 months of the CMS mandate for AS implementation in SNFs, and to examine their relevance to the CDC’s Core Elements for Nursing Homes. Methods: We conducted 56 semistructured interviews with administrators, clinicians, and nonclinical staff at 10 SNFs in urban, suburban, rural, and border regions of Arizona. All interviews were recorded, transcribed, and imported into NVivo v12.0 software for constant comparative analysis by 3 researchers using a priori and emergent codes. After iterative coding, we confirmed high interrater reliability (κ = 0.8), finalized the code book, and used matrix coding queries to examine relationships and generate themes. Results: We identified 7 themes as “influencers” that were less (barrier) or more (facilitator) supportive of AS in SNFs. Intra- and interfacility communication were the most frequently described: respondents described stronger communication within the SNF and between the SNF and hospitals, labs, and pharmacies as critical to robust AS implementation. Other influencers included AS education, antibiotic tracking systems, SNF prescribing norms, human resources, and diagnostic resources. The Core Elements were reflected in all influencer themes except interfacility communication between SNFs and hospitals. Additionally, themes pertaining to systems emerged as critical to successful AS implementation, including the need to address: the interactions of multiple roles across the traditional SNF hierarchy, stewardship barriers from the lens of patient-level concerns (as opposed to population-level concerns), the distinction between antibiotic prescribing gatekeepers and stewardship gatekeepers, and care transition policies and practices. The Core Elements target many aspects of these systems themes—for example, they recognize the importance of creating a culture of stewardship. However, they do not address care transition policies or procedures beyond recommending that transfer-initiated antibiotics be tracked and verified. Conclusions: Because the interactions of various agents within and beyond the SNF can facilitate or inhibit stewardship in complex ways, our findings suggest the use of a systems approach to AS implementation that prioritizes communication within the SNF hierarchy, and between SNFs and hospitals, diagnostic facilities, and pharmacies. When followed, the CDC’s Core Elements can provide crucial guidance. However, SNFs need support to overcome the challenges of incorporating these elements into policy and practice. Additionally, more work is needed to understand and enhance stewardship-related care transition, which remains under-addressed by the CDC.Disclosures: NoneFunding: None

scholarly journals MANAGING MANAGED CARE: PERSPECTIVES FROM KEY STAKEHOLDERS IN SKILLED NURSING FACILITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S498-S499
Author(s):  
Andrea E Daddato ◽  
Cynthia Drake ◽  
Edward A Miller ◽  
Pamela Nadash ◽  
Denise Tyler ◽  
...  
Keyword(s):  
Managed Care ◽  
Patient Care ◽  
Decision Makers ◽  
Skilled Nursing Facilities ◽  
Future Research ◽  
Fee For Service ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
Key Stakeholders ◽  
The Relationship

Abstract In recent years, Medicare Advantage (MA) plan enrollment has increased, a trend that is expected to continue. Many skilled nursing facilities (SNFs) rely on MA managed care insurer referrals to maintain their census in a market with high competition for post-acute care patients. This study used semi-structured interviews to describe the relationship between MA plans and SNFs from the perspective of key decision-makers in SNFs. Twenty-three interviews were conducted with key stakeholders from 11 Denver Metropolitan area SNFs. A combined purposive-snowball sampling approach was used to identify and recruit select staff from the participating facilities. Interviews focused on the relationship between MA plans and SNFs, including mechanisms of control, power dynamics, and preferences for MA versus Fee-for-Service (FFS) Medicare patients. Key findings included: 1) challenges SNF staff had navigating MA plans’ case management processes, a key mechanism used by MA plans to influence the behavior of SNF decision-makers; 2) MA plans exercising power over beneficiaries’ length of stay, potentially leading to early discharge and heightened risk for rehospitalization; 3) SNF preference for admitting Medicare FFS over MA patients due to higher rates of Medicare FFS reimbursement and greater control over patient care. SNFs are increasingly reliant on MA plans for patient referrals and revenue. The themes suggest that this growing reliance may place SNFs at odds with MA plans on how best to manage overall patient care. It is therefore important that future research investigate how MA plans’ influence over care affects patient outcomes in SNFs and other post-acute settings.

Group A Streptococcus outbreak among residents and employees of two skilled nursing facilities: North Carolina, 2017

2019 ◽  
Vol 47 (7) ◽  
pp. 846-849 ◽  
Author(s):  
Katie J. Palladino ◽  
Tammra Morrison ◽  
Sopio Chochua ◽  
Lori Bowers ◽  
Jennifer K. MacFarquhar
Keyword(s):  
North Carolina ◽  
Group A Streptococcus ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
Group A

scholarly journals Leadership among Director of Social Work at Skilled Nursing Facilities (SNFs)

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 907-907
Author(s):  
John Paul Abenojar
Keyword(s):  
Patient Care ◽  
Leadership Styles ◽  
Social Workers ◽  
Phenomenological Study ◽  
Chronically Ill ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Structured Interviews ◽  
Skilled Nursing ◽  
Leadership Model

Abstract Skilled Nursing Facilities (SNFs) provide ongoing care to the seniors and chronically ill. To maximize the quality of this care, SNF staff must be trained to respond to patient care crises and communicate across departments. Although researchers have studied the leadership styles, strategies, and interactions of facility administrators and nursing directors, little was known about the leadership styles and strategies imployed by the director of social worker (DSW). The aim of this phenomenological study was to explore how DSW influenced leadership policies, prepared subordinated for crisis intervention and management, perceived that social workers influenced patient care decisions, and believed that communication amongst SNF staff about patient care could be improved. The conceptual framework was based on the multilevel leadership model construct, the situational leadership model construct, and the complex adaptive leadership model construct. Participants included a purposive sample of 10 DSW working in a large, corporate SNFs in Virginia. Data were collected via in person, semi structured interviews consisting of open-ended questions. Data were analyzed via Hycner's phenomenological approach. Findings from this investigation helped clarify roles and responsibilities of DSW, thereby improving the leadership they provide to subordinate social workers. Findings may be used to improved communication across professionals within SNFs and in their role in patient decisions.

Regulatory requirements for recreational therapy in nursing homes

2017 ◽  
Vol 13 (1) ◽  
pp. 25
Author(s):  
Dawn De Vries, DHA, MPA, CTRS
Keyword(s):  
Nursing Homes ◽  
Long Term Care ◽  
Skilled Nursing Facilities ◽  
Recreational Therapy ◽  
Nursing Facilities ◽  
Regulatory Requirements ◽  
Term Care ◽  
Skilled Nursing

More recreational therapists than ever are practicing in long-term care and skilled nursing facilities (SNFs). Despite this increase in recreational therapists working in SNFs, there continues to be significant confusion about regulatory requirements, as well as practice and coverage issues. This article intends to provide information on regulatory, coverage, and practice issues related to recreational therapy in nursing homes.

scholarly journals THE SHARED MEANING OF COMPASSION FATIGUE AMONG REGISTERED NURSES WORKING IN SKILLED NURSING FACILITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S703-S703
Author(s):  
Marlene Steinheiser
Keyword(s):  
Patient Care ◽  
Registered Nurses ◽  
Compassion Fatigue ◽  
Skilled Nursing Facilities ◽  
Future Research ◽  
Nursing Facilities ◽  
Shared Meaning ◽  
Emotional Symptoms ◽  
Skilled Nursing

Abstract The purpose of this hermeneutic interpretive phenomenology study was to describe the shared meaning of compassion fatigue (CF) among registered nurses (RNs) who work in skilled nursing facilities (SNFs). The specific aims were to describe: 1) contributors (triggers, situation, or patient characteristics) that cause symptoms of compassion fatigue, 2) associated physical and emotional symptoms, and 3) the short-term outcomes of unresolved compassion fatigue impacting nurses and patient care. CF can negatively impact patient outcomes, is associated with decreased quality of patient care, and can be a reason why nurses leave the profession. Eight participants were interviewed three times each, while concurrent data analysis helped to formulate mutual understanding of the phenomenon and informed subsequent interviews. Self-reflection, journaling, record keeping, and use of direct quotes enhanced trustworthiness. Four shared meanings were abstracted:1) I feel conflicted and that causes my CF; 2) physical and emotional manifestations of CF; 3) CF is infused in every aspect of my life; 4) we are trying to cope with CF. The participants shared their central desire to make a difference in the lives of their patients, which was of paramount importance. When participants felt they were unable to make the desired difference, they began to develop symptoms of CF. Symptoms were compounded when they experienced frequent patient deaths. A resiliency program specifically addressing the needs of SNF nurses, incorporating individuals and their organizations, could positively impact the nurses’ professional quality of life. Future research is needed to better understand CF and interventions specific to SNF nurses.

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