No abstract

Background Nursing homes (NHs) are required to provide person-centered care, efforts often folded into broader culture change initiatives. Despite the known benefits of culture change, it is difficult to measure. This study aims to assess the criterion validity of the Preferences for Everyday Living Inventory (PELI) Implementation Indicator with other culture change measures. Methods Using data from Ohio-based NHs ( n = 771), logistic regression techniques demonstrated the relationship between the PELI Implementation Indicator and two validated culture change measures, the Resident Preferences for Care (RPC) and Certified Nursing Assistant (CNA) Empowerment scales. Results There was a significant relationship between the two scales and complete PELI implementation holding all other variables constant. The RPC and CNA Empowerment scales were significantly associated with complete PELI implementation. Discussion Findings suggest that the PELI Implementation Indicator can be used as a pragmatic indicator of a community’s adoption of person-centered care and culture change.

Background and Objectives Despite federal legislation requiring nursing home (NH) staff members to be vaccinated against COVID-19, unvaccinated staff pose an ongoing public health risk. The research question guiding this study is as follows: What is the relationship between strategies to address vaccine hesitancy and vaccination rates among staff? We used the Diffusion of Innovation (DOI) theory as a theoretical framework. Research Design and Methods The sample (N=627) included Ohio-based NHs. Using national and state NH data, multivariable linear regression techniques demonstrated the relationship between strategies to address vaccine hesitancy and vaccination rates among NH staff. Results Peer counseling and providing sick time or time off for vaccine symptoms were both statistically significant strategies. Compared to facilities that did not engage in peer counseling, those that did saw an average increase of 3.2% of their staff vaccinated. Those that provided sick time or time off saw an average increase of 3.9% of their staff vaccinated. There was no statistically significant relationship between hiring full- or part-time facility infection preventionists and vaccination rates. Discussion and Implications In order to foster vaccine confidence among long-term services staff, peer counseling and providing sick time or time off are examples of strategies that can impact vaccination rates among staff. According to DOI, these strategies target the communication channels and social system of an organization. While this study focuses on NHs, results remain critically important to the remainder of the long-term services system, which does not have vaccine requirements similar to the NH industry.

Background: The Preferences for Everyday Living Inventory (PELI) is a person-centered care (PCC) tool that uncovers/honors older adults’ important preferences. PCC implementation in nursing homes (NHs) often requires additional resources, such as staff time. We explored if PELI implementation is associated with NH staffing levels. Methods: Using NH-year as the unit of observation ( n = 1307), 2015 and 2017 data from Ohio NHs was used to examine the relationship between complete versus partial PELI implementation and staffing levels, measured in hours per resident day, for various positions and total nursing staff. Results: Complete PELI implementation was associated with higher nursing staff levels in both for-profits and not-for-profits; however, total nursing staff levels in not-for-profits were higher than for-profits (0.16 vs. 0.09 hours per resident day). The specific nursing staff associated with PELI implementation varied by ownership. Discussion: For NHs to fully implement PCC, a multifaceted approach to improve staffing is needed.

Implementation efforts of evidence-based practices focusing on the nursing home setting remain understudied. The purpose of this study was to explore the role of the Consolidated Framework for Implementation Research (CFIR) inner setting domain on the implementation of PAL Cards. Monthly qualitative interviews (n=50) with project champions (n=16) were audio-recorded, transcribed, checked for accuracy, and coded using the domain “Inner Setting” from the CFIR in Dedoose. Major themes emerging from the data included networks and communication (e.g., including PAL Card information in employee newsletter) among staff, compatibility of the PAL Cards (e.g., aligns with community values and fits into existing workflows), and available resources (e.g., adequate time and staff to implement the QIP). High-quality communication channels to educate and collaborate were shown to be an integral component of successful implementation. Implications for policy and practice will be discussed.