A model for implementing guidelines for person-centered care in a nursing home setting

Vikström, Sofia; Sandman, Per‐Olof; Stenwall, Ewa; Boström, Anne‐Marie; Saarnio, Lotta; Kindblom, Kristina; Edvardsson, David; Borell, Lena

doi:10.1017/s1041610214001598

Cited by 38 publications

(40 citation statements)

References 24 publications

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“…Anchoring the intervention in a theoretical framework consisting of established theories and evidence-based interventions, as well as a pedagogical framework that moves between knowledge translation, generation and dissemination is a strength of the study. Additionally, previous experiences from similar implementation protocols [35, 63] can be seen as strengthening the study.…”

Section: Discussionmentioning

confidence: 78%

A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-Age nursing home multi-centre, non-equivalent controlled group before-after trial

et al. 2017

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BackgroundThe literature suggests that person-centred care can contribute to quality of life and wellbeing of nursing home residents, relatives and staff. However, there is sparse research evidence on how person-centred care can be operationalised and implemented in practice, and the extent to which it may promote wellbeing and satisfaction. Therefore, the U-Age nursing home study was initiated to deepen the understanding of how to integrate person-centred care into daily practice and to explore the effects and meanings of this.MethodsThe study aims to evaluate effects and meanings of a person-centred and thriving-promoting intervention in nursing homes through a multi-centre, non-equivalent controlled group before-after trial design. Three nursing homes across three international sites have been allocated to a person-centred and thriving-promoting intervention group, and three nursing homes have been allocated to an inert control group. Staff at intervention sites will participate in a 12-month interactive educational programme that operationalises thriving-promoting and person-centred care three dimensions: 1) Doing a little extra, 2) Developing a caring environment, and 3) Assessing and meeting highly prioritised psychosocial needs. A pedagogical framework will guide the intervention. The primary study endpoints are; residents’ thriving, relatives’ satisfaction with care and staff job satisfaction. Secondary endpoints are; resident, relative and staff experiences of the caring environment, relatives’ experience of visiting their relative and the nursing home, as well as staff stress of conscience and perceived person-centredness of care. Data on study endpoints will be collected pre-intervention, post-intervention, and at a six-month follow up. Interviews will be conducted with relatives and staff to explore experiences and meanings of the intervention.DiscussionThe study is expected to provide evidence that can inform further research, policy and practice development on if and how person-centred care may improve wellbeing, thriving and satisfaction for people who reside in, visit or work in nursing homes. The combination of quantitative and qualitative data will illuminate the operationalisation, effects and meaning of person-centred and thriving-promoting care.Trial registrationThe trial was registered at ClinicalTrials.gov March 19, 2016, identifier NCT02714452.

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Section: Discussionmentioning

confidence: 78%

A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-Age nursing home multi-centre, non-equivalent controlled group before-after trial

et al. 2017

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“…A cross‐sectional design was applied using data with drawn from a larger intervention project conducted at a nursing home in Stockholm, Sweden (Vikstrom et al . ).…”

Section: The Studymentioning

confidence: 97%

“…The nursing home was involved in an intervention project with the aim of implementing the Swedish national guidelines for care of people with dementia disease and the project had been running for two years when the cross‐sectional data on thriving for this study were collected in 2013 (Vikstrom et al . ).…”

Section: The Studymentioning

confidence: 97%

Characteristics of residents who thrive in nursing home environments: a cross‐sectional study

Patomella

Sandman

Bergland

et al. 2016

Journal of Advanced Nursing

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“…Reported experiences from culture change programmes and interventions in residential aged care facilities, indicate that factors such as effective collaboration and communication, a shared vison of care philosophy, a supportive and enabling management style, informal and formal supervision influence the extent to which person-centred care is really improved in practice [ 21 , 30 – 35 ]. A number of authors argue that development of person-centred care in practice should be based on a multilevel approach including intervention actions related to organisation, environment as well as interventions aiming to develop the attitude and knowledge of staff [ 36 – 39 ].…”

Section: Introductionmentioning

confidence: 99%

Organisational and environmental characteristics of residential aged care units providing highly person-centred care: a cross sectional study

et al. 2017

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BackgroundFew studies have empirically investigated factors that define residential aged care units that are perceived as being highly person-centred. The purpose of this study was to explore factors characterising residential aged care units perceived as being highly person-centred, with a focus on organisational and environmental variables, as well as residents’ and staff’ characteristics.MethodsA cross-sectional design was used. Residents (n = 1460) and staff (n = 1213) data from 151 residential care units were collected, as well as data relating to characteristics of the organisation and environment, and data measuring degree of person-centred care. Participating staff provided self-reported data and conducted proxy ratings on residents. Descriptive and comparative statistics, independent samples t-test, Chi2 test, Eta Squared and Phi coefficient were used to analyse data.ResultsHighly person-centred residential aged care units were characterized by having a shared philosophy of care, a satisfactory leadership, interdisciplinary collaboration and social support from colleagues and leaders, a dementia-friendly physical environment, staff having time to spend with residents, and a smaller unit size. Residential aged care units with higher levels of person-centred care had a higher proportion of staff with continuing education in dementia care, and a higher proportion of staff receiving regular supervision, compared to units with lower levels of person-centred care.ConclusionsIt is important to target organisational and environmental factors, such as a shared philosophy of care, staff use of time, the physical environment, interdisciplinary support, and support from leaders and colleagues, to improve person-centred care in residential care units. Managers and leaders seeking to facilitate person-centred care in daily practice need to consider their own role in supporting, encouraging, and supervising staff.

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A model for implementing guidelines for person-centered care in a nursing home setting

Cited by 38 publications

References 24 publications

A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-Age nursing home multi-centre, non-equivalent controlled group before-after trial

A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-Age nursing home multi-centre, non-equivalent controlled group before-after trial

Characteristics of residents who thrive in nursing home environments: a cross‐sectional study

Organisational and environmental characteristics of residential aged care units providing highly person-centred care: a cross sectional study

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