An Exploration of Nursing Home Organizational Processes

Forbes-Thompson, Sarah; Gajewski, Byron J.; Scott-Cawiezell, Jill; Dunton, Nancy

doi:10.1177/0193945906287053

Cited by 54 publications

(53 citation statements)

References 24 publications

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“…The Staff Perceptions of Supervisory Style survey was collected because supervision style is known to influence quality improvement (Forbes-Thompson, Gajewski, Scott-Cawiezell, & Dunton, 2006; Scott, Vojir, Jones, & Moore, 2005). Scott and colleagues (2005) modified a hospital-focused scale focused on communication, teamwork, and leadership to the NH environment.…”

Section: Methodsmentioning

confidence: 99%

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Nursing Home Staff Intentions for Learned Communication Skills: Knowledge to Practice

Williams¹,

Perkhounkova²,

Bossen³

et al. 2016

J Gerontol Nurs

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Background Staff education is critical to improving nursing home dementia care practice. However, a lag in translation to practice is a barrier to improving care. As part of a clinical trial testing effects of a communication intervention on behaviors of residents with dementia, participant-reported likelihood of using learned skills in practice was evaluated in relation to organizational and individual factors in ten nursing homes. Hypotheses We hypothesized that organizational and individual factors would influence staff intention to use new skills in practice. Results Pre and post-training comparisons confirmed that staff gained knowledge about communication effectiveness. Staff reported high likelihood for using skills in practice based on modified Duke Diffusion of Innovation (DOI) Scale scores. Care organization was correlated with total DOI scores (r = .82, p < .01). DOI subscales correlations to organizational and individual attitudes are reported. Conclusion Evaluating quality improvement interventions in relation to translation to practice is essential in today’s nursing home environment.

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Section: Methodsmentioning

confidence: 99%

“…Scott and colleagues (2005) modified a hospital-focused scale focused on communication, teamwork, and leadership to the NH environment. The scale of 11 items developed for use by certified nursing assistants was utilized for this study (Forbes-Thompson et al, 2006). …”

Section: Methodsmentioning

confidence: 99%

Nursing Home Staff Intentions for Learned Communication Skills: Knowledge to Practice

Williams¹,

Perkhounkova²,

Bossen³

et al. 2016

J Gerontol Nurs

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show abstract

“…56 Will resident outcomes include self-report, and if so, how should one measure these outcomes in residents with marked cognitive impairment? [57][58][59] Was the measure developed for or validated in NHs?…”

Section: Methodsmentioning

confidence: 99%

Geriatric Palliative Care in Long-Term Care Settings with a Focus on Nursing Homes

Ersek

Carpenter

2013

Journal of Palliative Medicine

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Almost 1.7 million older Americans live in nursing homes, representing a large proportion of the frailest, most vulnerable elders needing long-term care. In the future, increasing numbers of older adults are expected to spend time and to die in nursing homes. Thus, understanding and addressing the palliative care needs of this population are critical. The goals of this paper are to describe briefly the current state of knowledge about palliative care needs, processes, and outcomes for nursing home residents; identify gaps in this knowledge; and propose priorities for future research in this area.

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“…For example, DON turnover may destabilize the workforce as new policies and expectations introduced by newly hired management teams create anxiety and tension among staff (Donoghue, 2010). Higher DON turnover has been related to poorer care quality (Anderson, Corazzini, & McDaniel, 2004; Forbes-Thompson, Gajewski, Scott-Cawiezell, & Dunton, 2006), whereas higher DON tenure has been related to higher staff retention and lower turnover (Donoghue, 2010), as well as reduced use of restraints and complications of immobility (Anderson et al, 2003). Thus to improve NH residents’ health outcomes, we must first understand how clinical management turnover contributes to multilevel nursing staff turnover and poor quality of care.…”

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confidence: 99%

Top Nurse-Management Staffing Collapse and Care Quality in Nursing Homes

2012

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Director of nursing turnover is linked to staff turnover and poor quality of care in nursing homes; however the mechanisms of these relationships are unknown. Using a complexity science framework, we examined how nurse management turnover impacts system capacity to produce high quality care. This study is a longitudinal case analysis of a nursing home (n = 97 staff) with 400% director of nursing turnover during the study time period. Data included 100 interviews, observations and documents collected over 9 months and were analyzed using immersion and content analysis. Turnover events at all staff levels were nonlinear, socially mediated and contributed to dramatic care deficits. Federal mandated, quality assurance mechanisms failed to ensure resident safety. High multilevel turnover should be elevated to a sentinel event for regulators. Suggestions to magnify positive emergence in extreme conditions and to improve quality are provided.

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An Exploration of Nursing Home Organizational Processes

Cited by 54 publications

References 24 publications

Nursing Home Staff Intentions for Learned Communication Skills: Knowledge to Practice

Nursing Home Staff Intentions for Learned Communication Skills: Knowledge to Practice

Geriatric Palliative Care in Long-Term Care Settings with a Focus on Nursing Homes

Top Nurse-Management Staffing Collapse and Care Quality in Nursing Homes

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