Patterns of Medical and Nursing Staff Communication in Nursing Homes: Implications and Insights From Complexity Science

Colón‐Emeric, Cathleen; Ammarell, Natalie; Bailey, Donald E.; Corazzini, Kirsten; Lekan‐Rutledge, Deborah; Piven, Mary L.; Utley-Smith, Queen; Anderson, Ruth A.

doi:10.1177/1049732305284734

Cited by 75 publications

(79 citation statements)

References 28 publications

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“…This review characterized PSC as problematic with many nursing homes having low scores (indicating poor PSCs), providing further rationale for additional research in this area. As part of this prior literature review (Bonner et al, 2008), and our own literature search, only one empirical study (i.e., Castle & Sonon, 2006) was identified that examined the PSC from the perspective of nursing home top managers. Most of the other studies examined PSC using information coming from nurse aides (Bonner et al, 2008).…”

Section: Patient Safety Culturementioning

confidence: 99%

“…Most of the other studies examined PSC using information coming from nurse aides (Bonner et al, 2008). Castle and Sonon (2006) examined PSC from the perspective of NHAs. Information came from 425 NHAs, and a hospital PSC instrument was modified for use in nursing homes (i.e., the Hospital Survey on Patient Safety Culture (HSOPSC); Sorra et al, 2007).…”

Section: Patient Safety Culturementioning

confidence: 99%

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Safety culture of nursing homes

Castle

Wagner²,

Ferguson³

et al. 2011

Health Care Management Review

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Background Examining the perception of the patient safety culture (PSC) of top managers in healthcare settings is important because their orientation to PSC can have a large influence on the facility. Purposes In this research, the perception of the PSC of Nursing Home Administrators (NHAs) and Directors of Nursing (DONs) is examined. Methodology/Approach Primary data were collected to examine the opinions of the PSC from NHAs and DONs. Information was collected from a large nationally representative sample of 4,000 nursing homes. The Nursing Home Survey on Patient Safety Culture (NHSPSC) survey instrument was used as a measure of PSC. This has 12 domains and 38 items. Bias indexes, intraclass correlation coefficients, and Pearson’s product-moment correlation coefficients of the differences between NHA and DON item scores were examined. Findings Using a 0–100 scale, most scores fell into the 55–80 range. Higher scores represent a higher (more favorable) PSC. Agreement between the NHA and DON was excellent for 10 items, good in 15 items, moderate in 4 items, and poor in 8 items. Of the 4 largest differences in scores, the NHA scores were higher than the DON scores for one item and DON scores were higher than the NHA scores for 3 items. Implications The overall perception from both NHAs and DONs, would appear to represent a somewhat “positive” outlook from these top managers on their institution’s PSC. However, NHAs in general report higher scores than DONs. The areas of divergence between these top managers are further discussed, with a view towards directing future patient safety investigations and initiatives in nursing homes.

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Section: Patient Safety Culturementioning

confidence: 99%

Section: Patient Safety Culturementioning

confidence: 99%

Safety culture of nursing homes

Castle

Wagner²,

Ferguson³

et al. 2011

Health Care Management Review

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“…CASs are characterized by a number of agents (staff) interacting locally in a dynamic, non-linear fashion.) Colon-Emeric et al 54 proposed that communication patterns in RAC facilities may influence the quality of care provided to residents. A tolerant and open rather than 'us and them' management style is required to encourage staff uptake of educational programmes.…”

Section: Discussionmentioning

confidence: 99%

Burnout matters: The impact on residential aged care staffs’ willingness to undertake formal palliative care training

Frey¹,

Boyd²,

Foster³

et al. 2014

Progress in Palliative Care

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Introduction: Palliative care delivery has become integral to the role of healthcare staff in residential aged care (RAC) internationally. Challenges within this work environment (e.g. workload, staffing levels, resources) may impact on healthcare staffs' willingness to undertake formal palliative care education. The study described herein explored factors (socioenvironmental and psychological) that influence staff willingness to engage in palliative care education. Methods: The predictors of palliative care education uptake for healthcare staff (n = 431) from 52 New Zealand RAC facilities in one large urban District Health Board were assessed. Logistic regression was used to explore willingness to engage in education. Results: Higher scores for burnout predicted a decreased likelihood of engaging in palliative care education (odds ratio (OR) 0.41, P = 0.01). The identified predictor of willingness to engage in education was previous palliative care experience (OR 1.59, P = 0.027). Discussion: These results can inform the design and delivery of future palliative care education programmes within RAC.

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“…For managers and administrators, enabling CNA observations within the facility could help unlock the capacity of the CNA to influence depression assessment. Systems developed, however, must attend to the facility barriers to CNA and clinical staff sharing of information (Anderson et al, 2005;Colón-Emeric et al, 2006a;Colón-Emeric et al, 2006b;Piven et al 2006). Given the high CNA turnover, it may argued that the time and cost of further educating CNAs is not prudent; but, providing additional training along with supervisory support may improve CNA morale and job satisfaction, influencing turnover.…”

Section: Discussionmentioning

confidence: 99%

“…No formalized processes are known that permit CNAs to consistently and effectively communicate their accumulated resident observations, influencing the care processes of resident assessment, care planning and decision-making (Colón-Emeric et al, 2006b;Piven et al, 2006). With low Registered Nurse-resident ratios (Eaton, 2000), contact with Registered Nurses and even Licensed Practical or Vocational Nurses may be limited, with few opportunities to share knowledge and jointly solve problems (Colón-Emeric et al, 2006b), much less time for clinical supervision. Positive relationships with nursing staff, especially the MDS Coordinators, improve the likelihood that CNAs will communicate resident observations for more accurate assessment of residents and individualized care planning .…”

Section: Facility and Staff Barriers To Inclusion Of Cna Observationsmentioning

confidence: 99%

Certified Nursing Assistants' Explanatory Models of Nursing Home Resident Depression

et al. 2008

Self Cite

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In this study, we explored how Certified Nursing Assistants (CNAs) understood resident depression. Interviews with 18 CNAs, working in two nursing homes were guided by Kleinman's Explanatory Models of Illness framework. Interview data were content analyzed and CNAs' descriptions of depression were compared to the MDS 2.0 Mood Screen and to DSM-IV-TR Depression Criteria. CNAs identified causes, signs, and symptoms of depression, but they were unsure about the duration and normalcy of depression in residents. Although they had no formal training, CNAs felt responsible for detecting depression and described verbal and non-verbal approaches that they used for emotional care of depressed residents. CNAs hold potential to improve the detection of depression and contribute to the emotional care of residents. Attention to knowledge deficits and facility barriers may enhance this capacity.

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Patterns of Medical and Nursing Staff Communication in Nursing Homes: Implications and Insights From Complexity Science

Cited by 75 publications

References 28 publications

Safety culture of nursing homes

Safety culture of nursing homes

Burnout matters: The impact on residential aged care staffs’ willingness to undertake formal palliative care training

Certified Nursing Assistants' Explanatory Models of Nursing Home Resident Depression

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