The Influence of Care Provider Access to Structural Empowerment on Individualized Care in Long-Term-Care Facilities

Caspar, Sienna; O’Rourke, Norm

doi:10.1093/geronb/63.4.s255

Cited by 91 publications

(95 citation statements)

References 24 publications

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“…Supervisory support, autonomy, and respect were found to support high commitment levels in long term care (Bishop et al, 2008), and DCWs have expressed that they most desire recognition, respect, rewards, empowerment, and inclusion in decision-making (Bowers et al, 2003;Caspar & O'Rourke, 2008;Leutz et al, 2009;Secrest et al, 2005;Stone, 2004Stone, , 2011. All such leader behaviors are reflected in the five transformational leadership subscales in some fashion, and the study results illustrated the statistically significant relationship between the transformational leadership subscales and overall organizational commitment, affective commitment, and normative commitment.…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Transformational Leadership and Organizational Commitment in Nonprofit Long Term Care Organizations: The Direct Care Worker Perspective

Porter¹

2015

CJIL

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Abstract. The United States population is rapidly aging, and retaining direct care workers (DCWs) will continue to be a workforce concern for the industry in addressing the demand for long term care services. To date, scant literature exists that addresses the DCW perspective of leadership behaviors and their influence on organizational commitment. To respond to this deficiency, this research studied leadership behaviors of direct importance for DCWs at the immediate supervisor level, and provided empirical insight into organizational commitment among workers closest to patient care. Research on leader behaviors has focused on managerial and executive levels, with scant consideration in long term care at the lower hierarchical levels. Transformational leadership was hypothesized to have a significant positive relationship with organizational commitment, specifically affective and normative commitments, and a significant inverse relationship with continuance commitment. The quantitative correlational study explored the relationship between transformational leadership and organizational commitment among 322 direct care workers employed by nonprofit, multi-level long term care organizations located in the Midwest. Results revealed a statistically significant relationship between overall transformational leadership and organizational commitment as well as affective and normative commitment dimensions, with no significant relationship found between transformational leadership and continuance commitment. The study results are beneficial to industry leaders, researchers, and policymakers for addressing operational policies, leadership training, human resource practices, and workforce policy development. Operational policies should reflect the values of the organization and follow from a compelling, collective vision and mission. Human resources practices warrant review if not aligned with the vision, mission, and values. Leadership development training should be considered for continuing education for supervisors at all levels as well as for potential policy alternatives.

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Section: Discussionmentioning

confidence: 99%

The Relationship between Transformational Leadership and Organizational Commitment in Nonprofit Long Term Care Organizations: The Direct Care Worker Perspective

Porter¹

2015

CJIL

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“…However, common across all Canadian LTC settings is the high proportion of unregulated care providers (that is, unlicensed staff who may also be referred to as care aides, nurses aides, or personal care workers in other jurisdictions across Canada and abroad) who deliver the majority of front-line, direct care to residents [14]. In 2007, 72% of care providers in LTC in Alberta were unregulated caregivers; regulated professionals (like registered nurses (RNs)/registered psychiatric nurses (RPNs) and licensed practical nurses (LPNs)) comprised only 17% and 11%, respectively [15].…”

Section: Introductionmentioning

confidence: 99%

“…As well as increasing numbers of LTC residents, a wide range of challenging co-morbidities often influence their needs [21], yet it is unregulated care providers (with the lowest level of education and pay) who are most in contact with them [14,16]. LTC thus relies on the least prepared individuals to provide the majority of care to a growing number of older adults with multifaceted health needs [8,22,23].…”

Section: Introductionmentioning

confidence: 99%

“…LTC thus relies on the least prepared individuals to provide the majority of care to a growing number of older adults with multifaceted health needs [8,22,23]. The high proportion of unregulated care providers may affect the quality of care in LTC settings, as they may be limited in their ability to respond appropriately to residents [14,24]. …”

Section: Introductionmentioning

confidence: 99%

“…Unregulated care providers have little autonomy [14] and decision makers rarely consult them [16,24]. Improving teamwork among the variety of care providers— especially between professional nurses and unregulated care providers—might improve quality of care [25-27].…”

Section: Introductionmentioning

confidence: 99%

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Unregulated provider perceptions of audit and feedback reports in long-term care: cross-sectional survey findings from a quality improvement intervention

et al. 2013

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BackgroundAudit with feedback is a moderately effective approach for improving professional practice in other health care settings. Although unregulated caregivers give the majority of direct care in long-term care settings, little is known about how they understand and perceive feedback reports because unregulated providers have not been directly targeted to receive audit with feedback in quality improvement interventions in long-term care. The purpose of this paper is to describe unregulated care providers’ perceptions of usefulness of a feedback report in four Canadian long-term care facilities.MethodsWe delivered monthly feedback reports to unregulated care providers for 13 months in 2009–2010. The feedback reports described a unit’s performance in relation to falls, depression, and pain as compared to eight other units in the study. Follow-up surveys captured participant perceptions of the feedback report. We conducted descriptive analyses of the variables related to participant perceptions and multivariable logistic regression to assess the association between perceived usefulness of the feedback report and a set of independent variables.ResultsThe vast majority (80%) of unregulated care providers (n = 171) who responded said they understood the reports. Those who discussed the report with others and were interested in other forms of data were more likely to find the feedback report useful for making changes in resident care.ConclusionsThis work suggests that unregulated care providers can understand and feel positively about using audit with feedback reports to make changes to resident care. Further research should explore ways to promote fuller engagement of unregulated care providers in decision-making to improve quality of care in long-term care settings.

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Power, empowerment, and person‐centred care: using ethnography to examine the everyday practice of unregistered dementia care staff

Scales

Bailey

Middleton

et al. 2017

Ageing, Dementia and the Social Mind

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The Influence of Care Provider Access to Structural Empowerment on Individualized Care in Long-Term-Care Facilities

Cited by 91 publications

References 24 publications

The Relationship between Transformational Leadership and Organizational Commitment in Nonprofit Long Term Care Organizations: The Direct Care Worker Perspective

The Relationship between Transformational Leadership and Organizational Commitment in Nonprofit Long Term Care Organizations: The Direct Care Worker Perspective

Unregulated provider perceptions of audit and feedback reports in long-term care: cross-sectional survey findings from a quality improvement intervention

Power, empowerment, and person‐centred care: using ethnography to examine the everyday practice of unregistered dementia care staff

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