Sie befinden Sich nicht im Netzwerk der Universität Paderborn. Der Zugriff auf elektronische Ressourcen ist gegebenenfalls nur via VPN oder Shibboleth (DFN-AAI) möglich. mehr Informationen...
Interpersonal Care Processes, Falls, and Hospitalizations in Green House and Other Nursing Homes
Ist Teil von
Seniors housing & care journal, 2016-01, Vol.24 (1), p.5
Ort / Verlag
Evanston: Mather LifeWays Institute on Aging
Erscheinungsjahr
2016
Link zum Volltext
Quelle
EBSCOhost Business Source Ultimate
Beschreibungen/Notizen
Interpersonal aspects of nursing home care processes have rarely been examined, including how resident risk is identified, if and how multidisciplinary communication and collaboration occur, and what other preventive practices are in place. This study examined select nursing home structures and interpersonal care processes and identified those associated with falls and hospitalizations, controlling for resident differences, to help inform care practices. Outcomes were also examined related to two types of nursing homes: traditional nursing homes and those that have undergone broad "culture change" as evidenced in Green House nursing homes. The study population included residents and staff from 11 Green House organizations and eight comparison nursing homes across 11 states. Minimum Data Set 3.0 resident data and structured interviews were used to gather information about residents and interpersonal care processes used in these sites from January 1, 2011, through June 30, 2012. Resident characteristics, nursing home structures (e.g., consistent staffing), and interpersonal care processes, including processes to identify risk (e.g., obtaining resident weights weekly), prevention strategies (e.g., conducting root cause analysis), and communication and collaboration processes, among disciplines about resident status (e.g., communicating about resident status), were measured to determine those that were significantly associated with outcomes of falls and hospitalizations. Findings indicate the importance of direct communication between dietary staff and certified nursing assistants (CNAs) about weight loss and nutrition risk, obtaining weekly weights, more staff hours/resident day, and staff conducting root cause analysis when trying to reduce resident falls or hospitalizations. Practices to be avoided include frequent CNA assignment changes and the omission of formal shift report from nurses to CNAs, because these were associated with more falls and/or hospitalizations. Certain modifiable nursing home structures and interpersonal care process factors, the latter of which have not been examined in other research projects and are not unique to any given model of nursing home care, are associated with fewer falls and hospitalizations; they suggest potential targets to improve quality of care and health outcomes of nursing home residents, regardless of setting.