Dissertations / Theses: 'Nursing homes'

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Velasquez, Donna Marie. "Measuring Nursing Care Complexity in Nursing Homes." Diss., Tucson, Arizona : University of Arizona, 2005. http://etd.library.arizona.edu/etd/GetFileServlet?file=file:///data1/pdf/etd/azu%5Fetd%5F1360%5F1%5Fm.pdf&type=application/pdf.

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Burd, David. "A nursing home community." PDF viewer required Home page for entire collection, 2008. http://archives.udmercy.edu:8080/dspace/handle/10429/9.

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Bostick, Jane E. "The relationship of nursing personnel and nursing home care quality." MU has:, 2002. http://wwwlib.umi.com/cr/mo/fullcit?3052150.

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Thomas, Kali. "Patient Safety in Nursing Homes." Scholar Commons, 2011. http://scholarcommons.usf.edu/etd/3380.

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Safety of residents has gained increased popularity in recent years following a report from the Institute of Medicine attributing 98,000 hospital deaths each year to errors by staff. As a result, regulatory agencies, advocates, and health care providers have shifted their focus to understanding patient safety and developing a culture that promotes safety. However, nursing homes lag behind other health care providers in their adoption of a patient safety culture and understanding what factors affect safety in resident care. These insights are needed to ensure that nursing home residents receive the safe care. The purpose of this dissertation is to explore factors that influence the safety of residents in nursing homes by conducting three separate studies and using Donabedian's Structure Process Outcome (SPO) framework. The first study examines facility characteristics that predict higher patient safety culture scores given by top managers among a nationally representative sample of nursing homes. Using the same sample, the second study examines the relationships among the three components of Donabedian's SPO model as they relate to patient safety: structure (patient safety culture), processes of care (restraint use) and a common patient safety outcome, resident falls. The final study uses a sample of Florida nursing homes and the SPO model to examine the relationships between nursing staff turnover, processes of care, and patient safety outcomes in nursing homes. Findings from this dissertation can contribute to a greater understanding of what predicts higher levels of patient safety in nursing homes. In the first analysis, facility characteristics that are traditionally related to quality of care in nursing homes are predictive of higher patient safety culture scores. In the second analysis, higher ratings of patient safety culture are related to better processes of care and a decreased likelihood of resident falls. In the final analysis, results indicate that Certified Nursing Assistant (CNA) turnover had an independent effect on two patient safety outcomes, falls and UTIs, and that this effect is mediated by processes of care within the nursing home. Collectively, the findings from this dissertation may have important implications for policy makers, providers, and consumers of nursing home services.

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Douglas, Amelia L. "Job satisfaction in nursing homes." Virtual Press, 1994. http://liblink.bsu.edu/uhtbin/catkey/902478.

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The recruitment, hiring, and retention of registered nurses (RNs) is of critical concern for nursing home administrators. Many times, nursing homes unsuccessfully compete with hospitals and staff relief agencies for available RNs (Braddy, Washburn, & Carroll, 1991). Understanding the factors that influence nurses to seek a particular employer is significant in recruitment and hiring. Factors related to nursing decisions to choose employment in nursing homes were identified in this descriptive study.Price and Mueller's (1981) Causal Model for Turnover (CMT) provided a conceptual framework for the study. The investigator used a revised form of an instrument developed by Price and Mueller for a 1981 study of hospital turnover. The instrument contained 67 items presented in a combination of 59 multiple choice items and 8 five-point Likert-type items. The reliability for each of the seven subscales was equal to or greater than .70.A sample of 300 full-time RNs with tenure of at least 6 months employment with a large for profit corporation was selected for this study. Questionnaires were mailed to participants with a letter of introduction from the investigator and the divisional vice president of the corporation. Subjects were provided with a self-addressed, stamped envelope to be used to return completed questionnaires. A follow-up call was done one week after the mailing requesting return of all completed questionnaires.There were no risks or ill effects from participating in this study. Respondents were free to ask any questions during the study. The agency and respondents were not identified in the sampling and the results of the study. Completion of the questionnaire was interpreted as the respondent's agreement to participate in the study.Results should help administrators understand the factors that influence registered nurses to seek employment in nursing homes. The results of the study should be utilized in reviewing current recruitment, hiring, and retention strategies.
School of Nursing

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Clark, Carrie. "Culture Change in Nursing Homes." Miami University / OhioLINK, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=miami1163699847.

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Bonifas, Robin P. "Multi-level factors related to deficiencies in psychological care in Washington State skilled nursing facilities /." Thesis, Connect to this title online; UW restricted, 2007. http://hdl.handle.net/1773/8139.

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Chang, Hui-Chen. "Evidence-based practice in nursing homes." Thesis, The University of Sydney, 2008. http://hdl.handle.net/2123/3572.

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Aim and significance: The aim of this research was to investigate how evidence-based practice (EBP) in nursing homes is understood in the context of Taiwan, a non-Western country. There is a growing movement towards using research evidence to inform practice in the nursing profession with variable success. To date, factors that promote or inhibit implementation of EBP in health care have been investigated through research conducted in hospital settings in Western countries. Remarkably little is known about nurses’ experience and perceptions of EBP in residential aged care facilities (RACFs), especially in non-Western countries. Method: The study adopted a mixed method approach. Subjects were recruited from six nursing homes in the Hsinchu district of Taiwan. In Stage 1, 89 registered nurses completed a comprehensive questionnaire specifically developed for this project. It was designed to elicit information about (1) their experience of and attitudes towards research and EBP; (2) the barriers they perceive to its implementation; and (3) what strategies they believe would enhance its implementation in the nursing home setting. In Stage 2, six nursing managers participated in semi-structured in-depth interviews that explored the same topic areas as those in the questionnaire but used an open-ended format which allowed for new themes to emerge. Findings: The majority of nurses and nursing managers expressed positive attitudes towards research and EBP but reported relatively little experience in its implementation. Nurses relied most heavily on knowledge derived from past experience and on interactions with nursing colleagues, medical staff and patients to inform their clinical practice. They identified the main barriers to EBP as: insufficient authority to change practice, their own lack of research knowledge and insufficient time to implement new ideas in the workplace. They believed EBP would be facilitated by: improved access to computers and internet facilities in the workplace; more effective research training; collaboration with academics; and dedicated time to search for and read research articles. As anticipated, nurses viewed the issues from a practical stance in relation to their own time, resources and lack of authority to effect change. Nursing managers expressed similar views to the nurses in relation to attitudes towards EBP implementation. However, they identified barriers which related to aspects of the organizational framework. In particular, they expressed concerns about issues such as budgetary constraints, staff quality (notably the reliance on minimally trained assistants in nursing (AINs) for direct resident care), as well as factors that reflected the wider political and economic context of health care in Taiwan. Conclusion: The findings of this study have implications for research, policy and practice in both Western and non-Western countries. Further research on EBP would be beneficial if conducted in settings other than hospitals, such as RACFs. There remains also the need to examine the potential for EBP in different social-cultural contexts, such as those in non-Western countries. Nursing managers have generally been excluded in previous research but, because of their particular role, there is a need to examine their perspectives of EBP and then compare these with those of the nurses. In Taiwan specifically, policy change is needed at both government and institutional levels to encourage and support the development of protocols and procedures for the implementation of EBP. If EBP was a government requirement for accreditation and a standard for protocols in hospitals and RACFs, it would lead to improved standards of care and cost effectiveness. This study supports the findings of a number of investigations conducted in Western countries which indicate that further education and training in research for nurses may lead to higher standards of patient care, greater job satisfaction and higher staff retention rates.

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Chang, hui chen. "Evidence-based practice in nursing homes." University of Sydney, 2008. http://hdl.handle.net/2123/3572.

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Doctor of Philosophy
Aim and significance: The aim of this research was to investigate how evidence-based practice (EBP) in nursing homes is understood in the context of Taiwan, a non-Western country. There is a growing movement towards using research evidence to inform practice in the nursing profession with variable success. To date, factors that promote or inhibit implementation of EBP in health care have been investigated through research conducted in hospital settings in Western countries. Remarkably little is known about nurses’ experience and perceptions of EBP in residential aged care facilities (RACFs), especially in non-Western countries. Method: The study adopted a mixed method approach. Subjects were recruited from six nursing homes in the Hsinchu district of Taiwan. In Stage 1, 89 registered nurses completed a comprehensive questionnaire specifically developed for this project. It was designed to elicit information about (1) their experience of and attitudes towards research and EBP; (2) the barriers they perceive to its implementation; and (3) what strategies they believe would enhance its implementation in the nursing home setting. In Stage 2, six nursing managers participated in semi-structured in-depth interviews that explored the same topic areas as those in the questionnaire but used an open-ended format which allowed for new themes to emerge. Findings: The majority of nurses and nursing managers expressed positive attitudes towards research and EBP but reported relatively little experience in its implementation. Nurses relied most heavily on knowledge derived from past experience and on interactions with nursing colleagues, medical staff and patients to inform their clinical practice. They identified the main barriers to EBP as: insufficient authority to change practice, their own lack of research knowledge and insufficient time to implement new ideas in the workplace. They believed EBP would be facilitated by: improved access to computers and internet facilities in the workplace; more effective research training; collaboration with academics; and dedicated time to search for and read research articles. As anticipated, nurses viewed the issues from a practical stance in relation to their own time, resources and lack of authority to effect change. Nursing managers expressed similar views to the nurses in relation to attitudes towards EBP implementation. However, they identified barriers which related to aspects of the organizational framework. In particular, they expressed concerns about issues such as budgetary constraints, staff quality (notably the reliance on minimally trained assistants in nursing (AINs) for direct resident care), as well as factors that reflected the wider political and economic context of health care in Taiwan. Conclusion: The findings of this study have implications for research, policy and practice in both Western and non-Western countries. Further research on EBP would be beneficial if conducted in settings other than hospitals, such as RACFs. There remains also the need to examine the potential for EBP in different social-cultural contexts, such as those in non-Western countries. Nursing managers have generally been excluded in previous research but, because of their particular role, there is a need to examine their perspectives of EBP and then compare these with those of the nurses. In Taiwan specifically, policy change is needed at both government and institutional levels to encourage and support the development of protocols and procedures for the implementation of EBP. If EBP was a government requirement for accreditation and a standard for protocols in hospitals and RACFs, it would lead to improved standards of care and cost effectiveness. This study supports the findings of a number of investigations conducted in Western countries which indicate that further education and training in research for nurses may lead to higher standards of patient care, greater job satisfaction and higher staff retention rates.

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Mack, Deborah Sara. "Statin Pharmacotherapy in U.S. Nursing Homes." eScholarship@UMMS, 2020. https://escholarship.umassmed.edu/gsbs_diss/1104.

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Background: Statins have questionable benefits among older adults with life-limiting illness. Statin use is widespread among U.S. older adults, but little is known about use in nursing homes. This dissertation was designed to identify the prevalence and predictors of statin pharmacotherapy use and discontinuation in U.S. nursing homes. Methods: Data sources (2011-2016) included: Minimum Data Set 3.0, Medicare administrative claims data, Provider of Service files, and Dartmouth Atlas files. Analyses included: descriptive statistics, multilevel modeling, and proportional change in cluster variations with adjustments to reduce confounding and model misspecification. Results: Approximately 36% of older adults admitted to U.S. nursing homes between 2015 – 2016 were actively using statins at the time of admission. Among long-stay residents with life-limiting illness, 34% were on statins at one time (2016; aged 65-75 years: 44%, >75 years: 31%). Statin use varied significantly by hospital referral regions, with most variation in the >75 age group. Limiting the sample to statin users, 20% discontinued statins within 30 days of nursing home admission. While discontinuation was positively associated with severity of life-limiting condition, the majority of residents remained on statins 30 days post-admission, including those with a < 6-month prognosis. Conclusion: Statin use is pervasive across US nursing homes and persists with life-limiting illness. Geographic variation appeared to coincide with clinical uncertainty, especially among adults >75 with few national guidelines. More needs to be done to prioritize statin deprescribing in nursing homes with research that identifies ways to facilitate improved patient-provider awareness and engagement in the discontinuation process.

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GOODRUM, ANN ELAINE. "HEARING AID MAINTENANCE IN NURSING HOMES." University of Cincinnati / OhioLINK, 2003. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1053696984.

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Evans, Allison M. "Developing Resident Relationships in Nursing Homes." Ohio University Honors Tutorial College / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ouhonors1556206070395263.

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Carter, Rebecca Rosaly Carter. "ANTIBIOTIC STEWARDSHIP IN AMERICAN NURSING HOMES." Case Western Reserve University School of Graduate Studies / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=case1538588980802258.

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Black, Amanda C. "Attitudes and Perceptions of Nursing Homes." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/honors/86.

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The purpose of this study was to examine how past experiences with nursing homes influence perceptions and attitudes of college students toward nursing homes in the United States. A review of the current research literature indicates that nursing homes are publicly scrutinized in a negative manner. Variables examined included students’ college of study, experience with nursing homes either from personal experience, from a well-known relative or friend, or the media, and different attitudes and perceptions including good or bad views of nursing homes. Results indicate that students’ perceive nursing homes more negatively than positively even when their experience came from personal knowledge. Students enrolled in health services do not perceive nursing homes more positively than negatively or any better than students enrolled in other courses of study. Moreover, there was no significant relationship between the students’ perceptions of nursing homes and their field of study.

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Kumlien, Suzanne. "Persons with stroke and their nursing care in nursing homes /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-406-6/.

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Tappeiner, Waltraud. "Disclosing nursing worlds within nursing homes : a later Heideggerian exploration." Thesis, Glasgow Caledonian University, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.518135.

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Amin, Muhammad Ismat. "CERTIFIED NURSING ASSISTANT RETENTION: A STAFFING CHALLENGE FOR NURSING HOMES." Miami University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=miami1507435442201555.

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Law, Emma. "Research in care homes : issues of participation and citizenship." Thesis, University of Stirling, 2016. http://hdl.handle.net/1893/25305.

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Across Scotland, there is a lack of research in care homes. This thesis explores this topic by examining links between inclusion, participation in general and participation in research and whether those who work and live in the care home environment experience social citizenship. Using a national survey and interviews with residents, staff, relatives and experts in care home research, this thesis investigated whether participation generally was linked to participation in research for residents, staff and visitors in a care home setting. The thesis further explored how social citizenship functions in a care home environment and whether there is a link between participation and citizenship. The findings suggest there is a lack of general participation which is connected with the leadership style and management within the care homes. There is misunderstanding about research and legislation amongst the care home staff, residents, visitors, as well as the junior research staff which inhibited staff and resident participation. Furthermore, citizenship is not experienced universally by residents or staff due to disempowerment, and exclusion occurs amongst residents due to age, frailty and dementia. By facilitating good leadership, communication and relationship-building such issues may be overcome. In addition, the analysis suggests a link is evident between inclusion, participation and citizenship. Where choice is provided and residents have their social position maintained, as well as have a degree of responsibility for shaping events, this leads to participation and inclusivity as described in Bartlett and O’Connor’s (2010) definition of social citizenship. Furthermore, if inclusion is adapted for cognition and frailty, then participation leads to the experience of social citizenship, encouraging a culture which can welcome research. The explicit emphasis on inclusion and participation in research has enabled this under-researched area of participation and experience of social citizenship in care homes to be more fully explored.

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Rodriguez, Jason. "Reimbursement comes from the heart the organizational structure of emotions and care-work in nursing homes /." Amherst, Mass. : University of Massachusetts Amherst, 2009. http://scholarworks.umass.edu/dissertations/AAI3380010/.

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Shin, Juh Hyun. "Relationship between nurse staffing and quality of life in Iowa nursing homes." Diss., University of Iowa, 2008. http://ir.uiowa.edu/etd/18.

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Davidson, Carrie Jane. "Profit Status and the Relationship between Medicaid Reimbursement and Nursing Home Quality in Ohio Nursing Homes." Connect to text online, 2006. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=case1138477611.

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Thesis (Ph. D.)--Case Western Reserve University, 2006.
[School of Medicine] Department of Epidemiology and Biostatistics. Includes bibliographical references. Available online via OhioLINK's ETD Center.

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Lansmon-Winter, Erin Cready Cynthia M. "Family perception of quality in nursing home care impact of gender, level of involvement, and utilization of empowered CNA teams /." [Denton, Tex.] : University of North Texas, 2008. http://digital.library.unt.edu/permalink/meta-dc-9069.

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Rudén, Mathilda. "HIV-knowledge and Attitudes in Swedish Nursing Homes : A collective case study of three nursing homes in Stockholm." Thesis, Södertörns högskola, Miljövetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:sh:diva-35653.

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Background: Due to the effective antiretrovirals are people living with HIV expected live up to 70 years of age. Approximately half of the people living with HIV in Sweden are above 50 years old and estimated to become enrolled into the Swedish elderly care system. Concern about the Swedish elderly care preparedness for greeting people living with HIV is growing, based on previous experiences of stigma in the general society, many are feeling anxious that they will become victims of stigmatization and discrimination in the Swedish elderly care system. Method: A collective case study was conducted of three nursing homes with different organizational background in Nacka municipality, Stockholm. Interviews with superintendents from each nursing home was performed and 95 health care workers at the nursing homes completed a questionnaire. Collected data was entered to Excel for descriptive analysis and all statistical analysis was performed in R: The R project for statistical computing. Pearson´s Chi-squared test was used to analyze categorial data, e.g., to find potential statistical significance between the variables and Pearson’s correlation coefficient was used to examine if the variables fluctuate together. Result: The general knowledge about HIV was not more than average among the participating health care workers and many stated concern towards HIV, which might impact on their attitudes and their practical performance when attending a person living with HIV. One of the nursing homes had experience of attending a person living with HIV and showed less feelings of concern compared to the other participating nursing homes. This support the idea that experience of attending a person living with HIV minimizes feelings of concern and negative attitudes to HIV. Like previous studies, this study highlights the relationship between higher degree of education and less negative attitudes towards HIV. However, none of the mentioned results showed a statistically significance outcome possibly due to the small sample size. To reduce risk of HIV stigma and feelings of concern among health care workers must HIV be discussed and prioritized in the Swedish elderly care system, as well as in municipalities.

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Chang, Hui-Chen. "Evidence-based practice in nursing homes a study of Taiwanese nurses' and nursing managers' perceptions /." Connect to full text, 2008. http://hdl.handle.net/2123/3572.

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Thesis (Ph. D.)--University of Sydney, 2008.
Title from title screen (viewed 11 February 2009). Includes tables and questionnaires. Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Behavioural and Community Health Sciences, Faculty of Health Sciences. Includes bibliographical references. Also available in print form.

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Fossum, Mariann. "Computerized decision support system in nursing homes." Doctoral thesis, Örebro universitet, Institutionen för hälsovetenskap och medicin, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-21673.

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The overall aim of this thesis was to study the thinking strategies and clinical reasoning processes of registered nurses (RNs) and to implement and test a computerized decision support system (CDSS) integrated into the electronic health care record (EHR) to improve patient outcomes, i.e. to prevent pressure ulcers (PUs) and malnutrition among residents in nursing homes. A think-aloud (TA) study with a purposeful sample of RNs (n=30) was conducted to explore their thinking strategies and clinical reasoning (Paper I). A quasi-experimental study with a convenience sample of residents (at baseline, n=491 and at follow-up, n=480) from nursing homes (n=15) allocated into two intervention groups and one control group was carried out in 2007 and 2009 (Paper II). In Paper III residents’ records were reviewed with three instruments. Nursing personnel (n=25) from four nursing homes that had used the CDSS for eight months were interviewed and the CDSS was tested by nursing personnel (n=5) in two usability evaluations (Paper IV). The results showed that the RNs used a variety of thinking strategies and a lack of systematic risk assessment was identified (Paper I). The proportion of malnourished residents decreased significantly in one of the intervention groups after implementing the CDSS, however there were no differences between the groups (Paper II). The CDSS resulted in more complete and comprehensive documentation of PUs and malnutrition (Paper III). The nursing personnel considered ease of use, usefulness and a supportive work environment as the main facilitators of CDSS use in nursing homes. Barriers were lack of training, resistance to using computers and limited integration of the CDSS within the EHR system (Paper IV). In conclusion, the findings support integrating CDSSs into the EHR in nursing homes to support the nursing personnel.

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Wagner, Kay. "Nursing homes' organizational factors and resident mistreatment /." Connect to full text via ProQuest. Limited to UCD Anschutz Medical Campus, 2008.

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Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2008.
Typescript. Includes bibliographical references (leaves 209-220). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;

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Ruler, Amanda Jane. "Culture of nursing homes : an ethnomethodological study /." Title page, contents and abstract only, 2000. http://web4.library.adelaide.edu.au/theses/09PH/09phr935.pdf.

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Peltz, Claudia. "Facility design & planning to improve nurses' effectiveness in administering care to fulltime residents of nursing homes." Muncie, Ind. : Ball State University, 2009. http://cardinalscholar.bsu.edu/436.

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Hughes, Susan D. "Participatory Management and Absenteeism and Turnover of Nursing Assistants in Nursing Homes." Thesis, University of North Texas, 2019. https://digital.library.unt.edu/ark:/67531/metadc1609104/.

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Nursing assistants (NAs) provide the majority of daily care to older adults in nursing homes (NHs); NAs working in NHs are the focus of this study. This study examined the influence of participatory management (the independent variable), and mediating variables, burnout – measured as emotional exhaustion, task performance, and affective organizational commitment, on NA withdrawal behaviors (the dependent variables absenteeism and turnover). Most of the data come from a 113-item self-administered questionnaire designed to measure NAs' perceptions of their job and work environment. Turnover data were collected from the NA's NH, on average about 16 months later. The two dependent variables were examined in separate analyses with the samples consisting of 246 participants for the absenteeism analysis and 244 for the turnover analysis. Data were analyzed using SPSS 25 and PROCESS 3.3, an SPSS macro add-in. Both ordinary least squares and logistic binary regression were used to examine the associations between variables. The results indicated that participatory management had statistically significant indirect effects on both outcomes. There were two significant mediation results for absenteeism: 1) participatory management increased NA task performance, which, in turn, decreased absenteeism and, 2) participatory management also decreased NA burnout, which, in turn, increased their performance and decreased absenteeism. There were four significant mediation results for turnover: 1) participatory management increased NA attachment to the NH, which, in turn, decreased turnover, 2) participatory management improved NAs' perceptions of their job performance, which, in turn, increased their turnover, 3) participatory management tended to decrease NA burnout, which, in turn, tended to increase attachment to the NH, and, then, tended to decrease turnover, and 4) participatory management tended to decrease NA burnout, which, in turn, tended to increase task performance, and, then, tended to increase turnover. These findings broaden the research on NAs' withdrawal behaviors and demonstrate the need to further explore this hypothesized model.

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Fisher, Lucille T. "The body/work nexus: The work of nursing assistants in nursing homes." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2007. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3261253.

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Jones, Cheryl. "Certified Nursing Assistants' Experiences Regarding Resident-to-Resident Bullying in Nursing Homes." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1541.

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Elder bullying is on the rise and occurs in many contexts such as senior living communities and nursing homes, causing concern for the well-being of the residents by families, staff, themselves, and society in general. Although research has been limited, it does reveal that resident-to-resident bullying in nursing homes is a problem warranting further scholarly attention. The purpose of this study was to investigate the experiences of certified nursing assistants (CNAs) regarding resident-to-resident bullying in nursing homes. The theory of reasoned action and the theory of reflective equilibrium provided a conceptual lens from which to explore and describe the importance of the CNAs' attitudes and behavior when recognizing, observing, and addressing bullying incidences. A phenomenological research design was employed. Using open-ended questions, 10 CNAs were individually interviewed. One major discovery of the study was that 100% of the CNAs interviewed indicated that they experienced resident-to-resident bullying and that it was a major problem in the nursing home. The findings of this study presented many possibilities for positive social change across all levels, from individuals and families to nursing home organizations and society as a whole, but most importantly, it increased awareness about bullying across nursing homes as the ultimate goal was for the improvement on the quality of life experienced by residents in nursing homes.

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Flesner, Marcia K. "Person centered care : a model for nursing homes /." free to MU Campus, others may purchase, 2003. http://wwwlib.umi.com/cr/mo/fullcit?p3091924.

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Renz, Susan Marie, and Susan Marie Renz. "Exploring Nurse to Physician Communication in Nursing Homes." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/626642.

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Background. The well-cited report from the Institute of Medicine stated that nearly 100,000 deaths in acute care are largely due to miscommunication. Residents in nursing homes are transported for acute care three times higher than those under the age of 65. Approximately 25 percent of these hospital transfers are avoidable. The influence of nurse-to-physician communication upon the decision to hospitalize nursing home residents is not well understood. Objective. The purpose of this study is to explore nurse-to-physician communication in the nursing home setting utilizing the Informatics Research Organizing Model (IROM) and Carrington’s Exploring Nurse-to-Nurse Communication Framework. Methods. The methodology use for this study was a qualitative descriptive (QD) design, with in-depth, one-on-one interviews of nurses and physicians with semi-structured open-ended interview questions. Communication between nurses and physicians regarding clinical events experienced by nursing home residents was digitally recorded and transcribed. Data was analyzed using natural language processing (NLP) methodology and conventional content analysis, as a means of intra-methods data triangulation. A purposive convenience sample of nurses and physicians who provide clinical care to nursing home residents at two sites was recruited. In addition to obtaining recorded communications between nurses and physicians pertaining to clinical events, these same study participants were interviewed to determine their perceptions regarding communication of the clinical events. Outcomes. Findings from this study will increase understanding of nurse-to-physician communication and its contribution to avoidable hospitalizations. Results will inform the development of an electronic interface that supports nurse-to-physician communication in the nursing home setting.

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Johnston, Anne E. "The culture change movement in Ohio's nursing homes." Oxford, Ohio : Miami University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=miami1185470927.

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Dubin, Stacie R. Dubin. "Characterization and Perceptions of Noise in Nursing Homes." University of Toledo / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1513362995616053.

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B, K. Anjali. "The Person-centered culture of Ohio nursing homes." Miami University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=miami1525438253602506.

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Myers, Julie Annette. "Discovering Barriers to Quality in Oklahoma Nursing Homes." Thesis, The University of Oklahoma Health Sciences Center, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10287164.

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Background: While the data indicate that Oklahoma’s nursing home care is lower in quality than the national average, there is a gap in the literature as to what staff perceive as barriers to quality care in Oklahoma. Staff perceptions impact organizational outcomes. Examining staff-perceived barriers presents the opportunity to approach improvement from the perspective of those responsible for implementing interventions.

Hypothesis: Nursing home staff in Oklahoma perceive the following as common barriers to delivering high quality care: (i) culture and structure of the organization; (ii) lack of authority and autonomy related to tasks and care delivery; (iii) high job demands related to disease burden; and (iv) limitations of the physical environment. The central question addressed is what do staff perceive as barriers to providing high quality care in Oklahoma nursing homes?

Methods: A written survey and interview guide were used to collect information from 28 nursing home staff from seven nursing homes in Oklahoma. The survey was crafted to test the perceptions of barriers in alignment with the conceptual model. Quantitative methods were used to determine the sample and analyze written survey responses. Qualitative methods were used to code themes from the interviews to elements of the conceptual model to determine if responses aligned with the hypothesis.

Results: Frequently cited barriers to delivering quality care include: social relationships inclusive of meals, care planning, activities, and dedicated staff time with residents; environmental factors inclusive of room size, privacy, layout, and access to outdoors; job demands inclusive of workload, time pressures, cognitive load, and demands from residents and families; performance evaluation, rewards, and incentives inclusive of recognition, appreciation, wage, bonus pay, performance feedback; and, supervisory and management style inclusive of consistency, equity, perceived fairness, and stress.

Conclusion: Real and perceived barriers to high quality care exist. Perceptions vary by staff role, and perceptions can be aligned with organizational structure and strategies through communication, transparency, and a justice-based approach. Along with changes to regulation and rules, improvement efforts must occur at the facility level with support from leadership and engagement of staff.

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Walthour, Renee. "Successful Strategies for Financial Sustainability in Nursing Homes." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4950.

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From 2014 to 2015, deficiency fines cost Pennsylvania nursing homes more than $2.5 million. Costs associated with adhering to increased health care regulations can reduce profit and affect the financial sustainability of the nursing home industry. Some nursing home administrators (NHAs) lack successful strategies to improve state and federal regulation compliance and promote financial sustainability. Drucker's management by objectives theory was the conceptual framework for this study. The purpose of this qualitative multiple case study was to explore successful strategies NHAs use to improve state and federal regulation compliance to mitigate deficiencies and derivative fines to promote financial sustainability of nursing homes. NHAs who manage 5-star rated nursing homes within a 100-mile radius of Pittsburgh, Pennsylvania use effective management strategies to mitigate deficiencies and derivative fines to earn a 5-star rating which, helps promote financial sustainability. Data were collected from semistructured face-to-face and telephone interviews with 4 NHAs and from Medicare's Nursing Home Compare website. The data on the website provided information on the 3 domains of health inspections, staffing, and quality measures, that made up the overall star rating of nursing homes. Data were analyzed using Yin's 5-phase cycle. The findings revealed 3 major themes: develop knowledgeable staff, enhance communication with staff and residents, and promote innovation for continuous quality improvement. The implications for positive social change could include increased quality of patients' health care, creation of employment opportunities to promote prosperity in communities, and financial sustainability in the United States nursing home industry.

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Chami, Kathleen. "Infections in nursing homes : epidemiology, control and preventability." Paris 6, 2011. http://www.theses.fr/2011PA066257.

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Les infections représentent un problème majeur de santé publique dans les institutions gériatriques. En France, dans les Établissements d’Hébergement pour Personnes Âgées Dépendantes (EHPAD), très peu d’études ont exploré le risque infectieux bien que 443 765 personnes âgées soient institutionnalisées dans 6 460 maisons de retraite et EHPAD (d’après extraction de la base ministérielle FINESS des établissements médicaux et médico-sociaux, au 1er janvier 2006). En 2005, missionné par le Ministère délégué aux personnes âgées, une unité de recherche tournée vers une meilleure compréhension et une stratégie offensive vis-à-vis des risques infectieux en gériatrie, l’Observatoire du Risque Infectieux en Gériatrie (ORIG), a réalisé une enquête pilote de prévalence dans le Val de Marne (94): le taux de prévalence des infections est estimée à 14. 5% [Intervalle de confiance à 95% (IC 95%): 13. 0 –16. 0]. A l’issue de ces résultats, un programme de surveillance et de prévention des infections en EHPAD (Programme Priam) a alors été commandé à l’ORIG par le Ministère délégué aux personnes âgées. Ce projet de thèse se base sur ce programme de santé publique. Basé sur le programme Priam, le projet de thèse vise à : Estimer le poids des infections en EHPAD (Enquête nationale Priam). Rédiger des recommandations pour la prévention des infections en EHPAD (CFE Priam). Estimer la part évitable des infections (Étude Enlil)

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Reimer, Nila B. "Things that matter to residents in nursing homes and the nursing care implications." Thesis, Indiana University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3668049.

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A move toward care of residents in nursing homes where they are respected and heard is finally emerging. Common strategies used in nursing homes to improve quality of care for residents are integration of person-centered care and assessing care using satisfaction surveys. Although approaches of integrating person-centered care and satisfaction surveys have been valuable in improving nursing home quality, strategies of care that include things that matter from residents' perspectives while living in nursing homes need investigation. The purpose of this qualitative descriptive study was to describe things that residents age 65 and older state matter to them while living in the long-term care sections of nursing homes. A qualitative mode of inquiry using purposeful sampling led to a natural unfolding of data that revealed things that mattered to residents. Content analysis was used to reduce the data in a manner that kept the data close to the context yet moved the data toward new ideas about including things that mattered to residents in nursing care. The findings revealed residents' positive and negative experiences and addressed the question: How can nurses manage residents' positive and negative aspects of care in nursing homes? This study substantiated the importance of developing nursing care strategies derived from residents' descriptions of care. Finding ways to promote nurses' investment in attitudes about a person-centered care philosophy is essential for successful person-centered care implementation. Enhancing nurses' knowledge, skills, and attitudes with an investment in person-centeredness will be more likely to put nurses in a position to role-model care that is person-centered from residents' perspectives.

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41

Lepore, Michael. "Care workers' motivations for employment in long-term care, assisted living, and particular facilities reconciling inconsistent values /." unrestricted, 2008. http://etd.gsu.edu/theses/available/etd-07102008-085239/.

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Thesis (Ph. D.)--Georgia State University, 2008.
Frank J. Whittington, committee chair; Mary M. Ball, Elisabeth O. Burgess, committee members. Electronic text (285 p. : ill.) : digital, PDF file. Description based on contents viewed Oct. 1, 2008; title from file title page. Includes bibliographical references (p. 213-230).

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Allocca, Hernandez Giacomo Antonio. "Nursing Home." Thesis, Virginia Tech, 2016. http://hdl.handle.net/10919/73662.

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Getting old involves a lot of changes in life. Family and social relations change and mobility can decrease. These variations require new settings, and of course special care. A nursing home is a place dedicated to help with this situation. Sometimes nursing homes can be perceived as mere institutions by society, and even by future residents. Inside, senior citizens are suppose to spend the rest of their lives doing the same activities day after day. How can we improve these days? Architecture can help. This project deals with architectural design of a nursing home located in an open green area in Blacksburg, Virginia. The project's focus is in creating a home that is related to its surroundings and the proximity to nature. Also deals with all the complexity of this kind of program, but tries to create a homely feeling, and an architectural environment that can adapt to the resident's physical and mental condition over time.
Master of Architecture

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Qiu, Xiao Qiu. "Distinctions between High and Low Performing Ohio Nursing Homes." Miami University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=miami1501168798072266.

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Damberg, Jonas. "Availability of primary care physicians in nursing homes and home care nursing services and associations with emergency care consumption." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-61585.

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Stranglen, Linda. "Job satisfaction and organizational commitment of nursing home foodservice workers in West Central Wisconsin." Online version, 2009. http://www.uwstout.edu/lib/thesis/2009/2009stranglenl.pdf.

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Nakagawa, Sage. "Payer source for single, elderly women in nursing homes." Thesis, California State University, Long Beach, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1524144.

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This study seeks to determine the payer source for single, elderly women in nursing homes. By determining the payer source for single, elderly women, the next generation of women can prepare for high nursing home costs by saving earlier or investing in long-term care insurance. Studies have shown the primary payer sources for nursing home costs are Medicare and Medicaid. This study hypothesized single women, when compared to married women, would utilize Medicaid and welfare to pay for nursing home costs. Secondary data from the 2004 National Nursing Home Survey was extracted and analyzed for the aforementioned hypotheses. The analysis determined the primary payer sources for elderly women in nursing homes were self-pay and Medicaid. Marital status did not have an impact on the payer sources for single, elderly women in nursing homes when compared to married women.

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Malmedal, Wenche. "Inadequate Care, Abuse and Neglect in Norwegian Nursing Homes." Doctoral thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for sosialt arbeid og helsevitenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-23721.

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Inadekvat pleie og omsorg, overgrep og forsømmelser i norske sykehjem Beboere på sykehjem er spesielt sårbare og i risiko for å bli utsatt for inadekvat pleie og omsorg, overgrep og forsømmelser. Dette fordi de er mer eller mindre avhengig av hjelp grunnet kroniske sykdommer, særlig gjelder dette beboere med kognitiv svikt og atferdsmessige problemer. Gjentatte rapporter om enkelthendelser indikerer at fenomenet også finnes i norske sykehjem, men det er fortsatt lite kunnskap om i hvor stor grad dette forekommer. En overordnet målsetting med denne avhandlingen var å bidra til økt kunnskap om inadekvat pleie og omsorg, overgrep og forsømmelser i sykehjem. Fra 16 sykehjem har 616 ansatte besvart et spørreskjema. Avhandlingen undersøker utbredelse av ulike typer handlinger rapportert av ansatte, i tillegg til å undersøke mulige faktorer som bidrar til inadekvat pleie og omsorg, overgrep og forsømmelser. Dette arbeidet vil gi kunnskap som kan være nyttig for å utvikle forebyggende strategier og dermed bidra til bedre kvalitet i sykehjem. Avhandlingen består av tre delstudier (Paper I-III), og i tillegg noen resultater som ikke er omhandlet i artiklene. Den første delstudien undersøkte utbredelsen av ulike typer inadekvat pleie, overgrep og forsømmelser som ansatte rapporterte at de hadde begått. Den andre delstudien undersøkte ulike faktorers innvirkning på inadekvat pleie, overgrep og forsømmelser. Den tredje delstudien undersøkte ansattes holdninger til å rapportere hendelser begått av kolleger. I tillegg til resultater presentert i de tre artiklene, ble det bl. a. undersøkt hvordan ansatte forklarte at slike hendelser kunne finne sted, og om de tilla ulik forklaring for de forskjellige typene inadekvat pleie, overgrep og forsømmelser. Studiens hovedfunn er at beboere i sykehjem utsettes for inadekvat pleie og omsorg av både emosjonell og fysisk karakter, samt forsømmelser. Totalt rapporterte 91% at de hadde observert en kollega begå minst en handling, og 87% rapporterte at de selv hadde begått minst en av de handlingene opplistet i spørreskjemaet. Forsømmelser og handlinger av emosjonell karakter var hyppigst rapportert, både som observert og selvutført. Videre ser en at ulike karakteristika ved institusjonen (f.eks. størrelse og beliggenhet), ved ansatte (f.eks. alder og utdanning), og relasjonelle faktorer (f.eks. konflikter) i ulik grad assosieres med de tre typene. Ansatte er stort sett positive til å ville rapportere handlinger begått av kolleger, selv om noen grupper er mer tilbakeholdne, f.eks. de eldste ansatte. Ulike typer inadekvat pleie, overgrep og forsømmelser tillegges ulike forklaringsfaktorer, dette understreker behovet for å undersøke hver av typene separat. Den høye forekomsten av inadekvat pleie og omsorg, overgrep og forsømmelser som er kommet fram i denne studien påpeker behovet for å intervenere. Det er fortsatt mangel på oppmerksomhet rundt dette i mange land, også i Norge. En forutsetning for endring er å erkjenne at problemet finnes, deretter må det følges opp med handling. Et viktig element i god praksis er å være i stand til å oppdage inadekvat pleie og omsorg, overgrep og forsømmelser og også å forstå hvilke alvorlige konsekvenser slike handlinger kan ha for beboerne. Denne avhandlingen har bidratt til økt kunnskap om inadekvat pleie, overgrep og forsømmelser i sykehjem, men det gjenstår fortsatt mye å undersøke.
Inadequate Care, Abuse and Neglect in Norwegian Nursing Homes Residents in nursing homes are particularly vulnerable and at risk of inadequate care, abuse and neglect because they are more or less dependent on their caregivers owing to chronic illnesses, especially those with cognitive and behavioural problems. Repeatedly reported single acts of inadequate care indicate that the phenomenon also occurs in Norwegian nursing homes, but there is a lack of knowledge about the extent to which it occurs. The overall purpose of this thesis was to contribute to increase knowledge of inadequate care, abuse and neglect in nursing homes by exploring the frequencies and types reported by staff, investigating factors seen as predictors of inadequate care, abuse and neglect, as well as how staff attributed inadequate care. Data in the thesis were obtained from a cross-sectional survey conducted in one county in the middle of Norway including nursing staff (n=616) from 16 nursing homes. The thesis consists of three studies, as well as some additional results. The first study (Paper I) investigated the frequency and types of inadequate care committed by staff in nursing homes. The second study (Paper II) investigated 11 factors that were hypothesized to be associated with inadequate care of emotional, negligent, and physical character committed by staff in nursing homes. The third study (Paper III) aimed to describe attitudes held by nursing home staff on reporting negative/ unwanted acts committed by their colleagues. Additionally (included in the thesis, but not published), perceived reasons for inadequate care, abuse and neglect and whether there are different reasons for the specific types of inadequate care were investigated. Main findings are that residents in Norwegian nursing homes are exposed to different types of inadequate care, abuse and neglect. All in all, 91% of the nursing staff reported they had observed a colleague commit at least one act of inadequate care and 87% reported that they themselves had committed at least one act of inadequate care. Acts of negligent and emotional character were most frequently reported, both as observed and committed. The types of inadequate care were associated with various institutional characteristics (e.g. size and location), staff (e.g. age and education), and relational characteristics (e.g. conflicts and aggression), but not to the same extent. Further, positive attitudes towards reporting acts of inadequate care committed by their colleagues were found, but also that some groups were more reluctant to report, e.g. the eldest groups of staff. Staff attributed the different types of inadequate care for different reasons, a result that emphasizes the need for further investigation. The high prevalence of inadequate care, abuse and neglect in this thesis underlines the need to intervene. There is still a lack of awareness of inadequate care, abuse and neglect in institutions for older persons in many countries, and recognition of the phenomena is the first step to a change, but it needs to be followed up by actions. An important element in nursing practice is to be able to recognize the occurrence of and understand the potential severe consequences of inadequate care, abuse and neglect particularly for frail, older persons. This thesis has contributed to extend the knowledge base regarding inadequate care, abuse and neglect in nursing homes, yet there is much more to be revealed and investigated.

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48

Bostwick, Paula Manuel. "Job satisfaction of registered nurses employed in nursing homes." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1020154.

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The nursing home industry has low registered nurse retention rates. Low retention rates can be related to job satisfaction. The nursing home industry needs qualified registered nurses (RNs) who are satisfied with all aspects of their jobs. The purpose of this study was to examine factors affecting job satisfaction of RNs currently employed in nursing homes using Herzberg's (1968) Dual Factor Theory.Herzberg (1968) has identified internal factors that motivate employees on the job. If intrinsic factors are met, the employee is satisfied. Extrinsic factors, if present, will not satisfy the employee, but will prevent dissatisfaction (Herzberg, 1968). The Minnesota Satisfaction Questionnaire - Short Form, was used to determine the intrinsic, extrinsic and general satisfaction scores of 48 (480) RNs currently employed in ten nursing homes from the midwest. Confidentiality and anonymity of the subjects were maintained as questionnaires contained no identifying information.Findings supported previous studies on job satisfaction of RNs employed in nursing homes. Participants did not identify intrinsic factors as being fully satisfactory, but responses were closer to satisfied than dissatisfied. Extrinsic factors were not sources of dissatisfaction, but responses were closer to dissatisfied than satisfied. General satisfaction scores determined respondents were not fully satisfied, but were closer to neutral scores. Responses were closer to being satisfied than not. Conclusions were that extrinsic and intrinsic factors influence job satisfaction.Implications call for examination of factors effecting job satisfaction. Managers should increase job security, social services, activites, independence and variety. Human relations, company policies and technical supervision should be open to input from staff as to how the extrinsic motivational factors can be improved. Recommendations include replication of this study with a large sample size; assuring nurses under 40 years of age participate in further studies and the need for nursing home administrators to address intrinsic and extrinsic factors that affect job satisfaction.
School of Nursing

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Lu, Wei. "Economic determinants of quality of care in nursing homes." Thesis, Wayne State University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3626093.

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This dissertation examines the factors that will affect nursing home quality of care using several national data sources on market regulation, county demographic characteristics, market structural and the characteristics of different types of long-term care providers in 2010.

The first study examines how nine different measures of nursing home care quality respond to the greater levels of local market competition from these alternative providers of long-term care, as well as other nursing homes. Findings reveal that faced with greater competition from assisted living facilities, nursing homes are left to care for more disabled, less healthy patients. Although the nursing home's staff-to-bed ratios rise in response, other measures of care quality decline, such as more process- and outcome-based measures. Competition from home health agencies likewise has mixed effects on nursing home care quality, and competition from other nursing homes in a market tends to decrease care quality. These finding suggest that care quality in nursing homes may continue to erode as the market for alternative, community-based long-term care services expands.

The second study examines the Medicare regulation effects on nursing home quality controlling for the whole long-term care market competition structure. In many local markets nursing homes now compete with assisted living facilities for residents, yet most previous studies of the effects of Medicaid nursing home reimbursement policies on care quality have analyzed nursing homes in isolation, ignoring the presence of nearby competitor firms, and how state regulation of assisted living facilities might also affect care quality in nursing homes. This study uses a richer model specification that accounts for a much broader range of state long-term care regulations as well as the structure of a nursing home's local market. Findings reveal that a higher Medicaid reimbursement rate leads to significant improvements in nine different aspects of nursing home quality, while state certificate-of-need programs for nursing homes lead to a decline in several (but not all) dimensions of it. A large presence of assisted living beds in a local market also tends to reduce nursing home quality, and state regulations regarding assisted living facilities indirectly affect nursing home care quality by altering the nature of local market competition. Overall, these results suggest that state laws related to all long-term care providers, not just nursing homes, are important determinants of nursing home care quality.

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Buiyan, Salmah, and Nongfei Sheng. "Experience of Oral Care among Elderly in Nursing Homes." Thesis, Umeå universitet, Tandläkarutbildning, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-97910.

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Life expectancy among the elderly has been improving for decades and edentulousness is constantly decreasing among the senior citizens. The steady decrease of tooth loss among the elderly is a challenge to the dental profession due to the increased demand of oral care. This study aims to explore the perspectives regarding oral health and oral care among the elderly living in nursing homes. Ten subjects from two nursing homes in Umeå were interviewed based on a defined interview guide. The interview guide contained open-ended questions regarding oral health and oral care. The subjects were interviewed, all the interviews were recorded and transcribed verbatim. Categories, subcategories and codes were created using qualitative content analysis. Two categories and six subcategories were established based on qualitative content analysis. The two categories revealed opposing attitudes, the first promoted oral care and the second disfavored oral health. The oral care promoted factors included general satisfaction with the elderly’s’ present oral status, positive experiences associated with oral care and strong desire to maintain their own oral hygiene. The most notable negative factors for good oral health was the lack of thorough oral examinations and individually adapted assistance with daily oral hygiene. The informants took oral hygiene as a part of their integrity and expressed wishes to be independent. In general, the informants held positive attitudes toward their current oral status and understood that proper oral care is a prerequisite to good oral health. However, it should be noted that assistance with oral hygiene is not practiced in either of the two nursing homes on a regular basis. This may be attributed to staff shortages and the residents desire to maintain their independence.

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Dissertations / Theses on the topic 'Nursing homes'

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