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Egede-Nissen, Veslemøy, Rita Jakobsen, Gerd S. Sellevold et Venke Sørlie. « Time ethics for persons with dementia in care homes ». Nursing Ethics 20, no 1 (22 août 2012) : 51–60. http://dx.doi.org/10.1177/0969733012448968.
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The purpose of this study was to explore situations experienced by 12 health-care providers working in two nursing homes. Individual interviews, using a narrative approach, were conducted. A phenomenological–hermeneutical method, developed for researching life experiences, was applied in the analysis. The findings showed that good care situations are experienced when the time culture is flexible, the carers act in a sovereign time rhythm, not mentioning clock time or time as a stress factor. The results are discussed in terms of anthropological and sociological theory: time as event and action and flexible time cultures. Care settings for persons with dementia represent many challenges, such as a heavy workload and time strain. Time ethics is a construction, understanding time used in caring for persons suffering from dementia, which involves a mature, responsible and flexible nursing approach to these patients.
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Dania, Ira Aini. « PSYCHIATRIC ASPECTS OF LONG ». JURNAL KESEHATAN MASYARAKAT & ; GIZI (JKG) 1, no 2 (29 avril 2019) : 27–37. http://dx.doi.org/10.35451/jkg.v1i2.128.
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The emergence of nursing homes in the Middle Ages has introduced health programs specifically health care which occupy the largest proportion of nursing homes services. Nursing homes provide services, medical care, for injury problems, disability in sick patients and need services and medical care and rehabilitation. Many nursing providers provide good care, but in many other countries it guarantees nursing homes to individuals who are cared for but they are very inadequate, sometimes very surprising, the services provided actually accelerate their physical, mental, and emotional health deterioration. They often get rights violations and are even subject to physical abuse. This article discusses matters relating to history and psychiatric services for those who have become nursing home residents since 1990.
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Ouslander, Joseph G., et John F. Schnelle. « Research in Nursing Homes : Practical Aspects ». Journal of the American Geriatrics Society 41, no 2 (février 1993) : 182–87. http://dx.doi.org/10.1111/j.1532-5415.1993.tb02055.x.
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Leskovic, Ljiljana, Goran Vukovič, Robert Leskovar et Jana Goriup. « Some Aspects of Burnout in Nursing Homes ». Acta Technologica Dubnicae 6, no 2 (1 août 2016) : 47–62. http://dx.doi.org/10.1515/atd-2016-0011.
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Abstract Nursing personnel in nursing homes for elderly citizens are exposed to a number of factors that contribute to possible burnout syndrome. For this reason, the set objective of the research was to measure the degree of burnout, check the correlation between the burnout syndrome and satisfaction at work, and psychosomatic symptoms, as well as to figure out the main characteristics of burnout syndrome among the nursing personnel in nursing homes for the elderly in Slovenia.
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Gjerberg, Elisabeth, Lillian Lillemoen, Reidar Pedersen et Reidun Førde. « Coercion in nursing homes ». Nursing Ethics 23, no 3 (6 janvier 2015) : 253–64. http://dx.doi.org/10.1177/0969733014564907.
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Background: Studies have demonstrated the extensive use of coercion in Norwegian nursing homes, which represents ethical, professional as well as legal challenges to the staff. We have, however, limited knowledge of the experiences and views of nursing home patients and their relatives. Objectives: The aim of this study is to explore the perspectives of nursing home patients and next of kin on the use of coercion; are there situations where the use of coercion can be defended, and if so, under which circumstances? Methods: The data are based on individual interviews with 35 patients living in six nursing homes and seven focus group interviews with 60 relatives. Ethical considerations: Participation was based on written informed consent, and the study was approved by the Regional Committees for Medical and Health Research Ethics. Results: More than half of the patients and the majority of the relatives accepted the use of coercion, trusting the staff to act in the patient’s best interest. However, the acceptance of coercion is strongly related to the patients’ lack of understanding, to prevent health risks and to preserve the patient’s dignity. Conclusion: The majority of nursing home patients and relatives accepted the use of coercion in specific situations, while at the same time they emphasised the need to try alternative strategies first. There is still a need for good qualitative research on the use of coercion in nursing homes, especially with a closer focus on the perspectives and experiences of nursing home patients.
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Gastmans, Chris. « Sexual expression in nursing homes ». Nursing Ethics 21, no 5 (14 juillet 2014) : 505–6. http://dx.doi.org/10.1177/0969733014531530.
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Maneschiöld, Per-Ola, et Diana Lucaci-Maneschiöld. « Nursing assistant's perceptions of the good work environment in municipal elderly care in Sweden –a focus group study ». Journal of Health Organization and Management 35, no 9 (29 avril 2021) : 163–77. http://dx.doi.org/10.1108/jhom-07-2020-0290.
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PurposeThe purpose of this paper is to investigate aspects related to difficulty to retain nursing assistants at nursing homes in Sweden related to perceived work environment characteristics.Design/methodology/approachTo reveal aspects related to difficulty to retain nursing assistants, the paper uses the BIKVA model, sense of coherence and New Public Management (NPM). In total, three focus groups with nursing assistants at three nursing homes are interviewed with corresponding individual interviews with their senior managers and users. The purpose is to analyze the situation from the affected group of nursing assistants. The focus of this study is how nursing assistants discuss related to recruit and retain nursing assistants at nursing homes and elderly care and the response from senior management related to those aspects.FindingsThe main conclusions are that nursing assistants consider their job as meaningful, but limited latitude and direct involvement in managing their daily tasks in a continuous communication with management affect negatively. Furthermore and combined with wage levels, aspects related to scheduling, working hours, shift work, split shifts and understaffing generate a burdensome and stressful environment affecting the possibility to retain staff in a negative direction.Originality/valueThe research uses a new approach utilizing the BIKVA model, sense of coherence and NPM. The study shows that central in retaining nursing assistants at nursing homes relates to aspects such as wages, staffing, shift work and split shifts and continuous communication between nursing assistants and management.
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Vilaplana-Prieto, Cristina, Carmelo S. Gómez Martínez, Paloma Echevarría Pérez et Isabel Legaz. « Sociosanitary Legal and Economic Aspects in Nursing Homes for the Elderly in Spain ». International Journal of Environmental Research and Public Health 20, no 6 (10 mars 2023) : 4928. http://dx.doi.org/10.3390/ijerph20064928.
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Aim: The study aimed to identify and compare aspects of the different Spanish regulations on the minimum conditions that nursing homes must meet and to compare whether these requirements significantly affect the price of a nursing home place in each region. Methods: We analyzed and compared the 17 regional regulations that must be met by nursing homes in terms of equipment and social and healthcare staff and combined this information with regional information concerning the price and coverage of public and subsidized places in nursing homes. Results: The study revealed significant regional inequality in physical facilities and human resources. However, the number of regulatory measures referring to the mandatory availability of physical space or specific material resources was not positively correlated with an increase in the price of a place in a public or subsidized nursing home. Conclusions: No unified regulations throughout Spain regulate the aspects that residential centers must comply with. There is a need to move towards a person-centered approach, providing an environment as close to home as possible. The regulation of minimum standards to be met by all nursing homes at the national level should not significantly impact prices.
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Hedman, Maria, Elisabeth Häggström, Anna-Greta Mamhidir et Ulrika Pöder. « Caring in nursing homes to promote autonomy and participation ». Nursing Ethics 26, no 1 (20 avril 2017) : 280–92. http://dx.doi.org/10.1177/0969733017703698.
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Background: Autonomy and participation are threatened within the group of older people living in nursing homes. Evidence suggests that healthcare personnel act on behalf of older people but are still excluding them from decision-making in everyday care. Objective: The purpose was to describe registered nurses’ experience of caring for older people in nursing homes to promote autonomy and participation. Research design: A descriptive design with a phenomenological approach was used. Data were collected by semi-structured individual interviews. Analysis was inspired by Giorgi’s method. Participants and research context: A total of 13 registered nurses from 10 nursing homes participated. Ethical considerations: Ethical approval was obtained from the Regional Research Ethics Committee. Informed consent was achieved and confidentiality guaranteed. Findings: The essence of caring for older people in nursing homes to promote autonomy and participation consisted of registered nurses’ awareness of older people’s frailty and the impact of illness to support health and well-being, and awareness of acknowledgement in everyday life and trusting relationships. Paying attention to older people by being open to the persons’ wishes were aspects that relied on registered nurses’ trusting relationships with older people, their relatives and surrounding healthcare personnel. The awareness reflected challenges in caring to promote older people’s right to autonomy and participation in nursing homes. Registered nurses’ strategies, hopes for and/or concerns about development of everyday life in nursing homes were revealed and mirrored their engagement in caring for older people. Discussion and conclusion: Awareness of older people’s frailty in nursing homes and the importance of maintained health and well-being were described as the main source for promoting autonomy and participation. Everyday life and care in nursing homes needs to be addressed from both older people’s and healthcare personnel’s perspectives, to promote autonomy and participation for residents in nursing homes.
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Lemos, Rute, Alexandra Lopes, Isabel Dias et Henrique Barros. « Portuguese Older Persons’ Views about Living in a Nursing Home : Challenges to the Rehabilitation of the Image of LTC in Post-Pandemic Times ». International Journal of Environmental Research and Public Health 19, no 17 (24 août 2022) : 10566. http://dx.doi.org/10.3390/ijerph191710566.
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This paper addresses the broad topic of what older people think about nursing homes in Portugal. In the aftermath of the COVID-19 pandemic and considering the tragic events taking place in nursing homes, the challenge of reimagining the sector involves not only improving procedures and models of care, making sure they meet what citizens consider adequate, but also rehabilitating the image people have about nursing homes and rebuilding trust. Current and future decisions about how one meets LTC needs is influenced by the extent to which individuals see the alternatives as adequate. The paper presents evidence collected from a qualitative study run just before the COVID-19 pandemic began, with a sample of 45 community-dwelling individuals aged 60 plus, in Portugal. Opinions and views about nursing homes were collected and the results point to enduring negative aspects that are considered at odds with what constitutes adequate care. The paper discusses in length what those aspects are and concludes that future reforms of the nursing homes sector in Portugal need to consider what current and future users think and feel about that specific type of service. Debates in Portugal tend to be more focused on discussions about expanding the sector and less on aspects of quality of care. Views and opinions of interviewed participants, however, suggest that people may be more worried about quality of care.
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Bollig, Georg, Eva Gjengedal et Jan Henrik Rosland. « Nothing to complain about ? Residents’ and relatives’ views on a “good life” and ethical challenges in nursing homes ». Nursing Ethics 23, no 2 (8 décembre 2014) : 142–53. http://dx.doi.org/10.1177/0969733014557719.
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Background: Nursing home residents are a vulnerable population. Most of them suffer from multi-morbidity, while many have cognitive impairment or dementia and need care around the clock. Several ethical challenges in nursing homes have been described in the scientific literature. Most studies have used staff members as informants, some have focused on the relatives’ view, but substantial knowledge about the residents’ perspective is lacking. Objective: To study what nursing home residents and their relatives perceive as ethical challenges in Norwegian nursing homes. Research design: A qualitative design with in-depth interviews with nursing home residents, and focus-group interviews with relatives of nursing home residents. The digitally recorded interviews were transcribed verbatim. Analysis was based on Interpretive Description. Participants and research context: A total of 25 nursing home residents from nine nursing homes in Norway, and 18 relatives of nursing home residents from three of these nursing homes. Ethical considerations: This study was reported to and approved by the Regional Ethics Committee in Oslo, Norway. Findings and discussion: The main ethical challenges in Norwegian nursing homes from the residents’ and relatives’ perspective were as follows: (a) acceptance and adaptation, (b) well-being and a good life, (c) autonomy and self-determination, and (d) lack of resources. The relationship with the staff was of outmost importance and was experienced as both rewarding and problematic. None of the residents in our study mentioned ethical challenges connected to end-of-life care. Conclusion: Residents and relatives experience ethical challenges in Norwegian nursing homes, mostly connected to “everyday ethical issues.”
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Holmgren, Jessica. « A Visual Analysis on How the Physical Environment Conditions Relatives’ Involvement in Nursing Homes ». SAGE Open 7, no 4 (octobre 2017) : 215824401774039. http://dx.doi.org/10.1177/2158244017740398.
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This study seeks to describe how the composition of the physical care environment conditions relatives’ involvement in nursing home institutions. It is well known that the physical care environment in institutions has a significant impact on the well-being of residents and the work satisfaction of nursing staff. Less explored is how physical care environmental factors are related to the involvement of relatives in nursing homes. A visual analysis of 52 photographs from three nursing homes in Sweden shows how the physical environment acts to condition the involvement of relatives through the use of design, information displays, and cultural symbols. Although various aspects of the physical environment promoted participation of relatives, that engagement was based on certain limited concepts of involvement. This suggests that other conceptual frameworks of involvement in nursing homes are possible, and that these might encourage other aspects of involvement from the relatives of nursing home residents.
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Solum, Eva Merethe, Åshild Slettebø et Solveig Hauge. « Prevention of Unethical Actions in Nursing Homes ». Nursing Ethics 15, no 4 (juillet 2008) : 536–48. http://dx.doi.org/10.1177/0969733008090524.
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Ethical problems regularly arise during daily care in nursing homes. These include violation of patients' right to autonomy and to be treated with respect. The aim of this study was to investigate how caregivers emphasize daily dialogue and mutual reflection to reach moral alternatives in daily care. The data were collected by participant observation and interviews with seven caregivers in a Norwegian nursing home. A number of ethical problems linked to 10 patients were disclosed. Moral problems were revealed as the caregivers acted in ways that they knew were against patients' interest. We used a theoretical interpretation according to Habermas' discourse ethics on the importance of dialogue when deciding moral courses of action for patients. This theory has four basic requirements: communicative competence, equality, self-determination, and openness about motives.
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Morey, Jim, Ken Wallis, Hoseoup Lee, Gary Scherzer et Robert Orilio. « Case Study : A Comparative Analysis Of Financial And Quality Indicators Of Nursing Homes That Have Closed And Nursing Homes That Have Remained Open ». Journal of Business Case Studies (JBCS) 4, no 11 (5 juillet 2011) : 27. http://dx.doi.org/10.19030/jbcs.v4i11.4819.
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Eight New York nursing homes, 4 open and 4 closed, were chosen at random for analysis. They were examined to determine if a relationship between age of assets, fiscal viability and quality of care existed. Three years of data for each nursing home was selected Several financial variables were used to construct a fiscal viability index; and a patient care index was created from selected measures that are used to measure specific aspects of institutional care. The premise was that the constructed indices will demonstrate a significant difference between closed nursing homes and homes remaining open. The analysis found that fiscal viability index could be a significant factor to differentiate the two groups of nursing homes, but the quality index showed no significant difference between the two groups.
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Ochi, Sae, Michio Murakami, Toshihiko Hasegawa et Yoshinori Komagata. « Prevention and Control of COVID-19 in Imperfect Condition : Practical Guidelines for Nursing Homes by Japan Environment and Health Safety Organization (JEHSO) ». International Journal of Environmental Research and Public Health 18, no 19 (28 septembre 2021) : 10188. http://dx.doi.org/10.3390/ijerph181910188.
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Infection control at nursing homes is a top priority to address the COVID-19 pandemic because people who are the most vulnerable to the pathogen live in close contact. Currently, control measures specifically for nursing homes often ignore under-resourced condition of the facilities. To make guidelines assuming realistic conditions, an expert meeting with 16 members established the key challenges in nursing homes, the basics of infection control, and the major transmission routes. A list of existing guidance was compiled and each item in the list was peer-reviewed by eight experts considering three aspects: significance, scientific validity, and feasibility. Factors related to the nursing home environment, the nature of SARS-CoV-2 transmission, and patient characteristics were identified as the causes of difficulties in infection control at nursing homes. To develop realistic prevention measures in under-resourced condition such as nursing homes, we may need to accept there are no perfect control measures that can achieve zero risk. Instead, the guidelines are based on the concept of deep defense, and practical checklists with 75 items were established. The evaluation of nursing homes by independent organizations using the checklists would be helpful to achieve sustainable infection control.
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Muldrew (née Preshaw), Deborah HL, Dorry McLaughlin et Kevin Brazil. « Ethical issues experienced during palliative care provision in nursing homes ». Nursing Ethics 26, no 6 (26 juin 2018) : 1848–60. http://dx.doi.org/10.1177/0969733018779218.
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Background: Palliative care is acknowledged as an appropriate approach to support older people in nursing homes. Ethical issues arise from many aspects of palliative care provision in nursing homes; however, they have not been investigated in this context. Aim: To explore the ethical issues associated with palliative care in nursing homes in the United Kingdom. Design: Exploratory, sequential, mixed-methods design. Methods: Semi-structured interviews with 13 registered nurses and 10 healthcare assistants (HCAs) working in 13 nursing homes in the United Kingdom were used to explore ethical issues in palliative care. The ‘Ethical Issues in Palliative Care for Nursing Homes’ instrument was used to measure the frequency and level of distress arising from ethical issues through a cross-sectional survey with 69 registered nurses and 129 healthcare assistants. Data collection occurred between December 2014 and November 2015. Ethical considerations: Ethical approval was granted by Queen’s University’s School of Nursing and Midwifery Research Ethics Committee and governance sought from each nursing home’s manager. Findings: The interviews revealed three themes: ethical issues in practice; relational issues; and organisational issues. No significant differences between registered nurses and healthcare assistants were evident, confirming the patterns emerging from the interviews. Relational issues, primarily issues with residents and families, occurred most frequently and caused greater distress. Conclusion: The shared environment is key in the experience of ethical issues; therefore, multidisciplinary education is needed for ethical decision making in palliative care. Addressing staff knowledge and service organisation may reduce ethical issues locally and provide a benchmark for global change.
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Slettebø, Åshild, et Eli Haugen Bunch. « Solving Ethically Difficult Care Situations in Nursing Homes ». Nursing Ethics 11, no 6 (novembre 2004) : 543–52. http://dx.doi.org/10.1191/0969733004ne737oa.
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Patients in nursing homes sometimes give accounts of episodes in which they feel their autonomy and/or self-respect are violated as a result of the care they receive from nursing staff. In these ethically difficult care situations nurses use strategies such as negotiation, explanation and, in some cases, restraint. This study investigates how nurses apply these strategies to resolve ethical dilemmas in such a way that patients experience respect rather than violation. Critical issues that will be discussed include the definition of ethically difficult care situations in nursing homes and the identification of strategies for resolving such situations. Examples of the use of three strategies are presented. The use of negotiation, restraint and explanation are discussed in order to ensure respect for patients’ autonomy and thus to optimize health care outcomes.
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Berendonk, Charlotte, et Vera Caine. « Life story work with persons with dementia in nursing homes : A Grounded Theory study of the perspectives of care staff ». Dementia 18, no 1 (15 septembre 2016) : 282–302. http://dx.doi.org/10.1177/1471301216669236.
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In Germany, the use of life story work as an approach to care in nursing homes has not been implemented successfully. Using Grounded Theory, we explored care staff’s understandings of life story work when caring for persons with dementia. Thirty-six staff from seven nursing homes participated in semi-structured interviews or group discussions. In this paper we discuss new aspects and theoretical connections between understandings and practices of life story work. For some participants, obtaining ‘true facts’ about a resident’s course of life was considered the most important topic. Others highlighted the importance of narratives as well as embodied stories told by persons with dementia, as aspects that generated emotionally meaningful situations. Delivering sound life story work can be challenging for care staff working with persons with dementia. To enhance care in nursing homes, the importance of life story work needs to be further developed.
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Corazzini, Kirsten N., Ruth A. Anderson, Eleanor S. McConnell, Christine Mueller, Lisa Day et Kristie Porter. « Perceptions of Nursing Practice Scale Pilot Study : Directors of Nursing in Nursing Homes ». Journal of Nursing Regulation 4, no 3 (octobre 2013) : 4–10. http://dx.doi.org/10.1016/s2155-8256(15)30123-x.
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Harrington, Charlene, Leslie Ross, Susan Chapman, Elizabeth Halifax, Bruce Spurlock et Debra Bakerjian. « Nurse Staffing and Coronavirus Infections in California Nursing Homes ». Policy, Politics, & ; Nursing Practice 21, no 3 (7 juillet 2020) : 174–86. http://dx.doi.org/10.1177/1527154420938707.
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In the United States, 1.4 million nursing home residents have been severely impacted by the COVID-19 pandemic with at least 25,923 resident and 449 staff deaths reported from the virus by June 1, 2020. The majority of residents have chronic illnesses and conditions and are vulnerable to infections and many share rooms and have congregate meals. There was evidence of inadequate registered nurse (RN) staffing levels and infection control procedures in many nursing homes prior to the outbreak of the virus. The aim of this study was to examine the relationship of nurse staffing in California nursing homes and compare homes with and without COVID-19 residents. Study data were from both the California and Los Angeles Departments of Public Health and as well as news organizations on nursing homes reporting COVID-19 infections between March and May 4, 2020. Results indicate that nursing homes with total RN staffing levels under the recommended minimum standard (0.75 hours per resident day) had a two times greater probability of having COVID-19 resident infections. Nursing homes with lower Medicare five-star ratings on total nurse and RN staffing levels (adjusted for acuity), higher total health deficiencies, and more beds had a higher probability of having COVID-19 residents. Nursing homes with low RN and total staffing levels appear to leave residents vulnerable to COVID-19 infections. Establishing minimum staffing standards at the federal and state levels could prevent this in the future.
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Fadayevatan, Reza, Majid Rahimi et Heidarali Abedi. « Care Process in Iranian Nursing Homes : A Grounded Theory Study ». Journal of Caring Sciences 10, no 3 (23 août 2021) : 160–68. http://dx.doi.org/10.34172/jcs.2021.024.
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Introduction: The need and use of long-term care services for older people has increased with their rising population and there is little information about the state of serving in nursing homes. This study aimed to identify the caring process in Iranian nursing homes. Methods: This qualitative study was conducted in three Iranian nursing homes using grounded theory approach. The participants included 28 individuals (14 older people and 14 caregivers). The data were collected using unstructured interviews up to data saturation, and analyzed by constant comparative method. Results: Fragmented care emerged as the core variable. The main factor for developing the core variable was ‘experience-based caring’. Other factors included ‘inappropriate structure for care’ as contextual factors in the nursing homes environment and ‘keeping instead of caring’, ‘dismal life’, and ‘up and down of the path’ as strategies and consequences. Conclusions: The most common type of care was the routine and unplanned one with focusing on physical aspects. To improve a delivery care system for older people in nursing homes, proposing a care plan with focus on an integrated model of care in nursing homes, provision of instructions for treatment, as well as supervision and training caregivers to provide better care are necessary
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Bergland, Ådel, et Marit Kirkevold. « Thriving in nursing homes in Norway : Contributing aspects described by residents ». International Journal of Nursing Studies 43, no 6 (août 2006) : 681–91. http://dx.doi.org/10.1016/j.ijnurstu.2005.09.006.
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Morey, Jim, Hoseoup Lee et Ken Wallis. « Impact Of Asset Age/Fiscal Viability On Selected Measures Of Patient Care In Nursing Homes ». Journal of Business Case Studies (JBCS) 3, no 2 (1 avril 2007) : 11–16. http://dx.doi.org/10.19030/jbcs.v3i2.4838.
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Forty-five New York nursing homes were examined to determine if a relationship between age of assets, fiscal viability and quality of nursing homes, as measured by patient care indices and survey deficiencies, existed. These factors were examined on 2004 data for the nursing homes selected. Several financial variables were used to construct a fiscal viability index; and a patient care index was created from selected procedural measures that may be used to measure specific aspects of institutional care. The premise is that age of assets and fiscal viability will influence quality of patient care/survey deficiencies. Utilizing both the financial and patient care and survey indices, the following statistical models were prepared:
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Longo, Beth A., Stacey C. Barrett, Stephen P. Schmaltz et Scott C. Williams. « A Multistate Comparison Study of COVID-19 Cases Among Accredited and Nonaccredited Nursing Homes ». Policy, Politics, & ; Nursing Practice 23, no 1 (7 décembre 2021) : 26–31. http://dx.doi.org/10.1177/15271544211063828.
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Widely acknowledged is the disproportionate number of COVID-19 cases among nursing home residents. This observational study examined the relationship between accreditation status and COVID-19 case rates in states where the numbers and proportions of Joint Commission accredited facilities made such comparisons possible (Illinois (IL), Florida (FL), and Massachusetts (MA)). COVID-19 data were accessed from the Centers for Medicare & Medicaid Services (CMS) Nursing Home Compare Public Use File, which included retrospective COVID-19 data submitted by nursing homes to the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network. The outcome variable was the total number of nursing home-identified COVID-19 cases from June 2020 to January 2021. Joint Commission accreditation status was the independent variable. Mediating factors included state, and county-level case rates. Increases in the county rate had a significant association with higher nursing home COVID-19 case rates ( p < .001). After adjusting for county case rates, no differences were observed in the mean group case rates for accredited and nonaccredited nursing homes. However, comparing predicted case rates to actual case rates revealed that accredited nursing homes were more closely aligned with their predicted rates. Performance of the nonaccredited nursing homes was more variable and had proportionally more outliers compared to accredited nursing homes. Community prevalence of COVID-19 is the strongest predictor of nursing home cases. While accreditation status did not have an impact on overall mean group performance, nonaccredited nursing homes had greater variation in performance and a higher proportion of negative outliers. Accreditation was associated with more consistent performance during the COVID-19 pandemic, despite being located in counties with a higher prevalence of COVID-19.
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Perez Benavides, Jason J. « Read It Three Times, Then Read It Again : How Nursing Homes Use “Responsible Party” Clauses in Admission Agreements to Charge Relatives for Their Loved Ones’ Care ». American Journal of Law & ; Medicine 49, no 4 (décembre 2023) : 511–24. http://dx.doi.org/10.1017/amj.2024.6.
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AbstractThis Note explores an alarming, decades-old trend that has received renewed attention from enforcement agencies and the media: nursing homes suing family members and friends ("relatives") for residents’ unpaid bills. As justification, nursing homes point to “responsible party” clauses within admission agreements signed by relatives during the admission process. Undeterred by the 1987 Federal Nursing Home Reform Act’s (FNHRA) prohibition on requiring relatives to act as financial guarantors in exchange for residents’ admission, nursing homes use carefully worded “responsible party” clauses to obtain virtually the same result: relatives’ total liability for residents’ unpaid balances. Relatives are frequently caught off-guard by these lawsuits; many who sign admission agreements do so without a proper understanding of the potential liability they are assuming and have limited (if any) access to residents’ assets. This problem is aggravated by several aspects of the admission process that disadvantage relatives, such as the stressful and emotional nature of admission, the complicated language in admission agreements, and the inadequate—at times, misleading—guidance provided by nursing homes. This Note examines the tension between the FNHRA’s financial protections for relatives and nursing homes’ admission practices and use of “responsible party” clauses. Furthermore, this Note proposes solutions aimed at better informing relatives of the legal risks associated with “responsible party” clauses.
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Häggström, Elisabeth, et Annica Kihlgren. « Experiences of Caregivers and Relatives in Public Nursing Homes ». Nursing Ethics 14, no 5 (septembre 2007) : 691–701. http://dx.doi.org/10.1177/0969733007077890.
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The aim of the present study was, by means of discussion highlighting ethical questions and moral reasonings, to increase understanding of the situations of caregivers and relatives of older persons living in a public nursing home in Sweden. The findings show that these circumstances can be better understood by considering two different perspectives: an individual perspective, which focuses on the direct contact that occurs among older people, caregivers and relatives; and a societal perspective, which focuses on the norms, values, rules and laws that govern a society. Relatives and caregivers thought that the politicians were sending out mixed messages: they were praising caregivers and relatives for their efforts, but at the same time the public health care sector was subjected to significant cutbacks in resources. Both caregivers and relatives were dissatisfied and frustrated with the present situation regarding the care of older persons in public nursing homes.
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Gjerberg, Elisabeth, Marit Helene Hem, Reidun Førde et Reidar Pedersen. « How to avoid and prevent coercion in nursing homes ». Nursing Ethics 20, no 6 (26 février 2013) : 632–44. http://dx.doi.org/10.1177/0969733012473012.
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In many Western countries, studies have demonstrated extensive use of coercion in nursing homes, especially towards patients suffering from dementia. This article examines what kinds of strategies or alternative interventions nursing staff in Norway used when patients resist care and treatment and what conditions the staff considered as necessary to succeed in avoiding the use of coercion. The data are based on interdisciplinary focus group interviews with nursing home staff. The study revealed that the nursing home staff usually spent a lot of time trying a wide range of approaches to avoid the use of coercion. The most common strategies were deflecting and persuasive strategies, limiting choices by conscious use of language, different kinds of flexibility and one-to-one care. According to the staff, their opportunities to use alternative strategies effectively are greatly affected by the nursing home’s resources, by the organization of care and by the staff’s competence.
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Horntvedt, May-Elin T., Maria Romøren et Betty-Ann Solvoll. « Ethical problems related to intravenous fluids in nursing homes ». Nursing Ethics 21, no 8 (18 mars 2014) : 890–901. http://dx.doi.org/10.1177/0969733014521093.
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Background: Intravenous fluids and/or antibiotics are applied to only a limited extent in Norwegian nursing homes, and the patients are often sent to hospital in these situations. A transfer and a stay in hospital may be unnecessary strains for frail older patients. Given this background, a collaborative research project was initiated in a Norwegian county in 2009. A teaching programme was developed, which aimed to strengthen the awareness of ethics, assessments and practical procedures related to intravenous fluid and/or antibiotics among healthcare professionals. Objectives: This qualitative study aimed to increase our knowledge of the ethical problems experienced by nursing home nurses in situations related to the administration of intravenous fluids and/or antibiotics. Research design: An exploratory design was used, and five focus group interviews were conducted with 26 registered nurses. A hermeneutic analytic approach was applied. Ethical considerations: This study was reported to the Norwegian Social Science Data Services in May 2010. The Regional Committee for Medical and Health Research Ethics approved the collaborative research project. Findings: The analysis showed that the nurses experienced difficult decision-making situations, which were interpreted as external pressure and internal pressure. External pressure emerged in interactions with patients and relatives. Organizational factors were also interpreted as external pressure. Internal pressure was interpreted as the nurses’ experience of feeling inadequate in situations where it was difficult to protect the dignity of patients. Discussion: These findings correspond with international studies, which show that ethical problems often arise during decision-making situations. Conclusion: In agreement with the definition of an ethical problem, we found that the nurses experienced uncertainty and disagreements about how situations should be managed. External and internal pressures related to intravenous fluids and/or antibiotics in nursing homes have not been reported in previous studies. Thus, these findings merit further exploration.
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Preshaw, Deborah HL, Kevin Brazil, Dorry McLaughlin et Andrea Frolic. « Ethical issues experienced by healthcare workers in nursing homes ». Nursing Ethics 23, no 5 (août 2016) : 490–506. http://dx.doi.org/10.1177/0969733015576357.
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Background: Ethical issues are increasingly being reported by care-providers; however, little is known about the nature of these issues within the nursing home. Ethical issues are unavoidable in healthcare and can result in opportunities for improving work and care conditions; however, they are also associated with detrimental outcomes including staff burnout and moral distress. Objectives: The purpose of this review was to identify prior research which focuses on ethical issues in the nursing home and to explore staffs’ experiences of ethical issues. Methods: Using a systematic approach based on Aveyard (2014), a literature review was conducted which focused on ethical and moral issues, nurses and nursing assistants, and the nursing home. Findings: The most salient themes identified in the review included clashing ethical principles, issues related to communication, lack of resources and quality of care provision. The review also identified solutions for overcoming the ethical issues that were identified and revealed the definitional challenges that permeate this area of work. Conclusions: The review highlighted a need for improved ethics education for care-providers.
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Jakobsen, Rita, Gerd Sylvi Sellevold, Veslemøy Egede-Nissen et Venke Sørlie. « Ethics and quality care in nursing homes : Relatives’ experiences ». Nursing Ethics 26, no 3 (11 septembre 2017) : 767–77. http://dx.doi.org/10.1177/0969733017727151.
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Background: A total of 71,000 people in Norway suffer from some form of dementia in 2013, of whom approximately 30,000 are in nursing homes. Several studies focus on the experiences of those who have close relatives and who are staying in a nursing home. Results show that a greater focus on cooperation between nursing staff and relatives is a central prerequisite for an increased level of care. Benefits of developing systematic collaboration practices include relief for nursing staff, less stress, and greater mutual understanding. Going through studies focusing on the experiences of nursing home patients’ relatives, negative experiences are in the majority. In this study, relatives are invited to share positive experiences regarding the care of their loved ones; a slightly different perspective, in other words. Aim: The aim of the study is to investigate relatives of persons with dementia’s experiences with quality care in nursing homes. Method: The study is a part of a larger project called Hospice values in the care for persons with dementia and is based on a qualitative design where data are generated through narrative interviews. The chosen method of analysis is the phenomenological–hermeneutical method for the study of lived experiences. Participants and research context: Participants in the project were eight relatives of persons with dementia who were living in nursing homes, long-term residences. The sampling was targeted, enrolment happened through collective invitation. All relatives interested were included. Ethical considerations: The Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services approve the study. Findings: Findings show that relatives have certain expectations as to how their loved ones ought to be met and looked after at the nursing home. The results show that in those cases where the expectations were met, the relatives’ experiences were associated with engagement, inclusion and a good atmosphere. When the expectations were not met, the relatives experienced powerlessness, distrust and guilt. Discussion: The results are discussed considering the concepts of trust, power and asymmetry. Conclusion: When asked about experiences with quality care, the relatives spoke both of expectations met and of expectations not met. Results in this study are important knowledge for developing units where performing quality care is the overall aim.
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Hantikainen, Virpi. « Physical Restraint : a descriptive study in swiss nursing homes ». Nursing Ethics 5, no 4 (juillet 1998) : 330–46. http://dx.doi.org/10.1177/096973309800500406.
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This article focuses on the reasons for using physical restraints, their prevalence and nurses’ experiences of their use. The data were collected by means of a questionnaire from nurses, trained nurse’s aids and auxiliary staff ( n = 173) in seven Swiss nursing homes. The results showed that physical restraints are used in nursing units, the mean number of restrained residents in each being 3.7 (SD 3.9). However, nursing staff did not necessarily understand and consider the term ‘restraint’ as a restrictive device in its negative sense. The most common reasons indicated for the use of restraint were related to the protection and safety of the residents themselves, the prevention of disturbance of other residents, and the residents’ restlessness and aggressiveness. As for the reasons related to staffing, reference was made to understaffing, a lack of competence on the part of nurses, and the demands of residents, their next of kin and doctors. It was not common practice to inform the elderly residents that they would be restrained, and therefore they were not always aware of what was happening to them and why. Twenty-nine per cent of the respondents reported that the flexibility of their work was affected by the use of physical restraint.
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Sion, Katya Y. J., Hilde Verbeek, Sandra M. G. Zwakhalen, Gaby Odekerken-Schröder, Jos M. G. A. Schols et Jan P. H. Hamers. « Themes Related to Experienced Quality of Care in Nursing Homes From the Resident’s Perspective : A Systematic Literature Review and Thematic Synthesis ». Gerontology and Geriatric Medicine 6 (janvier 2020) : 233372142093196. http://dx.doi.org/10.1177/2333721420931964.
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Background: The culture change from task-centered care to person- and relationship-centered care has resulted in the resident’s voice gaining importance when assessing experienced quality of care in nursing homes. This review aimed to identify which factors contribute to experienced quality of care in nursing homes worldwide from the resident’s perspective. Method: A systematic literature review and thematic data synthesis were performed. The databases PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, and Business Source Complete were searched to identify qualitative studies aimed at retrieving factors related to residents’ experienced quality of care in nursing homes. Only studies in which residents themselves were interviewed were included. Results: This literature review included 27 publications covering 14 countries. Thematic analysis revealed three overarching themes related to residents’ care experiences: (a) The nursing home environment consisted of the physical environment and caring environment, (b) individual aspects of living in the nursing home consisted of personhood and coping with change, and (c) social engagement consisted of meaningful relationships and care provision. Discussion: To achieve high experienced quality of care in nursing homes, residents’ care experiences need to be assessed and used in quality management.
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Susanti, Nurvi, Zulfan Saam, Nofrizal Nofrizal, Zahtamal Tamal et Nofri Hasrianto. « Elderly Psychological Conditions in the Nursing Home Tresna Werdha (Pstw) : A Study Descriptive Riau and West Sumatra Indonesia ». Open Access Macedonian Journal of Medical Sciences 9, E (15 novembre 2021) : 1393–97. http://dx.doi.org/10.3889/oamjms.2021.6219.
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The aspects of emotion, memory, motivation and independence are psychological conditions that are often experienced by the elderly who live in nursing homes. experienced by the elderly who are in the nursing home environment. This study aims to describe the psychological condition of the elderly in the Husnul Khotimah Pekanbaru social home for 35 elderly and 45 elderly Sabai Nan Aluih Pariaman nursing home. This research is a descriptive survey. The research subjects were 80 elderly who were taken with the total sampling technique. Data were collected using questionnaire sheets and descriptive analysis, this study shows that the psychological condition of the elderly which includes emotional aspects of the nursing home in the second category of the Husnul Khotimah nursing home is (69%) and the Sabai Nan Aluih nursing home is 73%.(80%) in the Husnul Khotimah nursing home and 69% in the good category in the Sabai Nan Aluih nursing home. Motivational aspectat both nursing homes is in the moderate category (51%) The independence aspect is in the good category (80%) in the Husnul Khotimah nursing home while the sufficient category is 67% in the Sabai Nan Aluih nursing home. Broadly speaking, the aspects of emotion, memory, motivation are good categories, category motivation is sufficient and the category independence is good at the Husnul Khotimah nursing home and sufficient at the Sabai Nan Aluih nursing home.
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van der Dam, S., TA Abma, AC Molewijk, MJM Kardol, JMGA Schols et GAM Widdershoven. « Organizing moral case deliberation Experiences in two Dutch nursing homes ». Nursing Ethics 18, no 3 (mai 2011) : 327–40. http://dx.doi.org/10.1177/0969733011400299.
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Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of this study was to evaluate one way of organizing MCD in two Dutch nursing homes. In both of these nursing homes the MCD groups had a heterogeneous composition and were organized apart from existing institutional communication structures. As part of a naturalistic evaluation, systematic observations, interviews and focus groups were completed. The findings indicate that the heterogeneous composition and MCD meetings separate from existing structures have benefits. However, the participants also reported negative experiences. This gives rise to the question whether a mixed MCD group which meets separately is an effective way to embed MCD as an instrument for reflection on moral issues in daily practice. We conclude that there is no single answer to that question. In the end, the two implementation strategies (i.e. within existing communication structures and a mixed MCD group) can be complementary to each other.
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Poldrugovac, Mircha, Sara Barsanti, Emiliano Pardini, Niek S. Klazinga et Dionne S. Kringos. « Relation between pre-existing quality management measures and prevention and containment of COVID-19 outbreaks in 159 nursing homes in Tuscany : a mixed methods study ». BMJ Open Quality 13, no 2 (avril 2024) : e002560. http://dx.doi.org/10.1136/bmjoq-2023-002560.
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BackgroundNursing homes were often the focus of COVID-19 outbreaks. Many factors are known to influence the ability of a nursing home to prevent and contain a COVID-19 outbreak. The role of an organisation’s quality management prior to the pandemic is not yet clear. In the Italian region of Tuscany nursing home performance indicators have been regularly collected since before the pandemic, providing the opportunity to better understand this relationship.ObjectivesTo test if there is a difference in the results achieved by nursing homes in Tuscany on 13 quality management indicators, when grouped by severity of COVID-19 outbreaks; and to better understand how these indicators may be related to the ability to control COVID-19 outbreaks, from the perspective of nursing homes.MethodsWe used a mixed methods sequential explanatory design. Based on regional and national databases, 159 nursing homes in Tuscany were divided into four groups by outbreak severity. We tested the significance of the differences between the groups with respect to 13 quality management indicators. The potential relation of these indicators to COVID-19 outbreaks was discussed with 29 managers and other nursing homes’ staff through four group interviews.ResultsThe quantitative analysis showed significant differences between the groups of nursing homes for 3 of the 13 indicators. From the perspective of nursing homes, the indicators might not be good at capturing important aspects of the ability to control COVID-19 outbreaks. For example, while staffing availability is seen as essential, the staff-to-bed ratio does not capture the turn-over of staff and temporary absences due to positive COVID-19 testing of staff.ConclusionsThough currently collected indicators are key for overall performance monitoring and improvement, further refinement of the set of quality management indicators is needed to clarify the relationship with nursing homes’ ability to control COVID-19 outbreaks.
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Zwakhalen, Sandra MG, Jan PH Hamers, Rieneke HA Peijnenburg et Martijn PF Berger. « Nursing Staff Knowledge and Beliefs about Pain in Elderly Nursing Home Residents with Dementia ». Pain Research and Management 12, no 3 (2007) : 177–84. http://dx.doi.org/10.1155/2007/518484.
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BACKGROUND: Aging is known to be associated with a high prevalence (up to 80%) of persistent pain among residents of nursing homes. However, even with high pain prevalence rates, nursing home residents are at risk for undertreatment. Knowledge deficits and beliefs among nurses influence staff behaviour in pain assessment and management.OBJECTIVES: To develop a psychometrically sound questionnaire and to gather information about knowledge and beliefs of nursing staff regarding various aspects of pain in elderly patients with dementia. In addition, the differences among several categories of nurses (based on educational level and work experience) with respect to beliefs about pain were investigated.METHODS: Participants were 123 staff members of psychogeriatric wards in two nursing homes in the Netherlands (mean of 11.4 years of experience). Their results were compared with those of two groups of nurses, one consisting of 25 registered nurse PhD students in nursing science and the other consisting of 20 trainee pain nurse specialists.RESULTS: The main findings indicate that nursing home staff respondents showed knowledge deficits about several aspects of pain, even though they were satisfied about the way pain was assessed and treated at their wards. Specific knowledge deficits were found regarding pain treatment and medication in elderly nursing home residents. Staff educational level seemed to influence their beliefs and knowledge about pain in elderly nursing home patients.
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Delarue, V. V., G. V. Kondratyev, O. I. Shutova et T. I. Guba. « ETHICAL AND PSYCHOLOGICAL COLLISIONS ON REFERRAL OF VIII TYPE INSTITUTIONS LEAVERS TO NURSING HOMES FOR CHRONIC MENTAL PATIENTS ». Bioethics 26, no 12 (2 novembre 2020) : 50–52. http://dx.doi.org/10.19163/2070-1586-2020-2(26)-50-52.
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Former research showed that up to 20–25 % of those who leave schools of type VIII (schools for children with cognitive development disorders) are referred to nursery homes for chronic mental patients not due to medical problems but because of social ones. According to the authors’ opinion, such social practice has more positive than negative aspects. However, this issue requires extensive discussions. Organizing special post-diploma training courses of 16–24 hours on ethical-psychological aspects of referral various categories of patients (not only leavers of type VIII institutions) to nursery homes for chronic mental patients also seems to be reasonable.
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Bass, Elizabeth, Karen Putney et Myrna Alvear. « Economic Aspects of Dementia Special Care Units in Veterans Affairs Nursing Homes ». Journal of the American Medical Directors Association 6, no 4 (juillet 2005) : 276–80. http://dx.doi.org/10.1016/j.jamda.2005.05.002.
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Dreyer, Anne, Reidun Førde et Per Nortvedt. « Ethical decision-making in nursing homes : Influence of organizational factors ». Nursing Ethics 18, no 4 (14 juin 2011) : 514–25. http://dx.doi.org/10.1177/0969733011403553.
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In this article we report findings from a qualitative study that explored how doctors and nurses in nursing homes describe professional collaboration around dying patients. The study also examined the consequences this can have for the life-prolonging treatment of patients and the care of them and their relatives. Nine doctors and 10 nurses from 10 Norwegian nursing homes were interviewed about their experience of decision-making processes on life-prolonging treatment and care. The findings reveal that the frameworks for the professional collaboration and organization of physicians and nurses prevent patient treatment and care complying with ethical considerations and the law. These conditions have a challenging impact on the care of dying patients and their relatives.
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Meyer, Madonna Harrington. « Institutional bias and medicaid use in nursing homes ». Journal of Aging Studies 8, no 2 (janvier 1994) : 179–93. http://dx.doi.org/10.1016/s0890-4065(05)80005-2.
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Rondeau, Kent V., et Terry H. Wagar. « Impact of Human Resource Management Practices on Nursing Home Performance ». Health Services Management Research 14, no 3 (août 2001) : 192–202. http://dx.doi.org/10.1177/095148480101400306.
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Management scholars and practitioners alike have become increasingly interested in learning more about the ability of certain ‘progressive’ or ‘high-performance’ human resource management (HRM) practices to enhance organizational effectiveness. There is growing evidence to suggest that the contribution of various HRM practices to impact firm performance may be synergistic in effect yet contingent on a number of contextual factors, including workplace climate. A contingency theory perspective suggests that in order to be effective, HMR policies and practices must be consistent with other aspects of the organization, including its environment. This paper reports on empirical findings from research that examines the relationship between HRM practices, workplace climate and perceptions of organizational performance, in a large sample of Canadian nursing homes. Data from 283 nursing homes were collected by means of a mail survey that included questions on HRM practices, programmes, and policies, on human resource aspects of workplace climate, as well as a variety of indicators that include employee, customer/resident and facility measures of organizational performance. Results derived from ordered probit analysis suggest that nursing homes in our sample which had implemented more ‘progressive’ HRM practices and which reported a workplace climate that strongly values employee participation, empowerment and accountability tended to be perceived to generally perform better on a number of valued organizational outcomes. Nursing homes in our sample that performed best overall were found to be more likely to not only have implemented more of these HRM practices, but also to report having a workplace climate that reflects the seminal value that it places on its human resources. This finding is consistent with the conclusion that simply introducing HRM practices or programmes, in the absence of an appropriately supportive workplace climate, will be insufficient to attain optimal organizational performance.
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Rondeau, Kent V., et Terry H. Wager. « Impact of human resource management practices on nursing home performance ». Health Services Management Research 14, no 3 (1 août 2001) : 192–202. http://dx.doi.org/10.1258/0951484011912690.
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Management scholars and practitioners alike have become increasingly interested in learning more about the ability of certain 'progressive' or 'high-performance' human resource management (HRM) practices to enhance organizational effectiveness. There is growing evidence to suggest that the contribution of various HRM practices to impact firm performance may be synergistic in effect yet contingent on a number of contextual factors, including workplace climate. A contingency theory perspective suggests that in order to be effective, HMR policies and practices must be consistent with other aspects of the organization, including its environment. This paper reports on empirical findings from research that examines the relationship between HRM practices, workplace climate and perceptions of organizational performance, in a large sample of Canadian nursing homes. Data from 283 nursing homes were collected by means of a mail survey that included questions on HRM practices, programmes, and policies, on human resource aspects of workplace climate, as well as a variety of indicators that include employee, customer/resident and facility measures of organizational performance. Results derived from ordered probit analysis suggest that nursing homes in our sample which had implemented more 'progressive' HRM practices and which reported a workplace climate that strongly values employee participation, empowerment and accountability tended to be perceived to generally perform better on a number of valued organizational outcomes. Nursing homes in our sample that performed best overall were found to be more likely to not only have implemented more of these HRM practices, but also to report having a workplace climate that reflects the seminal value that it places on its human resources. This finding is consistent with the conclusion that simply introducing HRM practices or programmes, in the absence of an appropriately supportive workplace climate, will be insufficient to attain optimal organizational performance.
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Weiner, Chava, Nili Tabak et Rebecca Bergman. « The Use of Physical Restraints for Patients Suffering from Dementia ». Nursing Ethics 10, no 5 (septembre 2003) : 512–25. http://dx.doi.org/10.1191/0969733003ne633oa.
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This study reviews the ethical dilemmas of nursing staff about using restraints on patients suffering from dementia in two types of health care settings in Israel: internal medicine wards of three general hospitals; and psychogeriatric wards of three nursing homes. The nurses’ level of knowledge about the Patient’s Rights Law, the Israeli Code of Ethics, and the guidelines on restraints was analysed. The purposes of restraints were defined as beneficial to: (1) the patient; (2) other patients; or (3) the institution. The concept was evaluated in a realistic situation (expressing views of daily practice) and in an idealistic situation (expressing personal and professional beliefs and values). It was shown that nurses in internal medicine wards of general hospitals agreed more with the use of restraints than those in psychogeriatric wards in nursing homes. Differences were more pronounced when restraints were beneficial to the institution. In addition, nurses working in psychogeriatric wards of nursing homes had more knowledge about the guidelines on restraints and were less inclined than their counterparts to agree with the use of restraints for the benefit of other patients or the institution.
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Macpherson, Ignacio, María Victoria Roqué et Ignacio Segarra. « Moral dilemmas involving anthropological and ethical dimensions in healthcare curriculum ». Nursing Ethics 27, no 5 (29 avril 2020) : 1238–49. http://dx.doi.org/10.1177/0969733020914382.
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Background Currently a variety of novel scenarios have appeared within nursing practice such as confidentiality of a patient victim of abuse, justice in insolvent patients, poorly informed consent delivery, non-satisfactory medicine outputs, or the possibility to reject a recommended treatment. These scenarios presuppose skills that are not usually acquired during the degree. Thus, the implementation of teaching approaches that promote the acquisition of these skills in the nursing curriculum is increasingly relevant. Objective The article analyzes an academic model which integrates in the curriculum a series of specific theoretical concepts together with practical skills to acquire the basic ethic assessment competency. Research design The project includes designing two subjects, General Anthropology and Ethics-Bioethics, with an applied approach in the nursing curriculum. The sequential structure of the curriculum in both subjects is constituted by three learning domains (theoretical, practical, and communicative) with different educational strategies. Ethical considerations No significant ethical considerations as this is a discussion paper. Findings The model was structured from the anthropology’s concepts and decision-making process, applied to real situations. The structure of the three domains theoretical–practical–communicative is present in each session. Discussion It is observed that theoretical domain fosters the capacity for critical analysis and subsequent ability to judge diverse situations. The practical domain reflected two significant difficulties: students’ resistance to internalizing moral problems and the tendency to superficial criticism. The communicative domain has frequently shown that the conflicting points are in the principles to be applied. Conclusion We conclude that this design achieves its objectives and may provide future nursing professionals with ethical competences especially useful in healthcare practice. The three domains of the presented scheme are associated with the same process used in decision making at individual levels, where the exercise of clinical prudence acquires particular relevance.
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Davis, M. A., et K. G. Provan. « A Cost-Constrained Model of Strategic Service Quality Emphasis in Nursing Homes ». Health Services Management Research 9, no 1 (février 1996) : 24–33. http://dx.doi.org/10.1177/095148489600900103.
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This study employed structural equation modeling to test the relationship between three aspects of the environmental context of nursing homes; Medicaid dependence, ownership status, and market demand, and two basic strategic orientations: low cost and differentiation based on service quality emphasis. Hypotheses were proposed and tested against data collected from a sample of nursing homes operating in a single state. Because of the overwhelming importance of cost control in the nursing home industry, a cost-constrained strategy perspective was supported. Specifically, while the three contextual variables had no direct effect on service quality emphasis, the entire model was supported when cost control orientation was introduced as a mediating variable.
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Halifax, Elizabeth, et Charlene Harrington. « Proposed Minimum Nurse Staffing Levels in Nursing Homes ». Policy, Politics, & ; Nursing Practice 25, no 2 (8 avril 2024) : 67–69. http://dx.doi.org/10.1177/15271544241237653.
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Proot, Ireen M., H. FJM Crebolder, H. Huijer Abu-Saad et R. HJ ter Meulen. « Autonomy in the care of stroke patients in nursing homes ». Nursing Ethics 8, no 1 (janvier 2001) : 79–80. http://dx.doi.org/10.1177/096973300100800110.
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Tuominen, Leena, Helena Leino-Kilpi et Riitta Suhonen. « Older people’s experiences of their free will in nursing homes ». Nursing Ethics 23, no 1 (8 décembre 2014) : 22–35. http://dx.doi.org/10.1177/0969733014557119.
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Background: Older people in institutional care should be allowed to live a meaningful life in a home-like environment consistent with their own free will. Research on actualisation of older people’s own free will in nursing home context is scarce. Objectives: The purpose of this study was to describe older people’s experiences of free will, its actualisation, promoters and barriers in nursing homes to improve the ethical quality of care. Research design: Fifteen cognitively intact older people over 65 years in four nursing homes in Southern Finland were interviewed. Giorgi’s phenomenological method expanded by Perttula was used to analyse the data. Ethical considerations: Chief administrators of each nursing home gave permission to conduct the study. Informants’ written informed consent was gained. Findings: Older people described free will as action consistent with their own mind, opportunity to determine own personal matters and holding on to their rights. Own free will was actualised in having control of bedtime, dressing, privacy and social life with relatives. Own free will was not actualised in receiving help when needed, having an impact on meals, hygiene, free movement, meaningful action and social life. Promoters included older people’s attitudes, behaviour, health, physical functioning as well as nurses’ ethical conduct. Barriers were nurses’ unethical attitudes, institution rules, distracting behaviour of other residents, older people’s attitudes, physical frailty and dependency. Discussion: Promoting factors of the actualisation of own free will need to be encouraged. Barriers can be influenced by educating nursing staff in client-orientated approach and influencing attitudes of both nurses and older people. Conclusion: Results may benefit ethical education and promote the ethical quality of older people’s care practice and management.
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Mahieu, Lieslot, Bernadette Dierckx de Casterlé, Jolien Acke, Hanne Vandermarliere, Kim Van Elssen, Steffen Fieuws et Chris Gastmans. « Nurses’ knowledge and attitudes toward aged sexuality in Flemish nursing homes ». Nursing Ethics 23, no 6 (3 août 2016) : 605–23. http://dx.doi.org/10.1177/0969733015580813.
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Background: Admission to a nursing home does not necessarily diminish an older person’s desire for sexual expression and fulfillment. Given that nursing staff directly and indirectly influence the range of acceptable sexual expressions of nursing home residents, their knowledge and attitudes toward aged sexuality can have far-reaching effects on both the quality of care they provide to residents and the self-image and well-being of these residents. Research objectives: To investigate nursing staff’s knowledge and attitudes toward aged sexuality, to determine whether certain sociodemographic factors of the nursing staff relate to their knowledge and attitudes toward later-life sexuality, and to examine the relationship between knowledge and attitudes. Research design: Descriptive cross-sectional survey study. Research participants and research context: The administered questionnaire collected sociodemographic data and data from an adapted, Dutch version of the Aging Sexual Knowledge and Attitudes Scale. Data were collected from November 2011 through April 2012. A total of 43 geographically dispersed nursing homes in Flanders, Belgium, participated. Out of a potential research sample of 2228 nursing staff respondents, 1166 participated. Ethical considerations: The study protocol was approved by the Ethics Committee of the Faculty of Medicine of the KU Leuven. Findings: Nursing staff appeared to be moderately knowledgeable about aged sexuality and displayed a rather positive attitude toward sexuality in older people. Significant relationships between various variables were found both at univariable and multivariable levels. Knowledge and attitudes proved to be positively related, indicating that a higher level of knowledge of aged sexuality is associated with a more positive attitude toward sexuality in later life. Discussion: Research findings are discussed within a broader international context. Conclusion: There is room for improvement for both nursing staff’s knowledge and attitudes toward aged sexuality. This might be aided by appropriate educational interventions. Our results identified different target groups of nursing home staff for these interventions.
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Gjerberg, Elisabeth, Reidun Førde et Arild Bjørndal. « Staff and family relationships in end-of-life nursing home care ». Nursing Ethics 18, no 1 (janvier 2011) : 42–53. http://dx.doi.org/10.1177/0969733010386160.
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This article examines the involvement of residents and their relatives in end-of-life decisions and care in Norwegian nursing homes. It also explores challenges in these staff—family relationships. The article is based on a nationwide survey examining Norwegian nursing homes’ end-of-life care at ward level. Only a minority of the participant Norwegian nursing home wards ‘usually’ explore residents’ preferences for care and treatment at the end of their life, and few have written procedures on the involvement of family caregivers when their relative is in the terminal phase. According to the respondents, most staff seem to comfort relatives well. However, several challenges were described. The study revealed a need for better procedures in the involvement of residents and relatives in nursing home end-of-life care. The findings emphasize a need to strengthen both the involvement of nursing home physicians and staff communication skills.