Nurse Faculty Scholars - Nursing Home

Advanced nursing assistant education program.

lsharp — Tue, 19 Oct 2010 13:26:59 +0000

Published Date:

Sun, 2010-08-01 (All day)

BACKGROUND: Nursing assistants provide 90% of the care to the elderly residents of nursing homes, but are the least educated direct-care employees. Supervisory workers believe that nursing assistants require additional training to meet the increasingly complex needs of nursing home residents.

METHODS: A day-long training program for experienced nursing assistants was provided to supplement their basic education. Using a pre- and posttest design, the effectiveness of the program for knowledge acquisition and application was tested. Future education needs were identified through a gap analysis.

RESULTS: There was a significant improvement in knowledge for nursing assistants attending the program. The attendees expressed interest in receiving additional education on dementia and infection control. All attendees identified a problem unique to their facility and were able to plan a detailed intervention and develop outcome measures for that plan.

CONCLUSIONS: Nursing assistants enrolled in this advanced training program expressed a desire for additional education to help them advance their caregiving skills. Advanced education is one method to increase job satisfaction among nursing assistants that can improve the quality of care for nursing home residents.

Satisfaction with Assisted Living: The Unexplored Role of Physical Activity

lsharp — Tue, 19 Oct 2010 13:21:48 +0000

Published Date:

Sat, 2010-05-01 (All day)

In the ongoing Interdisciplinary Nursing Quality Research Initiative Program study, we are testing the impact of Function-Focused Care, which is an approach to care in which we work with assisted living (AL) residents and staff to optimize the functional and physical activities of residents during daily activity. The purpose of this article is to evaluate life satisfaction of AL residents with a focus on the impact of physical activity. In a sample of 171 older adults from 4 ALs, it was found that depression, social support from friends and experts, time in caregiving, and fear of falling all had a significant relationship with life satisfaction in AL. Physical activity was not related to life satisfaction in this study. Ongoing research is necessary to explore whether changing attitudes about physical activity among older adults and increasing social support related to physical activity can improve life satisfaction.

The Impact of Anemia on Nursing Home Residents

lsharp — Tue, 19 Oct 2010 13:18:36 +0000

Published Date:

Sat, 2010-05-01 (All day)

The purpose of this secondary data analysis was to describe the prevalence and treatment of anemia and test the impact of anemia on physical and psychosocial outcomes at baseline and following restorative care interventions. A total of 451 residents from 12 nursing homes participated in this study. The average age of the participants was 83.74 (SD = 8.24), the majority were female (79%), White (66%), and unmarried (90%). A total of 245 (54%) residents were anemic, and 66% were treated with at least one medication. Physical performance was worse in those with anemia, and those with anemia associated with chronic kidney disease had lower self-efficacy and outcome expectations for functional activities than those without anemia. There was no time by treatment interaction between those with and without anemia. The findings provide some additional support for the prevalence of anemia and suggest that those with anemia associated with chronic kidney disease are less motivated to engage in functional activities.

Anemia and its impact on function in nursing home residents: What do we know?

lsharp — Tue, 19 Oct 2010 13:15:30 +0000

Published Date:

Mon, 2010-01-04 (All day)

Purpose: To provide the advanced practice nurse (APN) information on the prevalence and causes of anemia in elderly nursing home (NH) residents, in order to affect diagnostic and management strategies that may help improve physical function and mobility outcomes.

Data Sources: Literature review of current peer-reviewed research articles.

Conclusions: In the United States, the prevalence of anemia increases with advancing age, and are reported to be much higher among older NH residents than among community-dwelling older adults. Causes of anemia among the elderly are often multifactorial. Older individuals with anemia, including mild anemia and even low normal level, have demonstrated lower muscle strength, physical function, mobility, and increased morbidity and mortality outcomes.

Implications for Practice: Given the potentially significant relationship between anemia and physical performance outcomes among NH residents, gaining a better understanding will help guide future evidence-based care by allowing the APN an opportunity to tailor both medical and restorative care interventions. Because anemia is a potentially modifiable condition, intervention may preserve, limit, or reverse functional impairment and/or disablement, and allow for maximal functional independence.

Purpose: To provide

Nursing Home Resident Outcomes from the Res-Care Intervention

lsharp — Tue, 19 Oct 2010 13:10:06 +0000

Published Date:

Tue, 2009-06-30 (All day)

OBJECTIVES: To test the effectiveness of a restorative care (Res-Care) intervention on function, muscle strength, contractures, and quality of life of nursing home residents, with secondary aims focused on strengthening self-efficacy and outcome expectations.

DESIGN: A randomized controlled repeated-measure design was used, and generalized estimating equations were used to evaluate status at baseline and 4 and 12 months after initiation of the Res-Care intervention.

SETTING: Twelve nursing homes in Maryland.

PARTICIPANTS: Four hundred eighty-seven residents consented and were eligible: 256 from treatment sites and 231 from control sites. The majority were female (389, 80.1%) and white (325, 66.8%); 85 (17.4%) were married and the remaining widowed, single, or divorced/separated. Mean age was 83.8 ± 8.2, and mean Mini-Mental State Examination score was 20.4 ± 5.3.

INTERVENTION: Res-Care was a two-tiered self-efficacy-based intervention focused on motivating nursing assistants and residents to engage in functional and physical activities.

MEASUREMENTS: Barthel Index, Tinetti Gait and Balance, grip strength, Dementia Quality-of-Life Scale, self-efficacy, and Outcome Expectations Scales for Function.

RESULTS: Significant treatment-by-time interactions (P<.05) were found for the Tinetti Mobility Score and its gait and balance subscores and for walking, bathing, and stair climbing.

CONCLUSION: The findings provide some evidence for the utility and safety of a Res-Care intervention in terms of improving function in NH residents.

OBJE