Is elderspeak communication in simulated hospital dementia care congruent to communication in actual patient care? A mixed-methods pilot study.

AIMS: Simulation offers a feasible modality to prepare nurses for challenges communicating with patients with dementia. Elderspeak communication is speech that sounds like baby talk and can lead to rejection of care by patients with dementia. However, it is unknown if simulation can be used to capture elderspeak communication in dementia care. The purpose of this mixed-methods study was to determine if simulation accurately captures elderspeak communication by nursing staff in hospital dementia care. DESIGN: A 3-part mixed-methods design in which (1) three dementia care simulations were designed and validated by a panel of experts, (2) communication by nursing staff completing each simulation was quantitatively compared to communication during actual patient care, and (3) views on the realism were explored using within- and across-case coding. METHODS: Three simulations using different modalities (manikin, role-play, and standardised patient) were designed and validated with eight experts using the Lynn Method. Ten nursing staff were audio-recorded and their communication was coded for elderspeak communication. Results for each simulation were compared using Wilcoxon signed-rank test to recordings taken during actual dementia care encounters. Debriefings were coded for realism and results were converged. RESULTS: The average time using elderspeak during naturalistic care was 29.9% (SD = 20.9%) which did not differ from the average amount of elderspeak used across the three simulations modalities which ranged from 29.1% to 30.4%. Qualitative results suggested a lack of realism with the manikin condition and the nursing staff indicated preference for the simulation with the standardised patient. CONCLUSIONS: Communication elicited in the dementia care simulations was congruent to communication produced in actual dementia care but preference was for the standardised patient. IMPLICATIONS FOR PATIENT CARE: Elderspeak communication can be accurately produced in the simulated environment which indicates that simulation is a valid method for person-centred communication training in nursing staff. IMPACT: Simulation offers a feasible modality to prepare nurses for challenges communicating with patients with dementia. Elderspeak communication is speech that sounds like baby talk and can lead to rejection of care by patients with dementia. However, it is unknown if simulation can be used to capture elderspeak communication in dementia care. Elderspeak communication captured in the simulated environment was congruent to communication nursing staff use during actual patient care to hospitalised persons living with dementia. This study empirically identifies that communication is elicited in similar patterns by nursing staff in the simulated environment compared to the naturalistic care environment which demonstrates that simulation can be used as a valid tool for education and research on person-centred communication. REPORTING METHODS: STROBE. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Predictors of Nursing Home Nurses' Willingness to Report Medication Near-Misses.

Medication near-misses occur at higher rates than medication errors and are usually underreported. Reporting a medication near-miss is crucial, as it highlights areas of human and system failures. Identifying these incidents is particularly important in nursing home (NH) settings to help managers plan and initiate proactive measures to contain the errors. However, scarce evidence exists about predictors of nurses' willingness to report near-misses. Therefore, the purpose of this study was to test a proposed model for NH nurses' willingness to report medication near-misses. Data for this cross-sectional study were collected using a random sample of RNs working in NHs across one Midwestern state. The proposed model predicted a 19% variance in nurses' willingness to report medication near-misses, with the strongest predicators being non-punitive responses to errors (ß = 0.33, p < 0.001). According to the study results, system and social factors are needed to improve nurses' voluntary reporting of medication near-misses. [Journal of Gerontological Nursing, 46(4), 21-30.].