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1.
J Christ Nurs ; 41(4): 219-223, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39245833

RESUMO

ABSTRACT: Nurses who anticipate and plan for retirement have multiple options and opportunities. Financial planning, healthcare insurance considerations, and productive use of time are significant components toward a satisfying post-career life. Wisdom from the Bible provides great insight for nurses considering retirement.


Assuntos
Aposentadoria , Humanos , Aposentadoria/psicologia , Cristianismo , Pessoa de Meia-Idade , Satisfação no Emprego , Feminino , Recursos Humanos de Enfermagem/psicologia
2.
PLoS One ; 19(9): e0301651, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39250502

RESUMO

INTRODUCTION: People with dementia are more likely than people without dementia to be hospitalized and to experience in-hospital preventable adverse events, such as falls, skin injury, and infection, compared to other hospitalized groups. Negative attitudes towards people with dementia are common among acute healthcare workers and have been linked to a cascade of negative adverse events in this population. However, no qualitative systematic review has ever been conducted to synthesize the existing evidence in this area, which hampers the development of preventative measures. AIM: This is a protocol for a qualitative systematic review aimed at exploring and synthesizing existing qualitative evidence regarding the attitudes of nursing staff towards the prevention of adverse events among hospitalized people with dementia. METHODS: Literature searches will be performed in PubMed, CINAHL, PsycINFO, Web of Science, Biblioteca Virtual de Salud, Scopus, The Cochrane Library, and Google Scholar. The references of eligible studies will be checked for eligibility. All primary qualitative or mixed-methods studies with a qualitative component published in peer-reviewed academic journals in English, Portuguese, or Spanish will be eligible. There will be no limitations to the date of publication. The selection process will be conducted independently by two researchers using the software Rayyan and then compared and discussed. Any disagreements regarding eligibility will be discussed among the entire research team and resolved via consensus. Methodological quality will be assessed using Cochrane's guidance. A meta-aggregative approach will be employed to extract and synthesize the evidence using the software package QARI from the JBI. The confidence in the findings will be graded using ConQual. IMPLICATIONS: This review will help identify and better understand specific attitudinal and psychosocial aspects that influence nursing care delivery for people with dementia in hospital settings. Such data can be used to generate novel explanatory models of nursing behaviors in dementia care, as well as capacity building and training to enhance hospital care for people with dementia globally.


Assuntos
Atitude do Pessoal de Saúde , Demência , Hospitalização , Revisões Sistemáticas como Assunto , Humanos , Recursos Humanos de Enfermagem/psicologia , Pesquisa Qualitativa , Recursos Humanos de Enfermagem Hospitalar/psicologia
3.
JMIR Aging ; 7: e58629, 2024 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-39283666

RESUMO

BACKGROUND: Care robots have been proposed in response to nursing shortages in assisted living facilities (ALFs) and the growing population of older adults. While the use of care robots may improve the general health and well-being of older adults, their introduction changes the work of nursing staff fundamentally, and it has implications for the entire health care system. In developing such technology, it is important to include end users, but so far, the nursing staff's perspectives have largely been ignored. OBJECTIVE: This study aims to examine the literature on nursing staff's attitudes, needs, and preferences related to the use of care robots in ALFs, in order to discover gaps in the literature and guide future research. METHODS: This review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 protocol. On May 12, 2023, we searched PubMed, CINAHL Plus with Full Text, PsycINFO, the IEEE Xplore Digital Library, and the ACM Digital Library using predetermined search terms. Included publications, written in English, focused on the predevelopment phase, in which information was gathered on nursing staff's attitudes, needs, and preferences regarding care robots for ALFs. Publications were excluded if they did not provide peer-reviewed empirical data. The studies' findings were summarized, coded, and analyzed into major themes using thematic analysis and narrative synthesis. Their quality was assessed using McGill University's Mixed Methods Appraisal Tool and the Joanna Briggs Institute's critical appraisal tools. RESULTS: The final sample included 15 studies. Most of the studies (n=11, 73%) were rated as good quality; however, there was a general lack of reporting on important methodological decisions and sample characteristics. Nursing staff desired care robots that could assist with physically demanding tasks and reduce their workload but had mixed feelings on whether robots could or should assist with social tasks. In addition, nursing staff are concerned about the ethics of care robots, as well as about their safety, accessibility, and operability. The nursing staff's culture, qualification, and role in the facility may influence their perspectives of care robots. The studies lacked theory-driven designs and large sample sizes. Eight (53%) studies mentioned using a participatory design approach, but a lack of established criteria for what constitutes participatory design leads to varying degrees of methodological quality. CONCLUSIONS: There was consensus among nursing staff that care robots should serve as nursing assistants to reduce workload. Whether robots could or should assist with social tasks remains a question. Further research is needed to mitigate nursing staff's concerns and understand the socioecological factors that influence their perspectives of care robots and their adoption in ALFs. In addition, theory-driven and large sample size study designs are necessary, as well as work to develop clear criteria for related participatory design research.


Assuntos
Moradias Assistidas , Atitude do Pessoal de Saúde , Recursos Humanos de Enfermagem , Robótica , Humanos , Recursos Humanos de Enfermagem/psicologia
4.
Appl Nurs Res ; 79: 151828, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39256017

RESUMO

BACKGROUND: The global population of older aged 65 and over is increasing, which means an increase in people living with long-term health conditions and multimorbidity. Implementing new digital health technologies enables increased patient empowerment and responsibility, and the ability to respond to changes in their condition themselves, with less involvement of healthcare professionals. Important parameters need to be addressed for this digitally enabled empowerment to be successful, these include increased individual and organizational health literacy, the establishment of joint decision-making activities among patients and healthcare professionals, and efforts that target the individual's ability to manage their condition, which include education to increase skills and providing technology for self-monitoring. OBJECTIVE: To identify needed competencies of digital healthcare professionals to be able to provide the needed services to service users with chronic obstructive pulmonary disease in a 24/7 digital healthcare service. METHOD: Five registered nurses' work was observed weekly for five months. In total 13 participatory observations were conducted. Data from the observations was transcribed and analysed through inductive content analysis. RESULTS: Five main categories were identified in the analysis; 1) tasks, 2) communication, 3) the relationships between the registered nurses, 4) service users, and 5) technology. These categories contain different competencies needed for registered nurses working in a digitalized healthcare system. CONCLUSIONS: Future digital healthcare professionals will require several competencies, to be able to deliver proper care in a digital health community that goes beyond traditional healthcare competencies, including social, technological, and communication skills.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Telemedicina , Humanos , Doença Pulmonar Obstrutiva Crônica/enfermagem , Feminino , Masculino , Idoso , Pessoa de Meia-Idade , Assistência Centrada no Paciente , Adulto , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Empoderamento , Idoso de 80 Anos ou mais , Recursos Humanos de Enfermagem/psicologia
5.
Policy Polit Nurs Pract ; 25(3): 152-161, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39150355

RESUMO

Research to assess and inform health policy is an essential component of the policymaking process to advance equity in public health practice. This study investigated health disparities during the COVID-19 pandemic (2020-2022) in older adult institutional settings in Philadelphia, PA, to inform policy initiatives, interventions, and infrastructure development. We first explored the changing patterns of nursing staffing levels (total direct care staff and registered nurses [RNs]) measured by hours per resident per day (HPRD) before and after COVID-19. Our findings revealed that HPRD levels consistently fell below the Centers for Medicare and Medicaid Services recommended standards from 2018 to 2022, with notable declines observed starting from 2021. Results from multilevel modeling showed significant declines in HPRD for total direct care nursing staff in nursing homes located in zip codes with a high proportion of Black residents (≥40%). In contrast, HPRD for RNs significantly declined in nursing homes located in zip codes with a lower proportion of Black residents (<40%). Moreover, higher reported direct care HPRD and RN HPRD were associated with any reported COVID-19 cases only within zip codes with a low proportion of Black residents. These findings indicate the need for additional policies to address these observed patterns in staffing levels. Our study provides a foundation for future policy reviews utilizing a conceptual framework that is health equity-centric for local and state health departments program and units intended for institutional care settings for older adults.


Assuntos
COVID-19 , Casas de Saúde , Admissão e Escalonamento de Pessoal , Humanos , COVID-19/epidemiologia , Casas de Saúde/estatística & dados numéricos , Philadelphia/epidemiologia , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Idoso , Estados Unidos/epidemiologia , Feminino , Masculino , Pandemias , Recursos Humanos de Enfermagem/provisão & distribuição , Recursos Humanos de Enfermagem/estatística & dados numéricos , SARS-CoV-2 , Disparidades em Assistência à Saúde/estatística & dados numéricos , Idoso de 80 Anos ou mais
6.
BMC Health Serv Res ; 24(1): 878, 2024 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-39095796

RESUMO

BACKGROUND: Aging populations and nursing workforce issues are causing challenges for long-term care globally, and therefore, improving the work-related wellbeing and retention of nurses is crucial. As such, gaining a further understanding of the factors that affect work strain in long-term care is important. Previously, the effect of job demands on the wellbeing of nurses has been researched principally by subjective instruments. In this study, we examined the relationship between indirectly measured workday characteristics and perceived stress and time pressure among nurses working in Finnish long-term care (assisted living facilities with 24-hour assistance). METHODS: A total of 503 nurses from 44 assisted living facilities across Finland completed time measurement surveys and wellbeing questionnaires. The data were linked with client characteristics from the Resident Assessment Instrument register. The relationships between the measured number of care events during the workday, clients' care needs, and the amount of breaktime and perceived stress and time pressure were analyzed using multivariate logistic regression. RESULTS: Nurses who had more care events and clients with greater care needs were at higher odds of having high stress. More care events and reduced breaktime were associated with high time pressure. Disruptions during the workday were strongly associated with both high stress and time pressure. Last, nurses who were under high stress and time pressure worked more often in teams with lower team autonomy. CONCLUSIONS: Our findings on indirectly measured job demands indicate that dividing the workload equally among nurses through better work division can help reduce the stress and time pressure of nurses in long-term care. In addition, ensuring sufficient breaktime and preventing unnecessary disruptions is important. To help recruit and retain the care workforce, fair management of work that accounts for varying client care needs and workload is needed. In addition, legislative and governance tools, such as staffing level regulation, and further consideration of job demands might aid in reducing the job strain of nurses. PATIENT OR PUBLIC CONTRIBUTION: Patients or nurses were not involved in the design of the study, analysis, or interpretation of the results, or in the preparation of the manuscript.


Assuntos
Assistência de Longa Duração , Humanos , Finlândia , Estudos Transversais , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Inquéritos e Questionários , Carga de Trabalho/psicologia , Estresse Ocupacional/psicologia , Moradias Assistidas , Estresse Psicológico , Recursos Humanos de Enfermagem/psicologia
7.
J Gerontol Nurs ; 50(8): 5-10, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39088055

RESUMO

PURPOSE: To understand direct care workers' perceptions of the impact of implementing a person-centered communication tool, Preference for Activity and Leisure (PAL) Cards, into care. METHOD: PAL Cards provide at-a-glance information about a nursing home (NH) resident's background and important preferences for activities and leisure. As a quality improvement project, 11 NHs implemented use of PAL Cards in their communities and provided feedback (N = 91 feedback forms received) on their perceptions of impact of PAL Cards on care communication and delivery. RESULTS: A variety of NH staff members, across disciplines, were a part of PAL Card implementation. The majority of staff (84%) perceived that PAL Cards helped them start a conversation with a resident and 64% indicated that PAL Cards helped them provide care for a resident. CONCLUSION: PAL Cards are an effective tool for communicating information about NH residents' preferences to staff. [Journal of Gerontological Nursing, 50(8), 5-10.].


Assuntos
Comunicação , Casas de Saúde , Assistência Centrada no Paciente , Humanos , Atitude do Pessoal de Saúde , Idoso , Recursos Humanos de Enfermagem/psicologia , Masculino , Feminino
9.
Contemp Nurse ; 60(4): 409-419, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38968437

RESUMO

Background: Many of the overseas qualified nurses educated work as health care assistants and support workers for a decreased wage without scope for professional advancement. There is an imperative to ease their entry to the nursing register.Aim: To gather and provide evidence to the regulatory bodies regarding the demographics of this cohort of nurses and the challenges they face in attempting to register as a nurse.Design: This study used a mixed-method explanatory sequential design. The survey was completed by 857 unregistered nurses followed by five in-depth interviews. Results from both phases were triangulated.Results: The results signpost to the characteristics and challenges of these nurses working as unqualified grades of staff for a decreased wage without scope for professional advance.Discussion and conclusion: The downward occupational spiral of internationally educated nurses underscores the paradoxical nature of the pedagogical application of transition theory, as these nurses are compelled to revert to a novice status.


Assuntos
Enfermeiros Internacionais , Humanos , Adulto , Feminino , Masculino , Enfermeiros Internacionais/estatística & dados numéricos , Pessoa de Meia-Idade , Inquéritos e Questionários , Salários e Benefícios/estatística & dados numéricos , Pessoal Profissional Estrangeiro/estatística & dados numéricos , Recursos Humanos de Enfermagem/psicologia , Recursos Humanos de Enfermagem/estatística & dados numéricos
10.
Artigo em Inglês | MEDLINE | ID: mdl-39023035

RESUMO

OBJECTIVES: Religious exemptions (exceptions to nondiscrimination laws for individual religious/moral beliefs) in health care have surged, negatively affecting LGBTQ+ older adults in nursing homes with some of the highest caregiving needs. Given job differences between floor staff and managers, this study asks: How does meaning-making differ between nursing home floor staff and managers when staff refuse to care for LGBTQ+ residents? To answer this question, this study uses social coherence as a conceptual framework to understand the process of reflection that staff employ when a colleague invokes a religious exemption to care. METHODS: This qualitative comparative study uses in-depth semistructured interviews to compare responses from nursing home floor staff and managers (n = 80). Qualitative content analysis incorporated inductive and deductive coding approaches. RESULTS: Staff invoked 5 frames to reach social coherence: fairness, resident safety and comfort, individual religious beliefs, job obligations, and laws/policies. Floor staff and managers invoked the same 2 reasons (fairness, resident safety and comfort) to reach social coherence. However, floor staff differed from managers by also invoking individual religious beliefs and job obligations; whereas managers turned to laws and policies to reconcile tensions between religious rights and LGBTQ+ resident rights to care. DISCUSSION: In an increasingly polarized world, findings from this study illuminate nuances (and potential new areas of allyship) in how floor staff and managers understand and use various frames when deciding whether or not to accommodate a colleague who refuses care to an LGBTQ+ resident because of religious or moral reasons.


Assuntos
Casas de Saúde , Pesquisa Qualitativa , Minorias Sexuais e de Gênero , Humanos , Minorias Sexuais e de Gênero/psicologia , Feminino , Masculino , Idoso , Pessoa de Meia-Idade , Atitude do Pessoal de Saúde , Adulto , Recursos Humanos de Enfermagem/psicologia
11.
Pol Merkur Lekarski ; 52(3): 304-318, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39007469

RESUMO

OBJECTIVE: Aim: The purpose of this study is to report on the development and initial psychometric testing of a questionnaire to investigate nurses' discrimination attitudes and beliefs towards people of dif f erent ethnic origins. PATIENTS AND METHODS: Materials and Methods: The initial stage involved the selection of the questions of the tool after a comprehensive evaluation of the relevant international literature and the tools used in previous related studies. The reliability (forward-backward translation) of the questions was assessed, along with the content, face, and structure. To conduct the study, which was carried out from 07/2021 to 01/2022 a sample consisting of 30 and 2,034 nurses and their assistants was used for the pilot and the fi nal research, respectively. RESULTS: Results: Given that the Kaiser-Meyer-Olkin (KMO) threshold value of 0.89 was achieved, the sample was considered sufficient and appropriate for factor analysis. A statistically signif i cant result (p<0.001) from Bartlett's test indicated a substantial connection between the questions and conf i rmed that the data were suitable for factor analysis. Twenty statements altogether, with seven possible answers ranging from "totally disagree" to "completely agree," were included in the questionnaire. For the questions, three distinct factors - communication, difficulties, and discrimination - were shown to account for 47.1% of the variability. Reliability analyzes showed satisfactory Cronbach alpha coefficient scores for all factors, ranging from 0.78 to 0.82. CONCLUSION: Conclusions: The current study demonstrates that the questionnaire we developed is a legitimate and trustworthy instrument for evaluating professional nurses' discriminatory attitudes and beliefs toward individuals from various ethnic backgrounds. The questionnaire can be used to help design interventions to end discrimination, guarantee equitable access to healthcare services, and provide high-quality care for individuals from diverse backgrounds. It can also be used to identify the factors that inf l uence nurses' attitudes and perceptions toward these patient populations.


Assuntos
Atitude do Pessoal de Saúde , Psicometria , Humanos , Inquéritos e Questionários , Reprodutibilidade dos Testes , Feminino , Masculino , Adulto , Recursos Humanos de Enfermagem/psicologia , Pessoa de Meia-Idade , Preconceito , Enfermeiras e Enfermeiros/psicologia
12.
Rev. urug. enferm ; 19(1)jun. 2024.
Artigo em Espanhol | LILACS, BDENF - Enfermagem | ID: biblio-1561385

RESUMO

Objetivo: determinar la huella psicosocial de la pandemia por COVID-19 en enfermeras de 4 países de Sudamérica, año 2021-2022. Métodos: estudio de corte transversal, en una muestra de 279 enfermeras: colombianas (86), paraguayas (68), mexicanas (54) y chilenas (71), que cumplieron los criterios de inclusión.Se aplicaron las escalas de Duke-UNC para evaluar apoyo social recibido y confidencial; El cuestionario Medical Outcomes Study-Social Support Survey (MOS) para evaluar apoyo social y el cuestionario de variables de interacción psicosocial (VIP) Resultados: tanto el buen apoyo confidencial como afectivo, se asoció con las variables de vivir con dos o más personas, ser perteneciente a una religión, y trabajar en una unidad con pacientes. El consumo de medicamentos fue significativamente menor en el grupo con buen apoyo confidencial y afectivo, (p=0.012) Conclusiones:la ejecución del rol profesional de la enfermera es conocido como de alta calidad, y con una destacada responsabilidad, especialmente en pandemia por SAR COVID 19. Sin embargo, se aprecian huellas residuales físicas y emocionales en los profesionales de enfermería.


Objective: to determine the psychosocial footprint of the COVID-19 pandemic in nurses from 4 South American countries, 2021-2022. Methods: cross-sectional study, in a sample of 279 nurses: Colombian (86), Paraguayan (68), Mexican (54) and Chilean (71), who met the inclusion criteria. Duke-UNC scales were applied to assess received and confidential social support; The Medical Outcomes Study-Social Support Survey (MOS) questionnaire to assess social support and the psychosocial interaction variables (VIP) questionnaire. Results: both good confidential and affective support were associated with the variables of living with two or more people, belonging to a religion, and working in a unit with patients. Medication consumption was significantly lower in the group with good confidential and affective support, (p=0.012). Conclusions: the execution of the professional role of the nurse is known to be of high quality, and with outstanding responsibility, especially in the SAR pandemic. COVID 19. However, residual physical and emotional traces can be seen in nursing professionals.


Objetivo determinar a pegada psicossocial da pandemia de COVID-19 em enfermeiros de 4 países da América do Sul, 2021-2022. Métodos: estudo transversal, em uma amostra de 279 enfermeiras: colombianas (86), paraguaias (68), mexicanas (54) e chilenas (71), que atenderam aos critérios de inclusão. As escalas de Duke-UNC foram aplicadas para avaliar o suporte social recebido e confidencial; o questionário Medical Outcomes Study-Social Support Survey (MOS) para avaliar o apoio social e o questionário de variáveis de interação psicossocial (VIP). Resultados: tanto o bom apoio confidencial quanto o afetivo estiveram associados às variáveis morar com duas ou mais pessoas, pertencer a uma religião e trabalhar em unidade com pacientes. O consumo de medicamentos foi significativamente menor no grupo com bom apoio confidencial e afetivo, (p=0,012). Conclusões: sabe-se que o desempenho da função profissional do enfermeiro é de alta qualidade, e com destacada responsabilidade, principalmente na pandemia SAR COVID 19. No entanto, traços residuais físicos e emocionais podem ser observados nos profissionais de enfermagem.


Assuntos
Humanos , Apoio Social , Esgotamento Profissional , COVID-19 , Relações Enfermeiro-Paciente , Recursos Humanos de Enfermagem
13.
Front Public Health ; 12: 1401044, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38932768

RESUMO

Objective: To investigate the status quo of empathic fatigue, professional identity, and sleep quality of nursing staff in nursing institutions. To analyze the correlation between empathic fatigue, professional identity and sleep quality of nursing staff. Methods: This is a cross-sectional study. The method of convenient sampling was used to select 224 nursing workers from the older adult's institutions in the Panjin area as the investigation objects. The nurses' general data questionnaire, the Chinese version of the compassion fatigue short scale, the nurses' professional identity Scale, and the Pittsburgh Sleep Quality Index were used as evaluation tools. SPSS26.0 statistical software was used to sort out and analyze the data. Results: There was a positive correlation between empathic fatigue and sleep quality; there was a negative correlation between empathy fatigue and professional identity. Occupational identity and sleep quality were negatively correlated. Conclusion: There is a correlation between empathic fatigue, professional identity, and sleep quality of nursing workers. Empathy fatigue is positively correlated with sleep quality. Empathy fatigue was negatively correlated with professional identity. Occupational identity was negatively correlated with sleep quality. To provide a theoretical basis for the management of older adult's nursing staff and the formulation of corresponding management systems and policies, promote the mental health of older adult's nursing staff, improve sleep quality, and provide a theoretical basis and reference for future intervention research.


Assuntos
Fadiga de Compaixão , Qualidade do Sono , Humanos , Estudos Transversais , Masculino , Feminino , Adulto , Inquéritos e Questionários , Pessoa de Meia-Idade , Fadiga de Compaixão/psicologia , China , Empatia , Recursos Humanos de Enfermagem/psicologia , Recursos Humanos de Enfermagem Hospitalar/psicologia , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos
14.
J Am Med Dir Assoc ; 25(8): 105087, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38885933

RESUMO

OBJECTIVES: To examine the relationship between changes in nursing staff-hours per resident-day and injury-related emergency department (ED) visits among assisted living (AL) residents with Alzheimer disease and related dementias (ADRD). DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: We leveraged a data set of AL community characteristics in Ohio linked to Medicare claims data from 2007 to 2015. METHODS: We estimated Poisson models examining the relationships of personal care aide, registered nurse (RN), licensed practical nurse (LPN), and total nursing hours with injury-related ED visits. Models were adjusted for resident characteristics (ie, age, race, sex, dual eligibility, presence and number of chronic conditions), AL community characteristics (percentage of residents on Medicaid, average resident acuity), year fixed effects, and assisted living fixed effects. We examined all injury-related ED visits and injury-related ED visits resulting in hospital admission as separate outcomes. RESULTS: The sample included 122,700 person-months, representing 12,144 fee-for-service Medicare beneficiaries with ADRD within 455 different AL communities in Ohio between 2007 and 2015. Median total nursing hours increased from 1.34 in 2007 to 1.69 in 2015. In the fully adjusted model, an increase in 1 RN-hour per resident-day was associated with a decrease in the risk of any injury-related ED visit (incidence rate ratio 0.59, 95% CI 0.36-0.96), representing a 53% decrease. Changes in RN-hours were not associated with injury-related inpatient hospitalizations. Changes in total nursing, LPN, and personal care aide hours were not associated with changes in the risk of injury-related ED visits or inpatient hospitalizations. CONCLUSIONS AND IMPLICATIONS: Increases in RN staffing hours were associated with reduced injury-related ED use among AL residents with ADRD. RNs provide surveillance and care oversight that may help mitigate injury risk, and they are able to physically assess residents at the time of a fall and/or injury, which can preempt unnecessary ED transfers.


Assuntos
Doença de Alzheimer , Moradias Assistidas , Demência , Serviço Hospitalar de Emergência , Humanos , Masculino , Feminino , Estudos Retrospectivos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Idoso , Ohio/epidemiologia , Estados Unidos , Demência/epidemiologia , Idoso de 80 Anos ou mais , Recursos Humanos de Enfermagem , Ferimentos e Lesões/epidemiologia , Medicare , Visitas ao Pronto Socorro
15.
Int J Nurs Stud ; 157: 104815, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38905748

RESUMO

BACKGROUND: Care needs amongst 425,000 dependent older residents in English care homes are becoming more complex. The quality of care in these homes is influenced by staffing levels, especially the presence of registered nurses (RNs). Existing research on this topic, often US-focused and relying on linear assumptions, has limitations. This study aims to investigate the non-linear relationship between RN staffing and care quality in English care homes using machine learning and administrative data from two major care home providers. METHODS: A retrospective observational study was conducted using data from two English care home providers. Each was analysed separately due to variations in data reporting and care processes. Various care quality indicators and staffing metrics were collected for a 3.5-year period. Regression analysis and machine learning (random forest) were employed to identify non-linear relationships. Ethical approval was obtained for the study. RESULTS: Using linear methods, higher skill mix - more care provided by RNs - was associated with lower incidence of adverse outcomes, such as urinary tract infections and hospitalisations. However, non-linear skill mix-outcome relationship modelling revealed both low and high skill mix levels were linked to higher risks. The effects of agency RN usage varied between providers, increasing risks in one but not the other. DISCUSSION: The study highlights the cost implications of increasing RN staffing establishments to improve care quality, suggesting a non-linear relationship and an optimal staffing threshold of around one-quarter of care provided by nurses. Alternative roles, such as care practitioners, merit exploration for meeting care demands whilst maintaining quality. This research underscores the need for a workforce plan for social care in England. It advocates for the incorporation of machine learning models alongside traditional regression-based methods. Our results may have limited generalisability to smaller providers and experimental research to redesign care processes effectively may be needed. CONCLUSION: RNs are crucial for quality in care homes. Contrary to the assumption that higher nurse staffing necessarily leads to better care quality, this study reveals a nuanced, non-linear relationship between RN staffing and care quality in English care homes. It suggests that identifying an optimal staffing threshold, beyond which increasing nursing inputs may not significantly enhance care quality may necessitate reconsidering care system design and (human) resource allocation. Further experimental research is required to elucidate resource-specific thresholds and further strengthen evidence for care home staffing. TWEETABLE ABSTRACT: How much nursing care is needed to assure quality in care homes? Evidence from 2 English care home providers shows that nurse sensitive outcomes (an indicator of quality) are better when ~25 % of care is provided by nurses. Nurse shortages increase risks for residents.


Assuntos
Recursos Humanos de Enfermagem , Admissão e Escalonamento de Pessoal , Qualidade da Assistência à Saúde , Estudos Retrospectivos , Estudos Longitudinais , Humanos , Recursos Humanos de Enfermagem/provisão & distribuição , Casas de Saúde , Inglaterra , Assistência de Longa Duração
16.
Gerontologist ; 64(8)2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-38832394

RESUMO

BACKGROUND AND OBJECTIVES: The purpose of this study was to examine the relationship between dimensions of grief support (recognition of the relationship, acknowledgement of the loss, and inclusion of the griever) and aspects of burnout (emotional exhaustion, depersonalization, and personal accomplishment) among nursing home staff. RESEARCH DESIGN AND METHODS: Data were collected from 553 nursing home workers from 37 nursing home facilities in 5 states during fall of 2022. Responses to the Maslach Burnout Inventory and Grief Support Health Care Scale were analyzed for this study. RESULTS: The study found that recognizing the relationship with deceased patients led to a decrease in exhaustion and depersonalization among workers while simultaneously enhancing their sense of personal accomplishment. Including the griever in the support process lowered all burnout subscales for nursing home staff. Acknowledging the loss was associated with higher levels of personal accomplishment. Registered nurses, nurse practitioners, and physicians experienced higher levels of exhaustion and depersonalization compared to other nursing home staff. Behavioral health workers had the highest personal accomplishment, whereas direct support workers reported the lowest. DISCUSSION AND IMPLICATIONS: These findings have important implications for improving the well-being of nursing home staff, emphasizing the importance of organizational grief support, and tailored interventions to address burnout among different healthcare provider roles in nursing homes.


Assuntos
Esgotamento Profissional , Pesar , Casas de Saúde , Humanos , Esgotamento Profissional/psicologia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Apoio Social , Pessoal de Saúde/psicologia , Inquéritos e Questionários , Recursos Humanos de Enfermagem/psicologia , Satisfação no Emprego
17.
Int J Nurs Stud ; 157: 104825, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38901125

RESUMO

BACKGROUND: Various trials are investigating the effect of digital and face-to-face interventions on nurse resilience; however, it remains unclear whether these interventions have immediate, short-term or long-term effects. OBJECTIVE: The objective of the systematic review is to identify the types of interventions and assess the immediate (<3 months), short-term (3-6 months), and long-term (>6 months) effects of these interventions on nurse resilience. DESIGN: This systematic review was registered in the International Prospective Register of Systematic Reviews (Registered Number: CRD 42023434924), and results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. METHODS: Data were collated from the databases of CINAHL, Cochrane Library, Embase (OVID), Medline, and Scopus between March and May 2023. The research protocol was determined following the framework of population, exposure, outcomes, and type of study. The articles with full text published between 2000 and 2023 were included. Studies were included if they (1) involved the nurses who provided patient care directly, (2) utilised digital or face-to-face interventions, (3) reported resilience outcomes, and (4) were randomised controlled trials or clinical trials. The JBI critical appraisal tool was utilised to assess the risk of bias for the studies collected. RESULTS: A total of 18 studies met the criteria and were analysed. Pooled results demonstrated that digital interventions had a statistically significant positive effect on nurse resilience at 4-5-month follow-ups (standardised mean difference [SMD] = 0.71; 95 % CI = 0.13, 1.29; P = 0.02) compared to no interventions. Additionally, pooled data showed no effect on nurse resilience at all the follow-ups, compared to no interventions. No significant results were observed in comparisons of digital or face-to-face interventions between the intervention and control groups. CONCLUSIONS: The review assessed digital and face-to-face resilience interventions in nurses across 18 trials. Digital methods showed a short-term impact within 4-5 months, whilst face-to-face interventions had no effect during follow-ups. Realistic expectations, ongoing support, and tailored interventions are crucial for nurse resilience enhancement. TWEETABLE ABSTRACT: It was identified digital interventions had a short-term impact on nurse resilience, whilst face-to-face interventions had no effect during follow-ups @fionayyu.


Assuntos
Resiliência Psicológica , Humanos , Recursos Humanos de Enfermagem/psicologia
19.
Contemp Nurse ; 60(5): 496-515, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38861583

RESUMO

AIM: To assess the knowledge, attitudes and practices of Registered Nurses working in residential aged care facilities pertaining to pain management for residents living with dementia. BACKGROUND: Sub-optimal pain management continues for people living with dementia in residential aged care. Registered Nurses are the pivotal staff responsible for complex assessment and management of people residing in residential aged care facilities. DESIGN AND METHODS: :This integrative literature review was informed by Whittemore (2005). Searching and screening followed the PRISMA guidelines. RESULTS: Thirteen papers were identified, the major themes identified were gaps in knowledge and skills, uncertainty of assessment, and delays in treatment. CONCLUSION: Registered Nurses require education on pain management for people living with dementia in residential aged care. Broader issues in residential aged care contribute to the problem and require examination. Research pertaining to Registered Nurses' roles pain management for residents living with dementia is required.


Assuntos
Demência , Conhecimentos, Atitudes e Prática em Saúde , Manejo da Dor , Humanos , Demência/enfermagem , Manejo da Dor/métodos , Idoso , Recursos Humanos de Enfermagem/psicologia , Recursos Humanos de Enfermagem/educação , Pessoa de Meia-Idade , Feminino , Masculino , Adulto , Casas de Saúde , Instituição de Longa Permanência para Idosos , Idoso de 80 Anos ou mais , Competência Clínica , Atitude do Pessoal de Saúde
20.
Rev Bras Enferm ; 77(2): e20230167, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38896705

RESUMO

OBJECTIVE: to analyze sleep duration and sleep quality in nursing professionals who work in shifts. METHOD: this is a cross-sectional, analytical research, carried out between September 2017 and April 2018, at a public hospital in southern Brazil, with the nursing team. A socio-occupational and health symptoms questionnaire, the Epworth Sleepiness Scale, and the Pittsburgh Sleep Quality Index were used. Data are presented as descriptive and inferential statistics, bivariate analysis, and binary logistic regression. RESULTS: participants were 308 nursing professionals with a predominance of long-term sleep, absence of drowsiness, and poor sleep quality. Short-term sleep (<6h) was associated with day shift and poor sleep quality. Sleep quality was associated with presence excessive daytime sleepiness and work day shift. CONCLUSION: work shift, insomnia and headache were the main factors related short-term sleep for nursing professionals. The results may justify the development of intervention research for workers' health.


Assuntos
Qualidade do Sono , Humanos , Brasil , Estudos Transversais , Masculino , Feminino , Adulto , Inquéritos e Questionários , Pessoa de Meia-Idade , Tolerância ao Trabalho Programado/psicologia , Recursos Humanos de Enfermagem/estatística & dados numéricos , Recursos Humanos de Enfermagem/psicologia , Sono/fisiologia , Fatores de Tempo , Duração do Sono
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