Medicine and Health Sciences Commons^™

Intergenerational Programming In Long-Term Care Homes, Madison Lowe

Capstone Research Posters

This study explores how intergenerational programming can be improved and implemented throughout long-term care homes in Canada. To answer this question, five eligible participants were interviewed based on their experiences with intergenerational programming in long-term care settings. These participants were recruited by means of word-of-mouth, social media outreach and direct phone calls. The findings highlight the significance of selecting intergenerational activities that are accessible and enjoyable for participants, mitigating stigma towards the older generation, fostering open communication between the participants and the staff members at both facilities , having proper staffing and designation of responsibilities as well as accessibility to …

Assessment Of Self-Efficacy And Practice Change Following Pressure Injury Education In A Long-Term Care Facility, Charity L. Booker

Electronic Theses and Dissertations

The purpose of this scholarly project was to evaluate if pressure injury education improved nursing knowledge and self-efficacy in the prevention and management of pressure injuries with the intent to improve practice. A literature review was conducted to evaluate educational interventions for adult learners and nursing roles in the care process. Existing studies indicated that patient outcomes are improved when nurses have adequate knowledge in pressure injury prevention. This quality improvement project was implemented in a long-term care facility with 28 nursing staff. The Agency for Healthcare Research and Quality pressure injury best practices presentation was the basis for the …

Implementing An Evidence-Based Pressure Injury Bundle To Reduce Acquired Pressure Injuries In A Long-Term Care Facility, Latecia Rhoden

Doctor of Nursing Practice Projects

Background: Pressure injuries in the United States affect between 1-3 million people. Of the percentage of patients affected by pressure injuries, a range from 2% to 28% of those patients are in long-term care facilities. In Alabama, the pressure injury rate in long-term care facilities ranges from 2.3% to 18.4%. According to this long-term care facility's November 2022 quality improvement report, the acquired pressure rate rose from 2.2% to 8.3% in a year. A total of nineteen newly acquired pressure injuries were reported. Eleven of the nineteen pressure injuries occurred in the long-term stay unit, accounting for almost 58% of …

A Systematic Literature Review On Long-Term Care Quality Improvement Initiatives In The United States, Daisy D. Pang

Capstone Experience

As the number of people 65 and older increases due to the baby boomer population, there will be a greater demand for long-term care (LTC) services. Quality improvement in LTC is essential to ensure positive health outcomes, patient satisfaction, and reduction in healthcare costs. The purpose of this systematic literature review is to identify the current quality initiatives for LTC in the United States and evaluate the outcomes, effects, and values of each quality initiative identified to support the claim that current the quality initiatives have a limited effect on quality improvement in LTC settings. The Preferred Reporting Items for …

Wound Care Training Using Simulation: Impacts On Clinical Knowledge, Skill Performance, And Satisfaction Among Skilled Nursing Facility Staff, Anna Sue Moody, Vorachai Sribanditmongkol

College of Health Sciences Posters

Impaired skin integrity, wound formation, and infections are significant health concerns. Therefore, competent wound care is essential for skilled nursing facility residents in long-term care. To recoup losses sustained during the COVID-19 pandemic, one skilled, nursing facility in North Carolina increased admissions from other facilities from 59% to 68%, which resulted in a surge of residents with pre-existing and complex wounds. High staff turnover and inconsistent wound care practices were also observed. Research suggests that healthcare institutions with high attrition may experience degradations of clinical knowledge, skill proficiency, and safe, quality nursing care delivery. Evidence supports the use of simulation-based …

Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks

Walden Dissertations and Doctoral Studies

Nursing staff working in long-term care settings experience high levels of occupational stress related to many factors that can lead to poor outcomes for the nursing staff and the residents. In 2020, the World Health Organization declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a pandemic which over the course of 3 years, has added an additional source of work-related stress for long-term care nursing staff. This quantitative cross-sectional study was guided by the job demand-control-support model to explore perceived stress and nursing stress among nursing staff working in the long-term care setting in Georgia and …

Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks

Walden Dissertations and Doctoral Studies

Nursing staff working in long-term care settings experience high levels of occupational stress related to many factors that can lead to poor outcomes for the nursing staff and the residents. In 2020, the World Health Organization declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a pandemic which over the course of 3 years, has added an additional source of work-related stress for long-term care nursing staff. This quantitative cross-sectional study was guided by the job demand-control-support model to explore perceived stress and nursing stress among nursing staff working in the long-term care setting in Georgia and …

The Impact Of Race/Ethnicity On Occupational Stress In East Texas Certified Nursing Assistants, Jackie Schniederjan Mcdonald

Nursing Theses and Dissertations

Significance: Certified nursing assistants (CNAs) provide direct care to those who live in long-term care facilities. As the population ages, the need for CNAs has grown. Nurse researchers have studied turnover and occupational stress, but no studies have examined racial/ethnic differences in CNA stress in East Texas.

Design / Purpose Statement: A convergent parallel mixed methods study was planned to address occupational stress experienced by CNAs in East Texas long-term care facilities. The Work Stress Scale and demographic questions were used to compare levels of reported occupational stress between racially diverse CNAs. However, lack of response to interview invitations necessitated …

The Effect Of Isolation On The Mental Health Of Older Adults, Christina Yates

Senior Honors Theses

As individuals age and lose mobility and cognitive functioning, many require full-time care which their loved ones are unable to provide. This often results in placement into long-term care facilities, and these facilities are notorious for being understaffed. Physical health becomes the only priority, depriving the client of having their mental and emotional needs fulfilled. Family and friends may decrease visitation due to distance or convenience. In 2020, the Covid-19 pandemic closed the doors of many facilities to nearly all visitors. Thus, the only individuals the residents of these facilities experienced interaction with were overworked staff members looking intimidating in …

Development Of An Experienced Quality Measure For Clients, Informal And Formal Caregivers In Home Care In The Netherlands: A Participatory Action Research, Roy Haex, Theresa Thoma-Lürken Phd, Anna J.H.M. Beurskens Phd, Sandra M.G. Zwakhalen Phd, Rn

Patient Experience Journal

To optimise home care provision and to identify potential improvements in the care process, it is important to gain insight into the care experiences that influence care quality. The aim was to develop a qualitative experienced quality measure for home care in The Netherlands, facilitating conversations between clients and caregivers in generating possible points of improvement for the primary care process. A participatory action research design to develop the measure following three iterative cycles, using various data sources in evaluating requirements related to the goal, feasibility in care setting, and usability in the care process. The final design comprises an …

Examining Nurse Engagement In Antimicrobial Stewardship At Long-Term Care Facilities, Mosam S. Patel, Kathryn L. Dambrino, Olivia Bahemuka, David Phillippi

DNP Scholarly Projects

Background: The World Health Organization stated that antimicrobial resistance is one of the top 10 threats to global health. To combat antimicrobial resistance, antimicrobial stewardship (AMS) programs were developed. Efforts to engage nurses in stewardship efforts have been limited. Bedside nurses are in an optimal position to help decrease antimicrobial use, which is especially relevant in long-term care facilities where up to 75% of antibiotic use is deemed unnecessary or inappropriate. The purpose of this Doctor of Nursing Practice scholarly project was to examine factors that influence nurse engagement in AMS at long-term care facilities in Tennessee. Methods: A …

The Lived Experience Of Older Adults With Visual Impairments And Their Integration Into Social And Recreational Activities In The Long-Term Care Setting: A Phenomenological Study, Julie Ann Conboy Russo

Theses & Dissertations

The prevalence of vision loss in the elderly is high. Visual impairment in long-term care (LTC) settings may be a barrier to fully interacting in therapeutic recreational and social activities. Living with visual barriers may hamper safety (i.e., fear of falling and navigating in unfamiliar settings); cognitive ability; and participation in activities leading to isolation, depression, and loss of self-esteem. Decreased stimulation may affect one’s overall happiness and quality of life. A qualitative phenomenological design was followed to capture the lived experience of older adults with visual impairments living in LTC settings and their integration into social and recreational activities …

Hand Hygiene Compliance In Nursing Staff Of Long-Term Care Facilities, Lindsay Clontz

Master of Science in Nursing Theses and Projects

Elderly residents of long-term care facilities are most at risk to acquire serious infections. Because of the relationship with nursing staff members, they are most likely to get an infection from a member of the nursing team. It is imperative that nursing staff members receive proper training related to hand hygiene in order to adhere to infection prevention and control guidelines. The goal of this project is to improve hand hygiene in nursing staff to reduce the number of resident infections recorded on the monthly infection surveillance report. This project utilizes a multi-faceted approach including a pre-test, presentation, post-test, return …

Comparison Of The Mental Burden On Nursing Care Providers With And Without Mat-Type Sleep State Sensors At A Nursing Home In Tokyo, Japan: Quasi-Experimental Study, Sakiko Itoh, Hwee-Pink Tan, Kenichi Kudo, Yasuko Ogata

Research Collection School Of Computing and Information Systems

Background: Increasing need for nursing care has led to the increased burden on formal caregivers, with those in nursing homes having to deal with exhausting labor. Although research activities on the use of internet of things devices to support nursing care for older adults exist, there is limited evidence on the effectiveness of these interventions among formal caregivers in nursing homes. Objective: This study aims to investigate whether mat-type sleep state sensors for supporting nursing care can reduce the mental burden of formal caregivers in a nursing home. Methods: This was a quasi-experimental study at a nursing home in Tokyo, …

Increase Knowledge And Attitude In End-Of-Life For Long-Term Care Nurses, Lisa Mitchell

Walden Dissertations and Doctoral Studies

Nurses are key health professionals in long-term care facilities who have an essential role in providing compassionate care at the end-of-life. The customary education that nurses receive in end-of-life care is inadequate to meet the complex care of dying patients. The purpose of this scholarly project was to implement an evidence-based end-of-life educational program to improve the nursing staff knowledge, attitudes towards care of the dying, and standards in long-term care. The theoretical framework to guide this project is Bandura’s self-efficacy to support the confidence and attitude of nurses caring for the dying. The End-of-Life Nursing Education Consortium (ELNEC) Geriatric …

A Formal Antibiotic Stewardship Protocol To Reduce Antibiotic Use, Shalese Ladawne Collins

MSN Capstone Projects

Background: Antimicrobial resistance is a nationwide public health crisis which is a result of indiscriminate antibiotic use. Inappropriate antibiotic prescribing for infections have been overlooked for several years in long-term care facilities. The Centers for Disease Control and Prevention have been compelled to require long-term care facilities to start an antibiotic stewardship program that is a key measure to combat antimicrobial resistance and seeks to accomplish this by improving antibiotic use. Many healthcare workers report presumed urinary tract infections to the provider without the accurate understanding of what criteria is required for the need of antibiotics.

Objective: Create a protocol …

Intent To Stay, Moral Distress, And Nurse Practice Environment Among Long-Term Care Nurses, Amil Tan

Dissertations, Theses, and Capstone Projects

Background: Many long-term care facilities in the United States face significant problems with nurse retention and turnover. These challenges are attributed at least in part to moral distress and a negative nurse practice environment. Licensed nurses working in long-term care facilities experience ethical challenges such as lack of resources, use of restraints, end-of-life issues, and caring for residents with dementia that, if not resolved, can lead to moral distress- especially if left unresolved. Long-term care administrators and nurse managers increasingly strive to improve leadership support for long-term care staff that will positively affect the nurse practice environment.

Aim/Purpose: The purpose …

An Interprofessional Approach To Holistic End-Of-Life., Andrew Aschbacher

Doctor of Nursing Practice Papers

Purpose: The goal of this Doctor of Nursing Practice (DNP) project was to develop and evaluate an evidence-based clinical practice guideline (EBP) for an interprofessional approach across four end-of-life care domains (1) ethnocentric spiritual wellbeing, (2) mental wellbeing, (3) symptom management, and (4) value-based goals of care. Design and Methods: The Iowa Model for the Development of Evidence-Based Practice guided the development of the practice guideline. A multi-phase literature review was conducted to establish and grade the best evidence. A two-phase evaluation plan was developed. The University of Louisville Institutional Review Board approved the project. Results: In evaluation phase one, …

Rapid Evaluation Teams (Ret): No Longer Just For Hospitals, Amanda Thorson

Nursing Posters

Study:

Everyone goes to the Nursing Home for End of Life - Right? Wrong Cumulatively, over a 4-year study there were 678 residents with Full Code status residing at Carris Health Care Center and 687 residents the DNR/DNI status. That is only a 10-resident different between Full Code and DNR/DNI

Plan:

• Improve long-term care staff's ability to call for, and receive, support to rapidly evaluate and address an urgent or concerning situation.
• Need for this plan is supported by increased number of OHFC substantiated events related to code status in MN and number of residents with Full Code status in …

Improving The Utilization Of Cnas In Pressure Ulcer Prevention, Jaclyn N. Bitterman

Doctor of Nursing Practice Projects

An estimated 2.5 million Americans are affected by pressure ulcers annually with the largest majority impacted the geriatric population. In order to achieve prevention of facility acquired pressure ulcers, the nursing team must properly identify patients at risk to prevent the injury associated with pressure. CNAs play a key role in this effort. The purpose of this project was used to develop, implement, and evaluate a training program for CNA students to improve knowledge and promote engaged attitudes in the prevention of pressure ulcers. Results of the project showed improvement after the training, but overall was not statistically significant. Overall …

Is Anybody Listening?: Factors Affecting Pain Management In Veterans Within An Acute Care Rehab Setting, Laura Oseghae

Doctor of Nursing Practice

Background: In the United States, pain is a widely discussed issue due to the opioid epidemic stemming from a history of pain mismanagement. Clinical guidelines for successful pain management techniques are readily available for providers to incorporate into the individualized patient care plan.

Purpose: The purpose of this project is to improve pain management through implementation of the VA pain management guidelines and improved interdisciplinary team communication.

Objectives: This project aims to decrease the number of patients reporting moderate to severe pain, enhance staff/provider communication, and improve the provider’s overall process for managing pain with an individualized treatment plan.

Interventions: …

Preventing Falls In Long-Term Care Using Patient-Centered Fall Interventions, Angela Blakley

Student Scholarly Projects

Practice Problem: The practice problem identified within the Community Living Center included continuous falls, despite using current fall prevention strategies and provider-driven interventions. Baseline data reflected a fall rate of 4.2 in the long-term care areas despite improving the fall prevention program.

PICOT: The PICOT question that guided this project was: In older adult residents (P), what is the effect of a standing operating procedure (SOP) using patient-centered interventions (I) compared to physician-driven fall interventions (C) on decreasing falls and falls with injuries (O) within one month (T)?

Evidence: In twelve high-quality articles that fit the eligibility criteria and …

Exploring The Effects Of The Cycling Without Age Program On Older Adults Living In Long-Term Care, Victoria Cotnam

Electronic Thesis and Dissertation Repository

The Cycling Without Age program, offered in long-term care homes around the world, allows residents to experience the feeling of a bike ride in the trishaw as a volunteer pedals the electrical bike. The purpose of this pragmatic observational study was to measure the effects of an existing program in a Canadian long-term care home on residents’ happiness, quality of life, pain and functional status (using Resident-Assessment Instrument Minimum Data Set 2.0). A convenience sample of 39 residents participated in two groups, a biking group (n=23) and a strolls group (n=16) over the period of 12 weeks. Findings show that …

Acute Kidney Injury, Mary Boadu

Nursing Student Class Projects (Formerly MSN)

This poster presents up to date information regarding acute kidney injury (AKI) which often presents in patients in the intensive care unit (ICU). Most patients may not have identifiable symptoms therefore, advanced practice clinicians are charged with a great responsibility to diagnose, treat and follow-up with such patients. It is pertinent that clinicians recognize AKI early in an effort to prevent adverse consequences as seen in the progression of AKI to chronic kidney disease (CKD).

Education Module For Serotonin Syndrome With 24-Hour Dose Monitoring Intervention., Jonathon Blake Hicks

Doctor of Nursing Practice Papers

Background: Serotonin Syndrome (SS) is recognized by a combination of mental status changes, neuromuscular hyperactivity, and autonomic hyperactivity (Volpi-Abadie, Kaye, & Kaye, 2013). Despite the severity and commonality of SS, it is an under reported and an under treated condition (Boyer, 2018). The purpose of this project was to 1) implement an education module on SS using a pretest and posttest design to increase LTC staff knowledge, and 2) evaluate the effectiveness (e.g., confidence level, satisfaction) of the intervention among nursing staff. Method: An education module was implemented focusing on recognizing and treating SS in aging adults. A pretest-posttest design …

Improving Palliative And Hospice Knowledge Among Nurses In A Long-Term Care Facility., Kelly Rae Smith

Doctor of Nursing Practice Papers

Background: Early referral and implementation of palliative best-practices in patients with chronic diseases and at the end-of-life (EOL) significantly decreases patient symptom burden, increases quality-of-life, contributes to patient and family satisfaction with care, and reduces healthcare costs. Nurses in long-term care (LTC) are poised to help identify patients appropriate for referral, to provide quality palliative and EOL care, but lack adequate knowledge. Objectives: To determine if a short one-on-one or two-on-one palliative and hospice educational offering can improve (a) knowledge of best-practice palliative and hospice care symptom management techniques (b) the ability of nurses to identify patients appropriate for hospice …

Dnp Final Report: Pressure Injury Prevention Patient Initiative (Pippi), Melissa A. De Los Santos

DNP Final Reports

Background: Pressure injuries have been known to affect approximately 2.5 million patients each year, with roughly 60,000 patients dying as a direct result of a pressure injury. Associate healthcare costs are between $9.1-$11.6 billion per year in the United States. The cost of individual patient care was estimated between $20,900 and $151,700 per pressure injury. During the last three years, pressure injury prevalence has risen within the local long-term care organization. Pressure injury prevention interventions have been developed to improve healthcare outcomes, cut costs, and increase revenue for long-term care organizations.

Purpose: Deliver evidence-based educational intervention that incorporates strategies for …

Exploring The Homeless Persons Perception Of Living In A Long-Term Care Facility, Janice Woods

Dissertations

Objective:The purpose of this study was to explore the lived experiences of homeless persons admitted to a nursing home facility. Originally, the study was to explore their understanding of and their experience with advance health care planning; coincidently, the participants were more open to their experience of living in a long-term care facility.

Method:A convenience sample of 13 participants (12 male, 1 female) at four long-term care facilities in Southern California were interviewed about their perception of advanced health care planning, including the physician’s orders for life sustaining treatment (POLST); a consent form required in all nursing homes. …

Effects Of Therapeutic Music On Improving Depressive Symptoms Among Long-Term Care Facility Residents, Yi Jin

Evidence-Based Practice Project Reports

Depression is a common mental disorder that can contribute to both physical and psychological suffering (Skinner, 2014). The prevalence rate of depression is especially high among long-term care facility residents (CounsultGeri, 2018; Lolk & Andersen, 2015). The purpose of this EBP project was to establish a protocol incorporating therapeutic music as an adjunct therapy for managing depressive symptoms among residents of a long-term care facility in the Midwest. Roy adaptation model (Roy, 2009) was utilized as the theoretical framework, and the model for evidence-based practice change (Rosswurm & Larrabee, 2009) guided the project implementation. A total of 13 subjects were …

Quality Improvement On The Long-Term Care Ventilator Unit: Interventions To Increase Patient Safety And Prevent Patient Harm, Billie Anderson, Joanne Samuels

DNP Scholarly Projects

BACKGROUND: Tracheostomy patients are susceptible to life-threatening emergencies when their airways are compromised. Epidemiologic data suggests that 3.2% to 30% of tracheostomy patents have a complication. The long-term care ventilator unit (LTCVU) is a 25-bed unit in a nursing home. It has noted that 40% of patients have a complication. A group of hospitals demonstrated a 90% reduction in complications through five interventions.

METHODS: The Johns Hopkins Nursing Evidence-Based Practice model was utilized to take the Global Tracheostomy Collaborative interventions and apply them to the LTCVU with the aim of reducing the number of airway complications on the unit by …