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Full-Text Articles in Medicine and Health Sciences
Barriers To Safe Medication Administration In The Nursing Home--Exploring Staff Perceptions And Concerns About The Medication Use Process, A. Vogelsmeier, Jill Scott-Cawiezell, D. Zellmer
Barriers To Safe Medication Administration In The Nursing Home--Exploring Staff Perceptions And Concerns About The Medication Use Process, A. Vogelsmeier, Jill Scott-Cawiezell, D. Zellmer
Jill Scott-Cawiezell
The purpose of this study was to explore staff perceptions and concerns about the medication use process in the nursing home setting. A total of 76 staff members from 5 nursing homes in 3 Midwestern states participated in key informant interviews and focus groups. Common themes included issues related to communication, competing demands, and the challenges of a paper-based medication administration record. Concerns frequently were associated with the timeliness and accuracy of the medication administration process. Recognition of staff concerns are an important first step in improving the nursing home medication use process. Staff insight provided clarification related to impediments …
Measuring Pain Intensity In Nursing Home Residents, K. Jones, R. Fink, E. Hutt, C. Vojir, G. Pepper, Jill Scott-Cawiezell, B. Mellis
Measuring Pain Intensity In Nursing Home Residents, K. Jones, R. Fink, E. Hutt, C. Vojir, G. Pepper, Jill Scott-Cawiezell, B. Mellis
Jill Scott-Cawiezell
Assessing pain intensity in nursing home residents remains a challenge. As part of a multifaceted intervention study to improve pain practices in nursing homes, quarterly pain assessments were conducted in 12 Colorado nursing homes. Residents who reported pain or discomfort of any kind in the past 24 hours were asked to choose one of three pain intensity scales to quantify their current and highest level of pain intensity. They were also observed for pain behaviors using Feldt's Checklist of Nonverbal Pain Indicators. Residents preferred the Verbal Descriptor Scale almost 2:1 over the 11-point Verbal Numeric Rating Scale and the Faces …
Nursing Home Culture: A Critical Component In Sustained Improvement, Jill Scott-Cawiezell, K. Jones, L. Moore, C. Vojir
Nursing Home Culture: A Critical Component In Sustained Improvement, Jill Scott-Cawiezell, K. Jones, L. Moore, C. Vojir
Jill Scott-Cawiezell
In the third in a series of articles exploring working conditions and quality improvement in nursing homes, 31 nursing homes were surveyed using an adaptation of the Competing Values Framework (CVF) Organizational Assessment. The CVF provides information about the organizational culture through describing dominant perceived values, distribution of values across organizational characteristics, and orientation of values toward flexibility. Staff reported a dominant group culture, reflecting a family and team orientation within their settings. Leaders, however, were more often reported to reflect a hierarchy value orientation, emphasizing efficiency of operations and following rules and procedures.
Technology Implementation And Workarounds In The Nursing Home, A. Vogelsmeier, J. Halbesleben, Jill Scott-Cawiezell
Technology Implementation And Workarounds In The Nursing Home, A. Vogelsmeier, J. Halbesleben, Jill Scott-Cawiezell
Jill Scott-Cawiezell
OBJECTIVE: This study sought to explore the relationship of workarounds related to the implementation of an electronic medication administration record and medication safety practices in five Midwestern nursing homes. DESIGN: As a part of a larger study, this qualitative evaluation was conducted to identify workarounds associated with the implementation of an electronic medication administration record. Data were collected using multimethods including direct observation, process mapping, key informant interviews, and review of field notes from medication safety team meetings. MEASUREMENTS: Open and axial coding techniques were used to identify and categorize types of workarounds in relation to work flow blocks. RESULTS: …
Exploring Nursing Home Staff's Perceptions Of Communication And Leadership To Facilitate Quality Improvement, Jill Scott-Cawiezell, M. Schenkman, L. Moore, C. Vojir, R. Connoly, M. Pratt, L. Palmer
Exploring Nursing Home Staff's Perceptions Of Communication And Leadership To Facilitate Quality Improvement, Jill Scott-Cawiezell, M. Schenkman, L. Moore, C. Vojir, R. Connoly, M. Pratt, L. Palmer
Jill Scott-Cawiezell
Leadership and clinical staff were surveyed to explore communication and leadership in nursing homes. Registered nurses and other professionals perceived communication as better than their nursing colleagues did. Overall, results suggest all factors of communication could improve. In terms of leadership, licensed practical nurses perceived less clarity of expectations, encouragement of initiative, and support than other groups. The study provides insight into what is organizationally necessary to improve quality of care in nursing homes.
Detection Of Patient Risk By Nurses: A Theoretical Framework, L. Despins, Jill Scott-Cawiezell, J. Rouder
Detection Of Patient Risk By Nurses: A Theoretical Framework, L. Despins, Jill Scott-Cawiezell, J. Rouder
Jill Scott-Cawiezell
AIM: This paper is a description of a theoretical framework of how nurses detect and interpret patient risk signals in the context of organizational attitudes and procedures related to patient safety. BACKGROUND: The ability to detect when patients are at increased risk for harm is a challenge faced by nurses worldwide. How nurses are able to discriminate patient risk warning signals from background noise is not well understood. Also, the impact of system-level factors on nurses' signal detection capabilities has not been investigated. DATA SOURCES: Computerized database searches were used to identify nursing, organizational science, and cognitive psychology literature from …
Influencing Leadership Perceptions Of Patient Safety Through Just Culture Training, A. Vogelsmeier, Jill Scott-Cawiezell, B. Miller, S. Griffith
Influencing Leadership Perceptions Of Patient Safety Through Just Culture Training, A. Vogelsmeier, Jill Scott-Cawiezell, B. Miller, S. Griffith
Jill Scott-Cawiezell
There are differences in perceptions of safety culture between healthcare leaders and staff. Evidence suggests that an organization's actual safety performance is more closely reflected in staff perceptions suggesting that frontline staff may be more aware than the leadership of actual patient safety challenges within their organization. Closing the perception gap between healthcare leaders and staff is critical to aligning the resources and strategies required to create a true culture of safety.
A Just Culture: The Role Of Nursing Leadership, A. Vogelsmeier, Jill Scott-Cawiezell
A Just Culture: The Role Of Nursing Leadership, A. Vogelsmeier, Jill Scott-Cawiezell
Jill Scott-Cawiezell
No abstract provided.
Nursing Home Error And Level Of Staff Credentials, Jill Scott-Cawiezell, G. Pepper, R. Madsen, G. Petroski, A. Vogelsmeier, D. Zellmer
Nursing Home Error And Level Of Staff Credentials, Jill Scott-Cawiezell, G. Pepper, R. Madsen, G. Petroski, A. Vogelsmeier, D. Zellmer
Jill Scott-Cawiezell
Providing safe nursing home care is both a clinical and fiscal challenge in many countries. The fiscal realities result in the addition of other workers, such as medication technicians or aides (CMT/A), to the health care team. The purpose of this study was to determine the impact of various levels of credentialing among nursing home staff who deliver medications (RN, LPN, or CMT/A) on medication error. In addition, the impact of distractions and interruptions was explored. Using naive observation, 39 medication administrators representing various levels of credentialing were unobtrusively observed to determine the number of medication errors, distractions, and interruptions …
Entrepreneurial Program Of Research And Service To Improve Nursing Home Care, M. Rantz, D. Mehr, L. Hicks, Jill Scott-Cawiezell, G. Petroski, R. Madsen, R. Porter, M. Zwygart-Stauffacher
Entrepreneurial Program Of Research And Service To Improve Nursing Home Care, M. Rantz, D. Mehr, L. Hicks, Jill Scott-Cawiezell, G. Petroski, R. Madsen, R. Porter, M. Zwygart-Stauffacher
Jill Scott-Cawiezell
This is a methodological article intended to demonstrate the integration of multiple goals, multiple projects with diverse foci, and multiple funding sources to develop an entrepreneurial program of research and service to directly affect and improve the quality of care of older adults, particularly nursing home residents. Examples that illustrate how clinical ideas build on one another and how the research ideas and results build on one another are provided. Results from one study are applied to the next and are also applied to the development of service delivery initiatives to test results in the real world. Descriptions of the …
Are Nursing Homes Ready To Create Sustainable Improvement?, Jill Scott-Cawiezell
Are Nursing Homes Ready To Create Sustainable Improvement?, Jill Scott-Cawiezell
Jill Scott-Cawiezell
No abstract provided.
The Role Of Nursing Leadership In Successful Technology Implementation, A. Vogelsmeier, Jill Scott-Cawiezell
The Role Of Nursing Leadership In Successful Technology Implementation, A. Vogelsmeier, Jill Scott-Cawiezell
Jill Scott-Cawiezell
No abstract provided.
Linking Nursing Home Working Conditions To Organizational Performance, Jill Scott-Cawiezell, D. Main, C. Vojir, K. Jones, L. Moore, P. Nutting, J. Kutner, K. Pennington
Linking Nursing Home Working Conditions To Organizational Performance, Jill Scott-Cawiezell, D. Main, C. Vojir, K. Jones, L. Moore, P. Nutting, J. Kutner, K. Pennington
Jill Scott-Cawiezell
Exploring selected working conditions and performance in nursing homes suggests that high and low performers can be determined based on both quantitative and qualitative findings.
Measuring Organizational Attributes Of Primary Care Practices: Development Of A New Instrument, P. Ohman-Strickland, A. Orzano, P. Nutting, W. Perry Dickinson, Jill Scott-Cawiezell, K. Hahn, M. Gibel, B. Crabtree
Measuring Organizational Attributes Of Primary Care Practices: Development Of A New Instrument, P. Ohman-Strickland, A. Orzano, P. Nutting, W. Perry Dickinson, Jill Scott-Cawiezell, K. Hahn, M. Gibel, B. Crabtree
Jill Scott-Cawiezell
OBJECTIVE: To develop an instrument to measure organizational attributes relevant for family practices using the perspectives of clinicians, nurses, and staff. DATA SOURCES/STUDY SETTING: Clinicians, nurses, and office staff (n=640) from 51 community family medicine practices. DESIGN: A survey, designed to measure a practices' internal resources for change, for use in family medicine practices was created by a multidisciplinary panel of experts in primary care research and health care organizational performance. This survey was administered in a cross-sectional study to a sample of diverse practices participating in an intervention trial. A factor analysis identified groups of questions relating to latent …
Are Attributes Of Organizational Performance In Large Health Care Organizations Relevant In Primary Care Practices?, A. Orzano, A. Tallia, P. Nutting, Jill Scott-Cawiezell, B. Crabtree
Are Attributes Of Organizational Performance In Large Health Care Organizations Relevant In Primary Care Practices?, A. Orzano, A. Tallia, P. Nutting, Jill Scott-Cawiezell, B. Crabtree
Jill Scott-Cawiezell
Are organizational attributes associated with better health outcomes in large health care organizations applicable to primary care practices? In comparative case studies of two community family practices, it was found that attributes of organizational performance identified in larger health care organizations must be tailored to their unique context of primary care. Further work is required to adapt or establish the significance of the attributes of management infrastructure and information mastery.
Cost, Staffing And Quality Impact Of Bedside Electronic Medical Record (Emr) In Nursing Homes, M. Rantz, L. Hicks, G. Petroski, R. Madsen, G. Alexander, C. Galambos, V. Conn, Jill Scott-Cawiezell, M. Zwygart-Stauffacher, L. Greenwald
Cost, Staffing And Quality Impact Of Bedside Electronic Medical Record (Emr) In Nursing Homes, M. Rantz, L. Hicks, G. Petroski, R. Madsen, G. Alexander, C. Galambos, V. Conn, Jill Scott-Cawiezell, M. Zwygart-Stauffacher, L. Greenwald
Jill Scott-Cawiezell
OBJECTIVE: There is growing political pressure for nursing homes to implement the electronic medical record (EMR) but there is little evidence of its impact on resident care. The purpose of this study was to test the unique and combined contributions of EMR at the bedside and on-site clinical consultation by gerontological expert nurses on cost, staffing, and quality of care in nursing homes. METHODS: Eighteen nursing facilities in 3 states participated in a 4-group 24-month comparison: Group 1 implemented bedside EMR, used nurse consultation; Group 2 implemented bedside EMR only; Group 3 used nurse consultation only; Group 4 neither. Intervention …
Medication Safety Teams' Guided Implementation Of Electronic Medication Administration Records In Five Nursing Homes, Jill Scott-Cawiezell, R. Madsen, G. Pepper, A. Vogelsmeier, G. Petroski, D. Zellmer
Medication Safety Teams' Guided Implementation Of Electronic Medication Administration Records In Five Nursing Homes, Jill Scott-Cawiezell, R. Madsen, G. Pepper, A. Vogelsmeier, G. Petroski, D. Zellmer
Jill Scott-Cawiezell
BACKGROUND: The 1.6 million nursing home residents in the United States are at high risk for adverse effects from medication errors. In an attempt to decrease medication errors and improve safety practices, from 2003 through 2007 the study investigators partnered with five Midwestern nursing homes in implementing electronic point-of-care medication administration records (eMARs) and focused quality improvement (QI) efforts. METHODS: The eMAR, designed by a vendor as a part of a larger integrated electronic health record, provided a point of information integration for a variety of users, including practitioners, nursing staff, medication administrators, and nursing home leadership. At each nursing …
Moving From A Culture Of Blame To A Culture Of Safety In The Nursing Home Setting, Jill Scott-Cawiezell, A. Vogelsmeier, C. Mckenney, M. Rantz, L. Hicks, D. Zellmer
Moving From A Culture Of Blame To A Culture Of Safety In The Nursing Home Setting, Jill Scott-Cawiezell, A. Vogelsmeier, C. Mckenney, M. Rantz, L. Hicks, D. Zellmer
Jill Scott-Cawiezell
TOPIC: A culture of safety. PURPOSE: To explore the current culture of blame and what organizational elements must be impacted to move toward a culture of safety in the nursing home setting. METHODS: A mixed-method approach incorporating a case study and staff member survey results were used to explicate the organizational elements impacting the current nursing home culture. CONCLUSION: Nurse leaders can create an environment in which every member of the team feels a responsibility and an ability to insure that residents are safe by improving communication and participation in decision making.
Nursing Home Safety: A Review Of The Literature, Jill Scott-Cawiezell, A. Vogelsmeier
Nursing Home Safety: A Review Of The Literature, Jill Scott-Cawiezell, A. Vogelsmeier
Jill Scott-Cawiezell
The number of older persons in the United States is rapidly growing and, based on this growth projection, the number of consumers needing nursing home (NH) care will likely triple in the next 10 years. Although NHs have been bombarded and scrutinized about the care that they provide, the concept of safety (specifically, error prevention) remains at the margin of most quality improvement efforts. The purpose of this review is to explore what has recently been written (2000-2005) about the evolution of the NH as an organization focused on safety and the most critical clinical processes that must be closely …