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Full-Text Articles in Nursing
Outcomes Of Family Involvement In Care Intervention For Caregivers Of Individuals With Dementia, Meridean Maas, D. Reed, M. Park, Janet Specht, D. Schutte, Lisa Skemp Kelley, Elizabeth Swanson, Toni Tripp-Reimer, Kathleen Buckwalter
Outcomes Of Family Involvement In Care Intervention For Caregivers Of Individuals With Dementia, Meridean Maas, D. Reed, M. Park, Janet Specht, D. Schutte, Lisa Skemp Kelley, Elizabeth Swanson, Toni Tripp-Reimer, Kathleen Buckwalter
Elizabeth A. Swanson
BACKGROUND: Despite the increasing number of individuals with dementia relocated from caregiving at home to a nursing home, there is only a small body of literature examining the influence of institutional family-oriented practices on family member perceptions of care and family-staff relationships. OBJECTIVE: The study tested the effects of the Family Involvement in Care partnership intervention on family members' perceptions of their caregiving role, relationships with staff, and satisfaction with the care of relatives with dementia residing in special care units as well as the effects on staff attitudes toward families and staff satisfaction with a caregiving role. METHODS: A …
Alzheimer's Residents' Cognitive And Functional Measures: Special And Traditional Care Unit Comparison, Elizabeth Swanson, Meridean Maas, Kathleen Buckwalter
Alzheimer's Residents' Cognitive And Functional Measures: Special And Traditional Care Unit Comparison, Elizabeth Swanson, Meridean Maas, Kathleen Buckwalter
Elizabeth A. Swanson
The aim of this field experiment was to compare the effects of a special care unit (SCU) on residents with Alzheimer's disease (AD) who lived on the SCU and on traditional (integrated) nursing home units. Twenty-two subjects, 13 on the SCU and 9 on traditional integrated units were compared. Repeated measures ANOVA was used to assess differences between the two groups and within the groups over two bimonthly pretests and two bimonthly posttests. No significant differences on cognitive or functional abilities scores were evident for the groups and no significant differences were found over time. However, consistent with the prediction …
Family Visitation On Special Care Units, Lisa Skemp Kelley, Elizabeth Swanson, Meridean Maas, Toni Tripp-Reimer
Family Visitation On Special Care Units, Lisa Skemp Kelley, Elizabeth Swanson, Meridean Maas, Toni Tripp-Reimer
Elizabeth A. Swanson
With placement of a family member with Alzheimer's disease on a SCU, the family does not relinquish the caregiving role, rather they take on different roles in relation to the residents. Family visitation of the residents on the SCU is an integral part of family involvement in care of individuals with Alzheimer's disease, as well as SCU functioning. Within the context of changing relationships with the residents, family members visited the residents as a sense of duty to "be faithful," to monitor care by "being their eyes and ears," and to foster a sense of family through ongoing relationships and …
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 …
Quality Improvement In Long-Term Care. Are Nursing Homes Ready To Create Sustainable Improvement?, Jill Scott-Cawiezell
Quality Improvement In Long-Term Care. Are Nursing Homes Ready To Create Sustainable Improvement?, Jill Scott-Cawiezell
Jill Scott-Cawiezell
No abstract provided.
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 …
Staff Stress On An Alzheimer's Unit, Paula Mobily, Meridean Maas, Kathleen Buckwalter, Lisa Skemp Kelley
Staff Stress On An Alzheimer's Unit, Paula Mobily, Meridean Maas, Kathleen Buckwalter, Lisa Skemp Kelley
Paula Mobily
Nurses working with the elderly encounter many complex and potentially stressful care situations. Nowhere is this more true than for nursing home staff who work in highly demanding, labor- and client-intensive jobs. A number of factors contribute to the high levels of stress found among nurses who work with the elderly, including continual exposure to physical and emotional pathology and death, and conflict with families, co-workers, supervisors, and representatives from other departments or professions (Goldin, 1985; Klus, 1980). When the stress level in a long-term care facility becomes overwhelming, role conflict, ambiguity, poor self-esteem, and burnout may ensue (Goldin, 1985; …
The Cost Of Treating Pressure Ulcers Following Implementation Of A Research-Based Skin Care Protocol In A Long-Term Care Facility, Rita Frantz, S. Bergquist, Janet Specht
The Cost Of Treating Pressure Ulcers Following Implementation Of A Research-Based Skin Care Protocol In A Long-Term Care Facility, Rita Frantz, S. Bergquist, Janet Specht
Rita A. Frantz
Although concern for the costs associated with pressure ulcer treatments persists, studies that precisely quantify costs are limited. A retrospective research design was used to describe the costs incurred by an 830-bed, long-term care facility to treat 81 pressure ulcers over a one-year period following implementation of a research-based, skin care protocol. The total cost for the study period was $30,079 with 73% of these expenditures attributable to nursing care. Mean cost of treatment was $3.74/pressure ulcer/day, which was a reduction from the $5.35/pressure ulcer/day cost prior to implementation of the skin care protocol. These findings suggest that implementing a …
Iowa Certified Nursing Assistants Study: Self-Reported Ratings Of The Nursing Home Work Environment, Kennith Culp, S. Ramey, S. Karlman
Iowa Certified Nursing Assistants Study: Self-Reported Ratings Of The Nursing Home Work Environment, Kennith Culp, S. Ramey, S. Karlman
Kennith R. Culp
No abstract provided.
Hydration And Acute Confusion In Long-Term Care Residents... Including Commentary By Lindgren Cl And Mills Em With Author Response, Kennith Culp, J. Mentes, B. Wakefield
Hydration And Acute Confusion In Long-Term Care Residents... Including Commentary By Lindgren Cl And Mills Em With Author Response, Kennith Culp, J. Mentes, B. Wakefield
Kennith R. Culp
Although it is generally appropriate for a healthy adult to consume 2000 to 2500 ml per day, the literature does not address evaluating any standard. The objective here was to develop a weight-based hydration management intervention and evaluate the impact of this on the incidence of acute confusion (AC) using an N = 98. The intervention consisted of a fluid intake goal based on 100 ml per kg for the first 10 kg, 50 ml/kg for the next 10 kg, and 15 ml for the remaining body weight. The treatment group received instruction and assistance on the fluid goal and …
Comparing The Geriatric Depression Scale, Minimum Data Set, And Primary Care Provider Diagnosis For Depression In Rural Nursing Home Residents, C. Kerber, M. Dyck, Kennith Culp, Kathleen Buckwalter
Comparing The Geriatric Depression Scale, Minimum Data Set, And Primary Care Provider Diagnosis For Depression In Rural Nursing Home Residents, C. Kerber, M. Dyck, Kennith Culp, Kathleen Buckwalter
Kennith R. Culp
BACKGROUND: Depression has a substantial negative impact on quality of life. Underdiagnosis and undertreatment of depression are major problems in nursing home residents. OBJECTIVES: This study sought to determine the prevalence of depression among older adults in nursing homes in rural Iowa using the Geriatric Depression Scale (GDS), Minimum Data Set (MDS), and primary care provider (PCP) depression diagnosis. DESIGN: This is a secondary analysis of data collected from 279 randomly selected residents of nursing homes in rural Iowa. RESULTS: The prevalence of depression based on the GDS (score of 6 or greater) was 37.3%, the MDS was 21.3%, and …
Reducing Hydration-Linked Events In Nursing Home Residents... Including Commentary By Godkin D, J. Mentes, Kennith Culp
Reducing Hydration-Linked Events In Nursing Home Residents... Including Commentary By Godkin D, J. Mentes, Kennith Culp
Kennith R. Culp
The authors used a quasi-experimental treatment and control group design with 49 participants from four nursing homes to test the effectiveness of an 8-week hydration intervention in reducing hydration-linked events (HLEs). A Kaplan Meier survival curve with log rank test was calculated to determine incidence and time to occurrence of a HLE. Incidence of and time to a HLE did not differ between the treatment and control groups over an 8-week period (p > .05). However, treatment group participants were found to be more frail, more cognitively impaired and more at risk for acute confusion than the control group participants. Although …
Use Of A Urine Color Chart To Monitor Hydration Status In Nursing Home Residents, J. Mentes, B. Wakefield, Kennith Culp
Use Of A Urine Color Chart To Monitor Hydration Status In Nursing Home Residents, J. Mentes, B. Wakefield, Kennith Culp
Kennith R. Culp
To determine whether urine color, as measured by a color chart, might be a valid indicator of hydration status in frail nursing home residents, this study tested the associations between urine color and urine specific gravity. This is a descriptive correlational study set in seven nursing homes in eastern Iowa. Ninety-eight nursing home residents > or =65 years of age participated. Exclusion criteria for the study included: unstable congestive heart failure or diabetes, documented renal disease, hyponatremia (serum sodium or =50 ml/min) had significant associations between average urine color and average Usg. Females with mild renal impairment (CrCl between 30 and …
Antidepressant Treatment Of Depression In Rural Nursing Home Residents, C. Kerber, M. Dyck, Kennith Culp, Kathleen Buckwalter
Antidepressant Treatment Of Depression In Rural Nursing Home Residents, C. Kerber, M. Dyck, Kennith Culp, Kathleen Buckwalter
Kennith R. Culp
Under-diagnosis and under-treatment of depression are major problems in nursing home residents. The purpose of this study was to determine antidepressant use among nursing home residents who were diagnosed with depression using three different methods: (1) the Geriatric Depression Scale, (2) Minimum Data Set, and (3) primary care provider assessments. As one would expect, the odds of being treated with an antidepressant were about eight times higher for those diagnosed as depressed by the primary care provider compared to the Geriatric Depression Scale or the Minimum Data Set. Men were less likely to be diagnosed and treated with antidepressants by …
Clinical Profile Of Acute Confusion In The Long-Term Care Setting, P. Cacchione, Kennith Culp, J. Laing, Toni Tripp-Reimer
Clinical Profile Of Acute Confusion In The Long-Term Care Setting, P. Cacchione, Kennith Culp, J. Laing, Toni Tripp-Reimer
Kennith R. Culp
Aspects of acute confusion (AC) including risk factors, behavior patterns, and outcomes are not well documented in long-term care (LTC) residents. The purpose of this prospective study was to describe the clinical profile of AC in LTC including risk factors, behavior patterns, etiologies, and 3-month outcomes. Seventy-four elderly LTC residents were assessed for AC, depression, and global cognitive impairment. Risk factors associated with AC included hearing deficits, depression, pulmonary disorders, and abnormal serum sodium or potassium levels. Behavior patterns of acutely confused residents included hyperactive (n = 9, 31%), hypoactive (n = 8, 28%), and mixed (n = 7, 24%). …
Thematic Analysis Of The Experience Of Making A Decision To Place A Family Member With Alzheimer's Disease In A Special Care Unit, Howard Butcher, P. Holkup, M. Park, Meridean Maas
Thematic Analysis Of The Experience Of Making A Decision To Place A Family Member With Alzheimer's Disease In A Special Care Unit, Howard Butcher, P. Holkup, M. Park, Meridean Maas
Howard K. Butcher
The purpose of this study was to provide an in-depth description of the experience of making the decision to place a family member in a special care unit among a diverse sample of family caregivers. To achieve purposive maximum variation of the sample, the sample of 30 family caregivers was chosen from an original study of 256 family caregivers. The sample was randomly stratified according to ethnicity, gender, and relationship to the care receiver. Three independent researchers used Luborsky's method of thematic analysis to analyze the interviews. After mutual consensus, 1565 themes (descriptive statements) were identified and synthesized into 21 …