Search

A protocol for a literature study that aims: 1. To identify interventions that improve data quality in long-term care facilities. 2. To understand how participants experience data quality improvement interventions and identify determinants associated with data quality in long-term care facilities. 3. To understand how participants experienced the implementation of data quality improvement interventions and identify determinants and strategies for implementation.

Supplementary Material 2

Supplementary Material 1

Supplementary Material 4

Additional file 1. Supplementary Table 1: Values of EQ-5D-index and EQ-VAS by level of each independent categorical variable (reported by the levels of the ecological model).

Care workers in nursing homes often perform tasks that are rather related to organizational or management activities than 'direct patient care'. 'Indirect care activities', such as documentation or other administrative tasks are often considered by care workers as a burden, as they increase overall workload and keep them away from caring for residents. So far, there is little investigation into what kind of administrative tasks are being performed in nursing homes, by which type of care workers, and to which extent, nor how administrative burden is associated with care workers' outcomes.; The objective of this study was to describe care workers' administrative burden in Swiss nursing homes and to explore the association with four care worker outcomes (i.e., job dissatisfaction, emotional exhaustion, intention to leave the current job and the profession).; This multicenter cross-sectional study used survey data from the Swiss Nursing Homes Human Resources Project 2018. It included a convenience sample of 118 nursing homes and 2'207 care workers (i.e., registered nurses, licensed practical nurses) from Switzerland's German- and French-speaking regions. Care workers completed questionnaires assessing the administrative tasks and burden, staffing and resource adequacy, leadership ability, implicit rationing of nursing care and care worker characteristics and outcomes. For the analysis, we applied generalized linear mixed models, including individual-level nurse survey data and data on unit and facility characteristics.; Overall, 73.9% (n = 1'561) of care workers felt strongly or rather strongly burdened, with one third (36.6%, n = 787) reporting to spend 2 h or more during a "normal" day performing administrative tasks. Ratings for administrative burden ranged from 42.6% (n = 884; ordering supplies and managing stocks) to 75.3% (n = 1'621; filling out the resident's health record). One out of four care workers (25.5%, n = 561) intended to leave the profession, whereby care workers reporting higher administrative task burden (OR = 1.24; 95%CI: 1.02-1.50) were more likely to intend to leave the profession.; This study provides first insights on care workers' administrative burden in nursing homes. By limiting care workers' burdensome administrative tasks and/or shifting such tasks from higher to lower educated care workers or administrative personnel when appropriate, nursing home managers could reduce care workers' workload and improve their job satisfaction and retention in the profession.

Additional file 4. Joint display table integrating study findings from the INSPIRE population survey and interviews.

Additional file 2. Key resources for each component of the Basel Approach for coNtextual ANAlysis (BANANA).

Additional file 1. Survey questions extracted from the original INSPIRE Population Survey (translated from German) (Siqeca et al., 2021).

Additional file 3. Example Questions from the Interview Guide used in the INSPIRE parent study (translated from German) (Esser et al., 2022).

Additional file 4. List of articles excluded after full-text screening.

Additional file 3. Overview of contextual factors most commonly reported in empirical evidence to influence implementation.

Additional file 5. Concepts related to care and support of frail older adults in 2018 and preferences for future, mapped to adapted domains of the SELFIE framework, including only respondents who indicated no current use for each question respectively, but responded for future preferences.

Additional file 2. INSPIRE population survey respondents and dichotomized responses by content domain.

Additional file 1. The Basel Approach for coNtextual ANAlysis (BANANA): Overview of its development process and theoretical underpinning.

Additional file 1. Search strings used in the databases.

BACKGROUND: Health economic evaluations of the implementation of evidence-based interventions (EBIs) into practice provide vital information but are rarely conducted. We evaluated the health economic impact associated with implementation and intervention of the INTERCARE model-an EBI to reduce hospitalisations of nursing home (NH) residents-compared to usual NH care. METHODS: The INTERCARE model was conducted in 11 NHs in Switzerland. It was implemented as a hybrid type 2 effectiveness-implementation study with a multi-centre non-randomised stepped-wedge design. To isolate the implementation strategies' costs, time and other resources from the NHs' perspective, we applied time-driven activity-based costing. To define its intervention costs, time and other resources, we considered intervention-relevant expenditures, particularly the work of the INTERCARE nurse-a core INTERCARE element. Further, the costs and revenues from the hotel and nursing services were analysed to calculate the NHs' losses and savings per resident hospitalisation. Finally, alongside our cost-effectiveness analysis (CEA), a sensitivity analysis focused on the intervention's effectiveness-i.e., regarding reduction of the hospitalisation rate-relative to the INTERCARE costs. All economic variables and CEA were assessed from the NHs' perspective. RESULTS: Implementation strategy costs and time consumption per bed averaged 685CHF and 9.35 h respectively, with possibilities to adjust material and human resources to each NH's needs. Average yearly intervention costs for the INTERCARE nurse salary per bed were 939CHF with an average of 1.4 INTERCARE nurses per 100 beds and an average employment rate of 76% of full-time equivalent per nurse. Resident hospitalisation represented a total average loss of 52% of NH revenues, but negligible cost savings. The incremental cost-effectiveness ratio of the INTERCARE model compared to usual care was 22'595CHF per avoided hospitalisation. As expected, the most influential sensitivity analysis variable regarding the CEA was the pre- to post-INTERCARE change in hospitalisation rate. CONCLUSIONS: As initial health-economic evidence, these results indicate that the INTERCARE model was more costly but also more effective compared to usual care in participating Swiss German NHs. Further implementation and evaluation of this model in randomised controlled studies are planned to build stronger evidential support for its clinical and economic effectiveness. TRIAL REGISTRATION: clinicaltrials.gov ( NCT03590470 ). ispartof: BMC GERIATRICS vol:22 issue:1 ispartof: location:England status: published

Additional file 2. List of consulted websites and organizations.

Additional file 1.

The workforce in residential long-term care (LTC) is key in providing high-quality, person-centered care for residents. However, low staffing and adverse staffing outcomes such as turnover or job dissatisfaction hinder the provision of high-quality care. International research can add valuable insights for policy and practice by learning from different settings and cultures. The initiative “To Harmonize Research In long-term care liVing Environments (WE-THRIVE)”, is led by an international group of LTC researchers to identify common data elements (CDE) for cross-comparative research that support older adults thriving in LTC. In this symposium, we will present an overview of the WE-THRIVE initiative with a specific focus on CDEs and measurement. The first talk will provide the context for the WE-THRIVE initiative, and discuss the collaborative and iterative processes required to develop the initial CDEs in the area of workforce and staffing. In the second talk, we will discuss which staff should be “in the house” to meet the needs of residents during and after a pandemic, and what type of workforce data system should be available to ensure the best quality outcomes for residents and carers. Next, current issues in the measurement of staffing in LTC based on a review of reviews of staffing’s relationship to quality of care will be discussed. Finally, we extend the debate to consider theoretical and empirical explanations for the relationship between staffing and quality in LTC and the promotion of person-centred care outcomes.

Additional file 3: Supplementary file C. Table S1. Summary of variables and measurements.

Additional file 1. SPIRIT checklist. All elements of the SPIRIT checklist

Additional file 5. Conceptual basis for the intervention. Link between the programme theory resulting from the realist review, related concepts and theories and intervention components.

Additional file 3. Steps of the implementation part. Detailed process for the implementation strategies development according to the four-steps method proposed by French et al. (2012).

Additional file 2: Supplementary file B-List of abbreviations.

Additional file 6. ICAN domains. Life and clinical domains of the ICAN tool. Patients have to classify these as source of burden or satisfaction/help.

Additional file 7. «Stop » and « Go » progression criteria. Progression criteria that will inform the decision to conduct a larger and definitive trial.

Additional file 1: Additional definitions of terms in the Swiss Setting.

Additional file 1. Questionnaire measurements. Description of employee, client and relative questionnaire measurements.

Additional file 2. Implementation strategies. Detailed information about implementation strategies and related actions, their dose and temporality, and related implementation measures.

Als Teilprojekt der nationalen Demenzstrategie der Schweiz wurde untersucht, inwieweit die in den Alters- und Pflegeheimen bereits eingesetzten Bedarfsabklärungsinstrumente BESA und RAI ausreichend sind, um Symptome von Depressionen, Delirien und behavioralen und psychologischen Symptomen der Demenz (BPSD) frühzeitig zu erkennen. Während RAI für die Bewertung von Depressivität als ausreichend aufgefasst wurde, ist für BESA die Ergänzung um den Zwei-Fragen-Test und die geriatrische Depressionsskala zu empfehlen. Für die Erkennung von Delirien sind hingegen nur in BESA geeignete Fokusassessments vorhanden. Weder RAI noch BESA erfassen vollständig das grosse Spektrum der psychologischen und BPSD. Wir sehen in der konsequenten Anwendung dieser Assessments Möglichkeiten eines verbesserten interprofessionellen und -disziplinären Austauschs zwischen den Berufsgruppen und damit eine verbesserte Versorgung der Bewohner mit psychischen Symptomen. As part of the Swiss national strategy on dementia, we investigated to which extent the needs assessment instruments RAI and BESA can early detect symptoms of depression, delirium, and behavioral and psychological symptoms of dementia (BPSD) in long-term care facilities. While we decided that the RAI sufficiently detected depressive symptoms, we suggest to add the two-questions-test and the geriatric depression scale to the BESA assessment. The BESA evaluation had more targeted focused assessments, allowing for better identification of delirium. Neither RAI or BESA cover the whole spectrum of behavioral and psychological symptoms of dementia. We consider the continuous application of these assessment instruments an important step towards interdisciplinary exchange and a better treatment of residents with psychiatric symptoms.

Additional file 1. Search strategy used in PubMed.

COVID-19 has affected long-term residential care (LTRC) disproportionally due to the high-risk population, lack of resources and insufficient preventative measures. Protective measures, including quarantine and strict visitation restrictions have made transitions into LTRC more challenging. Further insight is needed to understand how residents, relatives and staff have experienced this during the COVID-19 pandemic. During four months of fieldwork in a LTRC facility in Switzerland, a rapid ethnography consisting of interviews, observations, informal conversations and document analysis was conducted. This study included a total of 14 residents, 21 healthcare staff from varying departments and 7 relatives of residents. First results indicate that protective measures interfere with a resident’s ability to find meaningful activities and interactions within LTRC as well as the possibility to maintain mobility. This and limited family contact following a move into LTRC prevents a smooth transition from home to LTRC and impacts overall resident quality of life.

Item does not contain fulltext The International Association of Gerontology and Geriatrics held its first conference on nursing home research in St Louis, MO, in November 2013. This article provides a summary of the presentations.

This dissertation presents a tri-national study, conducted in three long-term residential care homes in Switzerland, the UK and the Netherlands. The overall goal of this dissertation is to explore resident experiences of person-centred care in long-term residential care homes in three different European countries and how this could impact resident quality of life following a permanent move into care. Gaining information from three different countries, each practicing person-centred care prior to this study, provided valuable insight into the uniqueness of each individual long-term residential care setting. Having seen this, it is unsurprising that person-centred care remains a challenge, causing opportunities for person-centred actions to be missed. There are good opportunities to share knowledge between LTRC homes and internationally about what works and what doesn’t when implementing PCC practices. By understanding the context, with strong collaborations and most importantly, by keeping the end user as the central focus by listening to them and including them in research.

Background and Objectives As new models of care aiming to reduce hospitalizations from nursing homes emerge, their implementers must consider residents’ and relatives’ needs and experiences with acute changes in the residents’ health situations. As part of the larger INTERCARE implementation study, we explored these persons’ experiences of acute situations in Swiss nursing homes. Research Design and Methods 3 focus groups were conducted with residents and their relatives and analyzed via reflexive thematic analysis. Results The first theme, the orchestra plays its standards, describes experiences of structured everyday care in nursing homes, which functions well despite limited professional and competency resources. The second theme, the orchestra reaches its limits, illustrates accounts of acute situations in which resources were insufficient to meet residents’ needs. Interestingly, participants’ perceptions of acute situations went well beyond our own professional view, that is, changes in health situations, and included situations best summarized as “changes that might have negative consequences for residents if not handled adequately by care workers.” Within the third theme, the audience compensates for the orchestra’s limitations, participants’ strategies to cope with resource limitations in acute situations are summarized. Discussion and Implications Our findings suggest differences between care providers’ and participants’ perspectives regarding acute situations and care priority setting. Alongside efforts to promote staff awareness of and responsiveness to acute situations, care staff must commit to learning and meeting individual residents’ and relatives’ needs. Implications for the development and implementation of a new nurse-led model of care are discussed.