Abstract:The findings from this study showed that implementing a nurse practitioner-led pain team can significantly improve resident pain and functional status as well as clinical practice behaviours of LTC staff. LTC homes should employ a nurse practitioner, ideally located onsite as opposed to an offsite consultative role, to enhance inter-professional collaboration and facilitate more consistent and timely access to pain management.
“…Mentors should be approachable, dependable and knowledgeable, with strong communication skills and clinical expertise. It is also recommended that suitable mentors should have a good work ethic, and not simply be the bossy type who wants to control everything.I think that [NPs] are able to display a higher level of knowledge and understanding and so they gain the respect of the nurses who see them that way and not necessarily just another pair of hands… (Kaasalainen et al, , p. 85)the staff highly regarded the personal attributes of the NPs, which included being approachable, dependable, knowledgeable and having clinical expertise… (Kaasalainen et al, , p. 162)…”
Section: Resultsmentioning
confidence: 99%
“…the staff highly regarded the personal attributes of the NPs, which included being approachable, dependable, knowledgeable and having clinical expertise… (Kaasalainen et al, , p. 162)…”
Section: Resultsmentioning
confidence: 99%
“…(DeCicco, , p. 21)They also recognized several factors that were impeding efficacy of the Pain Team and pain management including: the large number of staff at the home in need of pain education, the lines of communication among staff, and the limited NP availability in the LTC home. (Kaasalainen et al, , p. 164)…”
Aim
To determine nursing home staff experiences in mentorship programmes, and staff perceptions of the enablers and barriers to implement mentorship programmes.
Background
Mentorship programmes are perceived as playing an important role in improving the quality of care in nursing homes. However, little is known about research evidence across the global about staff's experiences in the programmes.
Methods
A search for studies published from the earliest available date to April 2019 was undertaken. Two reviewers performed data extraction and an appraisal of eight studies using tools from the Joanna Briggs Institute. A pragmatic meta‐aggregative approach was applied to synthesise the findings. The qualitative research that was included was analysed to identify 63 findings that were organised into 12 categories and combined into three syntheses.
Results
The implementation of effective mentorship programmes is influenced by three factors: mentor capability, opportunity in the mentorship programmes, and motivation in the mentorship programmes.
Conclusions
There are a number of studies of nursing home staff experiences of mentorship programmes. However, systematic reviews that synthesise findings in this field are lacking. It is crucial to tailor the programme design to suit each unique nursing home care setting. We identified barriers and enablers, and learned that no barriers are insurmountable.
Implications for Nursing Management
Findings will inform nurse managers of an ideal environment for the implementation of a successful mentorship programme. Nursing homes need to establish and sustain mentorship programmes to help improve workforce capacity in delivering high‐quality care for residents.
“…Mentors should be approachable, dependable and knowledgeable, with strong communication skills and clinical expertise. It is also recommended that suitable mentors should have a good work ethic, and not simply be the bossy type who wants to control everything.I think that [NPs] are able to display a higher level of knowledge and understanding and so they gain the respect of the nurses who see them that way and not necessarily just another pair of hands… (Kaasalainen et al, , p. 85)the staff highly regarded the personal attributes of the NPs, which included being approachable, dependable, knowledgeable and having clinical expertise… (Kaasalainen et al, , p. 162)…”
Section: Resultsmentioning
confidence: 99%
“…the staff highly regarded the personal attributes of the NPs, which included being approachable, dependable, knowledgeable and having clinical expertise… (Kaasalainen et al, , p. 162)…”
Section: Resultsmentioning
confidence: 99%
“…(DeCicco, , p. 21)They also recognized several factors that were impeding efficacy of the Pain Team and pain management including: the large number of staff at the home in need of pain education, the lines of communication among staff, and the limited NP availability in the LTC home. (Kaasalainen et al, , p. 164)…”
Aim
To determine nursing home staff experiences in mentorship programmes, and staff perceptions of the enablers and barriers to implement mentorship programmes.
Background
Mentorship programmes are perceived as playing an important role in improving the quality of care in nursing homes. However, little is known about research evidence across the global about staff's experiences in the programmes.
Methods
A search for studies published from the earliest available date to April 2019 was undertaken. Two reviewers performed data extraction and an appraisal of eight studies using tools from the Joanna Briggs Institute. A pragmatic meta‐aggregative approach was applied to synthesise the findings. The qualitative research that was included was analysed to identify 63 findings that were organised into 12 categories and combined into three syntheses.
Results
The implementation of effective mentorship programmes is influenced by three factors: mentor capability, opportunity in the mentorship programmes, and motivation in the mentorship programmes.
Conclusions
There are a number of studies of nursing home staff experiences of mentorship programmes. However, systematic reviews that synthesise findings in this field are lacking. It is crucial to tailor the programme design to suit each unique nursing home care setting. We identified barriers and enablers, and learned that no barriers are insurmountable.
Implications for Nursing Management
Findings will inform nurse managers of an ideal environment for the implementation of a successful mentorship programme. Nursing homes need to establish and sustain mentorship programmes to help improve workforce capacity in delivering high‐quality care for residents.
“…One recent study by Kaasalainen et al. () showed beneficial effects for pain‐related resident outcomes and practice behaviour of NH care workers by implementing a nurse practitioner‐led pain team. The inter‐professional pain team met monthly or every other month.…”
“…The body of evidence regarding effective interventions to improve pain management is limited in terms both of quantity and of methodological rigor. Some recent approaches, for example, implementation of nurse practitioners (NPs), have yielded promising initial results concerning pain management practice and resident pain outcomes . With regard to the specific setting or country, introducing NPs may not be a feasible strategy due to the lack of training possibilities at the corresponding level or difficulties in recruitment.…”
OBJECTIVES
To evaluate the effectiveness and implementation of a multilevel pain management intervention in nursing homes (NHs) comprising a pain management guideline, care worker training, and pain champions.
DESIGN
An implementation science pilot study using a quasi‐experimental effectiveness‐implementation (hybrid II) design.
SETTING
Four NHs in Switzerland.
PARTICIPANTS
All consenting long‐term residents aged 65 years and older with pain at baseline (N = 62) and all registered and licensed practical nurses (N = 61).
INTERVENTION
Implementation of a contextually adapted pain management guideline, interactive training workshops for all care workers, and specifically trained pain champions.
MEASUREMENTS
Interference from pain, worst and average pain intensity over the previous 24 hours; proxy ratings of pain with the Pain Assessment in Advanced Dementia scale; and care workers' appraisal of the guideline's reach, acceptability, and adoption.
RESULTS
Pain‐related outcomes improved for self‐reporting residents (n = 43) and residents with proxy rating (n = 19). Significant improvements of average pain from baseline to T1 (P = .006), and in worst pain from baseline to T1 (P = .003) and T2 (P = .004). No significant changes in interference from pain (P = .18). With regard to the implementation efforts, about 76% of care workers indicated they were familiar with the guideline; 70.4% agreed that the guideline is practical and matches their ideas of good pain assessment (75.9%) and treatment (79.7%).
CONCLUSION
Implementation of a multilevel pain management intervention did significantly improve average and worst pain intensity in NH residents. However, to effect clinical meaningful changes in interference from pain, a more comprehensive approach involving other disciplines may be necessary. J Am Geriatr Soc 67:2574–2580, 2019
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