How do staff influence the quality of long-term dementia care and the lives of residents? A systematic review of the evidence

Anderson, Katrina; Bird, Mike; MacPherson, Sarah E.; Blair, Annaliese

doi:10.1017/s1041610216000570

Cited by 45 publications

(32 citation statements)

References 48 publications

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“…Reviews have indicated both that higher total staffing levels have been associated with improved quality of care and that there is no clear relationship . When describing quality care, the amount of time that care staff spend with residents is considered highly important by both residents and their family members .…”

Section: Discussionmentioning

confidence: 99%

“…Evidence has suggested positive associations between staff variables (including training, education, numbers and skills) and quality of care; yet, evidence is lacking in order to clearly determine a staffing mix that optimises quality of life for residents . Studies do suggest however that where staff treat and interact empathically in their care there are better outcomes for residents including behaviour (positive affect) and less decline in functional status …”

Section: Discussionmentioning

confidence: 99%

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Alternative staffing structures in a clustered domestic model of residential aged care in Australia

et al. 2019

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Objective: A clustered domestic model of residential aged care has been associated with better consumer-rated quality of care. Our objective was to examine differences in staffing structures between clustered domestic and standard models. Methods: A cross-sectional study involving 541 individuals living in 17 Australian not-for-profit residential aged care homes. Results: Four of the homes offered dementia-specific clustered domestic models of care with higher personal care attendant (PCA) hours-per-resident-per-day (mean [SD] 2.43 [0.29] vs. 1.74 [0.46], P < 0.001), slightly higher direct care hours-perresident-per-day (2.66 [0.35] vs. 2.58 [0.44], P = 0.006), higher staff training costs ($1492 [258] vs. $989 [928], P < 0.001) and lower registered/enrolled nurse hoursper-resident-per-day (0.23 [0.10] vs. 0.85 [0.17], P < 0.001) compared to standard models. Conclusions: An Australian clustered domestic model of care had higher PCA hours, more staff training and more direct care time compared to standard models.Further research to determine optimal staffing structures within alternative models of care is warranted. K E Y W O R D Shealth services for the aged, nursing homes, nursing staffThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Alternative staffing structures in a clustered domestic model of residential aged care in Australia

et al. 2019

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“…Moreover, studies have shown that nonpharmacological factors, such as aspects of the environment, can help to reduce residents’ symptoms and enhance quality of life. However, achieving an appropriate balance between pharmacological and nonpharmacological therapies depends on the trust that residents have in their caregivers, and it has been shown that when care is empathic and humane, residents demonstrated a positive mood, delayed functional dependence and consumed more food (Anderson, Bird, MacPherson, & Blair, 2016).…”

Section: Introductionmentioning

confidence: 99%

The impact of street clothes among caregivers on residents with dementia in special care units: The STRECLO study

Bailly

Sanchez

Ferrand

et al. 2020

Journal of Clinical Nursing

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Aims and objectives:To examine the impact of caregivers' street clothes on people living in special care units (SCUs). We hypothesised that caregivers wearing street clothes would improve residents' relationships with other residents and caregivers and, as a consequence, would improve their quality of life.Background: Environmental factors have been recognised as important elements in the care of people with dementia. Among these factors, the importance of the caregivers' appearance and more particularly their street clothes has been raised.Design: The Street Clothes study (STRECLO) was designed as a multicentre crossover observational study. Method:This study was conducted in two volunteer nursing homes. It involved videotaping residents (N = 24) over a 6-month period: caregivers wore uniform and then street clothes for two consecutive three-month periods. Three outcome measures were observed as follows: (a) behaviours of residents, (b) contents of conversations and (c) proximal interactions between residents and caregivers. The STROBE checklist was used to ensure quality reporting during this observational study.Results: When caregivers wore street clothes, we observed the following: (a) greater solicitation and less anxiety in residents, (b) content of conversations between residents and caregivers included more personal and less health information, and (c) more proximal interaction between caregivers and residents. Conclusion:To our knowledge, this is the first study which investigated the long-term effects on residents of SCU caregivers wearing street clothes. Our study demonstrated the potential benefit of not wearing uniform on the quality of life of institutionalised people with dementia.Relevance to clinical practice: Given the budgetary constraints faced by nursing homes, wearing street clothes for caregivers could be readily applied to clinical practice and represents a promising way to increase the quality of life of dementia residents and their families.

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“…이는 입소 노 인의 자율성 및 자기결정권을 보장할 뿐만 아니라 [5] 일상생 활 수행능력의 향상 및 무력감과 우울과 같은 부정적 정서의 감소, 전반적인 삶의 질 향상 [6], 욕창 발생률, 연간 병원 입원 율의 감소 등 [7]의 결과로 보고되었다. 노인요양시설에서 직 접 간호 및 요양서비스를 제공하는 간호사 및 간호보조 인력 의 인간중심케어 수준은 케어의 질과 입소 노인의 삶의 질에 영향을 미치는 것으로 나타났다 [8]. 노인요양시설 [6,8], 직무만족, 자기개발능력, 인 간중심케어에 대한 지식수준 등 [9,10]의 개인적 요인의 영향 을 받는 것으로 나타났다.…”

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“…노인요양시설에서 직 접 간호 및 요양서비스를 제공하는 간호사 및 간호보조 인력 의 인간중심케어 수준은 케어의 질과 입소 노인의 삶의 질에 영향을 미치는 것으로 나타났다 [8]. 노인요양시설 [6,8], 직무만족, 자기개발능력, 인 간중심케어에 대한 지식수준 등 [9,10]의 개인적 요인의 영향 을 받는 것으로 나타났다. 또한 시설 규모, 직원 대 노인 비율, 상급자의 리더십, 물리적 환경 등 조직적 요인의 영향을 받는 것으로 보고되었다 [11].…”

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Factors Influencing Patient-Centered Care by Nursing Staff in Nursing Homes

Kim¹,

Shin²

2020

J Korean Gerontol Nurs

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Purpose:The purpose of this study was to determine individual and organizational factors that influence patientcentered care. Methods: Data were collected through convenience sampling and hierarchical linear modeling (HLM) 7.0 was conducted to analyze the effects of individual and organizational factors for patient-centered care. Results: One hundred and thirty five participants were included, of which 42.2% were registered nurses (RNs), 20.0% certified nursing assistants, and 37.8% care workers. Among the 14 nursing homes assessed, the average proportion of registered nurses was 7.6%. Patient-centered care was explained by a power of 2.4% at the individual level and was significantly associated with religion of nursing staff. The explanatory variables were not significant at the organizational level. Conclusion: While previous studies have highlighted the association established between patient-centered care and both individual and organizational characteristics, the same degree of association was not found in the present study primarily due to convenience sampling. Possible avenues for improvement include further consideration of the differences between individual and organizational variables and the addition of more explanatory variables to measure their impact on patient-centered care. Nonetheless the present study provides informative perspectives on the perception of nursing staff regarding elder abuse and human rights sensitivity of nursing staff.

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How do staff influence the quality of long-term dementia care and the lives of residents? A systematic review of the evidence

Cited by 45 publications

References 48 publications

Alternative staffing structures in a clustered domestic model of residential aged care in Australia

Alternative staffing structures in a clustered domestic model of residential aged care in Australia

The impact of street clothes among caregivers on residents with dementia in special care units: The STRECLO study

Factors Influencing Patient-Centered Care by Nursing Staff in Nursing Homes

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