How registered nurses, licensed practical nurses and resident aides spend time in nursing homes: An observational study

Donovan, Cindy; Stewart, Connie; Donovan, Alicia

doi:10.1016/j.ijnurstu.2015.05.007

Cited by 33 publications

(34 citation statements)

References 38 publications

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“…The scoping review demonstrates a perceived lack of respect for the role of UCPs by other healthcare providers and a lack of authority for decision‐making in patient care. This theme was consistent across Canada, with studies from British Columbia (Reimer‐Kirkham, Sawatzky, Roberts, Cochrane, & Stajduhar, ), Alberta (Dahlke & Baumbusch, ; White, Jackson, Besner, & Norris, ), Ontario (Giosa et al., ; Heckman et al., ; Kaasalainen et al., ; Kontos, Miller, & Mitchell, ; McGilton, Guruge, Librado, Bloch, & Boscart, ; Tayab & Narushima, ; Wagner et al., ; Zeytinoglu et al., ) and New Brunswick (McCloskey, Donovan, Stewart, & Donovan, ; Rheaume, ) reporting minimal UCP contribution to interprofessional care teams and highlighting important challenges. Such challenges included vertical power hierarchies within the teams (Heckman et al., ; McGilton et al., ), isolation from teams or lack of communication and collaboration between UCPs and other members of the team (Dahlke & Baumbusch, ; Heckman et al., ; Tayab & Narushima, ), lack of role clarity and perceived differences in knowledge among team members (Heckman et al., ; Reimer‐Kirkham et al., ) and a limited role in documentation in patient charts (Kontos et al., ; McCloskey et al., ; White et al., ).…”

Section: Resultssupporting

confidence: 63%

The role of unregulated care providers in Canada—A scoping review

Afzal

Stolee

Heckman

et al. 2018

Int J Older People Nursing

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Section: Resultssupporting

confidence: 63%

The role of unregulated care providers in Canada—A scoping review

Afzal

Stolee

Heckman

et al. 2018

Int J Older People Nursing

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“…In addition, whereas a 5-7% decrease in time with nurses may seem small, length of patients' time spent with providers has been shown to be a key determinant of "quality of care" (Linzer et al, 2000;Whittington and McLaughlin, 2000;Wilson and Kaplan, 2000;Landau et al, 2007;Tai-Seale et al, 2007;Chen et al, 2009;Anand et al, 2011;Munyisia et al, 2011;McCloskey et al, 2014). For example, our data show that, relative to scheduled visits, walk-in patients are much more likely to visit the clinic for STD screening, STD treatment, or tuberculosis screening.…”

Section: Discussionmentioning

confidence: 59%

Capacity constraints and time allocation in public health clinics

2020

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Unlike in the production of most goods, changes in capacity for labor-intensive services only affect outcomes of interest insofar as service providers change the way they allocate their time in response to those capacity changes. In this paper, we examine how public sector service providers respond to unexpected capacity constraints in the specific context of public health clinics. We exploit an exogenous reduction in public health clinic capacity to quantify the trade-off between patients treated and time spent with each patient, which we treat as a proxy for a quality versus quantity decision. We provide evidence that these small and generally insignificant effects on nurse time favor public sector employees prioritizing quality of each interaction over clearing the patient queue.

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“…31 In the Netherlands, there is a tendency to exclude practical nurses from consulting older adults, with the argument that their education level might be too low or too practical for the learning process needed. However, nurses’ changing perceptions as demonstrated in this study illustrates their abilities and motivation to move forward in autonomy and self-management support.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of nurses’ changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care: a qualitative study

et al. 2016

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ObjectivesTo gain insights into the process of nurses’ changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care, and into the factors that contributed to these changes in their perceptions.DesignQualitative study alongside a cluster randomised controlled trial.Setting17 long-term care homes spread across the Netherlands.Participants34 licensed practical nurses supporting 54 dual sensory impaired older adults.InterventionA 5-month training programme designed to enable nurses to support the self-management of dual sensory impaired older adults in long-term care.Primary outcomesNurses’ perceptions on relevance and feasibility of the self-management programme collected from nurses’ semistructured coaching diaries over the 5-month training and intervention period, as well as from trainers’ reports.ResultsNurses’ initial negative perceptions on relevance and feasibility of the intervention changed to positive as nurses better understood the concept of autonomy. Through interactions with older adults and by self-evaluations of the effect of their behaviour, nurses discovered that their usual care conflicted with client autonomy. From that moment, nurses felt encouraged to adapt their behaviour to the older adults’ autonomy needs. However, nurses’ initial unfamiliarity with conversation techniques required a longer exploration period than planned. Once client autonomy was understood, nurses recommended expanding the intervention as a generic approach to all their clients, whether dual sensory impaired or not.ConclusionsLongitudinal data collection enabled exploration of nurses’ changes in perceptions when moving towards self-management support. The training programme stimulated nurses to go beyond ‘protocol thinking’, discovering client autonomy and exploring the need for their own behavioural adaptations. Educational programmes for practical nurses should offer more longitudinal coaching of autonomy supportive conversational skills. Intervention programming should acknowledge that change is a process rather than an event, and should include self-evaluations of professional behaviours over a period of time.Trial registration numberNCT01217502, Post-results.

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How registered nurses, licensed practical nurses and resident aides spend time in nursing homes: An observational study

Cited by 33 publications

References 38 publications

The role of unregulated care providers in Canada—A scoping review

The role of unregulated care providers in Canada—A scoping review

Capacity constraints and time allocation in public health clinics

Evaluation of nurses’ changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care: a qualitative study

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