Improving Nursing Home Staff Knowledge and Attitudes About Pain

Jones, Katherine R.; Fink, Regina; Pepper, Ginny; Hutt, Evelyn; Vojir, Carol P.; Scott, Jill; Clark, Lauren; Mellis, Karen

doi:10.1093/geront/44.4.469

Cited by 81 publications

(89 citation statements)

References 26 publications

(16 reference statements)

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“…In addition, a participant, who described the timing of medication as critical, expressed concern for residents, stating the RN should administer the drug before the resident was in "dire straits". These approaches to pain management are consistent with findings by Jones et al (2004), who suggest a conservative approach in pain management may be the result of nurses undervaluing residents' reports of pain.…”

Section: Nurses' Pain Medication Knowledgesupporting

confidence: 85%

“…This research also aligns with previous findings, for example, the issue of poor pain management practices are not unique to these facilities, or to only residential aged care facilities. Poor pain management practices at end of life are detailed in the literature and are found in many forms of healthcare (Holloway & McConigley, 2009;Jones et al, 2004;Wilson, 2007).…”

Section: Rigour As Trustworthinessmentioning

confidence: 99%

“…Although the value behind the statement was not pursued in the discussion, fear associated with the administration of opioids and accelerating death is a recognised problem and a known barrier to achieving optimal pain management (Brennan, Carr & Cousins, 2007;Good, 2003;Jones, Fink, Pepper, Hutt, Vojir, Scott, Clark & Mellis, 2004).…”

Section: Researcher's Note May 2008mentioning

confidence: 99%

“…Jones et al (2004) suggest the undervaluing of residents reporting pain can influence a nurse's response to pain. For example, if the culture of the organisation is to respond to pain when other work is completed, nurses can lose their perspective on the importance of addressing pain issues first.…”

Section: Pain Managementmentioning

confidence: 99%

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Dying in a rural residential aged care facility: An action research and reflection project to improve end‐of‐life care to residents with a non‐malignant disease

Rowley

Taylor

2011

Int J of Nursing Practice

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Rowley, J 2010, 'Dying in a rural residential aged care facility: an action research and reflection project to improve end of life care to residents with a non-malignant disease ', PhD thesis, Southern Cross University, Lismore, NSW. THESIS DECLARATIONI certify that the work presented in this thesis is, to the best of my knowledge and belief, original, expect as acknowledged in the text, and the material has not been submitted, either in whole or in part, for a degree at this or any other University. Special thanks, is reserved for my husband Greg, whose loving, extensive support helped me to achieve completion. In addition, to our children Dylan and Amber, who lovingly supported me throughout this journey.This thesis is dedicated to the memory of my father, Donald Raymond Riley.iii ABSTRACT This qualitative research explored end of life care provided to people dying with a non malignant disease in two Australian rural, residential aged care facilities.Residential aged care facilities provide end of life care for many people dying from non malignant diseases. The illness trajectory in non malignant diseases can be difficult to predict and symptom management can be challenging.Further, as the Australian population ages, the demand for optimal end of life care for frail, older people is anticipated to increase. Therefore, this study aimed to explore issues as identified by nurses and relatives of residents dying from a non malignant disease in order to examine ways in which nurses can provide nursing care that maximises the likelihood of a good death, identify the barriers nurses perceive to prevent optimal end of life care to dying residents, and explore the relationships between nurses and relatives of the dying resident, with the intention of improving care.Following ethical clearance, 14 aged care staff overall within both facilities were recruited to the project. Participants included Registered Nurses, Enrolled Nurses, Assistants in Nursing and other aged care staff personnel, all of whom were in a carer relationship with a dying resident. In addition, eight relatives of dying residents were interviewed, using individual, face to face, semi structured interviews.Taylor's (2006) 13 step action research and reflection method was incorporated into five main phases, including foundation building, reflection on practice iv stories, identifying thematic concerns, action plan creation, implementation and critical reflection. In both facilities, group meetings were held weekly for up to 19 weeks. Data were gathered using combinations of reflective drawing, practice stories, interviews and surveys.Relatives' interview transcripts were incorporated into the nurses' group meetings, so that end of life care issues of importance to relatives were shared, with the intention of assisting the nurses to examine the nature of aged care nursing and relationships that occur with relatives of the dying resident. This project demonstrated that it is possible to establish a working relationship with aged care nurses, with no prio...

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Section: Nurses' Pain Medication Knowledgesupporting

confidence: 85%

Section: Rigour As Trustworthinessmentioning

confidence: 99%

Section: Researcher's Note May 2008mentioning

confidence: 99%

Section: Pain Managementmentioning

confidence: 99%

See 2 more Smart Citations

Dying in a rural residential aged care facility: An action research and reflection project to improve end‐of‐life care to residents with a non‐malignant disease

Rowley

Taylor

2011

Int J of Nursing Practice

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“…Some research has explored the attitudes of NH direct care staff in managing pain, while two recent articles have explored the attitudes of direct care staff in NHs and ALFs involving falls and incontinence care [16][17][18]. They have yet to inform quality improvement (QI) interventions.…”

Section: Introductionmentioning

confidence: 99%

Direct Care Workers’ Views on Improving Care for People with Dementia in Residential Setting

Phillips¹,

Roberts²

2017

J Nurs Health Stud

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Background: Dementia is a brain disorder affecting memory, mood, personality and behaviour. An estimated 5 million people in the United States (US) have dementia and the vast majority of elders in residential care are cognitively impaired. Direct care workers, Certified Nursing Assistant (CNAs) and Care Assistants (CAs), provide most of the hands-on assistance for these residents. However, little is known about their views on providing care and ways to improve it.

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Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes

Baker

Camosso‐Stefinovic

Gillies

et al. 2010

Cochrane Database of Systematic Reviews

666

556

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Background In the previous version of this review, the effectiveness of interventions tailored to barriers to change was found to be uncertain. Objectives To assess the effectiveness of interventions tailored to address identified barriers to change on professional practice or patient outcomes. Search methods For this update, in addition to the EPOC Register and pending files, we searched the following databases without language restrictions, from inception until August 2007: MEDLINE, EMBASE, CINAHL, BNI and HMIC. We searched the National Research Register to November 2007. We undertook further searches to October 2009 to identify potentially eligible published or ongoing trials. Selection criteria Randomised controlled trials (RCTs) of interventions tailored to address prospectively identified barriers to change that reported objectively measured professional practice or healthcare outcomes in which at least one group received an intervention designed to address prospectively identified barriers to change. Data collection and analysis Two reviewers independently assessed quality and extracted data. We undertook quantitative and qualitative analyses. The quantitative analyses had two elements. We carried out a meta-regression to compare interventions tailored to address identified barriers to change with either no interventions or an intervention(s) not tailored to the barriers.We carried out heterogeneity analyses to investigate sources of differences in the effectiveness of interventions. These included the effects of: risk of bias, concealment of allocation, rigour of barrier analysis, use of theory, complexity of interventions, and the reported presence of administrative constraints. Main results We included 26 studies comparing an intervention tailored to address identified barriers to change to no intervention or an intervention(s) not tailored to the barriers. The effect sizes of these studies varied both across and within studies. Twelve studies provided enough data to be included in the quantitative analysis. A meta-regression model was fitted adjusting for baseline odds by fitting it as a covariate, to obtain the pooled odds ratio of 1.54 (95% CI, 1.16 to 2.01) from Bayesian analysis and 1.52 (95% CI, 1.27 to 1.82, P < 0.001) from classical analysis. The heterogeneity analyses found that no study attributes investigated were significantly associated with effectiveness of the interventions. Authors’ conclusions Interventions tailored to prospectively identified barriers are more likely to improve professional practice than no intervention or dissemination of guidelines. However, the methods used to identify barriers and tailor interventions to address them need further development. Research is required to determine the effectiveness of tailored interventions in comparison with other interventions.

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Improving Nursing Home Staff Knowledge and Attitudes About Pain

Cited by 81 publications

References 26 publications

Dying in a rural residential aged care facility: An action research and reflection project to improve end‐of‐life care to residents with a non‐malignant disease

Dying in a rural residential aged care facility: An action research and reflection project to improve end‐of‐life care to residents with a non‐malignant disease

Direct Care Workers’ Views on Improving Care for People with Dementia in Residential Setting

Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes

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