Mixed Methods in Action: The Dilemma of Nursing Home Residents Relocated to
            Hospital

Kada, Olivia; Janig, Herbert

doi:10.4135/978144627305015595375

Cited by 4 publications

(12 citation statements)

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“…However, the reasons leading to avoidable hospital admissions are complex depending on characteristics of residents, NHs, health professionals involved, and policy incentives ( Graverholt et al, 2011 ; Kada & Janig, 2016 ). Medical care in NHs is usually not provided around the clock; clinical leadership in NHs provided by physicians is lacking in many countries worldwide ( Tolson et al, 2011 ).…”

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confidence: 99%

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Reducing Avoidable Hospital Transfers From Nursing Homes in Austria

Kada

Janig

Likar

et al. 2017

Gerontology and Geriatric Medicine

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Hospital transfers from nursing homes (NHs) are frequent, burdensome for residents, and often avoidable. The evidence regarding the effectiveness of interventions to reduce avoidable transfers is limited, and most projects focus on nurses’ knowledge and skills. In the present project, interventions focusing on nurses and physicians are integrated, elaborated, and implemented in 17 NHs. Results of the 6 months preintervention period are reported. Hospital transfer rates (N = 1,520) and basic data on all residents (N = 1,238) were collected prospectively. Nurses’ preintervention knowledge and self-efficacy were assessed using standardized questionnaires (N = 330). Many hospital transfers were initiated by nurses without physician involvement, polypharmacy was common, and a high potential for reducing transfers by increasing physician presence was observed. Nurses showed rather low knowledge but high self-efficacy. The results are discussed against the background of the interventions including enhancement of physician presence and geriatric quality circles.

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confidence: 99%

“…The number of GPs NHs have to collaborate with varies considerably. Registered nurses (RNs) and assistant nurses (ANs) provide care for NH residents, with the limitation that the presence of RNs on site is not mandatory during night shifts ( Kada & Janig, 2016 ; Leichsenring et al, 2014 ).…”

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confidence: 99%

Reducing Avoidable Hospital Transfers From Nursing Homes in Austria

Kada

Janig

Likar

et al. 2017

Gerontology and Geriatric Medicine

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“…This might be interpreted in terms of moral distress (Goethals et al, 2010) if deciding in favor of own legal safety at the expense of residents' QoL. Given the fact that nurses are often forced to make transfer decisions without physician presence (Kada & Janig, 2016), interventions to reduce moral distress caused by decision dilemmas should be developed. Clear transfer guidelines, such as the ones developed and tested in the INTERACT project (Ouslander et al, 2011), can help to reduce ambiguity and moral distress (Goethals et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

“…One third of the study subjects that provided information on their professional background were registered nurses (RNs) (34%) and 66% were nurse assistants (NAs). NAs, whose primary duty is to assist RNs and physicians, were included in the experiment as NHs are not required to have RNs onsite during night shifts (Kada & Janig, 2016). Thirty-one percent had geriatric work experience less than 5 years, 29% reported a work experience between 5 and 10 years, and 40% had work experience in geriatric care of more than 10 years (missing values: n = 8).…”

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confidence: 99%

Hospital Transfers of Nursing Home Residents: A Vignette Experiment on Nurses’ Decision Making

Kada

2017

J Appl Gerontol

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Nursing home (NH) nurses play a key role in hospital transfer decisions. In case of unavailability of physicians, they have to decide alone. In doing so, they consider potential threats to residents' quality of life (QoL), but they also fear the consequences of wrong decisions. The present study examines the causal influence of these deliberations on nurses' transfer decisions and emotional strain. In all, 241 NH nurses participated in the experiment. The vignette describing a resident with deteriorating health state elicited either thoughts on residents' QoL, on legal consequences, or on QoL and legal consequences. In the QoL condition, the likelihood of a hospital transfer was lower compared with all other conditions. Emotional strain was stable across experimental conditions. When thoughts on QoL and legal consequences were induced at the same time, strain was positively correlated with the inclination to transfer the resident. Promoting QoL considerations can help to reduce avoidable transfers.

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“…Diese Unterschiede in der SWE sind eine Erklä-rung dafür, dass Personen trotz gleichen Wissens oder gleicher Fähigkeiten unterschiedlich mit Herausforderungen und Stressoren umgehen. In einem Arbeitsumfeld wie der stationären Altenpflege, welches von Unsicherheit, Ungewissheit und zahlreichen Belastungen geprägt ist [6,12], ist eine hohe Selbstwirksamkeit sicherlich eine notwendige Voraussetzung, um zu bestehen (vgl. dazu z.…”

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