Perceptions of Job Satisfaction and the Regulatory Environment Among Nurse Aides and Charge Nurses in Long-Term Care

Cherry, Barbara; Ashcraft, Alyce S.; Owen, Donna C.

doi:10.1016/j.gerinurse.2007.01.015

Cited by 44 publications

(42 citation statements)

References 18 publications

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“…They found that a one-standard deviation increase in the HRSI results in a 1.1% increase in nursing home costs. In terms of indirect costs, Cherry et al (23), consistent with theories of the "regulatory ratchet" (5), report that the adversarial relationship between nursing home staff and state surveyors increased paperwork and diverted effort from patient care.…”

Section: Arling Et Al (2)mentioning

confidence: 99%

Top-Down and Bottom-Up Approaches to Health Care Quality: The Impacts of Regulation and Report Cards

Mukamel

Haeder²,

Weimer

2014

Annu. Rev. Public Health

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The high cost of the US health care system does not buy uniformly high quality of care. Concern about low quality has prompted two major types of public policy responses: regulation, a top-down approach, and report cards, a bottom-up approach. Each can result in either functional provider responses, which increase quality, or dysfunctional responses, which may lower quality. What do we know about the impacts of these two policy approaches to quality? To answer this question, we review the extant literature on regulation and report cards. We find evidence of both functional and dysfunctional effects. In addition, we identify the areas in which additional research would most likely be valuable.

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Section: Arling Et Al (2)mentioning

confidence: 99%

Top-Down and Bottom-Up Approaches to Health Care Quality: The Impacts of Regulation and Report Cards

Mukamel

Haeder²,

Weimer

2014

Annu. Rev. Public Health

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“…Following new rehabilitation regulations, documentation improved but the actual delivery of occupational therapy services declined (Thomesen, 1996). Nurses and nurse aides report a negative impact of regulatory oversight on their work environment and job satisfaction; this is a concern given high industry turnover and nursing shortages (Cherry, Ashcraft, & Owen, 2007; Pfefferle & Weinberg, 2008). Nursing home staff also report that misaligned incentives resulting from regulations create barriers to implementing clinical practice guidelines (Colon-Emeric et al, 2005; Colon-Emeric et al, 2007) or undertaking culture change initiatives (The Commonwealth Fund, 2007).…”

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confidence: 99%

Regulation and Mindful Resident Care in Nursing Homes

Colón‐Emeric¹,

Plowman

Bailey

et al. 2010

Qual Health Res

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Regulatory oversight is intended to improve the health outcomes of nursing home residents, yet evidence suggests that regulations can inhibit mindful staff behaviors that are associated with effective care. We explored the influence of regulations on mindful staff behavior as it relates to resident health outcomes, and offer a theoretical explanation of why regulations sometimes enhance mindfulness and other times inhibit it. We analyzed data from an in-depth, multiple case study including field notes, interviews, and documents collected in 8 nursing homes. We completed a conceptual/thematic description using the concept of mindfulness to reframe the observations. Shared facility mission strongly impacted staff perceptions of the purpose and utility of regulations. In facilities with a resident-centered culture, regulations increased mindful behavior, whereas in facilities with a cost-focused culture, regulations reduced mindful care practices. When managers emphasized the punitive aspects of regulation we observed a decrease in mindful practices in all facilities.

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“…Having to take care of residents with mental deterioration who exhibit combative, uncooperative behavior and sometimes abuse workers was frequently mentioned as contributing to stress in the work environment. Consistent with this stress factor, the most frequently mentioned training need concerned managing dementia behavior 37) . Ripich et al found that nursing assistants frustrated by the difficulty of communicating with Alzheimer patients reported a definite benefit from communication training 38) .…”

Section: Discussionmentioning

confidence: 99%

Risk factors for work‐related stress and subjective hardship in health‐care staff in nursing homes for the elderly: A cross‐sectional study

Pélissier

Vohito

Fort

et al. 2015

Journal of Occupational Health

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attend job training courses, which should cover knowledge of the specific care needs of elderly patients and of the authority/responsibility required to do their job. (J Occup Health 2015; 57: 285-296) Key words: Health-care staff in nursing homes, Subjective hardship, Work-related stress, Working conditionsThe increase in the number of elderly persons with multiple chronic conditions including neuropsychiatric disorders and high levels of dependence entails increased demand for professional care workers in long-term residential care settings, such as nursing homes, in many countries 1−3) . In France, medical retirement or nursing homes are designated "establishments for the accommodation of dependent elderly persons" (Etablissements d'Hébergement pour Personnes Agées Dépendantes: EHPAD). They provide collective accommodation and overall management for the elderly, including lodging, health care and dependence-related aid. Management is founded on a qualified multidisciplinary team notably comprising nurses, nursing assistants and housekeepers, who are under the supervision of physicians. Nurses usually ensure technical care and coordinate the work of the nursing assistants. As well as catering and accompaniment, nursing assistants are in charge of hygiene, comfort and preventive and curative care and are under the supervision of a nurse. Housekeepers carry out cleaning tasks, catering tasks and sometimes care tasks such as helping with meals.Like other health-care workers, these workers are exposed to a variety of occupational risks 4) . Working with the elderly, however, may give rise to specific form of stress, such as having to deal with Abstract: Risk factors for work-related stress and subjective hardship in health-care staff in nursing homes for the elderly: A cross-sectional study: Carole PÉLISSIER, et al. Université Lyon 1, UMRESTTE (Joint unit IFSTTAR/UCLB), France-Objectives:This study aimed to explore potential risk factors for work-related stress by, detailing working conditions and subjective hardship according to occupational category in health-care staff working with elderly patients. Methods: A cross-sectional descriptive survey was conducted in 105 nursing homes for the elderly in France. Data on nursing home working conditions were collected by occupational physicians. The study population was limited to those in direct contact with the elderly, who were divided into 3 occupational groups defined by qualifications and tasks: housekeepers (HKs), nursing assistants (NAs) and nurses (Ns). Employees answered a questionnaire on their perceived working conditions and vocational training courses. Psychosocial stress was assessed with the Siegrist questionnaire. Results: The subjects included 706 HKs, 1,565 NAs and 378 Ns, and the findings showed confusion of tasks and responsibilities in the study population. Verbal abuse by residents was reported by 60.9% of HKs (versus 76.2% of NAs and 76.7% of Ns, p<0.001). Physical attack by residents was more frequently reported by NAs (59.1%) than Ns (52....

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Perceptions of Job Satisfaction and the Regulatory Environment Among Nurse Aides and Charge Nurses in Long-Term Care

Cited by 44 publications

References 18 publications

Top-Down and Bottom-Up Approaches to Health Care Quality: The Impacts of Regulation and Report Cards

Top-Down and Bottom-Up Approaches to Health Care Quality: The Impacts of Regulation and Report Cards

Regulation and Mindful Resident Care in Nursing Homes

Risk factors for work‐related stress and subjective hardship in health‐care staff in nursing homes for the elderly: A cross‐sectional study

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