C. V. Van Houtven, K. Miller, Rebecca J Gorges, H. Campbell, W. Dawson, J. McHugh, Brian E. McGarry, Ryan Gilmartin, N. Boucher, B. Kaufman, L. Chisholm, S. Beltran, S. Fashaw, Xiaochuan Wang, Olivia Reneau, A. Chun, Joseph W. Jacobs, Kathleen Abrahamson, K. Unroe, C. Bishop, G. Arling, Sheila Kelly, R. Werner, R. Konetzka, E. Norton
Context: COVID-19 has a high case fatality rate in high-risk populations and can cause severe morbidity and high healthcare resource use. Nursing home residents are a high-risk population; they live in congregate settings, often with shared rooms, and require hands-on care. Objectives: To assess state responses to the coronavirus pandemic related to nursing homes in the first half of 2020. Methods: An in-depth examination of 12 states’ responses to the COVID-19 pandemic in nursing homes through June 2020, using publicly reported information such as government decrees, health department guidance, and news reports. Findings: No state emerged as a model of care. All states faced difficulty with limited availability of testing and Personal Protective Equipment (PPE). State-level efforts to increase pay and benefits as a strategy to enable infected staff to quickly physically separate from residents were minimal, and other separation strategies depended on the ability to obtain test results rapidly and on state rules regarding accepting discharged COVID-19 patients into nursing homes. Visitor restrictions to reduce risk were ubiquitous, though based on a slim evidence-base. Limitations: The information used was limited to that which was publicly available. Implications: Overall, the results suggest that the states that handle the ongoing pandemic in nursing homes best will be those that find ways to make sure nursing homes have the resources to follow best practices for testing, PPE, separation, and staffing. Evidence is needed on visitor restrictions and trans mission, as states and their citizens would benefit from finding safe ways to relax visitor restrictions.
{"title":"State Policy Responses to COVID-19 in Nursing Homes","authors":"C. V. Van Houtven, K. Miller, Rebecca J Gorges, H. Campbell, W. Dawson, J. McHugh, Brian E. McGarry, Ryan Gilmartin, N. Boucher, B. Kaufman, L. Chisholm, S. Beltran, S. Fashaw, Xiaochuan Wang, Olivia Reneau, A. Chun, Joseph W. Jacobs, Kathleen Abrahamson, K. Unroe, C. Bishop, G. Arling, Sheila Kelly, R. Werner, R. Konetzka, E. Norton","doi":"10.31389/jltc.81","DOIUrl":"https://doi.org/10.31389/jltc.81","url":null,"abstract":"Context: COVID-19 has a high case fatality rate in high-risk populations and can cause severe morbidity and high healthcare resource use. Nursing home residents are a high-risk population; they live in congregate settings, often with shared rooms, and require hands-on care. Objectives: To assess state responses to the coronavirus pandemic related to nursing homes in the first half of 2020. Methods: An in-depth examination of 12 states’ responses to the COVID-19 pandemic in nursing homes through June 2020, using publicly reported information such as government decrees, health department guidance, and news reports. Findings: No state emerged as a model of care. All states faced difficulty with limited availability of testing and Personal Protective Equipment (PPE). State-level efforts to increase pay and benefits as a strategy to enable infected staff to quickly physically separate from residents were minimal, and other separation strategies depended on the ability to obtain test results rapidly and on state rules regarding accepting discharged COVID-19 patients into nursing homes. Visitor restrictions to reduce risk were ubiquitous, though based on a slim evidence-base. Limitations: The information used was limited to that which was publicly available. Implications: Overall, the results suggest that the states that handle the ongoing pandemic in nursing homes best will be those that find ways to make sure nursing homes have the resources to follow best practices for testing, PPE, separation, and staffing. Evidence is needed on visitor restrictions and trans mission, as states and their citizens would benefit from finding safe ways to relax visitor restrictions.","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87451921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brenda Frie, Cynthia Graham, A. Hynes, S. Dusek, Lecia Heinen, Mary Mehelich, Katherine Campbell
{"title":"Environmental Toolkit to Promote Quality Sleep in Long-Term Care: A Quality Improvement Initiative","authors":"Brenda Frie, Cynthia Graham, A. Hynes, S. Dusek, Lecia Heinen, Mary Mehelich, Katherine Campbell","doi":"10.31389/jltc.60","DOIUrl":"https://doi.org/10.31389/jltc.60","url":null,"abstract":"","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"101 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82248861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How Residents’ Quality of Life are Represented in Long-Term Care Policy: A Novel Method to Support Policy Analysis","authors":"Deanne Taylor, J. Keefe","doi":"10.31389/jltc.79","DOIUrl":"https://doi.org/10.31389/jltc.79","url":null,"abstract":"","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78662265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
equipment Context: The impact of Covid-19 on people working as personal assistants (PAs) or directly employed care workers potentially affects not only themselves and their clients but sometimes clients’ family members or carers. Objectives: This interview-based study aimed to hear directly from PAs of their experiences during the pandemic to inform policy and practice. Methods: A sample of 41 PAs working in England were interviewed by telephone during the early months of Covid-19 (April–June 2020) in England. Interview data were analysed thematically and accounts of PAs’ engagement with their clients’ family members were explored. Findings: Study findings illustrate the fluidity of relationships at this time within four dimensions: 1) some family members working more closely with PAs, 2) the development of tensions between PAs and family members, 3) displacement by family members of PAs and other care services, 4) PA accounts of working with clients who had little or no family contact or other assistance during the pandemic. Limita -tions: This study did not interview family members to hear their views of the relationships and circum stances discussed by the PAs. Implications for research include a need to hear from other care workers operating as live-in PAs and from family members and employers and to follow-up with PAs as the pandemic progressed. Policy implications include the need to encourage contingency planning and to ensure support for PAs. Practice implications are for staff responsible for individualised funding to ensure PAs are known to their systems to enable their support.
{"title":"Caring in Covid-19: Personal Assistants’ Changing Relationships with their Clients’ Family Members","authors":"J. Manthorpe, K. Samsi, C. Norrie, J. Woolham","doi":"10.31389/jltc.77","DOIUrl":"https://doi.org/10.31389/jltc.77","url":null,"abstract":"equipment Context: The impact of Covid-19 on people working as personal assistants (PAs) or directly employed care workers potentially affects not only themselves and their clients but sometimes clients’ family members or carers. Objectives: This interview-based study aimed to hear directly from PAs of their experiences during the pandemic to inform policy and practice. Methods: A sample of 41 PAs working in England were interviewed by telephone during the early months of Covid-19 (April–June 2020) in England. Interview data were analysed thematically and accounts of PAs’ engagement with their clients’ family members were explored. Findings: Study findings illustrate the fluidity of relationships at this time within four dimensions: 1) some family members working more closely with PAs, 2) the development of tensions between PAs and family members, 3) displacement by family members of PAs and other care services, 4) PA accounts of working with clients who had little or no family contact or other assistance during the pandemic. Limita -tions: This study did not interview family members to hear their views of the relationships and circum stances discussed by the PAs. Implications for research include a need to hear from other care workers operating as live-in PAs and from family members and employers and to follow-up with PAs as the pandemic progressed. Policy implications include the need to encourage contingency planning and to ensure support for PAs. Practice implications are for staff responsible for individualised funding to ensure PAs are known to their systems to enable their support.","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"2014 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86731789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Sugavanam, James Caiels, M. Peters, R. Fitzpatrick
{"title":"The Development of a Core Outcome Set for Trials and Evaluative Studies in Adult Social Care","authors":"T. Sugavanam, James Caiels, M. Peters, R. Fitzpatrick","doi":"10.31389/jltc.98","DOIUrl":"https://doi.org/10.31389/jltc.98","url":null,"abstract":"","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88909892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cynthia Beynon, K. Supiano, Elena O. Siegel, L. Edelman, Sara E Hart, Connie Madden
{"title":"It’s All about the Nurse Aides","authors":"Cynthia Beynon, K. Supiano, Elena O. Siegel, L. Edelman, Sara E Hart, Connie Madden","doi":"10.31389/jltc.103","DOIUrl":"https://doi.org/10.31389/jltc.103","url":null,"abstract":"","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78390520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Han, Salvatore Volpe, Aleksandra Zagorin, Patricia A. Tooker, Joseph Conte
{"title":"Reducing Sepsis Hospitalisations through a Standardized Quality Improvement Program in Skilled Nursing Facilities","authors":"M. Han, Salvatore Volpe, Aleksandra Zagorin, Patricia A. Tooker, Joseph Conte","doi":"10.31389/jltc.71","DOIUrl":"https://doi.org/10.31389/jltc.71","url":null,"abstract":"","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76841846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-11DOI: 10.21203/rs.3.rs-125014/v1
J. Salas, J. Palacios, Pablo Villalobos Dintrans, I. Madero-Cabib, R. Quilodrán, A. Ceriani, D. Meza
BackgroundThe COVID-19 affected disproportionately older people, and particularly people living in long-term care facilities. Considering this problem, the Chilean government issued a series of guidelines and protocols to prevent and manage COVID-19 outbreaks in these facilities. MethodsThis study aims to identify barriers and enablers that affect the implementation of these prevention and management measures. For the analysis, we used an implementation science approach and a mixed-method strategy—survey to facilities’ managers and interviews to carers—, classifying enablers and barriers into four categories: agreement with the intervention’s goals, financial resources to implement the measures, technical needs of the intervention, and cultural factors in the facilities.ResultsResults highlight the importance of the four aforementioned factors in the implementation of COVID-19 guidelines and protocols. Managers and caregivers differ in their view of the main enablers and barriers for implementation. However, they both identify the knowledge about the measures and availability of personal protective equipment as enablers and human resources as a potential barrier. ConclusionsThe identification of several factors related to goals and culture highlights the need to adopt a broad implementation approach when designing intervention for long-term care facilities, avoiding restricting the discussion to resources availability.
{"title":"Enablers and Barriers to Implement COVID-19 Measures in Long-Term Care Facilities: A Mixed Methods Implementation Science Assessment in Chile","authors":"J. Salas, J. Palacios, Pablo Villalobos Dintrans, I. Madero-Cabib, R. Quilodrán, A. Ceriani, D. Meza","doi":"10.21203/rs.3.rs-125014/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-125014/v1","url":null,"abstract":"\u0000 BackgroundThe COVID-19 affected disproportionately older people, and particularly people living in long-term care facilities. Considering this problem, the Chilean government issued a series of guidelines and protocols to prevent and manage COVID-19 outbreaks in these facilities. MethodsThis study aims to identify barriers and enablers that affect the implementation of these prevention and management measures. For the analysis, we used an implementation science approach and a mixed-method strategy—survey to facilities’ managers and interviews to carers—, classifying enablers and barriers into four categories: agreement with the intervention’s goals, financial resources to implement the measures, technical needs of the intervention, and cultural factors in the facilities.ResultsResults highlight the importance of the four aforementioned factors in the implementation of COVID-19 guidelines and protocols. Managers and caregivers differ in their view of the main enablers and barriers for implementation. However, they both identify the knowledge about the measures and availability of personal protective equipment as enablers and human resources as a potential barrier. ConclusionsThe identification of several factors related to goals and culture highlights the need to adopt a broad implementation approach when designing intervention for long-term care facilities, avoiding restricting the discussion to resources availability.","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73700895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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