Journal ArticleAging & mental health · January 2025
ObjectivesThis scoping review aims to map out the coping strategies among Persons with Mild Cognitive Impairment (PwMCI) and Persons with Mild Dementia (PwMD), identifying the facilitators and the barriers to the use of the strategies.Method
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Journal ArticleJournal of applied gerontology : the official journal of the Southern Gerontological Society · October 2024
Rapidly growing populations of older adults rely heavily on formal long-term care services such as those provided in nursing homes. Nursing home staff are confronted with complex challenges. We explored how staff (N = 88), particularly care aides, i ...
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Journal ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · July 2024
PurposeTo explore cancer-related cognitive impairment (CRCI) in older adults with acute myeloid leukemia (AML) receiving venetoclax in combination with hypomethylating agents or low-dose cytarabine chemotherapy.MethodsThis study is a long ...
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Journal ArticleThe Gerontologist · June 2024
Background and objectivesOrganizational context is thought to influence whether care aides feel empowered, but we lack empirical evidence in the nursing home sector. Our objective was to examine the association of features of nursing homes' unit o ...
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Journal ArticleImplementation science communications · June 2024
BackgroundContext (work environment) plays a crucial role in implementing evidence-based best practices within health care settings. Context is multi-faceted and its complex relationship with best practice use by care aides in long-term care (LTC) ...
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Journal ArticleCancer nursing · March 2024
BackgroundChemotherapy is essential for treating acute myeloid leukemia (AML). Previous studies concluded that survivors of cancer who were treated with chemotherapy experience cognitive impairment. Therefore, it is important to understand cogniti ...
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Journal ArticleGeriatr Nurs · 2024
Oral health declines in older adults with cognitive impairment. We aimed to improve oral hygiene outcomes for individuals with mild cognitive impairment (MCI) or mild dementia (MD) by fostering behavior changes among carepartners assisting them. We used qu ...
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Journal ArticleDisability and rehabilitation · June 2023
PurposeFatigue is a long-term symptom for stroke survivors. This scoping review synthesized how survivors achieve fatigue adaptation.MethodsFour databases were searched for studies between 2012 and 2021. Qualitative studies or qualitative ...
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Journal ArticleInnov Aging · 2023
BACKGROUND AND OBJECTIVES: Cognitive impairment is associated with poor oral health outcomes. Oral hygiene tasks are an essential target of interventions aiming to improve oral health for older adults with cognitive impairment. We aimed to examine whether ...
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Journal ArticleImplementation science : IS · December 2022
BackgroundThe number of research publications reporting the use of the Promoting Action on Research Implementation in Health Services (PARIHS) framework and the integrated PARIHS (i-PARIHS) framework has grown steadily. We asked how the last decad ...
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Journal ArticleImplementation Science Communications · December 1, 2022
Background: The importance of reporting research evidence to stakeholders in ways that balance complexity and usability is well-documented. However, guidance for how to accomplish this is less clear. We describe a method of developing and visualising dimen ...
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Journal ArticleJournal of the American Medical Directors Association · November 2022
ObjectiveTo compare characteristics of nursing home (NH) residents by age categories in Western Canada.DesignA cross-sectional, correlational analysis of secondary data.Setting and participants89,231 residents living in Western C ...
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Journal ArticleJMIR Research Protocols · September 1, 2022
Background: Caring for the well-being of older adults is one of the greatest challenges in modern societies. Improving the quality of care and life for older adults and the work lives of their care providers calls for effective knowledge translation of evi ...
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Journal ArticleResearch in nursing & health · August 2022
Assisted living (AL) communities are experiencing rising levels of resident acuity, challenging efforts to balance person-centered care-which prioritizes personhood, autonomy, and relationship-based care practices-with efforts to keep residents safe. Safet ...
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Journal ArticleBMJ Open · June 22, 2022
INTRODUCTION: Individuals with mild dementia are at high risk of poor oral health outcomes. To address this issue, we describe an intervention to teach care partners skills to guide individuals with mild dementia in proper oral hygiene techniques and provi ...
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Journal ArticleContemporary Clinical Trials Communications · June 1, 2022
Background: The Trial to Reduce Antimicrobial use In Nursing home residents with Alzheimer's disease and other Dementias (TRAIN-AD) was a cluster randomized clinical trial evaluating a multicomponent program to improve infection management among residents ...
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Journal ArticleJournal of the American Medical Directors Association · November 2021
ObjectivesThe percentage of younger nursing home (NH) residents (ages 18-64Â years) in some countries such as the United States and Canada has been increasing over the years. In fact, it is generally held that younger NH residents are considerably ...
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Journal ArticleNurs Sci Q · October 2021
The authors describe a family's adaptive challenges and adaptive work during a family member's treatment for Chronic Hepatitis C. We audiorecorded index and final clinical visits and interviewed participants (patients and providers) following the visits. W ...
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Journal ArticleGerodontology · September 2021
BACKGROUND AND OBJECTIVES: Older adults with cognitive impairment often experience poor oral health outcomes due to inadequate oral hygiene practices. This pilot study aimed to evaluate the feasibility of a care partner-assisted intervention to improve the ...
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Journal ArticleJAMA internal medicine · September 2021
ImportanceAntimicrobials are extensively prescribed to nursing home residents with advanced dementia, often without evidence of infection or consideration of the goals of care.ObjectiveTo test the effectiveness of a multicomponent interve ...
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Journal ArticleTrials · May 2021
BackgroundFidelity in complex behavioural interventions is underexplored and few comprehensive or detailed fidelity studies report on specific procedures for monitoring fidelity. Using Bellg's popular Treatment Fidelity model, this paper aims to i ...
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Journal ArticleNursing research · January 2021
BackgroundExposure to chronic stressors may contribute to the development of psychoneurological symptoms (i.e., fatigue, cognitive dysfunction, sleep disturbance, depressed mood, and pain) that can compromise maternal function.ObjectivesI ...
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Journal ArticleImplementation science : IS · September 2020
BackgroundFidelity in complex behavioral interventions is underexplored. This study examines the fidelity of the INFORM trial and explores the relationship between fidelity, study arm, and the trial's primary outcome-care aide involvement in forma ...
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Journal ArticleImplementation science : IS · September 2020
BackgroundEffective communication among interdisciplinary healthcare teams is essential for quality healthcare, especially in nursing homes (NHs). Care aides provide most direct care in NHs, yet are rarely included in formal communications about r ...
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Journal ArticleNursing research · March 2020
BackgroundSymptom clusters are conventionally distilled into a single score using composite scoring, which is based on the mathematical assumption that all symptoms are equivalently related to outcomes of interest; this may lead to a loss of impor ...
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Journal ArticleThe Gerontologist · January 2020
Background and objectivesPain and functional limitations can severely impede older adults' quality of life. In Chinese residential care facilities, limited research suggests that residents potentially have significant unmet care needs with pain an ...
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Journal ArticleTrials · October 2019
BackgroundInfections are common in nursing home (NH) residents with advanced dementia but are often managed inappropriately. Antimicrobials are extensively prescribed, but frequently with insufficient evidence to support a bacterial infection, pro ...
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Journal ArticleJournal of the American Medical Directors Association · May 2019
To support person-centered, residential long-term care internationally, a consortium of researchers in medicine, nursing, behavioral, and social sciences from 21 geographically and economically diverse countries have launched the WE-THRIVE consortium to de ...
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Journal ArticleApplied clinical informatics · March 2019
BackgroundThe purpose of this article is to describe neonatal intensive care unit clinician perceptions of a continuous predictive analytics technology and how those perceptions influenced clinician adoption. Adopting and integrating new technolog ...
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Journal ArticleJournal of applied gerontology : the official journal of the Southern Gerontological Society · February 2019
Empowering individuals to direct their own care is central to person-centered care and health care policy. However, there is limited knowledge of how "person-directed care planning" (PDCP) can be achieved in particular settings. This study identifies key s ...
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Journal ArticleGeriatr Nurs · 2019
We pilot tested a carepartner-assisted intervention to improve oral hygiene in persons with cognitive impairment (participants) and help carepartners become leaders who can adapt approaches that foster participants' ability to develop new skills for oral h ...
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Journal ArticleSage Open · 2019
Chronic Hepatitis C (CHC) is the most common blood-borne infection in the U. S. Patients with CHC undergoing treatment face many challenges including adherence to medications and management of symptoms; health care practitioners are well positioned to faci ...
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Journal ArticleInternational journal of qualitative methods · January 2019
Programs via the Internet are uniquely positioned to capture qualitative data. One reason is because the Internet facilitates the creation of a community of similar individuals who can exchange information and support related to living with a chronic illne ...
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Journal ArticleGerontology & geriatric medicine · January 2019
To support the development of internationally comparable common data elements (CDEs) that can be used to measure essential aspects of long-term care (LTC) across low-, middle-, and high-income countries, a group of researchers in medicine, nursing, behavio ...
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Journal ArticleInternational journal of older people nursing · December 2018
AimFederal regulations require nursing homes in the United States to support residents in directing their own care rather than having their care plans developed for them without their engagement, but knowledge of person-directed approaches to care ...
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Journal ArticleNursing outlook · November 2018
BackgroundLicensed nurse (registered nurse [RN] and licensed practical nurse [LPN]) roles in nursing homes are often viewed as interchangeable. Interchangeability occurs when the differences in RN and LPN education and scopes of practice are not r ...
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Journal ArticleJoint Commission journal on quality and patient safety · September 2018
BackgroundDespite emerging frameworks for quality improvement (QI) implementation, little is known about how the implementation process works, particularly in nursing home settings. A study was conducted to describe "how"' a complex frontline work ...
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Journal ArticleCritical care nursing clinics of North America · June 2018
In the intensive care unit, clinicians monitor a diverse array of data inputs to detect early signs of impending clinical demise or improvement. Continuous predictive analytics monitoring synthesizes data from a variety of inputs into a risk estimate that ...
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Journal ArticleJ Am Med Dir Assoc · May 2018
OBJECTIVES: Validated process measures that correlate with patient outcomes are needed for research and quality improvement. DESIGN: Cross-sectional analysis within a cluster-randomized fall prevention study. SETTING: Nursing homes in North Carolina (n = 1 ...
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Journal ArticleNursing research · May 2018
BackgroundThe theoretical landscape of health disparities research now emphasizes health inequities and the role that social determinants of health (SDOH) play in creating and perpetuating them. Whether National Institutes of Health (NIH) funding ...
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Journal ArticleJournal of medical Internet research · February 2018
BackgroundVirtual environments (VEs) facilitate interaction and support among individuals with chronic illness, yet the characteristics of these VE interactions remain unknown.ObjectiveThe objective of this study was to describe social in ...
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Journal ArticleGeriatric nursing (New York, N.Y.) · January 2018
As traditional family-based care in China declines, the demand for residential care increases. Knowledge of residents' experiences with long-term care (LTC) facilities is essential to improving quality of care. This pilot study aimed to describe residents' ...
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Journal ArticleHealth Care Manag (Frederick) · 2018
We sought to understand strategies reported by members of the nursing home management team used to prevent falls in short-stay nursing home patients. Using Donabedian's model of structure, process, and outcomes, we interviewed 16 managers from 4 nursing ho ...
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Journal ArticleJAMA Intern Med · November 1, 2017
IMPORTANCE: New approaches are needed to enhance implementation of complex interventions for geriatric syndromes such as falls. OBJECTIVE: To test whether a complexity science-based staff training intervention (CONNECT) promoting high-quality staff interac ...
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Journal ArticleLearning Health Systems · October 1, 2017
Introduction: The current Learning Health Systems literature affords insufficient attention to the process of learning. In response, Billings Clinic focused on how to advance its learning capabilities and subsequently to contribute new insights into the pr ...
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Journal ArticleBMC health services research · August 2017
BackgroundMedication reconciliation is a safety practice to identify medication order discrepancies when patients' transitions between settings. In nursing homes, registered nurses (RNs) and licensed practical nurses (LPNs), each group with differ ...
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Journal ArticleJ Am Geriatr Soc · April 2017
BACKGROUND: Nursing home (NH) residents who require assistance during mealtimes are at risk for malnutrition. Supportive handfeeding is recommended, yet there is limited evidence supporting use of a specific handfeeding technique to increase meal intake. O ...
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Journal ArticleJ Am Geriatr Soc · April 2017
OBJECTIVES: Little is known about how nursing home staff use resident characteristics to individualize care delivery or whether care is affected by implicit bias. DESIGN: Randomized factorial clinical vignette survey. SETTING: Sixteen nursing homes in Nort ...
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Journal ArticleJMIR research protocols · April 2017
BackgroundIndividuals with type 2 diabetes have an increased risk for comorbidities such as heart disease, lower limb amputations, stroke, and renal failure. Multiple factors influence development of complications in a person living with type 2 di ...
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Journal ArticleTrials · January 2017
BackgroundAudit and feedback is effective in improving the quality of care. However, methods and results of international studies are heterogeneous, and studies have been criticized for a lack of systematic use of theory. In TREC (Translating Rese ...
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Journal ArticleImplement Sci · July 16, 2016
BACKGROUND: Little is known about the sustainability of behavioral change interventions in long-term care (LTC). Following a cluster randomized trial of an intervention to improve staff communication (CONNECT), we conducted focus groups of direct care staf ...
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Journal ArticleHealth care management review · July 2016
BackgroundNursing homes are becoming increasingly complex clinical environments because of rising resident acuity and expansion of postacute services within a context of historically poor quality performance. Discrete quality markers have been lin ...
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Journal ArticleBMC Health Serv Res · May 17, 2016
BACKGROUND: Among hospitalized older adults who transfer to skilled nursing facilities (SNF) for short stays and subsequently transfer to home, twenty two percent require additional emergency department or hospital care within 30Â days. Transitional care se ...
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Journal ArticleArch Phys Med Rehabil · May 2016
OBJECTIVE: To examine contextual (facility and community) and individual factors associated with self-care and mobility outcomes among Medicare hip fracture patients receiving inpatient rehabilitation. DESIGN: Retrospective cohort study of 3 linked data fi ...
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Journal ArticleJournal of the American Medical Directors Association · February 2016
In response to the International Association of Gerontology and Geriatrics' global agenda for clinical research and quality of care in long-term care homes (LTCHs), the International Consortium on Professional Nursing Practice in Long Term Care Homes (the ...
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Journal ArticleJournal of nursing care quality · October 2015
This quality improvement project was designed to implement a sit-to-stand exercise program delivered by nursing assistants in an assisted living facility. The primary outcome was for residents to either improve or maintain function in activities of daily l ...
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Journal ArticleJournal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · September 2015
BackgroundUse of common data elements (CDEs), conceptually defined as variables that are operationalized and measured in identical ways across studies, enables comparison of data across studies in ways that would otherwise be impossible. Although ...
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Journal ArticleHealthcare (Basel, Switzerland) · September 2015
To understand the challenges arising from the context within which diabetic African-American caregiving grandmothers self-manage their diabetes we used the Adaptive Leadership Framework. Additionally, challenges to retaining this population in a longitudin ...
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Journal ArticleArchives of physical medicine and rehabilitation · May 2015
ObjectiveTo examine the influence of facility and aggregate patient characteristics of inpatient rehabilitation facilities (IRFs) on performance-based rehabilitation outcomes in a national sample of IRFs treating Medicare beneficiaries with hip fr ...
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Journal ArticleANS. Advances in nursing science · April 2015
We propose the Adaptive Leadership Framework for Chronic Illness as a novel framework for conceptualizing, studying, and providing care. This framework is an application of the Adaptive Leadership Framework developed by Heifetz and colleagues for business. ...
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Journal ArticleJournal of Nursing Regulation · April 1, 2015
Hospitalizations of nursing home residents are costly and adversely affect the health of already vulnerable residents, and reducing avoidable hospitalizations has been identified as a priority quality and safety outcome by the U.S. government. However, exi ...
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Journal ArticleGeriatr Nurs · 2015
This study examined whether chronic kidney disease (CKD) is associated with recurrent falls in older adults in nursing homes (NHs). We used data abstracted over a six month period from 510 NH residents with a history of falls. Thirty-five percent of the NH ...
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Journal ArticleJournal of Nursing Regulation · January 1, 2015
Emerging evidence indicates that harmful nursing home resident outcomes occur because of ineffective collaboration between registered nurses (RNs) and licensed practical nurses (LPNs) during assessment, care planning, delegation, and supervision. This obse ...
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Journal ArticleJournal of Nursing Regulation · January 1, 2015
Medication order discrepancies pose safety risks when nursing home residents transition between health care settings. In nursing homes, both registered nurses (RNs) and licensed practical nurses (LPNs) frequently are assigned to detect medication order dis ...
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Journal ArticleInternational Journal of Nursing Sciences · December 1, 2014
The need for institutional long-term care (LTC) services, including nursing homes (NHs), is increasing in Mainland China in part due to the aging population and changing family structures. In developing NH staff training programs, a review is needed to syn ...
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Journal ArticleNursing outlook · November 2014
The National Institute of Nursing Research (NINR) Centers of Excellence program is a catalyst enabling institutions to develop infrastructure and administrative support for creating cross-disciplinary teams that bring multiple strategies and expertise to b ...
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Journal ArticleImplementation science : IS · November 2014
BackgroundThe application of complexity science to understanding healthcare system improvement highlights the need to consider interdependencies within the system. One important aspect of the interdependencies in healthcare delivery systems is how ...
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Journal ArticleIssues in mental health nursing · October 2014
Adult daughters face distinct challenges caring for parents with dementia and may experience compassion fatigue: the combination of helplessness, hopelessness, an inability to be empathic, and a sense of isolation resulting from prolonged exposure to perce ...
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Journal ArticleNorth Carolina medical journal · September 2014
Successfully transitioning to person-centered care in nursing homes requires a new approach to solving care issues. The adaptive leadership framework suggests that expert providers must support frontline caregivers in their efforts to develop high-quality, ...
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Journal ArticleJournal of Nursing Regulation · July 1, 2014
Registered nurse (RN) students have difficulty learning delegation and supervision, and new RNs lack confidence in executing these skills. To improve safety, therefore, RN educators require new teaching and learning strategies to help prelicensure students ...
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Journal ArticleHealthcare (Basel, Switzerland) · July 2014
UnlabelledThe purpose of the manuscript is to describe long-term care (LTC) staff perceptions of a music cueing intervention designed to improve staff integration of pressure ulcer (PrU) prevention guidelines regarding consistent and regular movem ...
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Journal ArticleBMC Health Serv Res · June 5, 2014
BACKGROUND: To describe relationship patterns and management practices in nursing homes (NHs) that facilitate or pose barriers to better outcomes for residents and staff. METHODS: We conducted comparative, multiple-case studies in selected NHs (N = 4). Dat ...
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Journal ArticleGerontologist · June 2014
PURPOSE OF THE STUDY: The CONNECT intervention is designed to improve staff connections, communication, and use of multiple perspectives for problem solving. This analysis compared staff descriptions of the learning climate, use of social constructivist le ...
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Journal ArticleGeriatric nursing (New York, N.Y.) · March 2014
PurposeTo explore the multicaregiving roles African-American grandmothers assume while self-managing their diabetes.Design & methodsThis longitudinal, qualitative pilot study explored the challenges of self-managing diabetes among six Afr ...
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Journal ArticleRes Gerontol Nurs · 2014
During hospitalization, older adults are at high risk for cascade iatrogenesis, the serial development of complications. In this retrospective, descriptive, case-control pilot study, 28 patients (cases) who developed respiratory failure after an elective s ...
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Journal ArticleJ Am Geriatr Soc · January 2014
OBJECTIVES: To describe the time to first acute care use (e.g., emergency department (ED) use without hospitalization or rehospitalization) for older adults discharged to home after receiving postacute care in skilled nursing facilities (SNFs); to identify ...
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Journal ArticleHeart Lung · 2014
OBJECTIVES: To explore how family members of ICU patients at high risk of dying respond to nursing communication strategies. BACKGROUND: Family members of ICU patients may face difficult decisions. Nurses are in a position to provide support. Evidence of s ...
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Journal ArticleJ Am Geriatr Soc · December 2013
OBJECTIVES: To determine whether an intervention that improves nursing home (NH) staff connections, communication, and problem solving (CONNECT) would improve implementation of a falls reduction education program (FALLS). DESIGN: Cluster randomized trial. ...
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Journal ArticleIntensive & critical care nursing · December 2013
ObjectiveUsing the Adaptive Leadership framework, we describe behaviours that providers used while interacting with family members facing the challenges of recognising that their loved one was dying in the ICU.Research methodologyIn this ...
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Journal ArticleNursing Research and Practice · November 2013
Objectives. To (1) describe participation in decision-making as a systems-level property of complex adaptive systems and (2) present empirical evidence of reliability and validity of a corresponding measure. Method. Study 1 was a mail surv ...
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Journal ArticleJournal of Nursing Regulation · October 1, 2013
In nursing homes, the urgency to advance our measurement of nursing practice grows because nursing homes are increasingly regarded as an essential component of the care continuum needed to achieve national care quality goals. Prior qualitative case study r ...
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Journal ArticleJournal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · September 2013
PurposeSeveral literature reviews have been published summarizing objective knowledge about older patients with heart failure (HF). Although of vital importance to the treatment and diagnosis of HF, these reviews fail to explicate and summarize ol ...
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Journal ArticleNursing research · September 2013
BackgroundAlthough higher levels of registered nurse (RN) staffing in nursing homes are related to better care quality, licensed practical nurses (LPNs) provide most licensed-nursing care; prior research is mixed regarding how this influences qual ...
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Journal ArticleJ Am Med Dir Assoc · August 2013
BACKGROUND: The Safety Organizing Scale is a valid and reliable measure on safety behaviors and practices in hospitals. PURPOSE OF THE STUDY: This study aimed to explore the psychometric properties of the Safety Organizing Scale-Nursing Home version (SOS-N ...
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Journal ArticleJournal of Nursing Regulation · April 1, 2013
Understanding how nurse regulators can ensure optimal registered nurse-licensed practical/vocational nurse (RN-LPN) collaborations for patient safety and care quality is critically important.To aid this understanding, researchers conducted a comparative, m ...
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Journal ArticleJ Am Med Dir Assoc · April 2013
OBJECTIVES/INTRODUCTION: Demand for nursing home (NH) care by patients with end-stage renal disease (ESRD) is likely to increase with growing numbers of older adults initiating chronic dialysis. We completed a systematic review to summarize the literature ...
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Journal ArticleJournal of gerontological nursing · April 2013
Inadequate pain medication management is pervasive in nursing homes (NHs). Licensed practical nurses (LPNs) deliver the majority of licensed nursing care, but LPNs are neither trained nor licensed to provide comprehensive pain assessment and medication man ...
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Journal ArticleJ Palliat Med · March 2013
Family members of intensive care unit (ICU) patients want to be involved in decision making, but they may not be best served by being placed in the position of having to solve problems for which they lack knowledge and skills. This case report presents an ...
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Journal ArticleImplement Sci · January 2, 2013
BACKGROUND: Many challenges arise in complex organizational interventions that threaten research integrity. This article describes a Tool for Evaluating Research Implementation Challenges (TECH), developed using a complexity science framework to assist res ...
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Journal ArticleNursing research and practice · January 2013
Objectives. To (1) describe participation in decision-making as a systems-level property of complex adaptive systems and (2) present empirical evidence of reliability and validity of a corresponding measure. Method. Study 1 was a mail survey of a single re ...
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Journal ArticleAdvances in health care management · January 2013
In this commentary, I highlight a few of the assertions made by McDaniel et al. (2013) about the importance of complexity science guided management practices, and extend these ideas specifically to how we might think about reducing seemingly intractable pr ...
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Journal ArticleAdvances in health care management · January 2013
PurposeWe examine how interpersonal behavior and social interaction influence team sensemaking and subsequent team actions during a hospital-based health information technology (HIT) implementation project.Design/methodology/approachOver ...
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Journal ArticleInternational journal of older people nursing · December 2012
The need for personhood-focused long-term care (LTC) is well-documented. A myriad of sociocultural, political, nursing/professional and organisational contexts facilitate or hinder registered nurses (RNs)' capacity to ensure personhood-focused LTC. Complex ...
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Journal ArticleJournal of Healthcare Leadership · August 2012
In this paper we discuss the concept of leadership as a personal capability, not contingent on one’s position in a hierarchy. This type of leadership allows us to reframe both the care-giving and organizational roles of nurses and other front-line clinical ...
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Journal ArticleJournal of Applied Gerontology · August 2012
Director of nursing turnover is linked to staff turnover and poor quality of care in nursing homes; however the mechanisms of these relationships are unknown. Using a complexity science framework, we examined how nurse management turnover impacts system ca ...
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Journal ArticleHealth care management review · July 2012
BackgroundAs the American population ages and the proportion of individuals over the age of 65 expands, the demand for high-quality nursing home care will increase. However, nursing workforce instability threatens care quality and sustainability i ...
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Journal ArticleJournal of Nursing Regulation · April 1, 2012
A mailed survey of licensed practical nurses (LPNs) employed in nursing homes in Minnesota and North Carolina examined their role and responsibilities as well as barriers to and facilitators for working within their scope of practice. The study focused on ...
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Journal ArticleImplement Sci · February 29, 2012
BACKGROUND: Quality improvement (QI) programs focused on mastery of content by individual staff members are the current standard to improve resident outcomes in nursing homes. However, complexity science suggests that learning is a social process that occu ...
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Journal ArticleFam Community Health · 2012
After hospitalization, more than 1.5 million older adults each year receive postacute care in skilled nursing facilities (SNFs). Transitional care services, designed to prepare older SNF patients (and their family caregivers) for their transitions from an ...
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Journal ArticleNursing research · January 2012
BackgroundIn the context of declining registered nurse (RN) staffing levels in nursing homes, professional nursing jurisdiction over nursing care systems may erode.ObjectiveThe aim of this study was to develop a typology of professional n ...
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Journal ArticleNursing Research and Practice · October 2011
The objective of this paper is to analyze the literature concerning nurses' roles and strategies in EOL decision making in acute care environments, synthesize the findings, and identify implications for future research. We conducted searches in CINA ...
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Journal ArticleJournal of Nursing Regulation · July 2011
With changing staffing structures and persistent quality concerns in nursing homes, registered nurses are challenged to ensure that appropriate care is delivered. We describe differences in the nurse practice acts (NPAs) and related administrative code for ...
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Journal ArticleNursing outlook · July 2011
Effective staff interdependence is needed to improve care of older adults in nursing homes. We synthesized research about nursing management practices that help nursing home staff members manage their relationships for better care. We searched PubMed for s ...
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Journal ArticleJournal of Nursing Regulation · July 2011
With changing staffing structures and persistent quality concerns in nursing homes, registered nurses are challenged to ensure that appropriate care is delivered. We describe differences in the nurse practice acts (NPAs) and related administrative code for ...
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Journal ArticleMedical care · June 2011
BackgroundThere is inconclusive evidence that nursing home caregiver staffing characteristics influence quality of care. In this research, the relationship of caregiver staffing levels, turnover, agency use, and professional staff mix with quality ...
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Journal ArticleNursing research and practice · January 2011
Introduction. Compassion fatigue is a concept used with increasing frequency in the nursing literature. The objective of this paper is to identify common themes across the literature and to apply these themes, and an existing model of compassion fatigue, t ...
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Journal ArticleNursing research and practice · January 2011
The objective of this paper is to analyze the literature concerning nurses' roles and strategies in EOL decision making in acute care environments, synthesize the findings, and identify implications for future research. We conducted searches in CINAHL and ...
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Journal ArticleImplementation science : IS · November 2010
BackgroundImplementing new practices, such as health information technology (HIT), is often difficult due to the disruption of the highly coordinated, interdependent processes (e.g., information exchange, communication, relationships) of providing ...
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Journal ArticleQual Health Res · September 2010
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 mindf ...
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Journal ArticleOnline Journal of Issues in Nursing · May 2010
This article presents a qualitative, descriptive study of how registered nurses (RNs) (N=33) in leadership roles in institutional, long-term care settings delegate care. Findings from this study include both the strategies and processes these nurses used f ...
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Journal ArticleAlzheimer's Care Today · April 1, 2010
Efforts to improve dementia care through training occur in an organizational context that may enhance or inhibit improvement. This article used linear mixed models to examine the relationship of contextual and organizational factors to baseline knowledge, ...
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Journal ArticleJournal of evaluation in clinical practice · February 2010
RationaleData about health care organizations (HCOs) are not useful until they are interpreted. Such interpretations are influenced by the theoretical lenses used by the researcher.ObjectiveOur purpose was to suggest the usefulness of the ...
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Journal ArticleOnline Journal of Issues in Nursing · 2010
This article presents a qualitative, descriptive study of how registered nurses (RNs) (N=33) in leadership roles in institutional, long-term care settings delegate care. Findings from this study include both the strategies and processes these nurses used f ...
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Journal ArticleInt J Nurs Stud · November 2009
Older adults are at particular risk for injuries associated with hospitalization and the rate of adverse events increases significantly with age. The purpose of this paper is to review factors associated with the development of adverse events in hospitaliz ...
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Journal ArticleJ Aging Stud · August 2009
Each year thousands of older adults are admitted to nursing homes. Following admission, nursing home staff and family members must interact and communicate with each other. This study examined relationship and communication patterns between nursing home st ...
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Journal ArticleHealth care management review · April 2009
Featured Publication
BackgroundBecause health care organizations (HCOs) are complex adaptive systems (CASs), phenomena of interest often are dynamic and unfold in unpredictable ways, and unfolding events are often unique. Researchers of HCOs may recognize that the sub ...
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Journal ArticleJournal for nurses in staff development : JNSD : official journal of the National Nursing Staff Development Organization · January 2009
Featured Publication
Staff development nurses in long-term care are challenged to implement training programs that foster quality unlicensed assistive personnel (UAP) care and improve the transfer of their observations to licensed nursing staff for care planning. This study de ...
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Journal ArticleWest J Nurs Res · October 2008
Featured Publication
In this study, the authors describe certified nursing assistants' (CNA) Explanatory Models (EMs) of depression and aspects of their EMs that may contribute to the underdetection of depression in nursing homes. Interviews with 18 CNAs working in two nursing ...
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Journal ArticleArmed Forces and Society · January 1, 2008
The authors challenge the old school of hierarchical strategic leadership that dominates the military professional culture and, in contrast, emphasize complex adaptive systems (CASs) as a compelling alternative mental model to view the military profession. ...
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Journal ArticleJ Am Geriatr Soc · September 2007
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OBJECTIVES: To identify barriers to and facilitators of the diffusion of clinical practice guidelines (CPGs) and clinical protocols in nursing homes (NHs). DESIGN: Qualitative analysis. SETTING: Four randomly selected community nursing homes. PARTICIPANTS: ...
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Journal ArticleMedical care research and review : MCRR · April 2007
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We know little about factors associated with job satisfaction and dissatisfaction for nursing home workers. In this investigation, the authors use data from a large sample of nursing home administrators (NHAs) to examine: (1) their levels of job satisfacti ...
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Journal ArticleThe Gerontologist · April 2007
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PurposeThe relationship between job satisfaction of nurse aides and intent to leave and actual turnover after 1 year is examined.Design and methodsData came from a random sample of 72 nursing homes from 5 states (Colorado, Florida, Michig ...
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Journal ArticleWest J Nurs Res · December 2006
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Dissemination of research findings to practice and maintenance of rigor and validity in qualitative research are continuing challenges for nurse researchers. Using three nursing home case studies as examples, this article describes how exit interview-consu ...
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Journal ArticleWest J Nurs Res · April 2006
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This study describes how Minimum Data Set (MDS) coordinators' relationship patterns influence nursing home care processes. MDS coordinators interact with nursing home staff to coordinate resident assessment and care planning, but little is known about how ...
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Journal ArticleQual Health Res · February 2006
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Complexity science teaches that relationships among health care providers are key to our understanding of how quality care emerges. The authors sought to compare the effects of differing patterns of medicine-nursing communication on the quality of informat ...
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Journal ArticleHealth Care Manage Rev · 2006
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We describe how connections among nursing home staff impact the care planning process using a complexity science framework. We completed six-month case studies of four nursing homes. Field observations (n = 274), shadowing encounters (n = 69), and in-depth ...
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Journal ArticleQual Health Res · October 2005
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In a nursing home case study using observation and interview data, the authors described two mental models that guided certified nurse assistants (CNAs) in resident care. The Golden Rule guided CNAs to respond to residents as they would want someone to do ...
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Journal ArticleQualitative health research · May 2005
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Many wonder why there has been so little change in care quality despite substantial quality improvement efforts. Questioning why current approaches are not making true changes draws attention to the organization as a source of answers. The authors bring to ...
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Journal ArticleThe Gerontologist · June 2004
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PurposeTurnover in nursing homes is a widespread problem adversely affecting care quality. Using complexity theory, we tested the effect of administrative climate, communication patterns, and the interaction between the two on turnover, controllin ...
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Journal ArticleThe Journal of nursing education · February 2004
This clinical exemplar highlights how an academic clinical practice supported gerontological nursing students as they learned evidence-based approaches to managing complex geriatric syndromes in long-term care. Urinary incontinence (UI), which occurs in mo ...
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Journal ArticleAlzheimer’s Care Quarterly · 2004
Our current understanding of how nursing assistants (NAs) provide unlicensed nursing care to the cognitively impaired suggests NAs make choices about how to provide care in ways that may be classified as either rational or intuitive. ...
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Journal ArticlePublic health nursing (Boston, Mass.) · September 2003
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The purpose of this study was to examine comprehensive prenatal case management programs in terms of organizational, program, and process characteristics. Data from 66 program surveys of government agencies were used. Organizational capacity was measured a ...
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Journal ArticleHealth care management review · April 2003
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This study looks into the "black box" of hospital ownership conversion in a "natural experiment." We posed two competing theories about how conversion might influence management practices. Results support complexity theory and not threat-rigidity theory. A ...
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Journal ArticleNursing research · January 2003
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BackgroundDespite numerous clinical and regulatory efforts, problems of poor quality of care in nursing homes continue, suggesting a need for effective management practices.ObjectiveTo test complexity hypotheses about the relationship bet ...
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Journal ArticleResearch in nursing & health · October 2001
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Prior research has indicated that registered nurse (RN) participation in decision making (PDM) is related to better outcomes in nursing homes and hospitals. Little is known, however, about the roles of community-based case managers (CMs), most of whom are ...
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Journal ArticlePolicy, Politics, and Nursing Practice · February 2001
Smart card technology is about to emerge as a major solution to many of the problems currently faced in health care. At a minimum, smart cards will help with efficiency, patient safety, accuracy of documentation, medication ordering and dispensing, and ove ...
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Journal ArticleHealth care management review · January 2000
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This article examines the intersection of professionalism and complexity science as a source of new insights for improving the health care industry from both a clinical and business point of view. Viewing health care organizations as professional complex a ...
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Journal ArticleAnnals of Long-Term Care · December 16, 1999
Objective: To examine variations in resident care practices and staffing in Michigan nursing facilities. Design/Setting: Nonconcurrent prospective cohort study. Participants: Michigan nursing facilities (41,344 residents), compiled by the Michigan Departme ...
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Journal ArticleResearch in nursing & health · August 1999
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Case mix indicates, for a resident population, the degree of risk for developing favorable or unfavorable outcomes. In a study of 164 nursing homes, we explored two methods for combining resident assessment data into a case mix index (CMI). We compared a f ...
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Journal ArticleArch Phys Med Rehabil · May 1999
OBJECTIVES: (1) To assess the test-retest reliability of physical performance tests in subject groups with different levels of impairment and disability, and (2) to assess the stability of these tests over different time intervals. DESIGN: Test-retest, rep ...
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Journal ArticleHealth care management review · January 1999
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Comprehensive case management has become an industry standard and its pervasiveness raises questions about the ubiquitous need for this service. Analyzed from the perspective of transaction cost analysis and access, we argue that in some cases comprehensiv ...
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Journal ArticleHealth care management review · January 1999
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In the study on which this article is based, nursing homes with the most improvements in resident outcomes had greater registered nurse (RN) participation in decision making than did homes with the least improvements. The results suggest that nursing homes ...
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Journal ArticleResearch in nursing & health · August 1998
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The purpose of this study was to identify patterns of resource allocation that relate to resident outcomes in nursing homes. Data on structure, staffing levels, salaries, cost, case mix, and resident outcomes were obtained from state-level, administrative ...
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Journal ArticleThe Gerontologist · February 1998
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In this study of data obtained from nursing home administrators and directors of nursing, we found that intensity of registered nurses' (RNs') participation in nursing home decision making varied with decision content and decision level. The primary decisi ...
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Journal ArticleNursing times · 1997
This paper explains how a trust worked with a higher education institution to provide continuing education for clinical staff. The result was a staff development award that carries 60 CATS points at level 2. Evaluation shows that the award has not only hel ...
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Journal ArticleResearch in nursing & health · April 1996
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Despite state laws and professional norms, administrators intervene in different ways in response to chemically dependent nurses. The purpose of this study was to examine how context and interpretation affect these interventions. Nurse administrators from ...
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Journal ArticleNursing economic$ · March 1996
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Changes occurring in the health care industry are substantive and constitute a paradigm shift. Nurse managers can participate in shaping the health care organization of the future by understanding six critical areas of transformation and their driving forc ...
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Journal ArticleJournal of nursing measurement · January 1994
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The unit of analysis at which variables are conceptualized and measured is an important consideration when conducting patient outcomes research. Outcomes research ranges from study of individual responses to nursing intervention to investigation of group l ...
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Journal ArticleComputers in nursing · July 1992
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The authors describe a theory-based approach to computer skill development in nursing administration that is a strategy for preparing nurse administrators to meet the challenge for effective decision making in the rapidly changing health care environment. ...
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Journal ArticleNursing economic$ · March 1992
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In this study of 14 effective nursing homes, patterns of participation were found to be different from those proposed by traditional organizational theories; environmental turbulence was positively correlated with participation in decision making by RNs an ...
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Journal ArticleHealth services research · February 1991
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In this study of 162 hospitals, it was found that the chief executive officer's (CEO's) interpretation of strategic issues is related to the existing hospital strategy and the hospital's information processing structure. Strategy was related to interpretat ...
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Journal ArticleEvaluation and the Health Professions · 1990
The daily management of diabetes involves a complex interaction of metabolic variables, self-care behaviors, and psychological and social adjustments to having the disease. Diabetes patient-education programs usually focus on the self-care aspects of manag ...
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Journal ArticleHealth progress (Saint Louis, Mo.) · November 1989
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The complexity of a modern hospital can mystify and intimidate trustees; they may have difficulty understanding how the hospital works and thus may feel unable to contribute to its success. Stripping away some of the mystery may enable them to more effecti ...
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Journal ArticleThe Journal of nursing administration · June 1989
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What is the best educational preparation for top-level nurse executives? Which educational degrees will improve marketability? These questions were asked of nurse executives and their chief executive officers in a national market survey. The authors discus ...
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Journal ArticleThe Journal of nursing administration · May 1989
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Nurse administrators can formulate useful theories while solving the complex problems of practice. An awareness of the mental perspective that frames one's thoughts about experiences can aid in theory development. Examples are developed to illustrate how d ...
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