Scholars@Duke
Ruth A. Anderson

Ruth A. Anderson

Professor Emerita in the School of Nursing
School of Nursing
ruth.anderson@duke.edu
Box 3322 Med Ctr, Durham, NC 27710
School of Nursing, 1003 Clipp, Durham, NC 27710

Selected Publications

Adaptation to poststroke fatigue in stroke survivors and their care partners: a scoping review.

Journal Article Disability 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 ... Full text Cite

Conceptual and relational advances of the PARIHS and i-PARIHS frameworks over the last decade: a critical interpretive synthesis.

Journal Article Implementation 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 ... Full text Cite

Reporting unit context data to stakeholders in long-term care: a practical approach

Journal Article Implementation 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 ... Full text Cite

A Cross-Sectional, Correlational Study Comparing Individual Characteristics of Younger and Older Nursing Home Residents using Western Canadian Resident Assessment Instrument-Minimum Data Set (RAI-MDS) 2.0.

Journal Article Journal 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 ... Full text Cite

The Influence of Context on Implementation and Improvement: Protocol for a Mixed Methods, Secondary Analyses Study

Journal Article JMIR 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 ... Full text Cite

Developing a toolkit to improve resident and family engagement in the safety of assisted living: Engage-A stakeholder-engaged research protocol.

Journal Article Research 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 ... Full text Cite

Study protocol for a randomised controlled trial of a care partner assisted intervention to improve oral health of individuals with mild dementia.

Journal Article BMJ 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 ... Full text Link to item Cite

Provider adherence to training components from the Trial to Reduce Antimicrobial use In Nursing home residents with Alzheimer's disease and other Dementias (TRAIN-AD) intervention

Journal Article Contemporary 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 ... Full text Cite

Younger Nursing Home Residents: A Scoping Review of Their Lived Experiences, Needs, and Quality of Life.

Journal Article Journal of the American Medical Directors Association · November 2021 ObjectivesThe percentage of younger nursing home (NH) residents (ages 18-64 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 ... Full text Cite

Adaptive Challenges and Family Support: Patient Self-Management during Treatment for Chronic Hepatitis C.

Journal Article Nurs 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 ... Full text Link to item Cite

Care partner-assisted intervention to improve oral health for older adults with cognitive impairment: A feasibility study.

Journal Article Gerodontology · 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 ... Full text Link to item Cite

The Trial to Reduce Antimicrobial Use in Nursing Home Residents With Alzheimer Disease and Other Dementias (TRAIN-AD): A Cluster Randomized Clinical Trial.

Journal Article JAMA 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 ... Full text Cite

Fidelity is not easy! Challenges and guidelines for assessing fidelity in complex interventions.

Journal Article Trials · 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 ... Full text Cite

A Preliminary Investigation of Psychoneurological Symptoms in Low-Income Mothers.

Journal Article Nursing 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 ... Full text Cite

Examining fidelity in the INFORM trial: a complex team-based behavioral intervention.

Journal Article Implementation 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 ... Full text Cite

Comparing effects of two higher intensity feedback interventions with simple feedback on improving staff communication in nursing homes-the INFORM cluster-randomized controlled trial.

Journal Article Implementation 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 ... Full text Cite

Two Methods for Calculating Symptom Cluster Scores.

Journal Article Nursing 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 ... Full text Cite

Resident Challenges With Pain and Functional Limitations in Chinese Residential Care Facilities.

Journal Article The 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 ... Full text Cite

The trial to reduce antimicrobial use in nursing home residents with Alzheimer's disease and other dementias: study protocol for a cluster randomized controlled trial.

Journal Article Trials · October 2019 BACKGROUND:Infections 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, promoting t ... Full text Cite

Toward Common Data Elements for International Research in Long-term Care Homes: Advancing Person-Centered Care.

Journal Article Journal 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 ... Full text Cite

Adaptation to poststroke fatigue in stroke survivors and their care partners: a scoping review.

Journal Article Disability 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 ... Full text Cite

Conceptual and relational advances of the PARIHS and i-PARIHS frameworks over the last decade: a critical interpretive synthesis.

Journal Article Implementation 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 ... Full text Cite

Reporting unit context data to stakeholders in long-term care: a practical approach

Journal Article Implementation 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 ... Full text Cite

A Cross-Sectional, Correlational Study Comparing Individual Characteristics of Younger and Older Nursing Home Residents using Western Canadian Resident Assessment Instrument-Minimum Data Set (RAI-MDS) 2.0.

Journal Article Journal 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 ... Full text Cite

The Influence of Context on Implementation and Improvement: Protocol for a Mixed Methods, Secondary Analyses Study

Journal Article JMIR 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 ... Full text Cite

Developing a toolkit to improve resident and family engagement in the safety of assisted living: Engage-A stakeholder-engaged research protocol.

Journal Article Research 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 ... Full text Cite

Study protocol for a randomised controlled trial of a care partner assisted intervention to improve oral health of individuals with mild dementia.

Journal Article BMJ 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 ... Full text Link to item Cite

Provider adherence to training components from the Trial to Reduce Antimicrobial use In Nursing home residents with Alzheimer's disease and other Dementias (TRAIN-AD) intervention

Journal Article Contemporary 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 ... Full text Cite

Younger Nursing Home Residents: A Scoping Review of Their Lived Experiences, Needs, and Quality of Life.

Journal Article Journal of the American Medical Directors Association · November 2021 ObjectivesThe percentage of younger nursing home (NH) residents (ages 18-64 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 ... Full text Cite

Adaptive Challenges and Family Support: Patient Self-Management during Treatment for Chronic Hepatitis C.

Journal Article Nurs 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 ... Full text Link to item Cite

Care partner-assisted intervention to improve oral health for older adults with cognitive impairment: A feasibility study.

Journal Article Gerodontology · 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 ... Full text Link to item Cite

The Trial to Reduce Antimicrobial Use in Nursing Home Residents With Alzheimer Disease and Other Dementias (TRAIN-AD): A Cluster Randomized Clinical Trial.

Journal Article JAMA 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 ... Full text Cite

Fidelity is not easy! Challenges and guidelines for assessing fidelity in complex interventions.

Journal Article Trials · 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 ... Full text Cite

A Preliminary Investigation of Psychoneurological Symptoms in Low-Income Mothers.

Journal Article Nursing 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 ... Full text Cite

Examining fidelity in the INFORM trial: a complex team-based behavioral intervention.

Journal Article Implementation 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 ... Full text Cite

Comparing effects of two higher intensity feedback interventions with simple feedback on improving staff communication in nursing homes-the INFORM cluster-randomized controlled trial.

Journal Article Implementation 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 ... Full text Cite

Two Methods for Calculating Symptom Cluster Scores.

Journal Article Nursing 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 ... Full text Cite

Resident Challenges With Pain and Functional Limitations in Chinese Residential Care Facilities.

Journal Article The 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 ... Full text Cite

The trial to reduce antimicrobial use in nursing home residents with Alzheimer's disease and other dementias: study protocol for a cluster randomized controlled trial.

Journal Article Trials · October 2019 BACKGROUND:Infections 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, promoting t ... Full text Cite

Toward Common Data Elements for International Research in Long-term Care Homes: Advancing Person-Centered Care.

Journal Article Journal 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 ... Full text Cite

Diffusing an Innovation: Clinician Perceptions of Continuous Predictive Analytics Monitoring in Intensive Care.

Journal Article Applied 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 ... Full text Cite

Person-Directed Care Planning in Nursing Homes: Resident, Family, and Staff Perspectives.

Journal Article Journal 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 ... Full text Cite

Working together to learn new oral hygiene techniques: Pilot of a carepartner-assisted intervention for persons with cognitive impairment.

Journal Article Geriatr 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 ... Full text Link to item Cite

Clinical Encounters and Treatment Initiation for Chronic Hepatitis C Patients: Applications of Adaptive Leadership Framework for Chronic Illness.

Journal Article Sage 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 ... Full text Link to item Cite

Developing Methods That Facilitate Coding and Analysis of Synchronous Conversations via Virtual Environments.

Journal Article International 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 ... Full text Cite

Advancing Long-Term Care Science Through Using Common Data Elements: Candidate Measures for Care Outcomes of Personhood, Well-Being, and Quality of Life.

Journal Article Gerontology & 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 ... Full text Cite

Person-directed care planning in nursing homes: A scoping review.

Journal Article International 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 ... Full text Cite

Interchangeability of Licensed Nurses in Nursing Homes: Perspectives of Directors of Nursing.

Journal Article Nursing 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 ... Full text Cite

Implementing Frontline Worker-Led Quality Improvement in Nursing Homes: Getting to "How".

Journal Article Joint 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 ... Full text Cite

Advancing Continuous Predictive Analytics Monitoring: Moving from Implementation to Clinical Action in a Learning Health System.

Journal Article Critical 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 ... Full text Cite

Resident Vignettes for Assessing Care Quality in Nursing Homes.

Journal Article J 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 ... Full text Link to item Cite

Trends in Health Disparities, Health Inequity, and Social Determinants of Health Research: A 17-Year Analysis of NINR, NCI, NHLBI, and NIMHD Funding.

Journal Article Nursing 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 ... Full text Cite

Type 2 Diabetes Education and Support in a Virtual Environment: A Secondary Analysis of Synchronously Exchanged Social Interaction and Support.

Journal Article Journal of medical Internet research · February 2018 BACKGROUND:Virtual environments (VEs) facilitate interaction and support among individuals with chronic illness, yet the characteristics of these VE interactions remain unknown. OBJECTIVE:The objective of this study was to describe social interaction and s ... Full text Cite

Resident challenges with daily life in Chinese long-term care facilities: A qualitative pilot study.

Journal Article Geriatric 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' ... Full text Cite

Management Team Perceptions of Risks and Strategies for Preventing Falls Among Short-Stay Patients in Nursing Homes.

Journal Article Health 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 ... Full text Link to item Cite

Effect of Promoting High-Quality Staff Interactions on Fall Prevention in Nursing Homes: A Cluster-Randomized Trial.

Journal Article JAMA 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 ... Full text Link to item Cite

Learning: Contemplating the unexamined core of Learning Health Systems

Journal Article Learning 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 ... Full text Cite

A qualitative study describing nursing home nurses sensemaking to detect medication order discrepancies.

Journal Article BMC 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 ... Full text Cite

Experimental Comparison of Efficacy for Three Handfeeding Techniques in Dementia.

Journal Article J 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 ... Full text Link to item Cite

Study of Individualization and Bias in Nursing Home Fall Prevention Practices.

Journal Article J 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 ... Full text Link to item Cite

Analyzing Unstructured Communication in a Computer-Mediated Environment for Adults With Type 2 Diabetes: A Research Protocol.

Journal Article JMIR 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 ... Full text Cite

Improving Nursing Home Care through Feedback On PerfoRMance Data (INFORM): Protocol for a cluster-randomized trial.

Journal Article Trials · 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 ... Full text Cite

Sustaining complex interventions in long-term care: a qualitative study of direct care staff and managers.

Journal Article Implement 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 ... Full text Link to item Cite

Nursing home director of nursing leadership style and director of nursing-sensitive survey deficiencies.

Journal Article Health 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 ... Full text Cite

Transitional care in skilled nursing facilities: a multiple case study.

Journal Article BMC 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 30 days. Transitional care se ... Full text Link to item Cite

Self-Care and Mobility Following Postacute Rehabilitation for Older Adults With Hip Fracture: A Multilevel Analysis.

Journal Article Arch 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 ... Full text Link to item Cite

Recommendations From the International Consortium on Professional Nursing Practice in Long-Term Care Homes.

Journal Article Journal 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 ... Full text Cite

Implementation of an Exercise Program in an Assisted Living Facility.

Journal Article Journal 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 ... Full text Cite

Advancing Symptom Science Through Use of Common Data Elements.

Journal Article Journal 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 ... Full text Cite

Adaptive Challenges Rising from the Life Context of African-American Caregiving Grandmothers with Diabetes: A Pilot Study.

Journal Article Healthcare (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 ... Full text Cite

Performance-based outcomes of inpatient rehabilitation facilities treating hip fracture patients in the United States.

Journal Article Archives 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 ... Full text Cite

Adaptive leadership framework for chronic illness: framing a research agenda for transforming care delivery.

Journal Article ANS. 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. ... Full text Cite

Differentiating Scopes of Practice in Nursing Homes: Collaborating for Care

Journal Article Journal 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 ... Full text Cite

Chronic kidney disease and recurrent falls in nursing home residents: a retrospective cohort study.

Journal Article Geriatr 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 ... Full text Link to item Cite

Perceptions of Nursing Practice: Capacity for High-Quality Nursing Home Care

Journal Article Journal 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 ... Full text Cite

Detecting Medication Order Discrepancies in Nursing Homes: How RNs and LPNs Differ

Journal Article Journal 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 ... Full text Cite

Staff characteristics and care in Chinese nursing homes: A systematic literature review

Journal Article International 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 ... Full text Cite

National Institute of Nursing Research Centers of Excellence: a logic model for sustainability, leveraging resources, and collaboration to accelerate cross-disciplinary science.

Journal Article Nursing 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 ... Full text Cite

Manifestations and implications of uncertainty for improving healthcare systems: an analysis of observational and interventional studies grounded in complexity science.

Journal Article Implementation 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 ... Full text Cite

Compassion fatigue in adult daughter caregivers of a parent with dementia.

Journal Article Issues 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 ... Full text Cite

Adaptive leadership and person-centered care: a new approach to solving problems.

Journal Article North 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, ... Full text Cite

Teaching Delegation to RN Students

Journal Article Journal 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 ... Full text Cite

Evaluation of Cueing Innovation for Pressure Ulcer Prevention Using Staff Focus Groups.

Journal Article Healthcare (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 ... Full text Cite

Local interaction strategies and capacity for better care in nursing homes: a multiple case study.

Journal Article BMC 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 ... Full text Link to item Cite

Connecting the learners: improving uptake of a nursing home educational program by focusing on staff interactions.

Journal Article Gerontologist · 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 ... Full text Link to item Cite

The "invisible caregiver": multicaregiving among diabetic African-American grandmothers.

Journal Article Geriatric 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 ... Full text Cite

Cascade iatrogenesis: a case-control study to detect postoperative respiratory failure in hospitalized older adults.

Journal Article Res 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 ... Full text Link to item Cite

Restarting the cycle: incidence and predictors of first acute care use after nursing home discharge.

Journal Article J 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 ... Full text Link to item Cite

Nursing strategies to support family members of ICU patients at high risk of dying.

Journal Article Heart 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 ... Full text Link to item Cite

CONNECT for better fall prevention in nursing homes: results from a pilot intervention study.

Journal Article J 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. ... Full text Link to item Cite

Finding your way through EOL challenges in the ICU using Adaptive Leadership behaviours: A qualitative descriptive case study.

Journal Article Intensive & 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 ... Full text Cite

Participation in Decision Making as a Property of Complex Adaptive Systems: Developing and Testing a Measure

Journal Article Nursing 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 ... Cite

Perceptions of Nursing Practice Scale Pilot Study: Directors of Nursing in Nursing Homes

Journal Article Journal 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 ... Full text Cite

Older patients' experiences of heart failure-an integrative literature review.

Journal Article Journal 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 ... Full text Cite

Licensed practical nurse scope of practice and quality of nursing home care.

Journal Article Nursing 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 ... Full text Cite

First evidence on the validity and reliability of the Safety Organizing Scale-Nursing Home version (SOS-NH).

Journal Article J 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 ... Full text Link to item Cite

Understanding RN and LPN Patterns of Practice in Nursing Homes

Journal Article Journal 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 ... Full text Cite

End-stage renal disease in nursing homes: a systematic review.

Journal Article J 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 ... Full text Link to item Cite

Pain medication management in nursing homes and nursing scope of practice.

Journal Article Journal 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 ... Full text Cite

Restarting the Cycle: Predictors of Additional Acute Care Use after Nursing Home Discharge.

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2013 Link to item Cite

Adaptive leadership: a novel approach for family decision making.

Journal Article J 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 ... Full text Link to item Cite

Tool for evaluating research implementation challenges: a sense-making protocol for addressing implementation challenges in complex research settings.

Journal Article Implement 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 ... Full text Link to item Cite

Participation in decision making as a property of complex adaptive systems: developing and testing a measure.

Journal Article Nursing 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 ... Full text Cite

Commentary on "Health care organizations as complex systems: new perspectives on design and management" by Reuben R. McDaniel, Dean J. Driebe, and Holly Jordan Lanham.

Journal Article Advances 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 ... Full text Cite

Exploring interpersonal behavior and team sensemaking during health information technology implementation.

Journal Article Advances 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 ... Full text Cite

Supporting and promoting personhood in long term care settings: contextual factors.

Journal Article International 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 ... Full text Cite

Studying the clinical encounter with the Adaptive Leadership framework.

Journal Article Journal 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 ... Full text Cite

Top nurse management staffing collapse and care quality in nursing homes.

Journal Article Journal 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 ... Full text Link to item Cite

Registered nurse retention strategies in nursing homes: a two-factor perspective.

Journal Article Health 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 ... Full text Cite

Licensed Nurse Responsibilities in Nursing Homes: A Scope-of-Practice Issue

Journal Article Journal 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 ... Full text Cite

Licensed nurse responsibilities in nursing homes: a scope of practice issue.

Journal Article Journal of Nursing Regulation · April 2012 Cite

Improving Uptake of a Falls Educational Program by Focusing on Staff Interactions.

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2012 Link to item Cite

CONNECT for quality: protocol of a cluster randomized controlled trial to improve fall prevention in nursing homes.

Journal Article Implementation science : IS · February 2012 BackgroundQuality 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 th ... Full text Cite

Staff interaction strategies that optimize delivery of transitional care in a skilled nursing facility: a multiple case study.

Journal Article Fam 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 ... Full text Link to item Cite

Jurisdiction over nursing care systems in nursing homes: latent class analysis.

Journal Article Nursing 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 ... Full text Cite

Nursing Roles and Strategies in End-of-Life Decision Making in Acute Care: A Systematic Review of the Literature

Journal Article Nursing 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 ... Cite

Regulation of LPN scope of practice in long-term care.

Journal Article Journal 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 ... Cite

State of the science: relationship-oriented management practices in nursing homes.

Journal Article Nursing 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 ... Full text Cite

Regulation of LPN scope of practice in long-term care.

Journal Article Journal 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 ... Cite

Caregiver staffing in nursing homes and their influence on quality of care: using dynamic panel estimation methods.

Journal Article Medical 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 ... Full text Cite

Compassion fatigue: an application of the concept to informal caregivers of family members with dementia.

Journal Article Nursing 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 ... Full text Open Access Cite

Nursing Roles and Strategies in End-of-Life Decision Making in Acute Care: A Systematic Review of the Literature.

Journal Article Nursing 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 ... Full text Cite

Making sense of health information technology implementation: A qualitative study protocol.

Journal Article Implementation 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 ... Full text Open Access Cite

Regulation and mindful resident care in nursing homes.

Journal Article Qual 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 ... Full text Link to item Cite

Delegation in long-term care: Scope of practice or job description?

Journal Article Online 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 ... Full text Link to item Cite

The importance of organizational climate to training needs and outcomes in long-term care

Journal Article Alzheimer'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, ... Full text Cite

Implications of complex adaptive systems theory for interpreting research about health care organizations.

Journal Article Journal 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 ... Full text Cite

Delegation in long-term care: Scope of practice or job description?

Journal Article Online 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 ... Full text Cite

Cascade iatrogenesis: factors leading to the development of adverse events in hospitalized older adults.

Journal Article Int 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 ... Full text Link to item Cite

The Nature of Staff - Family Interactions in Nursing Homes: Staff Perceptions.

Journal Article J 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 ... Full text Link to item Cite

Implications of complex adaptive systems theory for the design of research on health care organizations.

Journal Article Health 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 ... Full text Cite

Use of a handheld computer observational tool to improve communication for care planning and psychosocial well-being.

Journal Article Journal 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 ... Full text Cite

Certified nursing assistants' explanatory models of nursing home resident depression.

Journal Article West 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 ... Full text Link to item Cite

Elizabeth C. Clipp, PhD, RN, FAAN.

Journal Article Journal of gerontological nursing · March 2008 Featured Publication Full text Cite

Where military professionalism meets complexity science

Journal Article Armed 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. ... Full text Cite

Barriers to and facilitators of clinical practice guideline use in nursing homes.

Journal Article J Am Geriatr Soc · September 2007 Featured Publication 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: ... Full text Link to item Cite

Job satisfaction of nursing home administrators and turnover.

Journal Article Medical care research and review : MCRR · April 2007 Featured Publication 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 ... Full text Cite

Job satisfaction of nurse aides in nursing homes: intent to leave and turnover.

Journal Article The Gerontologist · April 2007 Featured Publication 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 ... Full text Cite

Paying attention: A leap toward quality care.

Journal Article Director (Cincinnati, Ohio) · January 2007 Cite

Exit interview-consultation for research validation and dissemination.

Journal Article West J Nurs Res · December 2006 Featured Publication 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 ... Full text Link to item Cite

MDS coordinator relationships and nursing home care processes.

Journal Article West J Nurs Res · April 2006 Featured Publication 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 ... Full text Link to item Cite

Patterns of medical and nursing staff communication in nursing homes: implications and insights from complexity science.

Journal Article Qual Health Res · February 2006 Featured Publication 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 ... Full text Link to item Cite

Connection, regulation, and care plan innovation: a case study of four nursing homes.

Journal Article Health Care Manage Rev · 2006 Featured Publication 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 ... Full text Link to item Cite

Nurse assistant mental models, sensemaking, care actions, and consequences for nursing home residents.

Journal Article Qual Health Res · October 2005 Featured Publication 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 ... Full text Link to item Cite

Case study research: the view from complexity science.

Journal Article Qualitative health research · May 2005 Featured Publication 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 ... Full text Cite

The power of relationship for high-quality long-term care.

Journal Article J Nurs Care Qual · 2005 Featured Publication Full text Link to item Cite

Complexity science and the dynamics of climate and communication: reducing nursing home turnover.

Journal Article The Gerontologist · June 2004 Featured Publication 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 ... Full text Cite

Complexity theory: a long-term care specialty practice exemplar for the education of advanced practice nurses.

Journal Article The 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 ... Full text Cite

A conceptual framework for understanding decision-making processes of nursing assistants in providing dementia care.

Journal Article Alzheimer’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. ... Cite

Administrative characteristics of comprehensive prenatal case management programs.

Journal Article Public health nursing (Boston, Mass.) · September 2003 Featured Publication 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 ... Full text Cite

Effect of hospital conversion on organizational decision making and service coordination.

Journal Article Health care management review · April 2003 Featured Publication 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 ... Full text Cite

Nursing homes as complex adaptive systems: relationship between management practice and resident outcomes.

Journal Article Nursing research · January 2003 Featured Publication 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 ... Full text Cite

Intensity of case managers' participation in organizational decision making.

Journal Article Research in nursing & health · October 2001 Featured Publication 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 ... Full text Cite

Smart cards: Nurses at the forefront of radical advances in health care.

Journal Article Policy, 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 ... Full text Cite

Managing health care organizations: where professionalism meets complexity science.

Journal Article Health care management review · January 2000 Featured Publication 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 ... Full text Cite

Variations in staffing and resident care patterns in Michigan nursing homes

Journal Article Annals 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 ... Cite

Case mix adjustment in nursing systems research: the case of resident outcomes in nursing homes.

Journal Article Research in nursing & health · August 1999 Featured Publication 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 ... Full text Cite

Reliability of physical performance tests in four different randomized clinical trials.

Journal Article Arch 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 ... Full text Link to item Cite

Avoidable costs of comprehensive case management.

Journal Article Health care management review · January 1999 Featured Publication 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 ... Full text Cite

RN participation in organizational decision making and improvements in resident outcomes.

Journal Article Health care management review · January 1999 Featured Publication 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 ... Full text Cite

Resource allocation and resident outcomes in nursing homes: comparisons between the best and worst.

Journal Article Research in nursing & health · August 1998 Featured Publication 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 ... Full text Cite

Intensity of registered nurse participation in nursing home decision making.

Journal Article The Gerontologist · February 1998 Featured Publication 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 ... Full text Cite

Nursing staff turnover in nursing homes: A new look

Journal Article Public Administration Quarterly · 1997 Cite

Clinical staff development: a two-way solution.

Journal Article Nursing 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 ... Cite

Interventions in response to chemically dependent nurses: effect of context and interpretation.

Journal Article Research in nursing & health · April 1996 Featured Publication 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 ... Full text Cite

Take charge: managing six transformations in health care delivery.

Journal Article Nursing economic$ · March 1996 Featured Publication 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 ... Cite

Issues regarding aggregation of data in nursing systems research.

Journal Article Journal of nursing measurement · January 1994 Featured Publication 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 ... Full text Cite

Theory-based approach to computer skill development in nursing administration.

Journal Article Computers in nursing · July 1992 Featured Publication 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. ... Cite

The implication of environmental turbulence for nursing-unit design in effective nursing homes.

Journal Article Nursing economic$ · March 1992 Featured Publication 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 ... Cite

Nursing administration education.

Journal Article Annual review of nursing research · January 1992 Featured Publication Full text Cite

The thinking hospital.

Journal Article Health progress (Saint Louis, Mo.) · September 1991 Featured Publication Cite

Hospitals as interpretation systems.

Journal Article Health services research · February 1991 Featured Publication 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 ... Cite

Riding out the storm of environmental turbulence.

Journal Article Health progress (Saint Louis, Mo.) · June 1990 Featured Publication Cite

Testing a model of diabetes self-care management. A causal model analysis with LISREL

Journal Article Evaluation 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 ... Full text Cite

Demystifying the boardroom. Tips for timid trustees.

Journal Article Health progress (Saint Louis, Mo.) · November 1989 Featured Publication 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 ... Cite

Dual degree. Future preparation for nurse executives?

Journal Article The Journal of nursing administration · June 1989 Featured Publication 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 ... Cite

A theory development role for nurse administrators.

Journal Article The Journal of nursing administration · May 1989 Featured Publication 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 ... Cite

Collaborative learning method: enhancing excellence in nursing administration doctoral programs.

Journal Article Nursing administration quarterly · January 1988 Featured Publication Full text Cite

Products and product-line management in nursing.

Journal Article Nursing administration quarterly · January 1985 Featured Publication Full text Cite

A practical plan for medical direction of nursing homes.

Journal Article Hospitals · July 1967 Cite