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RISK OF MEDICATION ERRORS IN THE HOME: AN INTEGRATIVE LITERATURE REVIEW
Title
RISK OF MEDICATION ERRORS IN THE HOME: AN INTEGRATIVE LITERATURE REVIEW.
Creator
Crescenzi, Maria M, Bushy, Angeline, University of Central Florida
Abstract / Description
Regardless of the setting, medication errors are of great concern when associated with an individual's health outcomes, along with the increased costs to society, healthcare institutions, and providers. Current research focuses on medication error data primarily in acute and extended care facilities. However, there is a paucity of research examining the causes of medication errors that occur post hospital discharge when individuals transition to the home. The purpose of this integrative...
Show moreRegardless of the setting, medication errors are of great concern when associated with an individual's health outcomes, along with the increased costs to society, healthcare institutions, and providers. Current research focuses on medication error data primarily in acute and extended care facilities. However, there is a paucity of research examining the causes of medication errors that occur post hospital discharge when individuals transition to the home. The purpose of this integrative literature review is to examine risk factors for medication errors outside of these settings, specifically in the home. A systematic literature search was conducted using multiple databases for relevant articles in the English language between 2006 to 2017, including CINAHL, MEDLINE, PubMed, and PsycINFO. Search terms included 'medication errors', 'home care', 'post-discharge', 'hospital readmission', and 'medication error risks in the home'. Exclusion criteria included medication errors in acute and extended care settings. The integrative review involved reading, analyzing and selecting articles, and summarizing on a matrix. Findings on occurrences of medication errors in the home included impaired client mental status, confusion related to medication names, limited understanding of medication purpose in the care plan and its side effects, level of health literacy, and client-provider miscommunication in discharge planning. Consistent and conflicting findings are discussed along with gaps in the literature. Limitations and implications for nursing practice, policy, research, and education are also noted.
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Date Issued
2017
Identifier
CFH0000223, ucf:44678
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFH0000223
THE EXPERIENCES OF HEALTH CARE PROVIDERS PROVIDING COMFORT FOR NURSING HOME PATIENTS AT THE END OF LIFE
Title
THE EXPERIENCES OF HEALTH CARE PROVIDERS PROVIDING COMFORT FOR NURSING HOME PATIENTS AT THE END OF LIFE.
Creator
Baker, Herma, Rash, Elizabeth, University of Central Florida
Abstract / Description
Research shows that healthcare providers (HCPs) are not adequately prepared to provide comfort care for patients who are at the end of life. Since the 1990s, numerous legislative, research, and clinical initiatives have addressed concerns about improving care at the end of life. The purpose of this study was to describe the experiences of HCPs providing comfort for patients in the nursing home who are at the end of life. This study focused on physicians, nurse practitioners, nurses and nurses...
Show moreResearch shows that healthcare providers (HCPs) are not adequately prepared to provide comfort care for patients who are at the end of life. Since the 1990s, numerous legislative, research, and clinical initiatives have addressed concerns about improving care at the end of life. The purpose of this study was to describe the experiences of HCPs providing comfort for patients in the nursing home who are at the end of life. This study focused on physicians, nurse practitioners, nurses and nursesÂÂÂÂ' aides at a central Florida nursing home. A descriptive qualitative design was done utilizing a focus group discussion, individual interviews, and a self-administered questionnaire. The findings indicated that a lack of facility support, inadequate staffing, inadequate end of life care education, family and patient denial of prognosis, as well as decreased primary care physician involvement affect the delivery of comfort care for patients at the end of life in the nursing home. This study supports the need for end of life education to HCPs and the need for adjustments in staffing to meet the complex needs of patients in the nursing home who are at the end of life. A new finding of this study reflects the use of an angel cart to aid in the provision of comfort care for patients at the end of life. Recommendations for future research were made based on study results
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Date Issued
2010
Identifier
CFE0003305, ucf:48505
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0003305
NURSING HOMES' COMPLIANCE WITH STATE NURSE STAFFING STANDARDS AND ITS RELATION TO QUALITY-OF-CARE DEFICIENCIES
Title
NURSING HOMES' COMPLIANCE WITH STATE NURSE STAFFING STANDARDS AND ITS RELATION TO QUALITY-OF-CARE DEFICIENCIES.
Creator
Paek, Seung Chun, Wan, Thomas, University of Central Florida
Abstract / Description
The purpose of this dissertation is to examine nursing homes' compliance with state minimum nurse staffing standards and its relation to quality-of-care deficiencies. Specifically, this study, reviewing staffing standards from 50 states and the District of Columbia for the year 2007, proposes a unique algorithm to calculate the states' expected nurse staffing levels for individual nursing homes in order to investigate their compliance with the state nurse staffing standards. By using...
Show moreThe purpose of this dissertation is to examine nursing homes' compliance with state minimum nurse staffing standards and its relation to quality-of-care deficiencies. Specifically, this study, reviewing staffing standards from 50 states and the District of Columbia for the year 2007, proposes a unique algorithm to calculate the states' expected nurse staffing levels for individual nursing homes in order to investigate their compliance with the state nurse staffing standards. By using hierarchical linear modeling method, this study attempts to capture the impact of the staffing standards on actual nurse staffing levels under resource dependence perspectives. Path analysis using structural equation modeling was conducted to investigate both direct and indirect effects of the staffing standards on nurse staffing levels and quality-of-care deficiencies. The major findings were as follows: (1) nursing homes in states with higher state staffing standards for the categories of RN, LN, and total nurse were found to have higher RN, LN, and total staffing levels, respectively; (2) higher nurse staffing levels resulting from higher state staffing standards were significantly associated with better quality of care (less quality-of-care deficiencies cited) in nursing homes; and (3) state staffing standards were found to have much stronger contribution to nurse staffing levels than any other organizational or contextual factors while nurse staffing levels, particularly licensed staff, were found to have stronger contribution to quality-of-care deficiencies than any other organizational factors. The study findings suggest that if the goal is to increase nurse staffing levels for better quality, increasing the stringency of both federal and state nurse staffing standards would be the most effective way. However, the staffing standards first need technical changes to reduce their ambiguity and ensure their fairness. If the goal is to achieve better quality, merely increasing nurse staffing levels may not be effective since the variation of the quality-of-care deficiencies explained by exogenous variables was smaller than random variation 5%. If state Medicaid reimbursements can be utilized for financial incentives for better performing nursing homes, nursing homes may improve their productivity by efficiently managing organizational personnel or increasing job satisfaction among nursing practitioners. Lastly, longitudinal analysis, considering variation in length of state staffing policy implementations, is encouraged to investigate the long-term effects of state staffing standards on nurse staffing levels and quality of care.
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Date Issued
2011
Identifier
CFE0003754, ucf:48781
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0003754
FAMILY SUPPORT AND MENTAL HEALTH CARE QUALITY IN NURSING HOMES SERVING RESIDENTS WITH A MENTAL HEALTH HISTORY
Title
FAMILY SUPPORT AND MENTAL HEALTH CARE QUALITY IN NURSING HOMES SERVING RESIDENTS WITH A MENTAL HEALTH HISTORY.
Creator
Frahm, Kathryn, Gammonley, Denise, University of Central Florida
Abstract / Description
The prevalence of mental health disorders among the nursing home population is well recognized. However, providing adequate mental health services for nursing home residents who need them remains a challenging endeavor. The social support of family has long been recognized as a key resource for older adults with a mental health history and older adults residing in nursing homes. The purpose of this study is to examine the quality of mental health care provided for nursing home residents with...
Show moreThe prevalence of mental health disorders among the nursing home population is well recognized. However, providing adequate mental health services for nursing home residents who need them remains a challenging endeavor. The social support of family has long been recognized as a key resource for older adults with a mental health history and older adults residing in nursing homes. The purpose of this study is to examine the quality of mental health care provided for nursing home residents with a mental health history and to determine if family support influences the quality of their mental health care accounting for other facility resident and facility organizational characteristics. The study utilized a retrospective, cross-sectional design with 2003 national Online Survey Certification and Reporting (OSCAR) facility data merged with the resident-level Minimum Data Set (MDS) resulting in N=2,499 nursing homes. Guided by the convoy model of social support and socioemotional selectivity theory, descriptive statistics and exploratory factor analysis were used to create a profile of facility level data of nursing home residents with a mental health history, explore the role of family support, and determine if items within the OSCAR and MDS databases could respectively be used to measure mental health care quality and family support. Overall, it was found that families have a positive relationship with their relatives and are involved in their lives. Additionally, items within the OSCAR and MDS databases could be used to measure mental health care quality and family support. Finally, facility organizational characteristics explained more variation in the quality of mental health care than did facility resident, family support, or market characteristics. In sum, to enhance the quality of mental health care in nursing homes, partnering with families may be an important tool to meet resident needs.
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Date Issued
2009
Identifier
CFE0002529, ucf:47670
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0002529
Organizational Complexity, Emergency Management Plan Adequacy, and Nursing Home Resiliency: A Contingency Perspective
Title
Organizational Complexity, Emergency Management Plan Adequacy, and Nursing Home Resiliency: A Contingency Perspective.
Creator
Boyce, Cherie, Wan, Thomas, Zhang, Ning, Oetjen, Reid, Rivera, Fernando, Kapucu, Naim, University of Central Florida
Abstract / Description
Some social and organizational behavior scientists measure resiliency through anecdotal qualitative research, i.e. personality analyses and stories of life experience. Empirical evidence remains limited for identifying measurable indicators of resiliency. Therefore, a testable contingency model was needed to clarify resiliency factors pertinent to organizational performance. Two essential resiliency factors were: 1) a written plan and 2) affiliation with a disaster network.This contingency...
Show moreSome social and organizational behavior scientists measure resiliency through anecdotal qualitative research, i.e. personality analyses and stories of life experience. Empirical evidence remains limited for identifying measurable indicators of resiliency. Therefore, a testable contingency model was needed to clarify resiliency factors pertinent to organizational performance. Two essential resiliency factors were: 1) a written plan and 2) affiliation with a disaster network.This contingency study demonstrated a quantifiable, correlational effect between organizational complexity, disaster plan adequacy and organizational resiliency. The unit of analysis, the skilled nursing facility proved vulnerable, therefore justifying the need for a written emergency management plan and affiliation with a disaster network. The main purpose of this research was to verify the significance of emergency management plans within a contingency framework of complexity theory, resource dependency, systems theory, and network theory. Distinct sample moments quantified causal relationships between organizational complexity (A), plan adequacy (B) and resiliency (C). Primary and secondary research data were collected from within the context of public health and emergency management sectors within the State of Florida.
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Date Issued
2015
Identifier
CFE0005929, ucf:50842
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0005929
Infection Control and Health Care Associated Infection (HCAI) in the Nursing Home: A Study to Determine the Impact of an Educational Video and Pamphlet About Infection Control on Knowledge and Perception of Hand Hygiene in Certified Nurse Assistants
Title
Infection Control and Health Care Associated Infection (HCAI) in the Nursing Home: A Study to Determine the Impact of an Educational Video and Pamphlet About Infection Control on Knowledge and Perception of Hand Hygiene in Certified Nurse Assistants.
Creator
Hypes, Kathe, Blackwell, Christopher, Covelli, Maureen, Winton, Mark, University of Central Florida
Abstract / Description
The impact of an education program on perception, knowledge, and infection rate was evaluated in this study. The educational intervention consisted of a video on infection control and a World Health Organization (WHO) pamphlet for hand hygiene. The study was conducted in one nursing home in the Southeastern United States. The survey sample consisted of 66 certified nurse assistants (CNAs). A pre- and post-intervention design was employed using the WHO's Hand Hygiene Knowledge Questionnaire...
Show moreThe impact of an education program on perception, knowledge, and infection rate was evaluated in this study. The educational intervention consisted of a video on infection control and a World Health Organization (WHO) pamphlet for hand hygiene. The study was conducted in one nursing home in the Southeastern United States. The survey sample consisted of 66 certified nurse assistants (CNAs). A pre- and post-intervention design was employed using the WHO's Hand Hygiene Knowledge Questionnaire and the WHO Perception Survey. Friedman's test and central tendencies showed no statistical relationship between the educational intervention and the overall knowledge scores of the sample. There also were no statistical differences in perception of hand hygiene in the CNA sample. Infection frequency was reduced with a percent change of -42%. While results of knowledge and perception surveys were not statistically significant, multiple conclusions were derived to suggest that educational opportunities may impact hand hygiene practice in CNAs and lead to a decrease in infection.
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Date Issued
2012
Identifier
CFE0004551, ucf:49239
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0004551
THE USE OF PHYSICAL RESTRAINTS AMONG NURSING HOME RESIDENTS: DO DISPARITIES EXIST?
Title
THE USE OF PHYSICAL RESTRAINTS AMONG NURSING HOME RESIDENTS: DO DISPARITIES EXIST?.
Creator
Fashaw, Shekinah, Chisholm, Latarsha, University of Central Florida
Abstract / Description
Introduction: The purpose of this study is to examine how nursing home (NH) characteristics, specifically racial composition of nursing homes residents, influences the use of physical restraints. As the population ages and becomes more diverse, it is essential to mitigate/eliminate racial/ethnic disparities in quality care. Methods: This is cross-sectional study using a 2010 national data set from Brown University Center for Gerontology and Healthcare Research. This study employs Donabedian's...
Show moreIntroduction: The purpose of this study is to examine how nursing home (NH) characteristics, specifically racial composition of nursing homes residents, influences the use of physical restraints. As the population ages and becomes more diverse, it is essential to mitigate/eliminate racial/ethnic disparities in quality care. Methods: This is cross-sectional study using a 2010 national data set from Brown University Center for Gerontology and Healthcare Research. This study employs Donabedian's Structure-Process-Outcome (SPO) conceptual framework. Statistical analysis includes univariate, bivariate, and a logistic regression model. It is hypothesized that nursing homes with higher proportions of black residents, more Medicaid residents, and for-profit ownership status will be associated with higher prevalence of physical restraint use. Results: Findings show that nursing homes with high proportions of blacks have a lower likelihood of high physical restraint use. Nursing homes with a higher proportion of Medicaid-reliant residents have a higher likelihood of restraint use, as does for-profit nursing homes. Discussion: The findings indicate that there are no racial/ethnic disparities present in the use of physical restraints in nursing homes. There is indication of socio-economic disparities, since nursing homes with higher Medicaid-reliant residents are associated with greater restraint. There are policy implications associated with these findings, including raising Medicaid per diem or implementing a quality performance payment incentive. Further research will be needed to determine ways to reduce racial/ethnic disparities in nursing homes. This research, adds to the nursing home literature focused on socio-economic disparities.
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Date Issued
2014
Identifier
CFH0004700, ucf:45401
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFH0004700