Liza L Behrens1, Marie Boltz2, Ann Kolanowski2, Mark Sciegaj3, Caroline Madrigal4, Katherine Abbott5, Kimberly Van Haitsma2. 1. NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia. 2. College of Nursing, Pennsylvania State University, State College. 3. College of Health and Human Development, Pennsylvania State University, State College. 4. Center for Innovations in Long-term Services and Supports, Providence Veterans Affairs Medical Center, Rhode Island. 5. Department of Sociology and Gerontology, Miami University, Oxford, Ohio.
Abstract
BACKGROUND AND OBJECTIVES: Nursing home (NH) staff perceptions of risks to residents' health and safety are a major barrier to honoring resident preferences, the cornerstone of person-centered care (PCC) delivery. This study explored direct-care nursing staff perceptions of risk (possibilities for harm or loss) associated with honoring residents' preferences for everyday living and care activities. RESEARCH DESIGN AND METHODS: Qualitative, descriptive design using sequential focus group (FG) methodology. RESULTS: Participants (N = 27) were mostly female (85%), had more than 3 years of experience (74%), and worked in NHs recently experiencing 6-12 health citations. Content analysis of 12 sequential FGs indicated nursing staff perceptions of risks may impede delivery of person-centered care. This is supported by the overarching theme: pervasive risk avoidance; and subthemes of: staff values, supports for risk-taking, and challenges to honoring preferences. DISCUSSION AND IMPLICATIONS: Development of a multidimensional framework with specific risk engagement measures that account for the unique risk perspectives of nursing staff will contribute significantly to the clinical management of older adult preferences and research on the effectiveness of preference-based PCC delivery in the NH setting.
BACKGROUND AND OBJECTIVES: Nursing home (NH) staff perceptions of risks to residents' health and safety are a major barrier to honoring resident preferences, the cornerstone of person-centered care (PCC) delivery. This study explored direct-care nursing staff perceptions of risk (possibilities for harm or loss) associated with honoring residents' preferences for everyday living and care activities. RESEARCH DESIGN AND METHODS: Qualitative, descriptive design using sequential focus group (FG) methodology. RESULTS:Participants (N = 27) were mostly female (85%), had more than 3 years of experience (74%), and worked in NHs recently experiencing 6-12 health citations. Content analysis of 12 sequential FGs indicated nursing staff perceptions of risks may impede delivery of person-centered care. This is supported by the overarching theme: pervasive risk avoidance; and subthemes of: staff values, supports for risk-taking, and challenges to honoring preferences. DISCUSSION AND IMPLICATIONS: Development of a multidimensional framework with specific risk engagement measures that account for the unique risk perspectives of nursing staff will contribute significantly to the clinical management of older adult preferences and research on the effectiveness of preference-based PCC delivery in the NH setting.
Authors: Victoria Parker; Ryann L Engle; Melissa K Afable; Denise A Tyler; Katelyn Gormley; Kelly Stolzmann; Michael Shwartz; Jennifer L Sullivan Journal: Clin Gerontol Date: 2018-05-07 Impact factor: 2.619
Authors: Charlotte L Clarke; Jane Wilcockson; Catherine E Gibb; John Keady; Heather Wilkinson; Anna Luce Journal: Health Soc Care Community Date: 2010-09-09