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Scott J, Sykes K, Waring J, Spencer M, Young-Murphy L, Mason C, Newman C, Brittain K, Dawson P. Systematic review of types of safety incidents and the processes and systems used for safety incident reporting in care homes. J Adv Nurs 2024. [PMID: 38895931 DOI: 10.1111/jan.16264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/15/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024]
Abstract
AIMS To identify the safety incident reporting systems and processes used within care homes to capture staff reports of safety incidents, and the types and characteristics of safety incidents captured by safety incident reporting systems. DESIGN Systematic review following PRISMA reporting guidelines. METHODS Databases were searched January 2023 for studies published after year 2000, written in English, focus on care homes and incident reporting systems. Data were extracted using a bespoke data extraction tool, and quality was assessed. Data were analysed descriptively and using narrative synthesis, with types and characteristics of incidents analysed using the International Classification for Patient Safety. DATA SOURCES Databases were CINAHL, MEDLINE, PsycINFO, EMBASE, HMIC, ASSISA, Nursing and Allied Health Database, MedNar and OpenGrey. RESULTS We identified 8150 papers with 106 studies eligible for inclusion, all conducted in high-income countries. Numerous incident reporting processes and systems were identified. Using modalities, typical incident reporting systems captured all types of incidents via electronic computerized reporting, with reports made by nursing staff and captured information about patient demographics, the incident and post-incident actions, whilst some reporting systems included medication- and falls-specific information. Reports were most often used to summarize data and identify trends. Incidents categories most often were patient behaviour, clinical process/procedure, documentation, medication/intravenous fluids and falls. Various contributing and mitigating factors and actions to reduce risk were identified. The most reported action to reduce risk was to improve safety culture. Individual outcomes were often reported, but social/economic impact of incidents and organizational outcomes were rarely reported. CONCLUSIONS This review has demonstrated a complex picture of incident reporting in care homes with evidence limited to high-income countries, highlighting a significant knowledge gap. The findings emphasize the central role of nursing staff in reporting safety incidents and the lack of standardized reporting systems and processes. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE The findings from this study can inform the development or adaptation of safety incident reporting systems in care home settings, which is of relevance for nurses, care home managers, commissioners and regulators. This can help to improve patient care by identifying common safety issues across various types of care home and inform learning responses, which require further research. IMPACT This study addresses a gap in the literature on the systems and processes used to report safety incidents in care homes across many countries, and provides a comprehensive overview of safety issues identified via incident reporting. REPORTING METHOD PRISMA. PATIENT OR PUBLIC CONTRIBUTION A member of the research team is a patient and public representative, involved from study conception.
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Affiliation(s)
- Jason Scott
- Northumbria University, Newcastle upon Tyne, UK
| | - Kate Sykes
- Northumbria University, Newcastle upon Tyne, UK
| | | | - Michele Spencer
- North Tyneside Community and Health Care Forum, North Shields, UK
| | | | - Celia Mason
- Northumbria University, Newcastle upon Tyne, UK
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Siegel EO, Young HM. Assuring Quality in Nursing Homes: The Black Box of Administrative and Clinical Leadership—A Scoping Review. THE GERONTOLOGIST 2020; 61:e147-e162. [DOI: 10.1093/geront/gnaa175] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Indexed: 01/18/2023] Open
Abstract
Abstract
Background and Objectives
Licensed nursing home administrators (NHA) and directors of nursing (DON) are responsible for nursing home quality and assuring optimal performance and job satisfaction/retention of their nursing home workforce. NHA/DON-focused studies have generated important foundational knowledge over the last three decades; yet, targeted research is needed to understand and apply the complexities of the black box of this top management team. This scoping review identifies, reviews, synthesizes, and maps the topical areas of research in NHA/DON positions in U.S. nursing homes.
Research Design and Methods
We conducted searches of 5 databases, yielding 3,479 records; screening/review yielded 88 unique records. We used thematic analysis to code the primary foci of the studies and the variables associated with the concepts of interest.
Results
Most papers (n = 40) focused on role characteristics, 23 examined approaches to management and leadership, 24 focused on perceptions about the role, and the remaining 12 examined role structure. The role-related themes linked to outcomes (n = 42), processes (n = 27), and structures (n = 30).
Discussion and Implications
We highlight important gaps for future research and offer a call to action for research, policy, practice, and education collaborations to accelerate the rate of research and translate the findings into best practices for NHA/DON to lead and manage the nursing home workforce and build capacity to ensure person-centered, high-quality care. Based on foundational descriptive studies, it is time to use what is known to design and implement interventions that enhance the capacity of NHA/DON to improve the structures, processes, and outcomes of nursing homes.
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Affiliation(s)
- Elena O Siegel
- Betty Irene Moore School of Nursing, University California, Davis, Sacramento, USA
| | - Heather M Young
- Betty Irene Moore School of Nursing, University California, Davis, Sacramento, USA
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Malmedal W, Kilvik A, Steinsheim G, Botngård A. A literature review of survey instruments used to measure staff-to-resident elder abuse in residential care settings. Nurs Open 2020; 7:1650-1660. [PMID: 33072348 PMCID: PMC7544835 DOI: 10.1002/nop2.573] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 06/15/2020] [Accepted: 07/01/2020] [Indexed: 12/02/2022] Open
Abstract
Aim To review the literature of existing survey instruments used to measure the occurrence of staff‐to‐resident elder abuse in residential care settings. Methods A comprehensive literature search during May 2017 produced 2,037 records. Two authors independently reviewed these records for inclusion, where a total of 17 studies met eligibility criteria. Descriptive information of all identified survey instruments is provided. Results This literature review reveals a diversity of survey instruments used to measure staff‐to‐resident abuse in residential care settings. The survey instruments varied greatly, where most instruments were self‐developed by the authors and provided none or limited information on psychometric properties. Most studies were conducted in high‐income countries and many of them in the United States.
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Affiliation(s)
- Wenche Malmedal
- Department of Public Health and Nursing Norwegian University of Science and Technology Trondheim Norway
| | - Astrid Kilvik
- The Medicine and Health Library Norwegian University of Science and Technology Trondheim Norway
| | - Gunn Steinsheim
- Department of Public Health and Nursing Norwegian University of Science and Technology Trondheim Norway
| | - Anja Botngård
- Department of Public Health and Nursing Norwegian University of Science and Technology Trondheim Norway
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Archer S, Hull L, Soukup T, Mayer E, Athanasiou T, Sevdalis N, Darzi A. Development of a theoretical framework of factors affecting patient safety incident reporting: a theoretical review of the literature. BMJ Open 2017; 7:e017155. [PMID: 29284714 PMCID: PMC5770969 DOI: 10.1136/bmjopen-2017-017155] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES The development and implementation of incident reporting systems within healthcare continues to be a fundamental strategy to reduce preventable patient harm and improve the quality and safety of healthcare. We sought to identify factors contributing to patient safety incident reporting. DESIGN To facilitate improvements in incident reporting, a theoretical framework, encompassing factors that act as barriers and enablers ofreporting, was developed. Embase, Ovid MEDLINE(R) and PsycINFO were searched to identify relevant articles published between January 1980 and May 2014. A comprehensive search strategy including MeSH terms and keywords was developed to identify relevant articles. Data were extracted by three independent researchers; to ensure the accuracy of data extraction, all studies eligible for inclusion were rescreened by two reviewers. RESULTS The literature search identified 3049 potentially eligible articles; of these, 110 articles, including >29 726 participants, met the inclusion criteria. In total, 748 barriers were identified (frequency count) across the 110 articles. In comparison, 372 facilitators to incident reporting and 118 negative cases were identified. The top two barriers cited were fear of adverse consequences (161, representing 21.52% of barriers) and process and systems of reporting (110, representing 14.71% of barriers). In comparison, the top two facilitators were organisational (97, representing 26.08% of facilitators) and process and systems of reporting (75, representing 20.16% of facilitators). CONCLUSION A wide range of factors contributing to engagement in incident reporting exist. Efforts that address the current tendency to under-report must consider the full range of factors in order to develop interventions as well as a strategic policy approach for improvement.
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Affiliation(s)
- Stephanie Archer
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK
| | - Louise Hull
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK
- Centre for Implementation Science, King’s College London, London, UK
| | - Tayana Soukup
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK
| | - Erik Mayer
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK
| | - Thanos Athanasiou
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK
| | - Nick Sevdalis
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK
- Centre for Implementation Science, King’s College London, London, UK
| | - Ara Darzi
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK
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Clark MA, Roman A, Rogers ML, Tyler DA, Mor V. Surveying multiple health professional team members within institutional settings: an example from the nursing home industry. Eval Health Prof 2014; 37:287-313. [PMID: 24500999 PMCID: PMC4380513 DOI: 10.1177/0163278714521633] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Quality improvement and cost containment initiatives in health care increasingly involve interdisciplinary teams of providers. To understand organizational functioning, information is often needed from multiple members of a leadership team since no one person may have sufficient knowledge of all aspects of the organization. To minimize survey burden, it is ideal to ask unique questions of each member of the leadership team in areas of their expertise. However, this risks substantial missing data if all eligible members of the organization do not respond to the survey. Nursing home administrators (NHA) and directors of nursing (DoN) play important roles in the leadership of long-term care facilities. Surveys were administered to NHAs and DoNs from a random, nationally representative sample of U.S. nursing homes about the impact of state policies, market forces, and organizational factors that impact provider performance and residents' outcomes. Responses were obtained from a total of 2,686 facilities (response rate [RR] = 66.6%) in which at least one individual completed the questionnaire and 1,693 facilities (RR = 42.0%) in which both providers participated. No evidence of nonresponse bias was detected. A high-quality representative sample of two providers in a long-term care facility can be obtained. It is possible to optimize data collection by obtaining unique information about the organization from each provider while minimizing the number of items asked of each individual. However, sufficient resources must be available for follow-up to nonresponders with particular attention paid to lower resourced, lower quality facilities caring for higher acuity residents in highly competitive nursing home markets.
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Affiliation(s)
- Melissa A Clark
- School of Public Health, Brown University, Providence, RI, USA
| | - Anthony Roman
- Center for Survey Research, University of Massachusetts-Boston, Boston, MA, USA
| | | | - Denise A Tyler
- School of Public Health, Brown University, Providence, RI, USA
| | - Vincent Mor
- School of Public Health, Brown University, Providence, RI, USA
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Factors Related to Korean Nurses' Willingness to Report Suspected Elder Abuse. Asian Nurs Res (Korean Soc Nurs Sci) 2012; 6:115-9. [DOI: 10.1016/j.anr.2012.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 07/30/2012] [Accepted: 08/02/2012] [Indexed: 11/18/2022] Open
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Abstract
AIMS To explore through interviews of critical care nurses their perspectives on elder abuse to achieve a better understanding of the problems of reporting and generate ideas for improving the process. BACKGROUND In 44 states and the District of Columbia health care providers are required by law to report elder abuse but the patient, patient's family and health care providers all have barriers to reporting allegations of elder abuse. DESIGN This study design is qualitative. METHOD Through a mailed survey, critical care nurses were invited to participate in a taped in-depth qualitative interview. RESULTS Ten nurses were interviewed. A thematic analysis was used to describe the following core themes: types of elder abuse, suspicions of elder abuse, reporting of elder abuse, barriers to reporting elder abuse, legislation and improvement in practice. CONCLUSIONS Critical care nurses are aware of elder abuse and somewhat systematically evaluate for abuse at admission to their unit. They recognize signs and symptoms of abuse and are suspicious when it is warranted. They are aware of why an older person does not want to report abuse and take this into consideration when soliciting information. Facts, values and experience influence personally defining abuse, suspicion and dependence for each individual health care professional. RELEVANCE TO CLINICAL PRACTICE Critical care unit protocols and/or policies and procedure for reporting elder abuse are needed in critical care settings and are warranted for providing quality of care.
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Affiliation(s)
- Jeanette M Daly
- Department of Family Medicine, University of Iowa, Iowa City, IA, USA.
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Abstract
The purpose of this research was to provide a systematic review of, and assign an evidence grade to, the research articles on elder abuse. Sixteen health care and criminal justice literature databases were searched. Publications were reviewed by at least two independent readers who graded each from A (evidence of well-designed meta-analysis) to D (evidence from expert opinion or multiple case reports) on the quality of the evidence gained from the research. Of 6,676 titles identified in the search, 1,700 publications met inclusion criteria; omitting duplicates, 590 publications were annotated and graded.
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Affiliation(s)
- Jeanette M Daly
- Department of Family Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
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Schmeidel AN, Daly JM, Rosenbaum ME, Schmuch GA, Jogerst GJ. Health care professionals' perspectives on barriers to elder abuse detection and reporting in primary care settings. J Elder Abuse Negl 2012; 24:17-36. [PMID: 22206510 PMCID: PMC3298114 DOI: 10.1080/08946566.2011.608044] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The purpose of this study was to explore health care professionals' perspectives on elder abuse to achieve a better understanding of the problems of reporting and to generate ideas for improving the detection and reporting process. Through a mailed survey, nurses, physicians, and social workers were invited to participate in an interview. Nine nurses, 8 physicians, and 6 social workers were interviewed, and thematic analysis was used to identify the following core themes: preconceptions, assessment, interpretation, systems, and knowledge and education. Participants suggested a reorganization of the external reporting system. More frequent and pragmatic education is necessary to strengthen practical knowledge about elder abuse.
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Affiliation(s)
- Amy N Schmeidel
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
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Habjanič A, Lahe D. Are frail older people less exposed to abuse in nursing homes as compared to community-based settings? Statistical analysis of Slovenian data. Arch Gerontol Geriatr 2011; 54:e261-70. [PMID: 21872349 DOI: 10.1016/j.archger.2011.07.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Revised: 07/15/2011] [Accepted: 07/19/2011] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Although international research in recent years has often focused on elder abuse, its extent is not clear in community-based settings and even bigger mystery in nursing homes. BACKGROUND Until now in the literature it has in most cases only been assumed that nursing homes offer better protection from abuse for frail older people. METHODS A cross-sectional research design was applied by use of structured interviews. Those involved were frail older people (n=300) who were in need of some sort of professional nursing assistance. RESULTS Nursing home accommodation was extracted as the strongest predictor, significantly reducing the risk of physical abuse (odds ratio, OR 0.1, 95% confidence interval, 95% CI 0.0-0.3) and financial abuse (OR 0.2, 95% CI 0.1-0.4). Spouses and sons were revealed as the most regular perpetrators of physical and financial abuse. The results showed no statistical significance between settings as predictors of the occurrence of mental abuse (OR 0.9, 95% CI 0.5-1.6). DISCUSSION Results of the statistical analysis add to the general assumption that nursing home accommodation offers protection for frail older people in escaping physical and financial abuse. CONCLUSION In their clinical practice, community nurses should give special attention to frail older people who, besides their healthcare needs, are also heavily dependent in the activities of daily living (ADLs). In order to combat elder abuse, conditions in the family should be regularly verified.
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Affiliation(s)
- Ana Habjanič
- University of Maribor, Faculty of Health Sciences, Žitna ulica 15, SI-2000 Maribor, Slovenia.
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Clark M, Rogers M, Foster A, Dvorchak F, Saadeh F, Weaver J, Mor V. A randomized trial of the impact of survey design characteristics on response rates among nursing home providers. Eval Health Prof 2011; 34:464-86. [PMID: 21411474 DOI: 10.1177/0163278710397791] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
An experiment was conducted to maximize participation of both the Director of Nursing (DoN) and the Administrator (ADMIN) in long-term care facilities. Providers in each of the 224 randomly selected facilities were randomly assigned to 1 of 16 conditions based on the combination of data collection mode (web vs. mail), questionnaire length (short vs. long), and incentive structure. Incentive structures were determined by amount compensated if the individual completed and an additional amount per individual if the pair completed (a) $30 individual/$5 pair/$35 total; (b) $10 individual/$25 pair/$35 total; (c) $30 individual/$20 pair/$50 total; and (d) $10 individual/$40 pair/$50 total. Overall, 47.4% of eligible respondents participated; both respondents participated in 29.3% of facilities. In multivariable analyses, there were no differences in the likelihood of both respondents participating by mode, questionnaire length, or incentive structure. Providing incentives contingent on participation by both providers of a facility was an ineffective strategy for significantly increasing response rates.
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Affiliation(s)
- Melissa Clark
- Program in Public Health, Brown University, Providence, RI 02912, USA.
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Gironda MW, Lefever KH, Anderson EA. Dental Students’ Knowledge About Elder Abuse and Neglect and the Reporting Responsibilities of Dentists. J Dent Educ 2010. [DOI: 10.1002/j.0022-0337.2010.74.8.tb04938.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Melanie W. Gironda
- Division of Public Health and Community Dentistry; School of Dentistry; University of California; Los Angeles
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Natan MB, Lowenstein A, Eisikovits Z. Psycho-social factors affecting elders' maltreatment in long-term care facilities. Int Nurs Rev 2010; 57:113-20. [DOI: 10.1111/j.1466-7657.2009.00771.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gittler J. Governmental efforts to improve quality of care for nursing home residents and to protect them from mistreatment: a survey of federal and state laws. Res Gerontol Nurs 2010; 1:264-84. [PMID: 20078001 DOI: 10.3928/19404921-20081001-08] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
There are many federal and state laws addressing, directly and indirectly, the quality of care provided to nursing home residents and the protection of residents from mistreatment. They include: (a) state laws that govern the licensing of nursing homes, (b) federal laws that govern the certification of nursing homes for participation in the Medicare and Medicaid programs, (c) elder abuse laws prohibiting mistreatment of older adults in nursing homes and other settings, (d) health care fraud abuse laws that are increasingly being used to combat the provision of substandard care to Medicare and Medicaid beneficiaries in nursing homes, and (e) laws that have established long-term care ombudsman programs to promote the health, safety, well-being, and rights of nursing home residents. While these laws are generally viewed as having improved the care and treatment of nursing home residents, much remains to be done, particularly with respect to the implementation of these laws.
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Affiliation(s)
- Josephine Gittler
- The John A. Hartford Center of Geriatric Nursing Excellence, National health Law and Policy Resource Center, The University of Iowa, Iowa City, Iowa 52242, USA.
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Knowledge, detection, and reporting of abuse by health and social care professionals: a systematic review. Am J Geriatr Psychiatry 2009; 17:826-38. [PMID: 19916205 DOI: 10.1097/jgp.0b013e3181b0fa2e] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The authors systematically reviewed the 32 articles fitting predetermined criteria that investigated health and social care professionals' knowledge, detection, and reporting of elder abuse. These included 21 surveys (of 5,325 professionals), nine analyses of elder abuse reports to statutory bodies, and two intervention studies. Compatible results were pooled in a meta-analysis. Professionals consistently underestimated the prevalence of elder abuse. Only a quarter of U.S. physicians were aware of American Medical Association elder abuse guidelines. The authors found that 33.7% (95% confidence interval: 27.5-40.1) of health care professionals had detected a case of older adult abuse in the last year. This was slightly higher when only studies judged to be most representative, which all surveyed physicians, were included (39.9% [23.4-57.7]). About half of the detected abuse cases were reported. Professionals who recalled receiving any training on abuse were no more likely to detect abuse than those who stated they had not had training, although they were more likely to report the abuse if they detected it. Interventions that taught professionals about the management of abuse by face-to-face training were effective in increasing knowledge, whereas giving written information was not. No intervention studies have investigated whether detection and reporting of abuse can also be increased through education. Current evidence would support the development and testing of interventions to increase professionals' detection and reporting of abuse. These would encourage them to ask older people about abuse, and address professionals' concerns about the impact of reporting on therapeutic relationships, victims; and legal consequences for the reporter.
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McCool JJ, Jogerst GJ, Daly JM, Xu Y. Multidisciplinary reports of nursing home mistreatment. J Am Med Dir Assoc 2009; 10:174-80. [PMID: 19233057 DOI: 10.1016/j.jamda.2008.09.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2008] [Revised: 09/16/2008] [Accepted: 09/17/2008] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The purpose of this research was to learn about nursing home employees' knowledge and perspectives on mandatory reporting of elder abuse. DESIGN Mailed questionnaire and personal interviews. SETTING Two nursing facilities in Iowa. PARTICIPANTS All employees of the two nursing facilities. MEASUREMENTS A 28-item questionnaire that included questions on demographics, personal experiences with suspected elder abuse and reporting, legislation, facility protocols, and opinions on mandatory reporting was mailed to participants. An interview composed of 11 open-ended questions was conducted in the nursing facilities. RESULTS Forty-nine (15%) of the 335 employees who were sent the mailing returned the questionnaire and 22 (7%) participated in the interview. Over half (53%) of those who returned questionnaires reported suspecting a case of abuse in the facility where they currently work. Of these, 35% stated that they had not reported all the cases they suspected. Interviews of the 22 employees were about 15 minutes in length and took place at the nursing facility. Four themes emerged from these interviews, including the need for more staff education/training on the subject of elder abuse, difficulty in making judgments about whether the situation needs to be reported, barriers to reporting, and a sense that some abuse situations may occur because the staff is overworked, inexperienced, and/or frustrated from dealing with difficult residents. CONCLUSION Nursing home employees are knowledgeable about the mandatory reporter laws, but many remain hesitant to report suspected abuse for various reasons.
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Affiliation(s)
- Jessica J McCool
- Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
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Jogerst GJ, Daly JM, Dawson JD, Peek-Asa C, Schmuch G. Iowa nursing home characteristics associated with reported abuse. J Am Med Dir Assoc 2006; 7:203-7. [PMID: 16698504 DOI: 10.1016/j.jamda.2005.12.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the association of nursing home abuse reported by employees in Iowa licensed nursing homes with nursing home characteristics, inspection results, nursing staff hours, and census demographics. DESIGN Mailed survey. SETTING Iowa's 409 Medicare-certified stand-alone nursing homes. PARTICIPANTS Administrators and directors of nursing. RESULTS The annual rate of abusive events was 20.7 per 1000 nursing home residents, with a rate of 18.4 reported events and 5.2 substantiated events. A higher number of residents and a higher number of certified beds were significantly associated with higher incident, report, and substantiation rates. Higher incident and report rates were associated with nursing homes in metropolitan areas. Higher substantiation rates were associated with for-profit nursing homes. CONCLUSION Recognized abuse in nursing homes is not uncommon. Approximately 90% of events are reported to the state authorities with 29% of those being substantiated. Differences associated with nursing facility abuse rates are metropolitan area, ownership, occupancy rate, and number of residents and certified beds.
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Affiliation(s)
- Gerald J Jogerst
- Department of Family Medicine, University of Iowa, Carver College of Medicine, Iowa City, IA 52242, USA.
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Kapp MB. Is law good therapy for institutional adult abuse? J Am Med Dir Assoc 2005; 6:159. [PMID: 15871896 DOI: 10.1016/j.jamda.2005.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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