Organizational Learning and Motivation in Certified Nurse Aides: A Qualitative Study

Organizational learning is linked to improved outcomes in health care settings. In long-term care facilities, the unique position and expertise of certified nurse aides (CNAs) are crucial for excellent resident care, thus is it important to understand their sources of motivation. However, CNA motivation has not been adequately studied. The current qualitative descriptive study explored sources and implications of CNA motivation, particularly as it relates to engaging in organizational learning. Twenty-four CNAs working in a state Veteran's home were interviewed. CNAs described their sources of motivation as: I'm a Natural Caregiver, Support From Administration, Working as a Team, Love for Residents, and Self-Care. When motivated, CNAs had more positive attitudes about their work, a higher level of engagement with residents, a stronger drive to accomplish extra tasks, and less desire to quit. Engaging CNAs in organizational learning may provide an opportunity to motivate CNAs and optimize their unique position and expertise to improve resident care. [Research in Gerontological Nursing, xx(x), xx-xx.].

Positive Changes in Certified Nursing Assistants' Communication Behaviors With People With Dementia: Feasibility of a Coaching Strategy

Purpose This study investigated whether a 6-week coaching strategy resulted in positive changes in self-perceived knowledge and efficacy (SPKE) and positive communication behaviors in certified nursing assistants (CNAs) working with people with dementia in a skilled nursing facility. It also assessed the impact of the coaching strategy on negative responsive behaviors of people with dementia, such as yelling out, hitting, or spitting. Method Seven CNAs and seven people with dementia completed this study. Pretesting and posttesting were conducted for CNAs' SPKE. A single-subject, multiple-baseline design across five communication behaviors, the positive communication approach checklist, was completed to assess CNA communication behaviors after completion of a coaching strategy. Pretesting and posttesting of responsive behaviors of people with dementia were completed with the Cohen-Mansfield Agitation Inventory. Results Six out of seven CNAs improved their SPKE from pre- to postcoaching; however, this difference was not statistically significant. Per the positive communication approach checklist, there was a statistically significant increase, from baseline to follow-up, in CNA positive communication behaviors when interacting with people with dementia. The frequency of overall responsive behaviors of people with dementia significantly decreased from pre- to postcoaching, per the Cohen-Mansfield Agitation Inventory. Conclusions There is preliminary evidence to support the feasibility of a coaching strategy for the implementation of positive communication behaviors by CNAs when communicating with people with dementia. Negative responsive behaviors of people with dementia also decreased. Speech-language pathologists should consider acting as coaches to support positive communication for people with dementia. Supplemental Material https://doi.org/10.23641/asha.13564811.

Experiences of Social Distancing During Coronavirus Disease 2019 as a Catalyst for Changing Long-Term Care Culture

Purpose In this article, we draw a parallel between the experience of social isolation that occurred throughout the world during the Coronavirus Disease 2019 pandemic and similar experiences occurring in everyday life for people with communication disorders living in long-term care (LTC) facilities. We propose that speech-language pathologists can use the widespread experience of social isolation as a learning catalyst in the effort to shift the LTC culture to one that more highly values a communicative environment that is accessible to all, thereby reducing risk of social isolation for those with communication disorders. Conclusions Many training paradigms for promoting an accessible communicative environment are available in the speech-language pathology literature, yet institutional barriers exist for their widespread implementation. Overcoming these barriers is a challenge that requires awareness and learning on the part of staff and administration regarding the impact of an unfriendly communicative environment on social isolation, and the resulting psychosocial consequences. Learning theory indicates that new learning in adults is motivated by connections between personal experiences and the material to be learned. Explicitly infusing established training programs with the experience of social isolation brought on by the Coronavirus Disease 2019 pandemic may be the key needed for changing the communicative environment in LTC.