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Kim D, Hong Y, Chang SO. Ways of interdisciplinary approaches to advocating for nursing home residents with dementia. J Adv Nurs 2024. [PMID: 38771071 DOI: 10.1111/jan.16251] [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: 01/04/2024] [Revised: 04/04/2024] [Accepted: 05/10/2024] [Indexed: 05/22/2024]
Abstract
AIM To explore how nursing home staff advocate for residents with dementia. DESIGN Phenomenographic qualitative research. METHODS Twenty nursing home staff from four disciplines (six nurses, four physical therapists, five social workers and five care workers) were purposively recruited from three different nursing homes. Data were collected through semi-structured interviews conducted from February 2023 to March 2023, and the analysis followed the sequential steps of phenomenographic analysis. RESULTS The analysis identified five categories of description: focusing on what happened, finding the gaps in perspectives, how to bridge for finding a common perspective, how to tailor care such that each resident receives equitable care and how to establish interdisciplinary sharing for a consistent advocative pattern. Their structural relationship was also identified as an outcome space. CONCLUSION The cyclical advocacy structure illustrated that nursing home staff engage in an ongoing process of advocacy during conflict situations as part of interdisciplinary care, emphasizing continuity of care rather than separate occurrences of care. IMPLICATIONS FOR THE PROFESSION This study revealed that, in advocating for residents with dementia, nursing home staff adopted an approach that fosters consistent care and proactive prevention, achieved through the formation of shared knowledge applicable uniformly across similar situations. IMPACT This study contributes significantly to the continuing education or training of interdisciplinary staff in nursing homes. The revelations of the study hold significance not only for the practical application but also for the theoretical advancement of concepts related to safeguarding the dignity, human rights and personhood of residents with dementia, with the ultimate goal of enhancing their quality of life within nursing homes. REPORTING METHOD Reporting complied with the COREQ criteria for qualitative research. PATIENT OR PUBLIC CONTRIBUTION Nursing home directors have contributed to the validation of data analysis and interpretation.
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Affiliation(s)
- Dayeong Kim
- College of Nursing and L-HOPE Program for Community-Based Total Learning Health Systems, Korea University, Seoul, Republic of Korea
| | - Youjung Hong
- College of Nursing and L-HOPE Program for Community-Based Total Learning Health Systems, Korea University, Seoul, Republic of Korea
| | - Sung Ok Chang
- College of Nursing and L-HOPE Program for Community-Based Total Learning Health Systems, Korea University, Seoul, Republic of Korea
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Zagursky JM, Burke RE, Olson APJ, Readlynn JK. Gridlock: What hospitalists and health systems can do to help. J Hosp Med 2024. [PMID: 38606548 DOI: 10.1002/jhm.13353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/12/2024] [Accepted: 03/17/2024] [Indexed: 04/13/2024]
Affiliation(s)
- Jennifer M Zagursky
- Department of Medicine, Division of Hospital Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Robert E Burke
- Center for Health Equity Research and Promotion, Corporal Cresencz VA Medical Center, Philadelphia, Pennsylvania, USA
- Division of General Internal Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Andrew P J Olson
- Department of Medicine, Division of Hospital Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
- Department of Pediatrics, Division of Pediatric Hospital Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Jennifer K Readlynn
- Department of Medicine, Division of Hospital Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
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Lee SJ, Park MS, Chang SO. Capturing key function-focused care problems, nursing diagnoses, and interventions for nursing home patients using a web-based case management system. Int J Nurs Knowl 2024; 35:93-104. [PMID: 36891588 DOI: 10.1111/2047-3095.12420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/05/2023] [Indexed: 03/10/2023]
Abstract
PURPOSE The aim of this study is to identify the key functional care problems, NANDA-I nursing diagnoses, and intervention plans related to function-focused care (FFC) using a web-based case management system for patients who present different cognitive status. METHODS This study employed a retrospective descriptive research design. Data were obtained from system records on patients after the research team trained the case management system at a nursing home in Dangjin in South Chungcheong Province, South Korea. A total of 119 inpatient records were analyzed. RESULTS The key physical, cognitive, and social functional problems, nursing diagnoses in six domains (health promotion, elimination and exchange, activity/rest, perception/cognition, coping/stress tolerance, and safety/protection), and intervention plans were identified. CONCLUSION The identified FFC case management information of interdisciplinary caregivers will provide evidence for the implementation of effective interventions according to a patient's functional status. Additional studies related to the establishment of a large clinical database of advanced case management systems focusing on interdisciplinary caregivers' functional management are needed to support the prioritization of functional care.
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Affiliation(s)
- Su Jung Lee
- Assistant, Professor, College of Nursing, Institute of Health Science Research, Inje University, Gimhae, Republic of Korea
- Director, Inje Institute of Hospice & Palliative Care, Inje University, Gimhae, Republic of Korea
| | - Min Sun Park
- Assistant Professor, Department of Nursing, Cheongju University, Cheongju, Republic of Korea
| | - Sung Ok Chang
- Professor, College of Nursing, and BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Republic of Korea
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Verbeek FHO, van Lierop MEA, Meijers JMM, van Rossum E, Zwakhalen SMG, Laurant MGH, van Vught AJAH. Facilitators for developing an interprofessional learning culture in nursing homes: a scoping review. BMC Health Serv Res 2023; 23:178. [PMID: 36810021 PMCID: PMC9945386 DOI: 10.1186/s12913-023-09092-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 01/23/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Healthcare professionals in nursing homes face complex care demands and nursing staff shortages. As a result, nursing homes are transforming into home-like personalised facilities that deliver person-centred care. These challenges and changes require an interprofessional learning culture in nursing homes, but there is little understanding of the facilitators that contribute to developing such a culture. This scoping review aims to identify those facilitators. METHODS A scoping review was performed in accordance with the JBI Manual for Evidence Synthesis (2020). The search was carried out in 2020-2021 in seven international databases (PubMed, Cochrane Library, CINAHL, Medline, Embase, PsycINFO and Web of Science). Two researchers independently extracted reported facilitators that contribute to an interprofessional learning culture in nursing homes. Then the researchers inductively clustered the extracted facilitators into categories. RESULTS In total, 5,747 studies were identified. After removing duplicates and screening titles, abstracts and full texts, 13 studies that matched the inclusion criteria were included in this scoping review. We identified 40 facilitators and clustered them into eight categories: (1) shared language, (2) shared goals, (3) clear tasks and responsibilities, (4) learning and sharing knowledge, (5) work approaches, (6) facilitating and supporting change and creativity by the frontline manager, (7) an open attitude, and (8) a safe, respectful and transparent environment. CONCLUSION We found facilitators that could be used to discuss the current interprofessional learning culture in nursing homes and identify where improvements are required. Further research is needed to discover how to operationalise facilitators that develop an interprofessional learning culture in nursing homes and to gain insights into what works, for whom, to what extent and in what context.
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Affiliation(s)
- Frank H. O. Verbeek
- grid.450078.e0000 0000 8809 2093HAN University of Applied Sciences, School of Health Studies, Research Group Organisation of Healthcare and Services, Nijmegen, The Netherlands
| | - Merel E. A. van Lierop
- grid.5012.60000 0001 0481 6099Maastricht University, Care and Public Health Research Institute, Department of Health Services, Maastricht, The Netherlands ,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Judith M. M. Meijers
- grid.5012.60000 0001 0481 6099Maastricht University, Care and Public Health Research Institute, Department of Health Services, Maastricht, The Netherlands ,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands ,Zuyderland Care, Zuyderland Medical Center, Sittard-Geleen, the Netherlands
| | - Erik van Rossum
- grid.5012.60000 0001 0481 6099Maastricht University, Care and Public Health Research Institute, Department of Health Services, Maastricht, The Netherlands ,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands ,grid.413098.70000 0004 0429 9708Zuyd University of Applied Sciences, Research Centre for Community Care, Academy of Nursing, Heerlen, The Netherlands
| | - Sandra M. G. Zwakhalen
- grid.5012.60000 0001 0481 6099Maastricht University, Care and Public Health Research Institute, Department of Health Services, Maastricht, The Netherlands ,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Miranda G. H. Laurant
- grid.450078.e0000 0000 8809 2093HAN University of Applied Sciences, School of Health Studies, Research Group Organisation of Healthcare and Services, Nijmegen, The Netherlands
| | - Anneke J. A. H. van Vught
- grid.450078.e0000 0000 8809 2093HAN University of Applied Sciences, School of Health Studies, Research Group Organisation of Healthcare and Services, Nijmegen, The Netherlands
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Choi YR, Chang SO. Exploring interprofessional communication during nursing home emergencies using the SBAR framework. J Interprof Care 2023; 37:83-90. [PMID: 34757886 DOI: 10.1080/13561820.2021.1985985] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Communication breakdowns during emergencies threaten patient safety. In nursing homes (NHs) vulnerable residents may experience emergencies at any time. Concerns over clinical complexity and diverse communication styles among interprofessional practitioners heighten the need for standardized methods to improve practitioners' communication skills. This study explores communication structures among 32 practitioners in four NHs using in-depth interviews following a formalized Situation-Background-Assessment-Recommendation (SBAR) framework. Network analysis, a deductive approach to qualitative data analysis, and case analysis were performed for a comprehensive understanding of interprofessional communication in 48 emergency cases identified during interviews. Findings identified the flow of information, messaging, and management strategies that were expected of receivers during interprofessional communication. These results could help develop training regimens or guidelines to improve cooperative interprofessional communication, allowing practitioners to provide appropriate emergency care for NH residents.
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Affiliation(s)
- Young-Rim Choi
- College of Nursing, Korea University, Seoul, Republic of Korea
| | - Sung Ok Chang
- College of Nursing and BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Republic of Korea
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Choi YR, Lee YN, Kim DY, Chang SO. For the interprofessional management of the discomfort of long-term care facility residents with dementia. J Interprof Care 2022; 37:371-382. [PMID: 35687038 DOI: 10.1080/13561820.2022.2071242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Educating interprofessional practitioners in long-term care facilities (LTCFs) is critical for managing discomfort of residents with dementia, which is often unnoticed and undertreated. A framework of education on discomfort management that is applicable in various environments in different facilities is necessary. We developed a preliminary framework to educate interprofessional practitioners on discomfort management of dementia residents in LTCFs. We conducted a three-step research process: a literature review using topic modeling, in-depth interviews, and Delphi surveys. We derived four categories for an interprofessional approach toward discomfort management education in LTCFs: identifying visual and nonvisual signs to communicate among professionals, close observation using comparison and contrast to share information for discomfort care, harmony in interprofessional roles, and applying common and specific professional knowledge for discomfort management. The findings provide the first outline for an educational framework for interprofessional discomfort management in LTCFs for residents with dementia. We recommend interventions across different cultures to verify the framework in future research.
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Affiliation(s)
- Young-Rim Choi
- College of Nursing, Korea University, Seoul, Republic of Korea
| | - Ye-Na Lee
- Department of Nursing, The University of Suwon, Gyeonggi-do, Republic of Korea
| | - Da-Yeong Kim
- College of Nursing, Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, Seoul, Republic of Korea
| | - Sung Ok Chang
- College of Nursing and BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Republic of Korea
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PARK MS, LEE SJ, CHOI YR, CHANG SO. Exploring a Nursing Home-Specific, Interdisciplinary, Function-Focused, Communicative Framework Based on Situation, Background, Assessment, and Recommendation. J Nurs Res 2021; 29:e151. [PMID: 33840770 PMCID: PMC8126483 DOI: 10.1097/jnr.0000000000000428] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Improved methods of communication are needed among professionals in related fields to address the increasing complexity of clinical situations and various levels of functioning experienced by older adults who live in nursing homes. PURPOSE The purpose of this study was to explore function-focused clinical communication among nurses and providers based on the Situation, Background, Assessment, Recommendation (SBAR) approach toward interdisciplinary collaboration to maintain function among nursing home residents and to identify the characteristics of SBAR flows in nursing homes. METHODS Detailed interviews with 28 interdisciplinary professionals working in four nursing homes were conducted. Directed qualitative content analysis was used to identify the internal attributes of SBAR-based communication. Case analysis was conducted to identify SBAR flows. RESULTS Four themes emerged as key factors for function-focused interdisciplinary staff communication in nursing homes. Effective nursing care to maintain function among nursing home residents requires accurate awareness of abnormal circumstances. Knowledge of assessment and resident background are needed to address situations requiring intervention and identify the problems underlying a resident's current state. The optimal therapeutic environment is created by sharing roles and tasks among practitioners through referrals.Twelve generalized situations requiring function-focused communication (i.e., dislocation of body line because of joint contracture, change in walking, difficulty of moving because of pain, difficulty in eating, fever, change in sleep pattern, change in excretion pattern, change in weight, change in condition, change in problematic behavior, decrease in cognitive function, and change in relationships) and the related nurse-centered SBAR pathways were identified. CONCLUSIONS/IMPLICATIONS FOR PRACTICE These results represent a first prototype for developing practical communication guidelines for nursing-home-specific function-focused care and provide new insights into the interdisciplinary approach.
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Affiliation(s)
- Min Sun PARK
- PhD, RN, Assistant Professor, Department of Nursing, Cheongju University, Cheongju, Republic of Korea
| | - Su Jung LEE
- PhD, RN, Research Professor, College of Nursing, Korea University, Seoul, Republic of Korea
| | - Young Rim CHOI
- PhD, RN, Research Professor, College of Nursing, Korea University, Seoul, Republic of Korea
| | - Sung Ok CHANG
- PhD, RN, Professor, College of Nursing, and BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Republic of Korea
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Chang SO, Lee SJ, Park MS, Choi YL, Kim GM. Conceptualizations of function‐focused care used by practitioners in Korean nursing homes. Nurs Health Sci 2020. [DOI: 10.1111/nhs.12758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Su Jung Lee
- College of Nursing Korea University Seoul Korea
| | | | | | - Geun Myun Kim
- Department of Nursing Gangneung‐Wonju National University Wonju Korea
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Lee SJ, Park MS, Choi YR, Chang SO. Concept Development of Identification of Discomfort for Nursing Home Patients With Advanced Dementia. Int J Nurs Knowl 2020; 32:274-285. [PMID: 31957245 DOI: 10.1111/2047-3095.12277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 12/31/2019] [Accepted: 01/09/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of this study is to clarify the concept of discomfort identification by concept development in the nursing home. METHODS The Schwartz-Barcott and Kim's hybrid model was used. FINDINGS The identification of discomfort can be explained as an interactive and confirmative process of sympathetically responding to patients with dementia's problem behavior expressions that communicate unmet needs. CONCLUSIONS The identification of discomfort has the potential to improve the detection of multidimensional discomfort related to nursing diagnosis as a holistic and patient-centered approach. IMPLICATION FOR NURSING PRACTICE The findings could help nursing home nurses have a better understanding of identification of discomfort and can improve nurses and interdisciplinary caregivers' knowledge for developing appropriate comfort caring activities.
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Affiliation(s)
- Su Jung Lee
- Korea University College of Nursing, Seoul, Republic of Korea
| | - Min Sun Park
- Korea University College of Nursing, Seoul, Republic of Korea
| | - Young-Rim Choi
- Korea University College of Nursing, Seoul, Republic of Korea
| | - Sung Ok Chang
- Korea University College of Nursing, Seoul, Republic of Korea
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