Facilitating Staff Adoption of New Policies and Procedures in Aged Care Through Training for Readiness for Change

Effects of organizational agility on readiness for change in nurses: A cross-sectional study

AIM

To investigate the correlation between organizational agility and nurses' readiness for change.

BACKGROUND

The paradigm of agility in a healthcare organization is a novel concept that embodies the most advantageous organizational status. However, assessing the effects of organizational agility on nurses' readiness for change has not been previously studied.

METHODS

This cross-sectional study was conducted on 270 nurses working in a university hospital in Egypt. The study took place between January - March 2022, and participation was voluntary. Data were collected using the organizational agility scale and individual readiness for change scales. Data analysis was conducted using descriptive statistics, Pearson correlation, and structured equation modeling (SEM).

RESULTS

The results indicated that nurses in the hospital exhibited a moderate level of agility. Nurses' readiness for change is high. The SEM showed that organizational agility accounted for 64% of the variance in nurses' readiness for change.

CONCLUSIONS

Organizational agility is a significant predictor of nurses' readiness for change.

IMPLICATIONS FOR NURSING POLICYMAKING

As a means of ensuring that nurses are prepared for changes, nursing institutions should foster agility by instilling a vision for the future, enhancing staff capabilities, encouraging teamwork and open communication, and implementing total quality management, strategic planning, advanced nursing practice, participatory management, shared decision-making, and policy development.

Usability, Appeal, and Relevance of Music and Wellbeing Training for Carers of People with Dementia: A Think-Aloud Study

Background

Personalized music listening can be highly effective in supporting people experiencing changes in mood and behavior due to Alzheimer's disease and other conditions causing dementia. However, a lack of staff education can be a barrier to effective use of music in residential aged care.

Objective

This study investigates the usability, appeal and relevance of an online training course designed to help care staff develop personalized music programs for people living with dementia in their care.

Methods

A mixed methods approach was taken in which 13 participants took part in a think-aloud session while using the training. Qualitative data from the think-aloud session and interviews were triangulated with results of a survey evaluation of the training.

Results

Themes relating to Engagement, Usability and Appeal, Pedagogical Design and Content, and Transfer, Impact and Barriers to Uptake were discussed. Results indicated that participants regarded the virtual environment and pedagogical design as of high quality, although some minor issues in navigability were identified. Participants also found the training to be highly relevant to their roles as caregivers and reported ways they would incorporate key concepts into care practices. However, ongoing barriers to implementation of such training were identified including systemic issues that contribute to a culture of focus on physical care.

Conclusions

Consistency of navigation and clear instructions for interacting with content are important in training of time-poor care staff. Linking training to industry standards can provide important motivation for implementation of training, although systemic barriers can impede real-world change.

"It's Opened My Eyes to a Whole New World": Positive Behaviour Support Training for Staff and Family Members Supporting Residents With Dementia in Aged Care Settings

OBJECTIVES

This study examined the acceptability and usefulness of Positive Behaviour Support (PBS) training in enhancing the capabilities of support staff and family members providing behaviour support to residents with dementia in residential aged care (RAC).

METHODS

A mixed-methods pilot study was conducted across 3 RAC organisations, involving pre- and post-training questionnaire assessments for clinical leaders (n = 8), support staff (n = 37) and family members (n = 18).

RESULTS

Findings indicated increased confidence among support staff and family members in providing behaviour support, with 96% indicating it would support their practices across settings. Key training benefits included identifying and addressing underlying causes of challenging behaviours. A majority (89%) expressed the need for further behaviour support training.

CONCLUSION

Recommendations focus on developing systems to enable effective and collaborative behaviour support practices. Further research is needed to examine application of PBS principles and planning for residents living with dementia.

Barriers and Facilitators to Screening for Cognitive Impairment in Australian Rural Health Services: A Pilot Study

Australian National standards recommend routine screening for all adults over 65 years by health organisations that provide care for patients with cognitive impairment. Despite this, screening rates are low and, when implemented, screening is often not done well. This qualitative pilot study investigates barriers and facilitators to cognitive screening for older people in rural and regional Victoria, Australia. Focus groups and interviews were undertaken with staff across two health services. Data were analysed via thematic analysis and contextualized within the i-PARIHS framework. Key facilitators of screening included legislation, staff buy-in, clinical experience, appropriate training, and interorganisational relationships. Collaborative implementation processes, time, and workloads were considerations in a recently accredited tertiary care setting. Lack of specialist services, familiarity with patients, and infrastructural issues may be barriers exacerbated in rural settings. In lieu of rural specialist services, interorganisational relationships should be leveraged to facilitate referring ‘outwards’ rather than ‘upwards’.

Developing online training in using music for carers of people with dementia: A focus group study

OBJECTIVE

This study aimed to identify the core content and design issues in developing an online training course in the effective use of music for people with dementia.

METHODS

A co-design approach was taken in which focus groups were conducted with aged care staff and family caregivers (n = 17; 76.5% female). A general inductive approach was taken to data analysis. The consolidated criteria for reporting qualitative research (COREQ) guidelines were followed to ensure rigour in this study.

RESULTS

Participants identified five core concepts for inclusion in the training program including the benefits of music, the need to assess for vulnerability to negative responses, music selection strategies, timing of use and equipment selection. Themes on design and implementation such as the need for role-specific content for care staff at all levels and scenario-based learning were identified.

CONCLUSIONS

The development of online training in music use for carers of people with dementia needs to consider the demands on carers and develop training that is informative and engaging without placing large time demands on the user. Support at a management and executive level will be important to the implementation of such training in residential aged care contexts.

Organizational readiness to change as a leverage point for improving safety: a national nursing home survey

Background

A stronger safety climate in nursing homes may reduce avoidable adverse events. Yet efforts to strengthen safety climate may fail if nursing homes are not ready to change. To inform improvement efforts, we examined the link between organizational readiness to change and safety climate.

Methods

Seven safety climate domains and organizational readiness to change were measured with validated Community Living Center/CLC Employee Survey of Attitudes about Resident Safety and Organizational Readiness to Change Assessment. Safety climate domains comprised of safety priorities, supervisor commitment to safety, senior management commitment to safety, safety attitudes, environmental safety, coworker interactions around safety, and global rating of CLC. We specified models with and without readiness to change to explain CLC- and person-level variance in safety climate domains.

Results

One thousand three hundred ninety seven workers (frontline staff and managers) responded from 56 US Veterans Health Administration CLCs located throughout the US. Adding readiness to change reduced baseline CLC-level variance of outcomes (2.3–9.3%) by > 70% for interpersonal domains (co-workers, supervisors, and senior management). Readiness to change explained person-level variance of every safety climate domain (P < 0.05), especially for interpersonal domains.

Conclusions

Organizational readiness to change predicted safety climate. Safety climate initiatives that address readiness to change among frontline staff and managers may be more likely to succeed and eventually increase resident safety.

Benefits, Challenges and Solutions for Implementing Personalised Music Playlist Programs in Residential Aged Care in Australia

INTRODUCTION

Residential aged care facilities face the immense challenge of adapting to the increasingly high needs of their residents, while delivering personalised, holistic care. There is considerable evidence that music can provide an affordable, accessible way to reduce changes in behaviour associated with dementia, in order to meet these standards of care. However, a number of barriers exist to the effective implementation of music programs in long-term aged care facilities.

METHODS

This study involved focus groups with 17 participants including staff in residential aged care facilities and family caregivers to investigate the benefits of music programs, as well as the challenges and possible solutions to them. A general inductive approach was taken to data analysis.

RESULTS

A number of benefits of music programs were identified, including improvements to the wellbeing of both residents of aged care facilities and their caregivers. However, an ingrained culture within residential aged care of focusing on physical care rather than thinking holistically about wellbeing was identified as a significant barrier.

DISCUSSION

These findings revealed that education is a key component of changing ingrained cultures of task-driven care at both a managerial level and in care staff, so that attention can be given to psychological and emotional needs as well as the physical.