bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE CONTEXT for Nursing Home Resident Care: THE ROLE OF LEADERS IN DEVELOPING STRATEGIES
Authors: Swagerty Daniel L , Lee Robert H , Smith Barbara , Taunton Roma Lee 
Published: May 2014

ABSTRACT
Data obtained from three Midwestern nursing homes were used to identify and describe contextual factors that influenced resident care. A qualitative, emergent, case study design guided the study. In addition to 17 residents and 16 family members or friends of the respective residents, participants included 66 staff members and 9 managers involved in the planning and delivery of care to the participating residents. Data were collected via observation, semi-structured interview, and resident record audit. Contextual factors seemed to integrate or fragment care planning and delivery. Important integrators were shared values, the role of the Minimum Data Set coordinator, the role of other leaders, and family influence. Two fragmenting factors, competing demands for the staff members' time and a task orientation to care, appeared to be ubiquitous. External accountability also fragmented care to a discernible degree.
A TRAINING PROGRAM FOR Managing Agitation of Residents in Long-Term Care Facilities: DESCRIPTION AND PRELIMINARY FINDINGS
Authors: Landreville Philippe , Dicaire Louise , Verreault René , Lévesque Louise 
Published: May 2014

ABSTRACT
The purpose of this article is to describe a training program for managing agitation of long-term care residents and to report results of a pilot study. The program emphasizes the development of behavioral skills for the assessment, prevention, and reduction of both aggressive and non-aggressive agitated behavior. It includes 8 hours of class instruction followed by 8 hours of weekly supervision by the trainers. The nursing staff of all working shifts of a unit located in a large nursing home and the residents of this unit participated in the pilot study. Residents and staff were assessed prior to and after the 2-month training program. Staff members reported using behavioral techniques to a greater extent and feeling more effective in managing agitation after training. More than 90% of staff members were satisfied with the training program. During the supervision period, the staff developed and implemented individualized interventions for two residents. The interventions involved providing more attention to these residents and, in one case, modifying some aspects of the direct environment which seemed to trigger agitation. Both residents were less agitated after the interventions were implemented. Moreover, there was a reduction in the number and frequency of agitated behaviors for the other residents of the trainees' unit following staff training.
SELF-MANAGEMENT OF ALCOHOL PROBLEMS Among Aging Adults
Authors: Finfgeld-Connett Deborah L 
Published: May 2014

ABSTRACT
Alcohol abuse among aging adults is thought to be one of the fastest growing health concerns in the United States. To manage this problem, a stepped-care approach is recommended. This approach consists of brief interventions and, if necessary, a more extensive treatment program to help individuals self-manage their drinking habits. Brief interventions fall within the harm reduction philosophy and normally consist of one to five short sessions. In contrast, The Gerontology Alcohol Project (GAP) offers a more comprehensive treatment protocol for individuals who require enhanced self-management guidelines. Both treatment strategies are supported by research conducted with older alcohol abusers.
Care Intervention for Older Adults with Alzheimer's Disease and Related Dementias: Effect of Family Involvement on Cognitive and Functional Outcomes in Nursing Homes
Authors: Jablonski Rita A , Reed David , Maas Meridean L 
Published: May 2014

ABSTRACT
The purpose of this quasi-experimental study was to examine the effect of an intervention for caregivers of individuals with Alzheimer's disease and related dementias (ADRD) on nursing home residents' functional and cognitive status. Fourteen special care units (SCUs) in 14 midwestern nursing homes were paired according to size, ownership, and staff turnover. The paired nursing homes were randomly assigned to either experimental or control groups. The intervention consisted of the Family Involvement in Care (FIC) protocol. The FIC intervention was designed to help family caregivers of nursing home residents with dementia negotiate and establish a partnership with the staff caregivers for the care of residents. One hundred sixty-four residents participated in the study, 71 in the control group and 93 in the experimental group. Sixty-three residents were lost to attrition (38%).
The experimental group exhibited less global deterioration throughout the study. Inappropriate behavior, cognition, and functional status remained relatively unchanged over time within and between the groups, Increased family involvement did slow global deterioration in individuals with ADRD. The findings of the study show that more factors need to be examined to discover those interventions that preserve functional and cognitive abilities.
THE EVOLUTION OF Hospice in America: Nursing's Role in the Movement
Authors: Hoffmann Rosemary L 
Published: May 2014

ABSTRACT
In the current society, many individuals fear death and the feelings of suffering and loneliness that often accompany death. Two visionaries in the United States, Florence WaId and Dr. Elisabeth Kubler-Ross, recognized these fears and planned the nation's first hospice movement in the 1970s. The hospice philosophy continues to prosper in the new millennium. In this article, the founding American hospice's philosophy, types of facilities, standards, health team composition, patient demographics, organizations, reimbursement, and research are compared and contrasted with those of the current hospice movement. Existing issues with the modern movement are also discussed.
Palliative Care NURSING EDUCATION: OPPORTUNITIES FOR GERONTOLOGICAL NURSES
Authors: Ersek Mary , Ferrell Betty R 
Published: May 2014

ABSTRACT
Approximately 80% of Americans who die each year are 65 or older. Increasingly, gerontologi cal nurses are asked to deliver high quality end-of-life care. Studies, however, have identified deficiencies in the delivery of care to older adults who are dying-particularly those who die in nursing homes. Enhancing nursing education and training in end-of-life care is one strategy proposed as a remedy for inadequate care for nursing home residents who are dying. This article reviews the current status of end-of-life nursing home care, describes the philosophy and components of quality palliative care, and provides information about opportunities and resources for educating gerontological nurses in end-of-life care.
Building Relationships in Residential Long-Term Care
Authors: Gaugler Joseph E , Ewen Heidi H 
Published: May 2014

Determinants of Staff Attitudes Toward Family Members
ABSTRACT
The objective of this study was to identify staff-, family-, facility-, and resident-level predictors of staff attitudes toward family members. Data were used from 41 care staff members recruited from 5 nursing homes, 5 assisted living facilities, and 16 family care homes. A multiple regression model found that staff who reported greater quality in their relationships with residents also tended to indicate more positive perceptions of family members. The findings emphasize the need to consider family, resident, and staff relationships in concert when designing and implementing nursing interventions to improve quality of life and care in residential settings.
Spiritual Caring: End of Life in a Nursing Home
Authors: Touhy Theris A , Brown Cynthia , Smith Carol J 
Published: May 2014

ABSTRACT
The purpose of this qualitative study was to explore spiritual care for dying nursing home residents from the perspectives of registered nurses, practical nurses, certified nursing assistants, advanced practice nurses, and physicians. Five major themes emerged: honoring the person's dignity, intimate knowing in the nursing home environment, wishing we could do more, personal knowing of self as caregiver, and struggling with end-of-life treatment decisions. Spiritual caring was described within the context of deep personal relationships, holistic care, and support for residents. Spiritual care responses and similarities and differences in the experiences of participants are presented. Education and research about how to assist residents and families as they struggle with difficult end-of-life decisions, adequate time and staff to provide the kind of care they "wished they could," and development of models that honor the close connection and attachment of staff to residents could enhance end-of-life care in this setting.
Visual Spatial Abilities and Fall Risk
Authors: Olsson Roy H , Wambold Suzanne , Brock Barbara , Waugh Diana , Sprague Heather 
Published: May 2014

An Assessment Tool for Individuals with Dementia
ABSTRACT
Risk of falling is a major concern of long-term care facilities with residents diagnosed with dementia. Use of a brief cognitive assessment focusing on visual spatial abilities could be one strategy in the prevention of falls in residents with dementia. The objective of this study was to determine if a clock test could predict a risk of falls in residents diagnosed with dementia. Three hundred sixtyfour individuals with dementia participated (92 men and 272 women; ages 37 to 100, mean 80.5 years, median 83 years). Each participant was given the Reality Comprehension Clock Test (RCCT) three times, and Mini Mental-Status Examination (MMSE) two times to determine criterion-related validity, test-retest reliability, internal consistency; and to set and evaluate a risk of falls score based on the Visual Spatial Score (VSS) component produced by the RCCT Significant findings included .72 (p < .01) correlation between the RCCT and the MMSE, .90 (p < .01) correlation between the first administration of the RCCT and the second administration of the RCCT; an alpha of .95 (p < .001) and an F value of 76 (p < .001) producing a risk of falls initial VSS of 5 or lower compared to 9 or greater. Ch i -square of 6.3 for 30 days (p < .01), 11.08 for 60 days (p < .01) and 13.3 for 90 days (p < .01) indicated a significant difference in the number of falls occurring in the high risk group (VSS of 5 or lower) compared to the low/ no risk group (VSS of 9 or higher). A risk factor analysis suggested that residents in the higher risk group were three times more likely to have fallen than residents in the low risk group. Knowing a resident's visual spatial ability offers health care providers an opportunity to implement a resident-specific intervention that addresses their cognitive ability and visual spatial deficit that may reduce the resident's risk of falling.
Quality Improvement in Nursing Facilities: A NURSING LEADERSHIP PERSPECTIVE
Authors: Adams-Wendling Linda , Lee Robert 
Published: May 2014

ABSTRACT
The purposes of this study were to characterize the state of quality improvement (Ql) in nursing facilities and to identify barriers to improvement from nursing leaders' perspectives. The study employed a non-experimental descriptive design, using closedand open-ended survey questions in a sample of 51 nursing facilities in a midwestern state. Only two of these facilities had active Ql programs. Furthermore, turnover and limited training among these nursing leaders represented major barriers to rapid implementation of such programs. This study is consistent with earlier findings that Ql programs are limited in nursing homes.
On-line Communities: Helping "Senior Surfers" Find Health Information on the Web
Authors: Moore Georgia A 
Published: May 2014

ABSTRACT
Currently, it is estimated that approximately 10 million older adults use Internet communities to gain information on any health issue. It is nearly impossible to police all of the sites available to make sure correct information is distributed. A short website review demonstrates factors that create an unsafe or safe health environment. The ability of a facilitator to properly manage an online community and the problems that may be encountered in this setting are issues that warrant attention. Discussion forums provide information through threaded discussion boards, and frequently the information is inaccurate. Research is needed to determine if on-line health communities are a bane or a boon to the elderly population.
Effectiveness of Outpatient Geriatric Assessment Programs: EXPLORING CAREGIVER NEEDS, GOALS, AND OUTCOMES
Authors: Aminzadeh Faranak , Byszewski Anna , Dalziel William Burd , Wilson M , Deane N , Papahariss-Wright S 
Published: May 2014

ABSTRACT
In this study, the authors examined the goals and outcomes of 141 caregivers of older adults with cognitive impairment who attended a comprehensive geriatric assessment program (CGA). The vast majority of caregivers expressed at least one assessment goal, suggesting that the concept was relevant to them. Most caregiver goals focused on patient needs, with only 10% expressing goals specifically related to their own coping needs. At follow up, more than two-thirds of caregiver goals were attained. The findings confirm the great potential of CGA programs in promoting positive outcomes and point to the opportunities for nurses to improve the process of care.
Relaxing Music at Mealtime in Nursing Homes
Authors: Hicks-Moore Sandee Lynn 
Published: May 2014

Effects on Agitated Patients with Dementia
ABSTRACT
Agitation in individuals with severe cognitive impairment is a significant problem that affects care and overall quality of life. Building on research conducted by Goddaer and Abraham (1994), this quasi-experimental study proposed that relaxing music played during meals would exert a calming effect and decrease agitated behaviors among nursing home residents with dementia. Thirty residents residing in a Special Care Unit participated in the 4-week study. The Cohen-Mansfield Agitation Inventory (Cohen-Mansfield, Marx, & Rosenthal, 1989) was used to gather data. Baseline data was obtained in Week 1 (no music). Music was introduced in Week 2, removed in Week 3, and reintroduced in Week 4. At the end of the 4-week study, overall reductions in the cumulative incidence of total agitated behaviors were observed. Reductions in absolute numbers of agitated behaviors were achieved during the weeks with music and a distinct pattern was observed.
A TYPOLOGY OF ORAL HYDRATION: PROBLEMS EXHIBITED BY FRAIL NURSING HOME RESIDENTS
Authors: Mentes Janet C 
Published: May 2014

ABSTRACT
Dehydration remains a substantial problem for nursing home residents, often with poor health outcomes. The purpose of this investigation was to establish 6-month prevalence of dehydration events in nursing home residents and to describe common hydration problems of nursing home residents. In this prospective observational study, 35 nursing home residents were followed for 6 months to assess problems with hydration and to evaluate the presence of dehydration. Urine specific gravity and color, bioimpedance measurements, meal intake recordings, and chart abstraction were used to assess hydration status. Field notes and informal staff interviews were used to describe specific hydration problems and clinically relevant interventions. Dehydration events occurred in 31% (11 of 35) of residents during the 6-month period. A typology of hydration problems was developed from the field observations. The typology consists of four groups (i.e., Can Drink, Can't Drink, Won't Drink, End of Life) and six corresponding subgroups. Demographic and hydration characteristics of the subgroups were compared and contrasted. Comparisons revealed the Won't Drink group is most vulnerable to dehydration events because this group has the highest percentage of dehydration events (58%, 4 of 7), the highest average specific gravity, and the lowest consumption of fluids during meals. Nursing interventions for the subgroups are discussed. Targeting nursing interventions to the specific hydration problem exhibited is proposed.
Undernutrition in Older Adults Across the Continuum of Care: Nutritional Assessment, Barriers, and Interventions
Authors: Furman Ellen F 
Published: May 2014

ABSTRACT
Undernutrition can be a significant deterrent to healthy aging and can negatively affect health outcomes in older adults. Researchers have identified the prevalence of undernutrition in older adults and the need for intervention, yet the incidence remains high. The purpose of this article is twofold: to emphasize the need for nutritional assessment across the continuum of care as experienced by older adults, and to identify possible barriers to effective treatment. The assessment of nutritional status and the implementation of effective nutritional interventions are essential to the health of older adults.
Overcoming Restraint Use: EXAMINING BARRIERS IN AUSTRALIAN AGED CARE FACILITIES
Authors: Nay Rhonda , Koch Susan 
Published: May 2014

ABSTRACT
The purpose of this article is to discuss the outcomes of a project that sought to identify alternatives to restraint use in aged care facilities. (In Australia, the term aged care facility refers to those facilities previously known as hostels and nursing homes.) A literature review was conducted and discussion forums and individual interviews were held with interested stakeholders in Australian capital cities, as well as in a rural city in each state. Site visits were conducted at 16 aged care facilities. Participants identified legal concerns, existing organizational culture, and lack of alternatives as barriers to implementing restraint-minimization practices. Recommendations to facilitate minimal restraint are implementing national policy guidelines, adopting a best practice philosophy in relation to restraint minimization, continuing staff education related to alternatives, and maintaining constant communication with families.
Conflict Resolution Styles: A Comparison of Assisted Living and Nursing Home Facilities
Authors: Small Jeff A , Montoro-Rodriguez Julian 
Published: May 2014

ABSTRACT
In this exploratory study, the authors investigated how interpersonal conflict is resolved in assisted living and nursing home facilities. In particular, the authors examined whether conflict resolution styles differed between type of facility and between residents and staff in each type of facility. Four focus groups were conducted - two with residents and two with staff from each type of facility. The focus groups centered on discussing the occurrence of conflict and how each participant handled it. Discourse analysis was employed to identify participants' use of three styles of conflict resolution: controlling, solution-oriented, and non-confrontational. The results indicate that staff in each care context showed a preference for the solution-oriented approach. Residents in each setting reported equal use of the non -confrontational and solution-oriented styles. The findings suggest that preferred conflict resolution styles may vary more as a function of the role of each communicator than the context of the care setting.
Older Adults' Views of Cardiac Rehabilitation Programs: Is it Time to Reinvent?
Authors: Dolansky Mary A , Moore Shirley M , Visovsky Constance 
Published: May 2014

ABSTRACT
In spite of the documented benefits of cardiac rehabilitation program (CRP) participation, older adults are not likely to participate. Older adults' expectations of and experiences with CRPs are not known. It is also not known whether women and men differ in their expectations and experiences. This descriptive study used a convenience sample of 40 older adults who had experienced an acute cardiac event to identify patients' views of CRPs. Focus groups revealed that older adults do not have an accurate understanding of what to expect in CRPs, and that older adults' experiences in CRPs were generally positive. Older adults suggested CRPs could be improved by including more socialization opportunities, offering varied forms of exercise, enhancing teaching about stress management, and adapting teaching strategies. In this study, "strength of physician referral" was identified as the main reason for participating or not participating in a CRP. Older men feared physical pain with exercise and older women expressed a need for emotional support. A major finding in this study was the report of adverse events (i.e., exhaustion, collapse) during exercise experienced by individuals who did not go to a CRP. Because the majority of adults participating in CRPs are older, transforming CRPs to meet the needs of these older adults is important. Future research on the effectiveness of alternative CRP models will provide evidence to ensure the delivery of quality, cost-effective care.
Effect of combined dexamethasone therapy with nebulized r-epinephrine or salbutamol in infants with bronchiolitis: A randomized, double-blind, controlled trial
Authors: Bawazeer Manal , Aljeraisy Majed , Albanyan Esam , Abdullah Alanazi , Thaqafi Wesam Al , Alenazi Jaber , otaibi Zaam Al , Ghaihab Mohammed Al 
Published: May 2014

Abstract
Background: This study investigated the effect of combining oral dexamethasone with either nebulized racemic epinephrine or salbutamol compared to bronchodilators alone for the treatment of infants with bronchiolitis. Materials and Methods: This was a double-blind, randomized controlled trial on infants (1 to 12 months) who were diagnosed in the emergency department with moderate-to-severe bronchiolitis. The primary outcome was the rate of hospital admission within 7 days of the first dose of treatment, and the secondary outcomes were changes in respiratory distress assessment instrument score, heart rate, respiratory rate, and oxygen saturation (O 2 Sat) over a 4-hour observation period. Infants (n = 162) were randomly assigned to four groups: A (dexamethasone + racemic epinephrine) = 45, B (placebo and racemic epinephrine) =39, C (dexamethasone and salbutamol) = 40, or D (placebo and salbutamol) = 38. Results: Patients who had received dexamethasone + epinephrine exhibited similar admission rates compared to placebo + epinephrine or salbutamol (P = 0.64). Similarly, no statistically significant difference was observed in the rate of hospitalization for patients who received dexamethasone + salbutamol compared to those who received placebo + epinephrine or salbutamol (P = 0.51). Clinical parameters were improved at the end of the 4-hour observation period for all treatment groups. Treatment with dexamethasone + epinephrine resulted in a statistically significant change in HR over time (P < 0.005) compared to the other groups. Conclusions: This study adds to a body of evidence suggesting that corticosteroids have no role in the management of bronchiolitis for young infants who are first time wheezers with no risk of atopy.