Neighbourhood Team Development to promote resident centred approaches in nursing homes: a protocol for a multi component intervention
Veronique M Boscart, Souraya Sidani, Jenny Ploeg, Sherry L Dupuis, George Heckman, Jessica Luh Kim, Josie d'Avernas, Paul Brown, Veronique M Boscart, Souraya Sidani, Jenny Ploeg, Sherry L Dupuis, George Heckman, Jessica Luh Kim, Josie d'Avernas, Paul Brown
Abstract
Background: As the demand for nursing home (NH) services increases, older adults and their families expect exceptional services. Neighbourhood Team Development (NTD) is a multi-component intervention designed to train team members (staff) in the implementation of resident-centered care in NH settings. A neighbourhood is a 32-resident home area within a NH. This paper presents the protocol used to implement and evaluate NTD. The evaluation aimed to 1) examine fidelity with which the NTD was implemented across NHs; 2) explore contextual factors associated with implementation and outcomes of the NTD; and 3) examine effects of NTD on residents, team members, family, and organizational outcomes, and the association between level of implementation fidelity and outcomes.
Methods: The study employed a repeated measure, mixed method design. NTD consisted of a 30-month standardised training and implementation plan to modify the physical environment, organize delivery and services and align staff members to promote inter-professional team collaboration and enhanced resident centeredness. Training was centred in each 32-resident neighbourhood or home area. Quantitative and qualitative data were collected with reliable and valid measures over the course of 3 years from residents (clinical outcomes, quality of life, satisfaction with care, perception of person centeredness, opportunities for social engagement), families (satisfaction with care for relative, person centeredness, relationship opportunities), team members (satisfaction with job, ability to provide person centered care, team relationships) and organizations (retention, turnover, staffing, events) in 6 NHs. Mixed models were used for the analysis.
Discussion: The advantages and limitations of the NTD intervention are described. The challenges in implementing and evaluating this multi-component intervention are discussed as related to the complexity of the NH environment.
Trial registration: ClinicalTrials.gov ID: NCT03415217 (January 30, 2018 - Retrospectively registered).
Keywords: Care model; Cross-functional teams; Culture change; Long-term care; Multi-component intervention; Nursing homes; Quality of care; Resident-centered care.
Conflict of interest statement
The authors declare that they have no competing interests.
References
- World Health Organization (WHO) 10 facts on dementia. 2015.
- Department of Economic and Social Affairs Population Division (DESA) World Population Ageing 2013. 2013.
- Sherwin S, Winsby M. A relational perspective on autonomy for older adults residing in nursing homes. Health Expect. 2011;14:182–190. doi: 10.1111/j.1369-7625.2010.00638.x.
- Alzheimer Society of Canada . Rising tide: The impact of dementia on Canadian society. 2010.
- Kane R, Kling K, Bershadsky B, Kane R, Giles K, Degenholtz H, et al. Quality of life measures for nursing home residents. J Geron A Biol Sci Med Sci. 2003;58:240–248. doi: 10.1093/gerona/58.3.M240.
- Hughes C, Lapane K, Mor V. Impact of legislation on nursing home care in the United States: lessons for the United Kingdom. Brit Med J. 1999;319:1060–1063. doi: 10.1136/bmj.319.7216.1060.
- McCormack B, McCance T. Development of a framework for resident-centred nursing. J Adv Nurs. 2006;56:472–479. doi: 10.1111/j.1365-2648.2006.04042.x.
- Kane R, West J. It shouldn’t be this way: the failure of long-term care. Nashville: Vanderbilt University Press; 2005.
- Roth E, Eckert J. The vernacular landscape of assisted living. J Aging Stud. 2011;25:215–224. doi: 10.1016/j.jaging.2011.03.005.
- Levy-Storms L, Miller-Martinez D. Family caregiver involvement and satisfaction with institutional care during the first year after admission. J Appl Gerontol. 2005;24:160–174. doi: 10.1177/0733464804272102.
- McGilton K, McGillis Hall L, Brown M, Boscart V. Effects of director of care support on job stress and job satisfaction among long-term care nurse supervisors. Can J Nurs Leadersh. 2007;20:52–66. doi: 10.12927/cjnl.2007.19288.
- Castle N. Measuring staff turnover in nursing homes. Gerontologist. 2006;46:210–219. doi: 10.1093/geront/46.2.210.
- Clark C, Smith D, Ismail F. Residents with dementia: potential legal implications for long-term care facilities. Health Law Can. 2009;2009(30):20–22.
- Adeniran R, Burke K, Carrick L, Egan K, Evans L, Watts R, et al. Leadership and management skills for long-term care. New York: Springer Publishing Company, LLC; 2008.
- Gaugler J, Yu F, Krichbaum K, Wyman J. Predictors of nursing home admission for persons with dementia. Med Care. 2009;47:191–198. doi: 10.1097/MLR.0b013e31818457ce.
Source: PubMed