STAFF MANAGEMENT SYSTEM FOR BEHAVIORAL SKILLS

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The major goal of this study is to utilize a Formal Staff Management (FSM) system for motivating Certified Nursing Aides (CNA) to employ behavior management skills on the nursing units. The FSM system is based on a model proposed by the authors and field tested in their incontinence research. The FSM system contains the following components: (1) the CNAs will use performance checklists, which serve to remind them of the steps involved in appropriate task performance; (2) CNAs will use these checklists to self-monitor their own performance and nurse supervisors will monitor CNA performance on a consistent schedule; (3) nurse supervisors will provide immediate and delayed verbal performance feedback and written feedback to the group and individual CNAs. The FSM system will be compared with Conventional Staff Management (CSM) procedures, and changes in both staff and resident behaviors will be assessed. There are 3 specific aims: Aim 1: after establishing equivalence in behavior management skill acquisition in both groups, we will assess whether there are differences in skill performance on units under CSM and FSM conditions; Aim 2: we will evaluate the effects of CNA behavior management training on various resident behaviors; Aim 3: we will use computer-assisted real-time data collection procedures to analyze the effects of behavior management training on environmental contextual factors surrounding behaviorally disruptive events. We will examine whether type of dementia, cognitive and ADL status, and use of psychotropic medications predict disruptive behaviors or resident responsivity to treatment. We will also investigate whether CNA stress level or social support predicts their ability to acquire or perform behavior management skills. Finally, we will examine the costs of the training/management system related to the gains achieved.