TEST OF TRANSFER OF TRAINING EFFECTS IN NURSING HOMES

这项研究将评估行为管理的效果 护理人员在护理实践和居民行为方面的技能 模式，它直接建立在以前的工作，涉及发展 对工作人员的干预。 培训效果的传递是一种 护理之家质量改进的突出问题，最近授权 护理助理的培训和认证。 培训计划 在这个项目中提出的重点是行为管理战略， 护理人员，通过免费的监督培训得到加强 成分 概念模型反映了以下假设： 组织因素可能会缓和培训的影响， 护理实践和居民成果。 具体而言，监督 实践，管理气候和护理设计 助理的工作将与培训互动，以确定结果。 获得的知识，自我效能和对结果的信念被认为是 作为改变居民护理实践的工具。 工作设计， 将工作人员轮换与稳定分配给居民， 被假设为缓和训练对改变的影响， 护理实践以及这些变化对居民行为的影响。 该研究将在一组7个设施中进行， 哈特福德/斯普林菲尔德地区南部新英格兰。 养老院是 由Genesis Health Ventures拥有和运营，Genesis Health Ventures是一家专有的 养老院 这些设施的地理位置非常接近 在支付者组合、人员配备方面， 特色和居民组合。 它们都由一个 区域培训中心，通过该中心， 交付。 约140名护理助理，52名主管护士 和210名居民将作为受试者参与，分为干预 与对照组 设施内的单位将被随机分配一个 治疗条件，两种条件都在每个设施中表示。 4个站点使用轮换工作分配，3个站点使用稳定分配 组 将采用调查的前后跟踪设计， 停止行动视频响应，和居民行为的评级作为数据 收集方法。 分析将集中在测试的具体 假设使用方差分析和对数线性策略和评价 基于路径分析的培训效果传递概念模型 技术.

The proposed study will evaluate the effects of behavior management skills for nursing home staff on care practices and resident behavior patterns, It builds directly on previous work involving the development of interventions with staff. The transfer of training effects is a salient issue in nursing home quality improvement given recently mandated training and certification of nursing assistants. The training program proposed in this project is focused on behavior-management strategies for nursing staff, reinforced by a complimentary supervisory training component. The conceptual model reflects the assumption that organizational factors are likely to moderate the effects of training on care practices and resident outcomes. Specifically, supervisory practices, administrative climate, and the design of the nursing assistant's job will interact with training in determining outcomes. Acquired knowledge, self-efficacy, and beliefs about outcomes are viewed as instrumental in changing resident care practices. Job design, operationalized as rotating vs stable assignment of staff to residents, is hypothesized to moderate both the effects of training on changes in care practices and the effect of those changes on resident behaviors. The study will be conducted in a group of 7 facilities in the Hartford/Springfield area of Southern New England. The nursing homes are owned and operated by Genesis Health Ventures, a proprietary chain of nursing homes. The facilities are located in close geographic proximity and are typical of the industry in terms of payor mix, staffing characteristics and resident mix. They are all jointly served by a regional training center, through which the training intervention will be delivered. Approximately 140 nursing assistants, 52 supervising nurses and 210 residents will participate as subjects, divided into intervention and control groups. Units within facilities will be randomly assigned a treatment condition, with both conditions represented in each facility. Four sites use rotating job assignments and 3 use stable assignment groups. A pre-post-follow-up design will be employed using surveys, stop-action video-response, and ratings of resident behavior as the data collection methods. Analysis will focus on the test of specific hypotheses using ANOVA and loglinear strategies and evaluation of the conceptual model of transfer of training effects using path analytic techniques.