A Family-Staff Partnership to Improve LTC Quality

描述（由申请人提供）：几乎所有的从业者，政策制定者，研究人员和公众认识到需要提高护理质量在养老院和其他住宅长期护理设置。在很大程度上，质量问题的存在是因为没有足够的和不一致的劳动力来照顾长期护理居民。例如，在一个8小时的轮班中，护理助理平均只有15分钟的时间与居民交谈-这一数字与这些工人选择这份工作是因为他们希望与老年人建立关系并帮助他们的事实不符。其结果是93%的周转率和居民的护理受到损害，包括功能下降，感染发生率增加，住院治疗和虐待伤害。毫无疑问，如果工人的负担和流动率降低，护理质量将得到改善。幸运的是，有一个可能的补救工人负担，已经到位，并等待动员：居民的家庭。大多数居民都有定期的家庭访客，他们希望参与护理。不幸的是，长期护理系统一般不欢迎他们的参与，使家庭对他们的适当作用感到困惑，并与工作人员产生负面关系。动员家庭和工作人员的伙伴关系，其中家庭和工作人员共同努力，制定居民照顾计划，旨在为家庭提供一个角色，帮助居民在简单而重要的活动，涉及居民的生活质量，并明确促进家庭工作人员的沟通，可能会提高家庭和工作人员的满意度，减少工作人员的负担和流动，并改善居民的成果。因此，本项目的目的是在24家疗养院和住宿护理/辅助生活设施中进行为期6个月的家庭-工作人员伙伴关系计划的随机临床试验，旨在使家庭（N = 960）参与以居民为中心的活动，并促进家庭和工作人员之间的关系（护理助理和个人护理助理; N = 544），从而提高了家庭和工作人员的满意度;减少了工作人员的压力、倦怠、缺勤和更替;更多的家庭参与居民的生活质量和良好的工作人员同情的看法;改善家庭工作人员的接触;减少设施对临时工的依赖;和改善居民的成果。结果对长期护理的劳动力危机有影响，并且可以使所有居住，工作和关心那些生活和工作在养老院和住宅护理/辅助生活设施的人受益。

DESCRIPTION (provided by applicant): Virtually all practitioners, policy-makers, researchers and the general public recognize a need to improve the quality of care in nursing homes and other residential long-term care settings. In large part, quality concerns exist because there is an insufficient and inconsistent workforce to care for long-term care residents. During an eight hour shift, for example, nursing assistants have on average only 15 minutes to talk with residents - a figure inconsistent with the fact that these workers chose this job because of their desire to develop a relationship with and help older adults. The result is a 93% turnover rate and compromised care for the resident, including declining function, increased infection incidence, hospitalization, and injury from abuse. There is no doubt that the quality of care would improve if worker burden and turnover were reduced. Fortunately, there is a likely remedy to worker burden, already in place and waiting to be mobilized: residents' families. The majority of residents have regular family visitors who want to be involved in care. Unfortunately, the long-term care system is not generally welcoming of their involvement, leaving family at a loss as to their proper role and engendering negative relations with staff. Mobilizing a family-staff partnership wherein family and staff work together to develop resident care plans designed to provide a role for family in helping the resident in simple yet important activities that relate to resident quality of life, and which expressly facilitates family-staff communication, is likely to improve family and staff satisfaction, reduce staff burden and turnover, and improve resident outcomes. Therefore, the aim of this project is to conduct a six month randomized clinical trial of a family-staff partnership program in 24 nursing homes and residential care/assisted living facilities, that is designed to involve families (N = 960) in resident-focused activities and facilitate relations between family and staff (nursing assistants and personal care aides; N = 544), thereby resulting in higher levels of family and staff satisfaction; less staff stress, burnout, absenteeism and turnover; more family involvement in resident quality of life and favorable perceptions of staff empathy; improved family-staff contacts; reduced facility reliance on temporary workers; and improved resident outcomes. Results have implications for the workforce crisis in long-term care, and can benefit all individuals who live in, work in, and care about those living and working in, nursing homes and residential care/assisted living facilities.