A Family-Staff Partnership to Improve LTC Quality

描述(由申请人提供)：几乎所有从业者、政策制定者、研究人员和普通公众都认识到需要改善疗养院和其他住宅长期护理环境中的护理质量。在很大程度上，质量问题的存在是因为没有足够和不稳定的劳动力来照顾长期护理居民。例如，在8小时的轮班中，护士助理平均只有15分钟与住院医生交谈--这一数字与这些工人之所以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%的流失率和对居民的折衷护理，包括功能下降、感染发生率增加、住院和滥用造成的伤害。毫无疑问，如果减轻工人的负担和流动率，护理质量将会得到改善。幸运的是，有一个可能的解决工人负担的办法，已经到位，等待动员：居民家庭。大多数居民都有定期的家人探望，他们希望参与护理。不幸的是，长期护理系统普遍不欢迎他们的参与，使家人对他们的适当作用感到困惑，并与工作人员产生了负面关系。动员家庭-工作人员伙伴关系，其中家庭和工作人员共同努力制定居民护理计划，旨在帮助居民在与居民生活质量有关的简单但重要的活动中发挥作用，并明确促进家庭与工作人员的沟通，这可能会提高家庭和工作人员的满意度，减少工作人员负担和更替，并改善居民成果。因此，这个项目的目标是在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-工作人员伙伴计划的随机临床试验，旨在让家庭(N=960)参与以居民为重点的活动，并促进家庭与工作人员(护理助理和个人护理助理；N=544)之间的关系，从而提高家庭和工作人员的满意度；减少工作人员的压力、倦怠、缺勤和流动率；更多的家庭参与居民的生活质量和对工作人员同理心的良好看法；改善家庭与工作人员的联系；减少设施对临时工的依赖；以及改善居民工作成果。结果对长期护理中的劳动力危机有影响，并可使在养老院和住宅护理/辅助生活设施中生活、工作和照顾那些生活和工作的所有个人受益。

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.