Nursing Aides Research Articles

Impact of Implementing Simulated Electronic Health Record into Nurse Aide CourseImpact of Implementing Simulated Electronic Health Record into Nurse Aide Course

Electronic health records are an integral part of the healthcare system and have been found to improve access to health services, increase efficiency within the health care system, & enhance the safety and quality of patient care (Kleib et al., 2021). Despite how vital EHRs are in healthcare, research found that only 20% of nurses surveyed had EHR training within the school (Repsha et al., 2020). When nursing students do receive simulated EHR training their documenting and critical thinking skills have shown to improve (Everett-Thomas et al., 2021). Students also report high satisfaction with use of the simulated EHR system. While there is research on the impact of simulated EHR education on nursing students, there is limited information on the impact of simulated EHR education on nurse aide students. It is anticipated that nurse aide students who experienced simulated EHR training within their nurse aide course reported higher confidence levels when using EHR systems in the clinical environment and when in the workforce than nurse aide students who did not receive simulated EHR training

A review to access knowledge, attitudes, and practices among nurses of cardiac medicine for heart failure patients to prevent readmission in hospitals

This research paper conducts an in-depth evaluation in order to improve nurses' comprehension of self-care management and patient discharge education for patients with Heart Failure (HF). It also discusses the reasons and obstacles to nurses for increasing their knowledge, attitude, and practice to support improved health outcomes and reduce readmission. In order to prevent readmission and re-hospitalization through discharge training, this study aims to raise awareness about the gaps in knowledge, practice, and attitude among nurses working with patients admitted with heart failure. The study evaluates the nurses' knowledge and aids in the education that heart failure patients must receive. By using effective medication management and post-discharge instructions, heart failure symptoms and disease progression can be controlled. Therefore, effective medication management following discharge is crucial for improving the quality of life, controlling symptoms, avoiding deterioration that triggers hospital readmission, and reducing death. Additionally, it is not always possible for healthcare team members to exchange enough accurate information with one another effectively. Numerous nations have emphasised the importance of the right health practices, optimistic attitudes, and suitable education among healthcare professionals to dispel misconceptions, increase confidence in providing support, and promote effective treatment.

PROMOTING RESIDENT SAFETY THROUGH TRAINING FOR CERTIFIED NURSE AIDES, RESIDENTS, FAMILIES, AND OMBUDSMEN

Abstract Preventing COVID-19 infections and ensuring resident safety in the nursing home (NH) setting requires collaboration among NH leadership, staff, residents, and their advocates including families, caregivers, and nursing home ombudsmen. To address this multi-collaborative need, the University of North Texas Health Science Center Geriatric Workforce Enhancement Program developed training in two focus areas. The first focused on resilience training for Certified Nurse Aides (CNAs) with the United Way that addresses factors influencing well-being, economic stability, mental health, and other social determinants. The second focused on training residents, families, ombudsmen, and other resident advocates to become active partners with NH leadership and staff in the prevention and control of healthcare acquired infections. To ensure training reflects the needs and preferences of key NH stakeholders, we developed a Nursing Home Advisory Council in partnership with state Ombudsman Programs in Texas, Louisiana, and New Mexico.

A comparative analysis of the work environments for registered nurses, nurse aides, and caregivers using the 5th Korean Working Conditions Survey

BackgroundSince the quality of work life of healthcare workers is affected by various factors, an improvement in their work environment can reduce the burden on them, increasing their performance. This study aimed to identify the current problems in working environments for registered nurses (RNs), nurse aides (NAs), and caregivers using the 5th Korean Working Conditions Survey (KWCS), presenting measures to improve working conditions by analyzing their predictors: 1) degree of exposure to work-related risk factors (musculoskeletal and mental), 2) working patterns, 3) work-family balance, 4) work situations, and 5) self-rated health.MethodsThe sampling frame was a list of apartment and general survey zones, excluding islands, dormitories, special social facilities, tourist hotels, and foreigner zones, among the total survey zones of the 2010 Population and Housing Census. The KWCS was given to 50,205 participants of various occupations, and responses from 494 RNs, 201 NAs, and 505 caregivers were extracted to compare their 1) degree of exposure to work-related risk factors (musculoskeletal and mental), 2) working pattern, 3) work-family balance, 4) work situations, and 5) self-rated health.ResultsThe response rate was 0.449. There were significant differences in all the variables (exposure to musculoskeletal and mental work-related risk factors, working pattern, work-family balance, work situations, self-rated health, and satisfaction with working conditions) among RNs, NAs, and caregivers (p < 0.001). The degree of work-related musculoskeletal and mental risk exposure was higher among caregivers and RNs than among NAs; irregular working patterns, challenges with work-family balance, and work environment satisfaction were higher among caregivers than among NAs. In addition, work situations were poorer among caregivers and NAs than among RNs. Self-rated health was the highest among caregivers, followed by RNs and NAs. The most potent predictor of self-rated health was occupation, followed by work environment satisfaction and work-family balance; the most potent predictor of work environment satisfaction was self-rated health, followed by degree of exposure to work-related musculoskeletal and mental risk factors, occupation, work-family balance, work situation, and working patterns.ConclusionThis study confirmed that a variety of factors influence work environment satisfaction. Thus, practical and realistic measures to improve work environments tailored to each healthcare occupation should be developed at the national and community levels. Further qualitative studies are needed to analyze the work environments of nurses and other care workers in depth.

Understanding person-centered dementia care from the perspectives of frontline staff: Challenges, opportunities, and implications for countries with limited long-term care resources.

Semi-skilled or unskilled nursing care aides primarily provide direct care to residents in long-term care (LTC) facilities in China and many other countries around the world. There has been a significantly increased commitment from nurses and other formally trained professionals to provide person-centered care (PCC) for people with dementia (PwD). However, it is still unclear how nursing care aides who provide direct care to older residents with dementia understand and adopt PCC in their daily work. It is of utmost importance to understand person-centered dementia care from the perspectives of care aides, and to identify implications to facilitate and sustain their efforts in providing quality care for older residents with dementia. We adopted a descriptive qualitative approach and interviewed 40 care aides from 5 nursing homes in China. The interview methods followed the consolidated criteria for a qualitative research report. We found that the seemingly beneficial mental models used by care aides in their work can hinder them from playing a more adaptive role in tailoring their care to the needs of older residents. Infantilizing older residents with dementia and labeling them using mother wit can prevent meaningful, equal, and person-centered conversations between both parties. Care aides do not have regular formal interactions and sense making with nurses and other professionals in nursing homes. Increasing interactions and communication between care aides and health care professionals in nursing homes can lead to insight for changing the approach to in-service training to achieve better acceptance by care aides. The current study derives implications for operationalizing and embedding the principles of PCC in daily care.

Improving Hourly Rounding on an Orthopaedic/Trauma Unit.

Hourly rounding impacts multiple patient care outcomes. The task of rounding has several obstacles and is made more time-consuming by donning and doffing protective personal equipment kits, especially in the setting of the COVID-19 pandemic. To improve the frequency of hourly rounding performance on the unit, nurses and unlicensed assistive personnel on an orthopaedic/trauma unit at an academic hospital in the Midwest United States were introduced to potential interventions in several PDSA (Plan-Do-Study-Act) cycles using quality improvement methodology. Methods included chart auditing, repetitive interventions designed by evaluating previous iterations, creation of educational material, and changing unit policy by communication during unit huddle. Results found a 10-percentage point improvement of hourly rounding compliance, from 77.3% to 87.3%, with use of a "redline" policy for isolation precautions. The policy implementation was a success. Future research may consider the expansion of this policy to other units.

Effect of Medicaid Expansion on Health Insurance for Low-Income Nursing Home Aides.

We examine how the Affordable Care Act Medicaid expansion affected the insurance coverage and the sources of coverage among low-income nursing home aides using the 2010-2019 American Community Survey data. Insurance coverage for low-income nursing home aides increased from about 60% to nearly 90% in expansion states but rose to only about 80% in nonexpansion states. Using a difference-in-differences regression design, we find that Medicaid expansion was associated with a 5.1 percentage-point increase in overall insurance coverage. Expansion states had a 12.2 percentage-point gain in Medicaid that was partially offset by a 6.4 percentage-point reduction in private insurance coverage. Our results show that ACA Medicaid expansion increased insurance coverage for low-income nursing home aides; however, there was substantial crowd-out of private insurance coverage in this population. Policymakers should consider expanding Medicaid while incentivizing affordable private health insurance options for low-income nursing home aides to improve insurance coverage.

Unlicensed assistive personnel in ambulatory care: A systematic integrative review.

In Brief Researchers aimed to identify current practices within the ambulatory care setting for using unlicensed assistive personnel (UAP) and features of successful implementations of UAP roles in ambulatory care settings. Results indicated that using a systematic framework can help standardize expectations for UAP. Ensuring adequate training and competency verification and a shared understanding of the UAP role are critical to success.

Patient-reported outcomes in a linguistically diverse cancer population: Addressing barriers to access.

168 Background: The census metropolitan area served by BC Cancer is Vancouver which has a population of 2.4 million. Census Canada noted the mother tongue learned in childhood and still spoken was: 54% English, 17% Indo-European, 16% Chinese, 10% Indo-Iranian, 3% English+other language, 2% other. At BC Cancer, implementation of patient reported outcomes (PROs) was launched 1 year ago with consideration of preferred language. Our goal was to examine the implementation of PROs with respect to equity of access and language preferences. Methods: BC Cancer Vancouver implemented PROs including the Edmonton Symptom Assessment Scale Revised, Canadian Problem Checklist and EQ5D in April 2021 using a web-based platform. A 1-year cohort was reviewed for patients’ mother tongue and the language used for the PROs. Qualitative interviews were undertaken for non-English mother tongue patients to ask for preferred language of PROs and reasons for the choice if mother tongue was not selected. Results: 86 patients were enrolled in the PRO program. Baseline characteristics: 66% female, age 30% &lt; 60/ 31% 60-69/ 39% &gt;70, primary site 54% lung/ 34% colorectal/ 18% other. Ethnic origin: 53% North American and European, 40% East and Southeast Asian, 2% Latin/Central and South American, 3% South Asian, 1% Indigenous, 1% other. Mother tongue: 52% English, 48% non-English (39% English proficient, 9% low English proficiency). Patient preferred language for PROs: 81% English, 11% Chinese, 7% other. Reasons for non-English mother tongue preference for English language included comfort with written English, use of family assistance completing questionnaires for both language and familiarity with electronic devices. Conclusions: In the Vancouver linguistically diverse cancer population, the majority of patients preferred English language PROs. Reasons for this include proficiency in the written language and the use of family members to complete the questionnaires. With 39% of patients over the age of 70 in our study, the use of electronic devices for completion may have introduced an additional barrier to access. In clinic iPad questionnaires with nursing and care aide support have been introduced to help address this gap. Clinical trial information: NCT05057234.

The Effect of Nurse Aide Retention on Ohio's Nursing Home Resident Care Experience Scores: A Facility-Level Analysis.

This study examined whether certified nurse aide (CNA) retention was positively related to nursing home (NH) resident care experiences at the organizational-level. The 2017 Ohio Biennial Survey of Long-Term Care Facilities and the 2017 Ohio Nursing Home Resident Satisfaction Survey provided the key variables. Quartiles of CNA retention (0-48%, 49-60%, 61-72%, 73-100%) were created from the analysis sample (N = 667). Regression analyses clustered NHs within counties and controlled for structural characteristics, financial resources, empowered managers, resilience, quality of work-life, resident, and community characteristics. NHs in Quartile 3 of CNA retention had higher environment scores by 1.36 percentage points compared to Quartile 1 (p < .05). NHs in Quartile 4 had lower facility culture scores by 1.31 percentage points than NHs in Quartiles 1-3 (p < .05); this pattern repeated when Quartiles 3 and 4 were compared on other outcomes. Future research should explore NHs with very high CNA retention to improve understanding of the measure.

Work Stress and Willingness of Nursing Aides during the COVID-19 Pandemic.

Objectives: During the coronavirus disease 2019 (COVID-19) pandemic, nursing aides (NAs) experienced greater work stress than they do typically because they worked in highly contagious environments. This may have influenced their work morale and willingness to work, which can reduce patient satisfaction, influence their physical and mental health, and even endanger patient safety or cause medical system collapse. Design: A cross-sectional survey with a structured self-report questionnaire was conducted. Setting and Participants: 144 NAs from a medical center in Central Taiwan participated. Methods: We recruited NAs through convenience sampling to discuss their work stress, willingness to work, and patients’ satisfaction with them during the COVID-19 pandemic. Result: Of the 144 recruited NAs, 115 (79.9%) were women and 29 (20.1%) were men, and 89 (61.8%) had completed COVID-19 training courses. NAs with different work tenure lengths exhibited significant differences in work stress (p = 0.022), willingness to work (p = 0.029), and patient satisfaction (p = 0.029) scores during the pandemic. Conclusion: The study findings provide crucial data for the management of NAs during pandemics to prevent them from neglecting patients due to excessive work stress or losing their willingness to work, which may cause the medical system to collapse.

Validating a Questionnaire Assessing Knowledge, Attitude and Performance of Nurse Aids and Service Staff in regard to Nosocomial Infections

Validating a Questionnaire Assessing Knowledge, Attitude and Performance of Nurse Aids and Service Staff in regard to Nosocomial Infections

Predictors of patient safety activities among registered nurses and nurse aides in long-term care facilities: cross-sectional study

BackgroundIn Korea, nurse aides (NAs) are legally permitted as substitutes for registered nurses (RNs) in long-term care (LTC) facilities, even though they have very different levels of education and qualification standards. Many studies in hospitals have shown better hospital nurse staffing, more educated nurses, and improved nurse work environments have been associated with lower hospital mortality and length of stay. There is research showing that a higher percentage of RNs with a bachelor’s degree corresponded to lower incidence rates of pressure ulcers in Korean LTC facilities. This study aimed to explore the factors that influence patient safety activities of the RNs and NAs working in LTC facilities and to identify the relationship between patient safety culture (PSC) and patient safety activities.MethodsThis study is a descriptive cross-sectional survey. The study participants were conveniently collected from 88 RNs and 71 NAs who worked at 33 LTC facilities for more than three months. The patient safety activities tool was developed by the researchers for residents of LTC facilities based on the tools developed by Park et al. (2012) for hospital nurses and the patient safety goals of the Joint Commission. The questionnaires were collected by email or mobile application and kept confidential. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression analysis.ResultsThe mean scores of PSC and patient safety activities were 4.03 ± 0.51 points and 4.29 ± 0.49 points out of 5, respectively. There was significant correlation between PSC and patient safety activities (r = .23, p = .004). Factors influencing patient safety activities among RNs and NAs in LTC facilities were RNs (β = .377, p < .001), organizational system of PSC (β = .314, p < .010), and work shift type (fixed night shift, on-call, 24-h shift) (β = -.264, p = .004), which explained about 36.0% of total variance (F = 5.69, p < .001).ConclusionThe findings indicate that it is necessary to mandate RNs instead of NAs to enhance residents’ safety in LTC facilities. Additionally, the importance of an organizational safety system and effective working shift types to prevent residents’ safety accidents in LTC facilities is indicated.

Effectiveness of Multimedia-Based Learning on the Improvement of Knowledge, Attitude, and Behavioral Intention toward COVID-19 Prevention among Nurse Aides in Taiwan: A Parallel-Interventional Study.

Because nurse aides are one of the first-line care providers in hospitals, they should possess better knowledge, attitude, and behavioral intention toward COVID-19 during the pandemic. This study aimed to compare the improvements of COVID-19-related education on learning outcomes between multimedia-based and traditional face-to-face learning models for nurse aides. The parallel-group randomized controlled trial recruited 74 participants in both the experimental and control groups. Two 90 min interventions with the same contents, but in different ways, were delivered. A structured questionnaire was used to collect data of demographic information, knowledge, attitude, and behavioral intention toward COVID-19 before and after the interventions. Results from generalized estimation equations analysis indicated that the nurse aides in the multimedia-based learning group had greater improvement in the scores of knowledge (difference in change: 3.2, standard error: 0.97, p < 0.001), attitude (difference in change: 10.2, standard error: 2.97, p < 0.001), and behavioral intention (difference in change: 0.5, standard error: 0.04, p < 0.001) than those in the face-to-face learning group. During the outbreak of COVID-19, multimedia-based learning as an effective learning method could improve the learning outcomes related to COVID-19 and achieve learning goals without close contact.

Understanding person-centered dementia care from the perspectives of frontline staff: Challenges, opportunities, and implications for countries with limited long-term care resources

Semi-skilled or unskilled nursing care aides primarily provide direct care to residents in long-term care (LTC) facilities in China and many other countries around the world. There has been a significantly increased commitment from nurses and other formally trained professionals to provide person-centered care (PCC) for people with dementia (PwD). However, it is still unclear how nursing care aides who provide direct care to older residents with dementia understand and adopt PCC in their daily work. It is of utmost importance to understand person-centered dementia care from the perspectives of care aides, and to identify implications to facilitate and sustain their efforts in providing quality care for older residents with dementia. We found that the seemingly beneficial mental models used by care aides in their work can hinder them from playing a more adaptive role in tailoring their care to the needs of older residents. Infantilizing older residents with dementia and labeling them using mother wit can prevent meaningful, equal, and person-centered conversations between both parties. Care aides do not have regular formal interactions and sensemaking with nurses and other professionals in nursing homes. Increasing interactions and communication between care aides and health care professionals in nursing homes can lead to insight for changing the approach to in-service training to achieve better acceptance by care aides. The current study derives implications for operationalizing and embedding the principles of PCC in daily care.

Participatory Development of an Image-Based Communication Aid for Migrant Patients and Emergency Nurses.

Language barriers hamper or delay delivery of urgent and emergency care to migrant children when they or their parents don't speak any of the languages commonly spoken in Switzerland. In such situations, nurses often fall back to use ad hoc communication aids, including translation apps and visual dictionaries, to collect information about a patient's medical history. In this paper, we report on the participatory design process for a novel image-based communication aid. It is specifically tailored to the needs of migrant patients and nurses within Swiss pediatric clinics. We collected requirements in surveys and in-depth interviews with pediatric nurses. A prototype app was developed and tested with users in a scenario-based usability test. The results clearly show that the images developed, especially for symptoms, accidents or nutrition and excretion, are well comprehensible for triage and anamnesis. In contrast, a temporal classification or chronological occurrence of health incidents is difficulty to express with images.

Working Dynamics of Licensed Nurses and Nurse Aides in Nursing Homes: A Scoping Review.

Collaboration between licensed nurses (LNs) and nurse aides (NAs) is critical in the provision of quality care for residents living in nursing homes (NHs). The current scoping review explores how working dynamics between LNs and NAs in the NH setting are researched and described in the literature. Thirty-five articles were identified and reviewed that address the LN/NA relationship in the context of (a) the LN role as a supervisor and leader; (b) variation in structure; (c) expanding, understanding, and supporting staff roles; and (d) communication. We found that the LN/NA relationship has been primarily explored through the LN lens and often studied in the context of role expansion and revision associated with new models of care. Our contribution to the literature includes the following main points: efforts to improve LN/NA collaboration may be hindered without substantial structural change; collaboration may be limited within the hierarchal LN/NA relationship; LNs and NAs in NHs need greater support, recognition, and empowerment; and NAs require a representative voice. [Journal of Gerontological Nursing, 48(5), 27-34.].

Reporting Incidents in the Psychiatric Intensive Care Unit: A Retrospective Study in an Italian University Hospital.

To evaluate the characteristics of the reported workplace violence in a psychiatric intensive care unit (PICU) by analyzing an electronic hospital incident reporting system (IRS). One hundred thirty reports were retrieved from January 2017 to June 2020, referring to assaults committed by patients (71% males) with an average age of 29.8 years (SD, 14.9). The most frequent psychiatric diagnosis was a neurodevelopmental disorder (33%). Physical aggression (84%) was more frequent than the other types of aggression. Nurses and unlicensed assistive personnel were the most frequent victims (65%). Aggressions were more frequent on Friday (18%) and between 4 p.m. and 8 p.m. (35%). A total of 64.9% of the incidents happened in the first 5 days of hospitalization. A significant association between physical aggression and diagnosis of neurodevelopmental disorder emerged. IRS could be helpful to identify high-risk patient groups and develop clinical strategies to reduce adverse events in clinical practice.

Nursing Activities and Job Satisfaction of the Licensed Practical Nurse Workforce in New Jersey

Background Licensed practical nurses (LPNs) are important members of the nursing workforce in the United States, particularly in long-term care and home care settings. A previous qualitative study found LPNs have expanded their role, yet detailed information about the nursing activities performed by LPNs is lacking in New Jersey (NJ). Purpose The purpose of this study was to describe current nursing activities and job satisfaction of LPNs in NJ and to determine whether there is a difference in the nursing activities and job satisfaction of LPNs working in nursing homes and those working in other settings. Methods For this descriptive, cross-sectional study, LPNs who had email addresses listed with the NJ Board of Nursing were sent a survey about their nursing activities and job satisfaction. Results The 804 LPNs who completed the survey were representative of the NJ LPN workforce. The top nursing activities that LPNs performed daily were documenting, providing basic nursing care, checking vital signs, and administering medications. LPNs working in nursing homes also identified supervising unlicensed assistive personnel as an additional top nursing activity. Many LPNs also reported independently performing comprehensive and focused assessments and formulating care plans. Compared with LPNs working in other settings, LPNs working in nursing homes had less job satisfaction. Conclusion Our findings reveal that LPN scope of practice has increased, and some LPNs are functioning beyond their scope of practice. With a shared agenda, nurse leaders in practice, academe, trade organizations, and regulatory bodies should convene to discuss and ensure a clear understanding of the LPN role and scope of practice. Licensed practical nurses (LPNs) are important members of the nursing workforce in the United States, particularly in long-term care and home care settings. A previous qualitative study found LPNs have expanded their role, yet detailed information about the nursing activities performed by LPNs is lacking in New Jersey (NJ). The purpose of this study was to describe current nursing activities and job satisfaction of LPNs in NJ and to determine whether there is a difference in the nursing activities and job satisfaction of LPNs working in nursing homes and those working in other settings. For this descriptive, cross-sectional study, LPNs who had email addresses listed with the NJ Board of Nursing were sent a survey about their nursing activities and job satisfaction. The 804 LPNs who completed the survey were representative of the NJ LPN workforce. The top nursing activities that LPNs performed daily were documenting, providing basic nursing care, checking vital signs, and administering medications. LPNs working in nursing homes also identified supervising unlicensed assistive personnel as an additional top nursing activity. Many LPNs also reported independently performing comprehensive and focused assessments and formulating care plans. Compared with LPNs working in other settings, LPNs working in nursing homes had less job satisfaction. Our findings reveal that LPN scope of practice has increased, and some LPNs are functioning beyond their scope of practice. With a shared agenda, nurse leaders in practice, academe, trade organizations, and regulatory bodies should convene to discuss and ensure a clear understanding of the LPN role and scope of practice.

MINA: A Robotic Assistant for Hospital Fetching Tasks

In this paper, a robotic Multitasking Intelligent Nurse Aid (MINA) is proposed to assist nurses with everyday object fetching tasks. MINA consists of a manipulator arm on an omni-directional mobile base. Before the operation, an augmented reality interface was used to place waypoints. Waypoints can indicate the location of a patient, supply shelf, and other locations of interest. When commanded to retrieve an object, MINA uses simultaneous localization and mapping to map its environment and navigate to the supply shelf waypoint. At the shelf, MINA builds a 3D point cloud representation of the shelf and searches for barcodes to identify and localize the object it was sent to retrieve. Upon grasping the object, it returns to the user. Collision avoidance is incorporated during the mobile navigation and grasping tasks. We performed experiments to evaluate MINA’s efficacy including with obstacles along the path. The experimental results showed that MINA can repeatedly navigate to the specified waypoints and successfully perform the grasping and retrieval task.