Workers In Long-term Care Facilities Research Articles

Ethical Influence of Fall Prevention Sensors on Older Adults, their Families, Nurses and Care Workers in Long-term Care Facilities

Ethical Influence of Fall Prevention Sensors on Older Adults, their Families, Nurses and Care Workers in Long-term Care Facilities

Seroprevalence of SARS-CoV-2 infection among residents and workers of long-term care facilities in Ribeirão Preto, Brazil: an epidemiological survey

OBJECTIVE: Residents and workers in long-term care facilities (LTCF) for older adults share the same space, and residents are more susceptible to COVID-19 complications. The aim of this study was to determine the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies as an indication of previous infection of both residents and workers in LTCFs, as well as associated factors. METHODS: This epidemiological survey was conducted in Ribeirão Preto, Brazil, a medium-sized city. Stratified sampling was performed, with data collected on demographics, health, LTCF protective measures, activities of daily living, and cognition. A serological test was carried out on all selected individuals. RESULTS: The mean resident and worker ages were 80.62 (SD, 9.66) and 37.41 (SD, 12.42) years, respectively. The serological test was positive in 13.33% of the residents, who had 2.91 (SD, 1.28) chronic diseases and used 5.65 (SD, 2.79) medications. Dementia screening was negative in only 11.1%, and only 20% were independent in activities of daily living. The serological test results were positive in 25.93% of the workers, although SARS-CoV-2 had been previously detected in only 6.9%. The LTCF did not perform systematic screening of worker respiratory symptoms. CONCLUSIONS: There was a higher seroprevalence of SARS-CoV-2 among LTCF workers than residents. Systematic screening of worker symptoms before each shift was not regularly performed. The high prevalence of cognitive changes among LTCF residents can impede adherence to personal protection measures.

The Effect of National Weekly COVID-19 Screening Testing of All Workers in Long-Term Care Facilities: A Decrease in Mortality

Background: Outbreaks of Coronavirus 2019 (COVID-19) in Long-Term Care Facilities (LTCFs) have resulted mainly from disease transmission by asymptomatic health care workers (HCW's). It is not known whether routine COVID-19 screening tests carried out on HCW's would reduce mortality of LTCF residents. Since mid-July 2020, the Israeli national LTCF defense program – "Senior Shield" - has used weekly COVID-19 PCR tests on all LTCF employees. Methods: A nationwide, government funded, screening program on all LTCF personnel for four months during the second COVID-19 wave. We evaluated differences between the two waves in the national LTCF's system with regard to hospitalizations and mortality. Estimation of national health system predicted outcomes, in the absence of this weekly screening plan, was calculated. Findings: COVID-19 tests were taken weekly in all 1,107 LTCFs which includes 62,159 HCWs and 100,046 residents. A median of 55,282 (range – 16,249) tests were performed each week. Turnaround time from sampling to result was less than 24 hours in 95% of tests. Compared to the first wave, in which 45.3% of national mortality was attributed to the LTCF's, the second wave saw a 33.8% reduction in this mortality ratio. Estimation of national health system outcomes during the second wave showed that the activation of the screening program reduced hospital load by 35% and prevented 30% of national mortality from COVID-19.Interpretation: Routine weekly COVID-19 PCR testing of all LTCF employees may reduce national hospitalizations and mortality.Funding Statement: None to declare. Declaration of Interests: None to declare.Ethics Approval Statement: The study was determined to be exempt by the Institutional Review Board of Soroka University Medical Center and thus informed consent was not required (0429-20-SOR).

Effectiveness of BNT162b2 mRNA COVID-19 Vaccine Against Acquisitions of SARS-CoV-2 Among Health Care Workers in Long-Term Care Facilities: A Prospective Cohort Study

Background: We assessed vaccine effectiveness (VE) of BNT162b2 mRNA COVID-19 vaccine against SARS-CoV-2 acquisition among health care workers (HCWs) of long-term care facilities (LTCFs).Methods: This prospective study, in the framework of "Senior Shield" program in Israel, included routine, weekly nasopharyngeal SARS-CoV-2 RT-PCR testing from all LTCF HCWs since July 2020. All residents and 75% of HCWs were immunized between December 2020 and January 2021. The analysis was limited to HCWs adhering to routine testing. Fully vaccinated (14+ days after second dose; n=6960) and unvaccinated HCWs (n=2202) were simultaneously followed until SARS-CoV-2 acquisition, or end of follow-up, April 11, 2021. Hazard ratios (HR) for vaccination vs. no vaccination were calculated (Cox proportional hazards regression models, adjusting for socio-demographics and residential-area COVID-19 incidence). VE was calculated as [(1– HR)×100]. RT-PCR cycle threshold values (Cts) were compared between vaccinated and unvaccinated HCWs.Findings: At >14 days post second dose, 40 vaccinated HCWs acquired SARS-CoV-2 (median follow-up, 66 days; cumulative incidence 0·6%) vs. 84 unvaccinated HCWs (median follow-up 43 days; cumulative incidence, 5·1%); HR=0·11 (95% CI 0·07, 0.17), unadjusted VE=89% (95% CI 83%, 93%). Adjusted VE beyond seven days and >14 days post second dose were similar. The median PCR Cts targeting ORF1ab gene among 20 vaccinated and 40 unvaccinated HCWs was 32·0 vs. 26·7, respectively, p=0·008.Interpretation: VE following two doses of BNT162b2 against SARS-CoV-2 acquisition in LTCF HCWs was high. The lower viral loads among SARS-CoV-2 positive HCWs suggests further reduction in transmission.Funding Information: The current study did not have external funding sources.Declaration of Interests: None.Ethics Approval Statement: The study protocol was approved by the institutional review board of the Soroka University Medical Center, Beer-Sheva, Israel.

Workers at long-term care facilities and their risk for severe COVID-19 illness

Given the high concentration of COVID-19 cases in long-term care (LTC) facilities in the United States, individuals working in these facilities are at heightened risk of SARS-CoV-2 exposure. Using data from the nationally-representative 2017 and 2018 National Health Interview Surveys on adults who reported working in LTC facilities, this study examines the extent to which LTC workers are also at increased risk or potentially at increased risk for severe illness from COVID-19 including hospitalization, intubation, or death. We used the Centers for Disease Control and Prevention's list of conditions placing individuals in these risk categories to the extent possible. We also examined the sociodemographic characteristics of LTC workers by occupation and COVID-19 illness severity risk status.One percent (552 out of 52,159) of the weighted NHIS sample worked in LTC facilities. Workers in LTC facilities were disproportionately Black, female, and low income. Half of LTC workers (50%) were at increased risk of severe illness from COVID-19 and another 19.6% were potentially at increased risk. There were few significant differences in demographic characteristics between risk groups, though those at increased risk had lower educational attainment and recent trouble affording prescription medications.Despite the high degree of vulnerability of both LTC residents and workers to severe illness from COVID-19, many LTC facilities still have inadequate supplies of personal protective equipment and COVID-19 tests. Given that state budget deficits due to the COVID-19 pandemic limit the potential for state actions, enhanced federal efforts are needed to protect LTC residents and staff from COVID-19.

Feasibility of a Mobile Meal Assistance Program for Direct Care Workers in Long-Term Care Facilities in South Korea.

PurposeThe purpose of this study was to assess the feasibility and examine the preliminary effectiveness of a mobile application-based meal assistant training program (APP) for use by direct care workers (CAs) assisting residents with dementia in long-term care facilities in South Korea.MethodsWe adopted a mixed methods research design, which included a pre- and post-intervention study and focus group interviews for the feasibility assessment. Participants included 23 dyads of older adults with dementia and their CAs from a long-term care facility in South Korea. Upon completion of the APP intervention, focused group interviews were conducted with six CAs and five nurses.ResultsThe results of paired t-tests showed that the effects of the APP intervention on the older adults with dementia and their CAs were not significant; however, the results of the focused group interviews support the potential usefulness of the APP for CAs.ConclusionThe APP may be applicable to long-term care workers who need meal assistant skills education.

Barriers to seasonal influenza vaccine uptake among health care workers in long-term care facilities: A cross-sectional analysis.

Objectives The vaccination of health care workers (HCWs) against influenza is recommended by numerous public health authorities. Despite these recommendations, the rate of vaccine uptake is poor, particularly among those working in long-term care. The current study aimed to use the theoretical domains framework to identify the barriers associated with influenza vaccine uptake among HCWs in long-term care facilities. Design The study employed a cross-sectional survey design. Methods HCWs (n=372) at 21 long-term care facilities in the west of Ireland completed a paper-based questionnaire, which assessed the socio-demographic and psychosocial determinants associated with HCW influenza vaccine uptake. Results Findings indicated that a logistic regression using the theoretical domains framework demonstrated a strong ability to correctly classify whether or not HCWs received the influenza vaccine. Significant predictors of receiving the vaccine were past vaccination (OR=16.16, 95% CI=5.52-47.34), Goals (OR=3.15, 95% CI=1.63-6.06), Intentions (OR=2.42, 95% CI=1.23-4.77), Social influences (OR=0.39, 95% CI=0.18-0.84), and Reinforcement (OR=0.46, 95% CI=0.21-0.98). Conclusions This research identified the key psychological determinants associated with HCW vaccine uptake. Interventions that target the theoretical domains, Goals, Intentions, Social influences, and Reinforcement, may enhance vaccine uptake among HCW in long-term care facilities. Statement of contribution What is already known on this subject? Seasonal influenza vaccine uptake among health care workers in long-term care settings is suboptimal. Many socio-demographic, psychosocial, and organizational barriers to vaccination have been identified. However, few studies have explored the barriers to vaccination among health care workers in long-term care settings within a behaviour change theory framework. What does this study add? This is the first study to apply the theoretical domains framework to vaccination behaviour. Health care worker vaccine uptake was associated with having previously received the vaccine and the domains Goals, Intentions, Social influences, and Reinforcement. The findings suggest that interventions that target these domains may increase vaccine uptake among health care workers in long-term care facilities. Possible interventions could include vaccination action planning and promoting vaccination as a positive act rather than a professional responsibility.

Integrated Literature Review of Infection Control of Nursing Care Workers in Long-term Care Facilities

Integrated Literature Review of Infection Control of Nursing Care Workers in Long-term Care Facilities

Relationships between social support, job autonomy, job satisfaction, and burnout among care workers in long-term care facilities in Hawaii

ABSTRACTThis study examined the effects of social support, job autonomy, and job satisfaction on burnout among long-term care workers in Hawaii, USA. Data were collected from 170 care workers working at long-term care facilities in Hawaii. The study variables included demographic data, burnout, social support, job autonomy, and job satisfaction. The study findings support the association between social support, job autonomy, job satisfaction, and burnout among care workers at long-term care facilities. Social support, job autonomy, and job satisfaction were negatively and significantly associated with the level of burnout of care workers in Hawaii. Furthermore, the findings suggest the need to develop policy and practice considerations for reducing burnout risks among care workers in order to improve quality of care.

The social integration of healthcare agency workers in long-term care facilities: A cross-sectional study

BackgroundPatient care quality is a key concern for long-term care facilities and is directly related to effective collaboration between healthcare professionals. The use of agency staff in long-term care facilities creates important challenges in terms of coordination and communication within work units. ObjectivesThe purpose of this study is to assess the mediating effect of common in-group identity in the relationship between permanent employees’ perceptions regarding the use of agency workers -namely distributive justice, perceptions of threat, perceived similarities with agency workers, and leader inclusiveness toward agency staff- and the permanent employees’ adoption of collaborative behaviours. DesignCross-sectional study. SettingsThree long-term care facilities. Participants290 regular healthcare employees (nurses and care attendants). MethodsData were obtained through questionnaires filled out by employees. Hypotheses were tested using structural equation analyses. ResultsThe results showed the indirect effects of perceived distributive justice, perceived similarity and leader inclusiveness toward agency workers on permanent employees’ cooperation behaviours through common group identification. Perceptions of threat were not related to common group identification or collaborative behaviours. The results also showed that common in-group identification is related to cooperation behaviours only for employees without previous experience as agency workers. ConclusionsThis study suggests that permanent healthcare employees who feel they are fairly compensated relative to agency workers, who consider these workers as similar to them, and who believe their supervisor appreciates agency workers’ contributions tend to develop a common in-group identity, which fosters collaborative behaviours. Managers of long-term care facilities who wish to foster collaboration among their blended workforce should thus create an environment conducive of a more inclusive identity, particularly if their employees have no previous experience as agency workers.

A Typology of Social Workers in Long-Term Care Facilities in Israel.

This article explores moral distress among long-term care facility (LTCF) social workers by examining the relationships between moral distress and environmental and personal features. Based on these features, authors identified a typology of LTCF social workers and how they handle moral distress. Such a typology can assist in the identification of social workers who are in a particular need for assistance. Overall, 216 LTCF social workers took part in the study. A two-step cluster analysis was conducted to identify a typology of LTCF social workers based on features such as ethical environment, support in workplace, mastery, and resilience. The variance of the identified clusters and their associations with moral distress were examined, and four clusters of LTCF social workers were identified. The clusters varied from each other in relation to their personal and environmental features and in relation to their experience of moral distress. The article concludes with a discussion of the importance of developing programs for LTCF social workers that provide support and enhancement of personal resources and an adequate and ethical environment for practice.

Development and content validation of a questionnaire to assess moral distress among social workers in long-term care facilities

ABSTRACTObjective: Despite the significance of ethical issues faced by social workers, research on moral distress among social workers has been extremely limited. The aim of the current study is to describe the development and content validation of a unique questionnaire to measure moral distress among social workers in long-term care facilities for older adults in Israel. Methods: The construction of the questionnaire was based on a secondary analysis of a qualitative study that addressed the moral dilemma of social workers in nursing homes in Israel. A content validation included review and evaluation by two experts, a cognitive interview with a nursing home social worker, and three focus groups of experts and the target population. Results: The initial questionnaire consisted of 25 items. After the content validation process the questionnaire in its final version, consisted of 17 items and included two scales, measuring the frequency of morally loaded events and the intensity of distress that followed them. Conclusions: We believe that the questionnaire can contribute by broadening and deepening ethics discourse and research, with regard to social workers’ obligation dilemmas and conflicts.

The Effect of Risk Management System and Safety Culture on the Safety Behavior of Care Workers in Long-term Care Facilities

The Effect of Risk Management System and Safety Culture on the Safety Behavior of Care Workers in Long-term Care Facilities

Psychometric testing of Korean versions of self-efficacy and outcome expectations for restorative care activities scales

This study aimed to examine the validity and reliability of Korean versions of the Nursing Assistant Self-Efficacy for Restorative Care Scale, and the Nursing Assistant Outcome Expectations for Restorative Care Scale. Psychometric testing was performed with 697 direct care workers in long-term care facilities in South Korea. Data were analyzed using SPSS/WIN 21.0, AMOS 22.0, and WINSTEPS 3.68.2. There was evidence for content validity. Factor loading in the Korean versions of the Nursing Assistant Self-Efficacy for Restorative Care Scale was 0.66–0.94, and Nursing Assistant Outcome Expectations for Restorative Care Scale was 0.43–0.77. Scores on the Korean versions of the Nursing Assistant Outcome Expectations for Restorative Care Scale correlated positively with scores on a scale of knowledge of restorative care. Additionally, Rasch model analysis of the K-NASERC and K-NAOERC indicates acceptable item data fit. These results indicated that the Korean versions of the Nursing Assistant Self-Efficacy, and Outcome Expectations for Restorative Care Scale are satisfactorily valid and reliable for the measurement.

Moral Distress Among Long-Term Care Social Workers

Objective: To describe the quantitative validation of a unique questionnaire to measure moral distress among social workers in long-term care facilities in Israel. Method: Overall, 216 long-term care facilities’ social workers took part in the pilot study that included psychometric evaluation and construct validation. Moral distress was examined by two scales, measuring the frequency and the intensity of morally loaded events. A third scale was created, representing the product of the frequency and intensity scores for each item separately. Results: Two items with high floor effect were removed. The internal reliability of each of the three Moral Distress Scales was .92. An exploratory factor analysis suggested a single-factor solution. The construct validity was approved. In its final version, the questionnaire consisted of 15 items. Conclusions: We believe that the questionnaire can contribute by broadening and deepening ethics discourse and research with regard to social workers’ moral conflicts and moral distress.

The impacts of job stress and supervision on burnout among care workers in long-term care facilities： Professional identity as a mediator

The impacts of job stress and supervision on burnout among care workers in long-term care facilities： Professional identity as a mediator

Diet Quality and Associated Factors Among Eldercare Workers in Long-Term Care Facilities

Background: Eldercare workers have a higher prevalence of poor health status, especially in terms of dietary behavior, than general workers. Therefore, the objective of this study was to investigate diet quality and related factors among eldercare workers in long-term care facilities. Methods: We conducted a cross-sectional study on 466 employees in seven long-term care facilities. All participants completed a brief food frequency questionnaire. Diet quality was assessed using three indexes: the American heart association healthy diet score (AHA-HDS), the world health organization healthy diet index (WHOHDI), and the Mediterranean diet score (MDS). Results: Eldercare workers had significantly lower AHA-HDS and MDS than general workers. Although no differences were seen between the two groups in WHO-HDI scores, a significant positive association was found between all three indexes and combined healthy lifestyle scores (sum of four items: no overweight/obesity, no smoking, adequate alcohol intake, and regular exercise). Conclusions: This is the first study to report that AHA-HDS and MDS are low in eldercare workers compared with general workers. Assessing dietary quality and improving adherence to healthier dietary patterns in eldercare workers could therefore be expected to aid health promotion.

Effect of an Education Presentation on the Knowledge and Awareness Of Urinary Tract Infection among Non-Licensed and Licensed Health Care Workers in Long-Term Care Facilities

This article presents the findings of a pre-test, post-test quality improvement project that describes the change in knowledge from prior to and following an evidence-based education presentation. The presentation addressed the clinical symptoms, diagnostic processes, interventions, and responsibilities of licensed and unlicensed health care workers employed in long-term care facilities related to prevention and detection of non-catheter-related urinary tract infections. Results indicate that the education presentation improved knowledge in specific.

Patient Safety Culture, Attitude Toward Falls, and Fall Prevention Activities of Care Workers in Long-term Care Facilities

Purpose: The aim of this study was to provide basic data for the improvement of patient safety by investigating the relationship among patient safety culture, attitude toward falls, and fall prevention activities of care workers in long-term care facilities. Methods: This study was a descriptive correlational research. Data were collected between August 9 and October 2, 2014 from 190 care workers in long-term care facilities in G, S, and W cities. A structured questionnaire which included patient safety culture, attitude toward falls, and fall prevention activities was used for data collection. Results: There were positive correlations between patient safety culture and attitude toward falls, and between patient safety culture and fall prevention activities. There was a statistically significant positive correlation between attitude toward falls and fall prevention activities. A more positive evaluation of level of safety management correlated with a positive attitude toward falls and high practice of fall prevention activities. Conclusion: Findings indicate that considering care workers’ careers, nurses should enhance patient safety education and establish a system that objectively evaluates patient safety management activity including fall prevention activities. 주요어: 요양기관, 요양보호사, í™˜ìžì•ˆì „, 낙상, 예방활동 Key Words: Nursing homes, Caregivers, Patient safety, Accidental falls, Accident prevention

장기요양시설 요양보호사의 구강건강관리에 대한 지식, 태도, 행동

The aim of this study was to assess the oral health knowledge, attitude and behavior among geriatric care workers in long-term care facilities. A self-administered questionnaire was obtained from 212 geriatric care workers attending a professional education program of 2014 dementia pilot project. The questionnaire consisted of 4 parts of the training experience (2 items), knowledge (16 items), attitude (13 items), and behavior (4 items) on oral health care. Collected data were analyzed by frequency analysis, independent t-test, and one-way ANOVA using SPSS Statistics ver. 20.0. The percentage of educational experience on oral care was 27.9% and most respondents answered that they have received the education about denture cleaning (98.3%) and brushing method (91.4%). The average knowledge score was , and respondents showed high-level agreement in 8 of the 10 items in attitude questions. They revealed difficulties in providing oral care to the elderly people because of their lack of knowledge. The deficiencies of knowledge about oral care would have a decisive effect on not only oral and general health, but also quality of life of the elderly people. Therefore, it is required to develop professional oral care training programs for geriatric care workers and support systems should be legalized.