Dataset Information

Use of Notification and Communication Technology (Call Light Systems) in Nursing Homes: Observational Study.

ABSTRACT:

Background

The call light system is one of the major communication technologies that link nursing home staff to the needs of residents. By providing residents the ability to request assistance, the system becomes an indispensable resource for patient-focused health care. However, little is known about how call light systems are being used in nursing homes and how the system contributes to safety and quality of care for seniors.

Objective

This study aimed to understand the experiences of nursing home staff who use call light systems and to uncover usability issues and challenges associated with the implemented systems.

Methods

A mix of 150 hours of hypothetico-deductive (unstructured) task analysis and 90 hours of standard procedure (structured) task analysis was conducted in 4 different nursing homes. The data collected included insights into the nursing home's work system and the process of locating and responding to call lights.

Results

The data showed that the highest alarm rate is before and after mealtimes. The staff exceeded the administration's expectations of time to respond 50% of the time. In addition, the staff canceled 10.0% (20/201) of call lights and did not immediately assist residents because of high workload. Furthermore, the staff forgot to come back to assist residents over 3% of the time. Usability issues such as broken parts, lack of feedback, lack of prioritization, and low or no discriminability also contributed to the long response time. More than 8% of the time, residents notified the staff about call lights after they waited for a long time, and eventually, these residents were left unattended.

Conclusions

Nursing homes that are still using old call light systems risk the continuation of usability issues that can affect the performance of the staff and contribute to declining staff and resident outcomes. By incorporating feedback from nurses, nursing home management will better understand the influence that the perceptions and usability of technology have on the quality of health care for their residents. In this study, it has been observed that the call light system is perceived to be an important factor affecting the outcomes of the care process and satisfaction of both residents and staff as well as the staff's performance. It is important to recognize that communication and notification technology contributes to the challenges the staff faced during their work, making their working conditions more difficult and challenging.

SUBMITTER: Ali H

PROVIDER: S-EPMC7148550 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Use of Notification and Communication Technology (Call Light Systems) in Nursing Homes: Observational Study.

Ali Haneen H Li Huiyang H

Journal of medical Internet research 20200327 3

<h4>Background</h4>The call light system is one of the major communication technologies that link nursing home staff to the needs of residents. By providing residents the ability to request assistance, the system becomes an indispensable resource for patient-focused health care. However, little is known about how call light systems are being used in nursing homes and how the system contributes to safety and quality of care for seniors.<h4>Objective</h4>This study aimed to understand the experien ...[more]

PMID: 32217497

Similar Datasets

Project description:Off-label antipsychotic prescribing in nursing homes (NHs) is common and is associated with increased risk of mortality in older adults. Prior large-scale, controlled trials in the NH setting failed to show meaningful reductions in antipsychotic use.To quantify the influence of a large-scale communication training program on NH antipsychotic use called OASIS.This investigation was a quasi-experimental longitudinal study of NHs in Massachusetts enrolled in the OASIS intervention. Participants were residents living in NHs between March 1, 2011, and August 31, 2013. The data were analyzed from December 2015, to March 2016, and from November through December 2016.The OASIS educational program targets all NH staff (direct care and nondirect care) using a train-the-trainer model. The program goals were to reframe challenging behaviors of residents with cognitive impairment as the communication of unmet needs, to train staff to anticipate resident needs, and to integrate resident strengths into daily care plans.This study used an interrupted time series model of facility-level prevalence of antipsychotic medication use, other psychotropic medication use (antidepressants, anxiolytics, and hypnotics), and behavioral disturbances to evaluate the intervention's effectiveness in participating facilities compared with control NHs in Massachusetts and New York. The 18-month preintervention (baseline) period was compared with a 3-month training period, a 6-month implementation period, and a 3-month maintenance period.This study included 93 NHs enrolled in the OASIS intervention (27 of which had a high prevalence of antipsychotic use) compared with 831 nonintervention NHs. Among OASIS facilities, prevalences of atypical antipsychotic prescribing were 34.1% at baseline and 26.5% at the study end (absolute reduction of 7.6% and relative reduction of 22.3%) compared with a drop of 22.7% to 18.8% in the comparison facilities (absolute reduction of 3.9% and relative reduction of 17.2%). In the OASIS implementation phase, NHs experienced a reduction in antipsychotic use prevalence among OASIS facilities (-1.20%; 95% CI, -1.85% to -0.09% per quarter) greater than that among non-OASIS facilities (-0.23%; 95% CI, -0.47% to 0.01% per quarter), resulting in a net OASIS influence of -0.97% (95% CI, -1.85% to -0.09%; P?=?.03). A difference in trend was not sustained in the maintenance phase (difference of 0.93%; 95% CI, -0.66% to 2.54%; P?=?.48). No increases in other psychotropic medication use or behavioral disturbances were observed.Antipsychotic use prevalence declined during OASIS implementation of the intervention, but the decreases did not continue in the maintenance phase. Other psychotropic medication use and behavioral disturbances did not increase. This study adds evidence for nonpharmacological programs to treat behavioral and psychological symptoms of dementia.

Project description:BackgroundFrail residents in the nursing home sector call for extra care in prescribing. The Norwegian General Practice Nursing Home (NORGEP-NH) list of 34 explicit criteria for potentially inappropriate medication use in nursing homes was developed explicitly for this population. The aim of this study was to employ the NORGEP-NH Criteria to study the extent of potentially inappropriate medication use among nursing home residents and explore possible associated factors.MethodsCross-sectional observational pharmacoepidemiological study from residents in nursing homes in the county of Vestfold, Norway. Data collected 2009-11 included residents' demographic and clinical status and all medications, regular and on demand.Results881 patients from 30 institutions (mean 85.9 years, 68.6% female), were included. According to NORGEP-NH, 43.8% were prescribed at least one potentially inappropriate regular medication, and 9.9% regularly received three or more potentially inappropriate medications. When also including a) the NORGEP-NH Deprescribing Criteria and b) including drugs prescribed for use as needed, 92.7% of all residents received medication that needs particular surveillance according to the NORGEP-NH. 69.7% of the nursing home residents used at least one psychotropic drug regularly. Female residents received more often than males at least one potentially inappropriate regular medication (OR 1.60, p=0.007). Regarding the prescription of three or more concomitant psychotropic medications, odds ratio for females was 1.79 (p=0.03) compared to males. Residents with the best performance in activities of daily living, and residents residing in long-term wards, had higher risk of using three or more psychotropic drugs. Use of multiple psychoactive drugs increased the risk of falls in the course of an acute episode of infection or dehydration (odds ratio 1.70, p=0.009).ConclusionsPrevalence of potentially inappropriate medications in nursing homes according to the NORGEP-NH was extensive, and especially the use of multiple psychotropic drugs. The high prevalence found in this study shows that there is a need for higher awareness of medication use and side effects in the elderly population.Trial registrationRetrospectively registered. Data obtained from clinical trial NCT01023763 registered with ClinicalTrials.gov 12/01/2009.

Project description:ImportanceControlling antimicrobial resistance in health care is a public health priority, although data describing antimicrobial use in US nursing homes are limited.ObjectiveTo measure the prevalence of antimicrobial use and describe antimicrobial classes and common indications among nursing home residents.Design, setting, and participantsCross-sectional, 1-day point-prevalence surveys of antimicrobial use performed between April 2017 and October 2017, last survey date October 31, 2017, and including 15 276 residents present on the survey date in 161 randomly selected nursing homes from selected counties of 10 Emerging Infections Program (EIP) states. EIP staff reviewed nursing home records to collect data on characteristics of residents and antimicrobials administered at the time of the survey. Nursing home characteristics were obtained from nursing home staff and the Nursing Home Compare website.ExposuresResidence in one of the participating nursing homes at the time of the survey.Main outcomes and measuresPrevalence of antimicrobial use per 100 residents, defined as the number of residents receiving antimicrobial drugs at the time of the survey divided by the total number of surveyed residents. Multivariable logistic regression modeling of antimicrobial use and percentages of drugs within various classifications.ResultsAmong 15 276 nursing home residents included in the study (mean [SD] age, 77.6 [13.7] years; 9475 [62%] women), complete prevalence data were available for 96.8%. The overall antimicrobial use prevalence was 8.2 per 100 residents (95% CI, 7.8-8.8). Antimicrobial use was more prevalent in residents admitted to the nursing home within 30 days before the survey date (18.8 per 100 residents; 95% CI, 17.4-20.3), with central venous catheters (62.8 per 100 residents; 95% CI, 56.9-68.3) or with indwelling urinary catheters (19.1 per 100 residents; 95% CI, 16.4-22.0). Antimicrobials were most often used to treat active infections (77% [95% CI, 74.8%-79.2%]) and primarily for urinary tract infections (28.1% [95% CI, 15.5%-30.7%]). While 18.2% (95% CI, 16.1%-20.1%) were for medical prophylaxis, most often use was for the urinary tract (40.8% [95% CI, 34.8%-47.1%]). Fluoroquinolones were the most common antimicrobial class (12.9% [95% CI, 11.3%-14.8%]), and 33.1% (95% CI, 30.7%-35.6%) of antimicrobials used were broad-spectrum antibiotics.Conclusions and relevanceIn this cross-sectional survey of a cohort of US nursing homes in 2017, prevalence of antimicrobial use was 8.2 per 100 residents. This study provides information on the patterns of antimicrobial use among these nursing home residents.

Project description:BackgroundPhysiotherapy can improve functional ability, prevent falls and reduce pain for older adults in nursing homes. However, there are no legislations or guidelines that specify the parameters of physiotherapy required in nursing homes. With the increasing healthcare demands of ageing populations worldwide, it is important to understand the current use of physiotherapy services to ensure they are both evidence-based and promote equity.Objectives(1) When and how are physiotherapy services used by older adults living in nursing homes? (2) What are the factors associated with use of physiotherapy services in nursing homes? (3) How are physiotherapy services in nursing homes documented and monitored?MethodsSeveral databases and grey literature (including MEDLINE, PubMed, Pedro and EMBASE) were searched following PRISMA guidelines in March 2018. Searches were limited to English language publications from 1997. Assessment for inclusion, data extraction and quality assessment were completed by two investigators independently using standardised forms. Studies were included if they considered any type of physiotherapy service that involved a qualified physiotherapist (such as exercise, massage and staff education) with older adults (aged 60 years and older) that were primarily permanent residents of a nursing home. Data extracted included proportion of clients that used physiotherapy services, type, frequency and duration of physiotherapy services, and factors associated with physiotherapy service use.ResultsEleven studies were included. Between 10% and 67% of nursing home clients used physiotherapy services. Factors associated with greater use of physiotherapy services included larger size facilities, and if clients had a physical impairment and mild or no cognitive impairment. Types of physiotherapy services reported were pain management and pressure ulcer management.ConclusionsPhysiotherapy service use in nursing homes varied widely. The development of physiotherapy benchmarks and quality standards are needed to support older adults in nursing homes. PROSPERO registration number: CRD42018082460.

Project description:BackgroundPolypharmacy and potentially inappropriate medications (PIMs) are still frequent among older adults in nursing homes. Deprescribing is an intervention that has been shown to be effective in reducing their use. However, the implementation of deprescribing in clinical practice has not yet been widely evaluated. The Quality Circle Deprescribing Module (QC-DeMo) intervention has been trialled through an effectiveness-implementation hybrid type 2 design. The intervention consists of a quality circle workshop session between healthcare professionals HCPs (physicians, nurses, and pharmacists) within a nursing home, in which they define a consensus to deprescribe specific PIMs classes. The aim of this study was to evaluate the implementation of the QC-DeMo intervention in nursing homes.MethodsThis observational study focuses on the implementation part of the QC-DeMo trial. Implementation was based on the Framework for Implementation of Pharmacy Services (FISpH). Questionnaires at baseline and follow-up were used to evaluate reach, adoption, implementation effectiveness, fidelity, implementation, maintenance and the implementation strategies. Other data were collected from the QC-DeMo trial and routine data collected as part of the integrated pharmacy service where the QC-Demo trial was embedded. Implementation strategies included training of pharmacists, integration of the intervention into an existing quality circle dynamic and definition of tailored strategies to operationalise the consensus by each nursing home.ResultsThe QC-DeMo intervention was successfully implemented in 26 nursing homes in terms of reach, fidelity, adoption, implementation and implementation effectiveness. However, the intervention was found to be implemented with low maintenance as none of the nursing homes repeated the intervention after the trial. Implementation strategies were well received by HCPs: training was adequate according to pharmacists. Pre-existing quality circle dynamic facilitated interprofessional collaboration as involvement and support of each HCP was rated as high. HCPs recognized a specific and important role for each HCP in the deprescribing process. The most relevant tailored strategies to implement the consensus defined by each nursing home were identification of the patients by the pharmacist and a systematic review of medication's patients.ConclusionsThe implementation of a Quality Circle on Deprescribing is feasible but its maintenance in practice remains challenging. This study explores multiple implementation outcomes to better inform future implementation efforts of these types of interventions.Trial registrationClinicalTrials.gov ( NCT03688542 ), registered on 26.09.2018.

Dataset Information

Use of Notification and Communication Technology (Call Light Systems) in Nursing Homes: Observational Study.

Background

Objective

Methods

Results

Conclusions

Publications

Use of Notification and Communication Technology (Call Light Systems) in Nursing Homes: Observational Study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets