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Evaluating nonphysician staff members' self-perceived ability to provide multisource evaluations of residents.

ABSTRACT: BACKGROUND: Multisource evaluations of residents offer valuable feedback, yet there is little evidence on the best way to collect these data from a range of health care professionals. OBJECTIVE: This study evaluated nonphysician staff members' ability to assess internal medicine residents' performance and behavior, and explored whether staff members differed in their perceived ability to participate in resident evaluations. METHODS: We distributed an anonymous survey to nurses, medical assistants, and administrative staff at 6 internal medicine residency continuity clinics. Differences between nurses and other staff members' perceived ability to evaluate resident behavior were examined using independent t tests. RESULTS: The survey response rate was 82% (61 of 74). A total of 55 respondents (90%) reported that it was important for them to evaluate residents. Participants reported being able to evaluate professional behaviors very well (62% [36 of 58] on the domain of respect to staff; 61% [36 of 59] on attire; and 54% [32 of 59] on communication). Individuals without a clinical background reported being uncomfortable evaluating medical knowledge (60%; 24 of 40) and judgment (55%; 22 of 40), whereas nurses reported being more comfortable evaluating these competencies. Respondents reported that the biggest barrier to evaluation was limited contact (86%; 48 of 56), and a significant amount of feedback was given verbally rather than on written evaluations. CONCLUSIONS: Nonphysician staff members agree it is important to evaluate residents, and they are most comfortable providing feedback on professional behaviors. A significant amount of feedback is provided verbally but not necessarily captured in a formal written evaluation process.

SUBMITTER: Nikels SM

PROVIDER: S-EPMC3613321 | biostudies-other | 2013 Mar

REPOSITORIES: biostudies-other

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Project description:In the Seattle, Washington metropolitan area, where the first case of novel coronavirus 2019 disease (COVID-19) in the United States was reported (1), a community-level outbreak is ongoing with evidence of rapid spread and high morbidity and mortality among older adults in long-term care skilled nursing facilities (SNFs) (2,3). However, COVID-19 morbidity among residents of senior independent and assisted living communities, in which residents do not live as closely together as do residents in SNFs and do not require skilled nursing services, has not been described. During March 5-9, 2020, two residents of a senior independent and assisted living community in Seattle (facility 1) were hospitalized with confirmed COVID-19 infection; on March 6, social distancing and other preventive measures were implemented in the community. UW Medicine (the health system linked to the University of Washington), Public Health - Seattle & King County, and CDC conducted an investigation at the facility. On March 10, all residents and staff members at facility 1 were tested for SARS-CoV-2, the virus that causes COVID-19, and asked to complete a questionnaire about their symptoms; all residents were tested again 7 days later. Among 142 residents and staff members tested during the initial phase, three of 80 residents (3.8%) and two of 62 staff members (3.2%) had positive test results. The three residents had no symptoms at the time of testing, although one reported an earlier cough that had resolved. A fourth resident, who had negative test results in the initial phase, had positive test results 7 days later. This resident was asymptomatic on both days. Possible explanations for so few cases of COVID-19 in this residential community compared with those in several Seattle SNFs with high morbidity and mortality include more social distancing among residents and less contact with health care providers. In addition, early implementation of stringent isolation and protective measures after identification of two COVID-19 cases might have been effective in minimizing spread of the virus in this type of setting. When investigating a potential outbreak of COVID-19 in senior independent and assisted living communities, symptom screening is unlikely to be sufficient to identify all persons infected with SARS-CoV-2. Adherence to CDC guidance to prevent COVID-19 transmission in senior independent and assisted living communities (4) could be instrumental in preventing a facility outbreak.

Project description:Long-term care facility (LTCF) residents are at particularly high risk for morbidity and mortality associated with infection with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), given their age and high prevalence of chronic medical conditions, combined with functional impairment that often requires frequent, close contact with health care providers, who might inadvertently spread the virus to residents (1,2). During March-May 2020 in Fulton County, Georgia, >50% of COVID-19-associated deaths occurred among LTCF residents, although these persons represented <1% of the population (3,4). Mass testing for SARS-CoV-2 has been an effective strategy for identifying asymptomatic and presymptomatic infections in LTCFs (5). This analysis sought to evaluate the timing at which mass testing took place in relation to the known presence of a COVID-19 infection and the resulting number of infections that occurred. In 15 LTCFs that performed facility-wide testing in response to an identified case, high prevalences of additional cases in residents and staff members were found at initial testing (28.0% and 7.4%, respectively), suggesting spread of infection had already occurred by the time the first case was identified. Prevalence was also high during follow-up, with a total of 42.4% of residents and 11.8% of staff members infected overall in the response facilities. In comparison, 13 LTCFs conducted testing as a preventive strategy before a case was identified. Although the majority of these LTCFs identified at least one COVID-19 case, the prevalence was significantly lower at initial testing in both residents and staff members (0.5% and 1.0%, respectively) and overall after follow-up (1.5% and 1.7%, respectively). These findings indicate that early awareness of infections might help facilities prevent potential outbreaks by prioritizing and adhering more strictly to infection prevention and control (IPC) recommendations, resulting in fewer infections than would occur when relying on symptom-based screening (6,7).

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Evaluating nonphysician staff members' self-perceived ability to provide multisource evaluations of residents.

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