Distance learning: A strategy for improving incontinence care in nursing homes
ABSTRACT This article describes a distance learning model designed to help nursing homes implement incontinence management best practices. A basic premise is that translating research into practice requires both a feasible intervention and a dissemination strategy responsive to the target audience's needs.
Over 8 months, nurse supervisors from 14 nursing homes in nine states learned how to implement prompted voiding during monthly 60- to 90-min teleconferences. Supervisors completed field assignments that required them to implement prompted voiding. Descriptive evaluation data were collected using a resident data form, pre- and posttraining quizzes, and a project evaluation survey.
Nursing home staff attended an average of 6.5 teleconferences; on average, three staff members typically attended each teleconference. Eighty-nine percent of all survey respondents (N = 28) reported that they (a) would participate in a similar project and (b) would recommend the course to colleagues. Average scores on the quiz increased 16% (p < .05) from pre- to posttraining. Collectively, participating facilities assessed a total of 261 incontinent residents and reported maintaining 117 (44.8%) on prompted voiding, for an average of 10 residents per facility.
The intervention implementation results were promising for a management strategy often described as challenging to maintain. The distance learning model worked as expected. Given its strengths and relatively few weaknesses, it appears to be a feasible, effective, and low-cost strategy for translating research into nursing home practice.
Conference Paper: Technology modeling for emerging SOI devices[Show abstract] [Hide abstract]
ABSTRACT: New physical models, algorithms, and parameters are needed to accurately model emerging silicon-on-insulator (SOI) devices. We discuss key modeling tools and methodologies used to support research, development, and manufacturing of emerging SOI device technology. Although commercial TCAD tools are available, new physical models, parameters, and algorithms are needed to study these novel device structures.Simulation of Semiconductor Processes and Devices, 2002. SISPAD 2002. International Conference on; 02/2002
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ABSTRACT: A comprehensive multilevel intervention was tested to build organizational capacity to create and sustain improvement in quality of care and subsequently improve resident outcomes in nursing homes in need of improvement. Intervention facilities (N = 29) received a 2-year multilevel intervention with monthly on-site consultation from expert nurses with graduate education in gerontological nursing. Attention control facilities (N = 29) that also needed to improve resident outcomes received monthly information about aging and physical assessment of elders. The authors conducted a randomized clinical trial of nursing homes in need of improving resident outcomes of bladder and bowel incontinence, weight loss, pressure ulcers, and decline in activities of daily living. It was hypothesized that following the intervention, experimental facilities would have higher quality of care, better resident outcomes, more organizational attributes of improved working conditions than control facilities, higher staff retention, similar staffing and staff mix, and lower total and direct care costs. The intervention did improve quality of care (P = .02); there were improvements in pressure ulcers (P = .05) and weight loss (P = .05). Organizational working conditions, staff retention, staffing, and staff mix and most costs were not affected by the intervention. Leadership turnover was surprisingly excessive in both intervention and control groups. Some facilities that are in need of improving quality of care and resident outcomes are able to build the organizational capacity to improve while not increasing staffing or costs of care. Improvement requires continuous supportive consultation and leadership willing to involve staff and work together to build the systematic improvements in care delivery needed. Medical directors in collaborative practice with advanced practice nurses are ideally positioned to implement this low-cost, effective intervention nationwide.Journal of the American Medical Directors Association 08/2011; 13(1):60-8. DOI:10.1016/j.jamda.2011.06.012 · 4.78 Impact Factor
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ABSTRACT: This article describes and evaluates a long distance coaching course aimed at improving nutritional care in nursing homes (NHs). The course was structured to provide more support than traditional training programs offer. Methods: In a series of 6 monthly teleconferences led by an expert in NH nutritional care, participating NH staff received step-by-step instructions for implementing an evidence-based nutritional management program. After each session, participants were asked to implement the care step they had just learned. Coaching calls helped facilitate implementation. Staff in 18 NHs in 12 states completed the course. Evaluation data were collected using a resident data form, pre- and post-training quizzes, a participant course evaluation survey, and a supervisor's report. NH staff attended an average of 4.8 teleconferences, with 5 staff members typically attending each teleconference. Average quiz scores increased 30% (p < .0001) from pre- to post-training. A majority of course participants (N = 35) said they would participate in a similar course (82.9%) and would recommend the course (80%). Just under half preferred the coaching course to a more traditional 1- to 2-day conference. Nine of 12 reporting supervisors said their facility planned to continue the new nutritional care program. The 10 NHs that submitted resident data assessed an average of 5 residents using the recommended protocols. We recommend the coaching course format. Dissemination outcomes may improve if resources currently used for short-duration training activities are used instead on coaching activities that support NHs over extended periods.The Gerontologist 11/2011; 52(4):571-80. DOI:10.1093/geront/gnr111 · 3.21 Impact Factor