Carole A Estabrooks

Carole A Estabrooks
University of Alberta | UAlberta · Faculty of Nursing

PhD

About

332
Publications
97,092
Reads
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13,677
Citations
Introduction
I am the principal investigator of the Translating Research in Elder Care (TREC) research program. TREC is focused on developing solutions for improving the quality of care provided to nursing home residents, enriching the work life of their caregivers, and enhancing system efficiency.
Additional affiliations
July 2005 - present
University of Alberta
Position
  • Professor (Full)

Publications

Publications (332)
Article
Full-text available
This study assessed individual and organizational context (work environment) factors that influence use of best practices by care aides (nursing assistants) in nursing homes. Little scientific attention has been focused on understanding best practice use in nursing homes and almost none on care aides. A total of 1262 care aides in 25 nursing homes...
Article
Full-text available
High-quality care at the end of life supports freedom from pain and other potentially burdensome symptoms. Lowering symptom burden at the end of life is an urgent and achievable goal in delivering services in nursing home settings. Few published reports describe symptom burden among older adults in nursing homes; none examine links between symptom...
Article
Full-text available
RÉSUMÉ Les personnes âgées recevant soins de longue durée ou soins infirmiers résidentiels ont des besoins de plus en plus complexes, y compris exhibitant plus de la démence que dans le passé, mais on ne connait que peu en ce qui concerne la population non réglementée qui fournit leurs soins. Nous avons interrogé 1 381 aides dans un échantillon rep...
Article
RÉSUMÉ Les maisons de soins infirmiers sont devenues des environnements offrant des soins complexes, dont les habitants ont des besoins importants et la plupart souffrent de la démence liée a l’âge. S’appuyant sur les recherches de Hirdes et al. (2011), nous décrivons un profil des résidents dans un échantillon représentatif de 30 maisons de soins...
Article
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In the past forty years, many gains have been made in our understanding of the concept of research utilization. While numerous studies exist on professional nurses' use of research in practice, no attempt has been made to systematically evaluate and synthesize this body of literature with respect to the extent to which nurses use research in their...
Article
Full-text available
Background Complex interventions are increasingly applied to healthcare problems. Understanding of post-implementation sustainment, sustainability, and spread of interventions is limited. We examine these phenomena for a complex quality improvement initiative led by care aides in 7 care homes (long-term care homes) in Manitoba, Canada. We report on...
Article
Background: Long-term care (LTC) residents frequently experience transitions in the location of more advanced care delivery, including receiving emergency department (ED) care. In this proof-of-concept study, we aimed to determine if we could identify measures in quality of care across transitions from LTC to the ED, via emergency medical services...
Article
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Background: Inappropriate health care leads to negative patient experiences, poor health outcomes and inefficient use of resources. We aimed to conduct a systematic review of inappropriately used clinical practices in Canada. Methods: We searched multiple bibliometric databases and grey literature to identify inappropriately used clinical practi...
Article
Background and Objectives When staff experience responsive behaviors from residents, this can lead to decreased quality of work-life and lower quality of care in long-term care homes. We synthesised research on factors associated with resident responsive behaviours directed towards care staff and characteristics of interventions to reduce the behav...
Article
Objectives Residents with cognitive impairment favor “slow care,” so rushed care may cause additional responsive behaviors (eg, verbal threats, hitting) among residents. We assessed the association of rushed care (physical and social) by care aides with their experiences of responsive behaviors from residents. Design Cross-sectional analysis of su...
Article
Full-text available
Background: The Translating Research in Elder Care (TREC) program is a partnered health services research team that aims to improve the quality of care and quality of life for residents and quality of worklife for staff in nursing homes. This team includes academic researchers, trainees, research staff, citizens (persons living with dementia and f...
Article
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Background Numerous studies have examined the efficacy and effectiveness of health services interventions. However, much less research is available on the sustainability of study outcomes. The purpose of this study was to assess the lasting benefits of INFORM (Improving Nursing Home Care Through Feedback On perfoRMance data) and associated factors...
Article
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Objectives Maximizing quality of life (QoL) is the ultimate goal of long-term dementia care. However, routine QoL measurement is rare in nursing home (NH) and assisted living (AL) facilities. Routine QoL measurement might lead to improvements in resident QoL. Our objective was to assess the feasibility of using DEMQOL-CH, completed by long-term car...
Article
Introduction Health care aides (personal support workers and nursing assistants) provide ~80%–90% of direct care to residents in nursing homes; it is therefore important to understand whether supervision of health care aides affects quality of care. We sought to determine whether health care aide reporting practices are associated with resident out...
Article
Purpose: Organizational context influences the effect of facilitation efforts on research use in care settings. The interactions of these factors are complex. Therefore, the use of traditional statistical methods to examine their interrelationships is often impractical. Big Data analytics can automatically detect patterns within the data. We appli...
Article
We identified quality indicators (QIs) for care during transitions of older persons (≥ 65 years of age). Through systematic literature review, we catalogued QIs related to older persons’ transitions in care among continuing care settings and between continuing care and acute care settings and back. Through two Delphi survey rounds, experts ranked r...
Article
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Background Fidelity in complex behavioural interventions is underexplored and few comprehensive or detailed fidelity studies report on specific procedures for monitoring fidelity. Using Bellg’s popular Treatment Fidelity model, this paper aims to increase understanding of how to practically and comprehensively assess fidelity in complex, group-leve...
Article
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Introduction Dementia is a public health issue and a major risk factor for poor quality of life among older adults. In the absence of a cure, enhancing health-related quality of life (HRQoL) of people with dementia is the primary goal of care. Robust measurement of HRQoL is a prerequisite to effective improvement. The DEMQOL suite of instruments is...
Article
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Objectives: To identify socially isolated long-term care residents and to compare their demographic characteristics, functional status, and health conditions to residents who are not isolated. Methods: We conducted a retrospective cohort study using the Resident Assessment Instrument, Minimum Data Set, 2.0 (RAI-MDS) data, from residents in 34 long-...
Article
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Residents of long-term care (LTC) whose deaths are imminent are likely to trigger a transfer to the emergency department (ED), which may not be appropriate. Using data from an observational study, we employed structural equation modeling to examine relationships among organizational and resident variables and death during transitions between LTC an...
Article
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Background: Fidelity in complex behavioral interventions is underexplored. This study examines the fidelity of the INFORM trial and explores the relationship between fidelity, study arm, and the trial's primary outcome-care aide involvement in formal team communications about resident care. Methods: A concurrent process evaluation of implementat...
Article
Full-text available
Background: Effective communication among interdisciplinary healthcare teams is essential for quality healthcare, especially in nursing homes (NHs). Care aides provide most direct care in NHs, yet are rarely included in formal communications about resident care (e.g., change of shift reports, family conferences). Audit and feedback is a potentiall...
Article
Full-text available
The Royal Society of Canada Task Force on COVID-19 was formed in April 2020 to provide evidence-informed perspectives on major societal challenges in response to and recovery from COVID-19. The Task Force established a series of working groups to rapidly develop policy briefings, with the objective of supporting policy makers with evidence to infor...
Article
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Background: The study purpose was to compare the effectiveness of monthly or quarterly peer reminder knowledge translation interventions, with monthly or quarterly paper-based reminders, to sustain a mobility innovation, the sit-to-stand activity. Method: A cluster RCT using a stratified 2 × 2 factorial design was conducted in 24 Canadian reside...
Article
Objectives: This study examined challenges experienced by long-term care staff in caring for unbefriended residents who are incapacitated and alone. These residents often are estranged from or have no living family or live geographically distant from them and require a public guardian as their surrogate decision-maker. To date, research on unbefri...
Article
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This article examines provincial policy influence on long-term care (LTC) professionals’ advice-seeking networks in Canada’s Maritime provinces. The effects of facility ownership, geography, and region-specific political landscapes on LTC best-practice dissemination are examined. We used sociometric statistics and network sociograms, calculated fro...
Article
Full-text available
Background: The Translating Research in Elder Care (TREC) program is a longitudinal partnered program of research in Western Canada that aims to improve the quality of care and quality of life for residents and quality of worklife for staff in long-term care settings. This program of research includes researchers, citizens (persons living with dem...
Article
Full-text available
Background: Research funders in Canada and abroad have made substantial investments in supporting collaborative research approaches to generating and translating knowledge as it is believed to increase knowledge use. Canadian health research funders have advocated for the use of integrated knowledge translation (IKT) in health research, however, t...
Preprint
Full-text available
Background Effective communication among interdisciplinary healthcare teams is essential for quality healthcare, especially in nursing homes (NHs). Care aides provide most direct care in NHs, yet are rarely included in formal communications about resident care (e.g., change of shift reports, family conferences). Audit and feedback is a potentially...
Preprint
Full-text available
Background: Effective communication among interdisciplinary healthcare teams is essential for quality healthcare, especially in nursing homes (NHs). Care aides provide most direct care in NHs, yet are rarely included in formal communications about resident care (e.g., change of shift reports, family conferences). Audit and feedback is a potentially...
Article
Objective: To evaluate the response process validity of the Resident Assessment Instrument-Minimum Data Set 2.0 (RAI) oral/dental items and the organisational processes for assessing nursing home (NH) residents' oral/dental status. Background: Although care aides provide most direct care to NH residents, including oral care, they are not directl...
Article
Full-text available
Importance In Canada, approximately 81% of residents of nursing homes live with mild to severe cognitive impairment. Care needs of this population are increasingly complex, but resources, such as staffing, for nursing homes continue to be limited. Staff risk missing or rushing care tasks and interfering with quality of care and life. Objective To...
Article
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Background: Hospitalized infants undergo multiple painful procedures daily. Despite the significant evidence, procedural pain assessment and management continues to be suboptimal. Repetitive and untreated pain at this vital developmental juncture is associated with negative behavioral and neurodevelopmental consequences. To address this knowledge...
Article
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Background: Implementation scientists and practitioners, alike, recognize the importance of sustaining practice change, however post-implementation studies of interventions are rare. This is a protocol for the Sustainment, Sustainability and Spread Study (SSaSSy). The purpose of this study is to contribute to knowledge on the sustainment (sustaine...
Article
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Multi-sectoral, interdisciplinary health research is increasingly recognizing integrated knowledge translation (iKT) as essential. It is characterized by diverse research partnerships, and iterative knowledge engagement, translation processes and democratized knowledge production. This paper reviews the methodological complexity and decision-making...
Article
Objective: To compare Resident Assessment Instrument-Minimum Data Set 2.0 (RAI) oral/dental items collected by nursing home (NH) care staff to (a) assessments collected by trained research assistants (RAs) and (b) "gold standard" clinical assessments by dental hygienists (DHs). Background: Routine collection of RAI oral/dental items is mandatory...
Article
Full-text available
Even though social isolation is a significant predictor of poor health and mortality in older adults, very little is known about social isolation in long-term care (LTC) settings. The aim of this study was to describe the prevalence, demographic characteristics, health outcomes, and disease diagnoses of residents without family contact in Alberta L...
Article
A population's health is dependent on the availability of skilled health professionals. We know little about retirement decision-making among publicly employed Canadian registered nurses (RNs) and allied health professionals (AHPs). We identified and compared factors reported to influence early versus 65+ retirement decisions among RNs (n = 794) an...
Conference Paper
NTRODUCTION: Availability of health professionals is fundamental to a population’s health. Despite shortages, we know little about retirement decision-making among publicly-employed, Canadian Registered Nurses (RNs) and allied health professionals (AHPs). Limited data on RN/AHP “supply” inhibits the effectiveness of health workforce planning. OBJEC...
Article
Aim: To identify demographic-, individual-, and organizational-level predictors of job satisfaction among managers in residential long-term care (LTC) facilities. Background: Job satisfaction predicts turnover among managers in LTC settings. However, factors affecting job satisfaction among LTC facility managers remain poorly understood. Method...
Article
Objectives: We examined demographic, individual, and organizational context factors associated with nurses' job satisfaction in residential long-term care (LTC) settings. Job satisfaction has implications for staff turnover, staff health, and quality of care. Design: A cross-sectional analysis of survey data collected in the Translating Research...
Article
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Background: Early retirement (before age 65) is the norm among registered nurses (RNs) and allied health professionals (AHPs) employed in Canada's public system. As a country whose population is rapidly aging, it is in Canada's best interest to try and extend the work lives of RNs and AHPs. Objectives: (1) To test the predictive validity of our...
Article
Full-text available
The objective of this study was to assess the prevalence of residents who are incapacitated and have no surrogate decision maker, known as the “unbefriended” in Alberta long-term care (LTC) homes. Using cross-sectional online survey methods, data were collected from 123 staff (i.e., directors of care/nursing, administrators) from Alberta LTC homes....
Chapter
This chapter describes 10 years of research into organizational context in residential long-term care (LTC) settings. It focuses on this book’s first and third questions: What constitutes context for an event, situation, or phenomenon? And how do contexts change, and what is the role of actors in such processes? Although with respect to change, it...
Article
Full-text available
Fusion validity assessments employ structural equation models to investigate whether an existing scale functions in accordance with theory. Fusion validity parallels criterion validity by depending on correlations with non-scale variables but differs from criterion validity because it requires at least one theorized effect of the scale, and because...
Article
A Profile of Regulated Nurses Employed in Canadian Long-Term Care Facilities—CORRIGENDUM - Volume 38 Issue 2 - Janet E. Squires, Jennifer Baumbusch, Melissa Demery Varin, Ibo MacDonald, Stephanie Chamberlain, Anne-Marie Boström, Genevieve Thompson, Greta Cummings, Carole A. Estabrooks
Article
Objectives: We examined the influence of individual characteristics and organizational context features on nurses' self-reported use of research evidence in long-term care (LTC) homes. Design: A cross-sectional analysis of survey data collected in the Translating Research in Elder Care program. Setting and participants: 756 nurses (registered...
Article
Full-text available
Introduction In the last decade, increasing research interest has been expressed in responsive behaviours of older adults living in long-term care (LTC) homes, including nursing homes and assisted living facilities. Responsive behaviours are not only a sign of underlying unmet needs, but when directed against (towards) paid staff can lead to decrea...
Article
Full-text available
RÉSUMÉ Le personnel infirmier autorisé (PIA) et les infirmiers auxiliaires (I aux ) fournissent le volet spécialisé des soins infirmiers dans les centres de soins de longue durée au Canada. Cependant, peu d’études se sont penchées sur cette main-d’œuvre importante. Une enquête a été réalisée chez 309 PIS et 448 I aux provenant de 91 centres pour pe...
Article
Objectives: To assess (1) temporal changes (2008-2015) in nursing home (NH) length of stay (LoS) in 3 Canadian health jurisdictions (Edmonton, Calgary, Winnipeg), (2) resident admission characteristics associated with LoS, and (3) temporal changes of admission characteristics in each of the 3 jurisdictions. Design: Retrospective cohort study usi...
Article
Full-text available
Background There is increasing recognition in Canada and globally that a substantial proportion of health care delivered is inappropriate as evidenced by (1) harmful and/or ineffective practices being overused, (2) effective clinical practices being underused, and (3) other clinical practices being misused. Inappropriate health care leads to negati...
Article
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Background Interpersonal relationships among professionals drive both the adoption and rejection of consequential innovations. Through relationships, decision-makers learn which colleagues are choosing to adopt innovations, and why. The purpose of our study was to understand how and why long-term care (LTC) leaders in a pan-Canadian interpersonal n...
Article
Objectives: This study explored the impact of being ‘unbefriended’ for residents in Canadian long-term care (LTC) homes. Residents are ‘unbefriended’ if they lack decision-making capacity and family or friends to act as their legal representative. Research suggests that unbefriended individuals may have unmet needs and experience poor quality of ca...
Article
Full-text available
Background Health care practice needs to be underpinned by high quality research evidence, so that the best possible care can be delivered. However, evidence from research is not always utilised in practice. This study used the Promoting Action on Research Implementation in Health Services (PARIHS) framework as its theoretical underpinning to test...
Article
Full-text available
Background:Health care practice needs to be underpinned by high quality research evidence, so that the best possible care can be delivered. However, evidence from research is not always utilised in practice. This study used the PromotingAction on Research Implementation in Health Services (PARIHS) framework as its theoretical underpinning to test w...
Article
Objective: For long-term care (LTC) residents, transfers to emergency departments (EDs) can be associated with poor health outcomes. We aimed to describe characteristics of residents transferred, factors related to decisions during transfer, care received in emergency medical services (EMS), ED settings, outcomes on return to LTC, and times of tra...