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OBJECTIVES To measure pressure ulcer quality indicator (QI) scores and to describe the self-reported skin integrity assessment, pressure ulcer risk assessment, and pressure ulcer prevention and treatment practices in long-term care facilities (LTCFs). DESIGN Retrospective analysis of a large data set and comparative survey. SETTING LTCFs in Missouri. (More)
OBJECTIVE This study sought to explore the relationship of workarounds related to the implementation of an electronic medication administration record and medication safety practices in five Midwestern nursing homes. DESIGN As a part of a larger study, this qualitative evaluation was conducted to identify workarounds associated with the implementation of(More)
TOPIC A culture of safety. PURPOSE To explore the current culture of blame and what organizational elements must be impacted to move toward a culture of safety in the nursing home setting. METHODS A mixed-method approach incorporating a case study and staff member survey results were used to explicate the organizational elements impacting the current(More)
PURPOSE We describe the development of a statewide strategy to improve resident outcomes in nursing facilities, and we present some evaluative data from this strategy. DESIGN AND METHODS Key components of the strategy include (a) a partnership between the state agency responsible for the nursing home survey and certification and the school of nursing in(More)
The purpose of this study was to explore staff perceptions and concerns about the medication use process in the nursing home setting. A total of 76 staff members from 5 nursing homes in 3 Midwestern states participated in key informant interviews and focus groups. Common themes included issues related to communication, competing demands, and the challenges(More)
Providing safe nursing home care is both a clinical and fiscal challenge in many countries. The fiscal realities result in the addition of other workers, such as medication technicians or aides (CMT/A), to the health care team. The purpose of this study was to determine the impact of various levels of credentialing among nursing home staff who deliver(More)
The number of older persons in the United States is rapidly growing and, based on this growth projection, the number of consumers needing nursing home (NH) care will likely triple in the next 10 years. Although NHs have been bombarded and scrutinized about the care that they provide, the concept of safety (specifically, error prevention) remains at the(More)
BACKGROUND Medication reconciliation has been at the forefront of national patient safety efforts for nearly a decade, yet health care institutions remain challenged with implementation. OBJECTIVES The objective of this article was to report an analysis of a qualitative study of the experiences of physicians, nurses, and pharmacists with medication(More)
There are differences in perceptions of safety culture between healthcare leaders and staff. Evidence suggests that an organization's actual safety performance is more closely reflected in staff perceptions suggesting that frontline staff may be more aware than the leadership of actual patient safety challenges within their organization. Closing the(More)
It appears that the implementation and use of a bedside electronic medical record in nursing homes can be a strategy to improve quality of care. Staff like using the bedside electronic medical record and believe it is beneficial. Information gleaned from this qualitative evaluation of four nursing homes that implemented complete electronic medical records(More)