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1.
Innovation in aging ; 5(Suppl 1):1055-1056, 2021.
Article in English | EuropePMC | ID: covidwho-1602264

ABSTRACT

As COVID-19 has resulted in a skilled nursing facility (SNF) staffing crisis, administrators attempt to maintain adequate staffing and stem decreasing patient census levels. We conducted four repeated interviews to date (n=130) at 3-month intervals with administrators from 40 SNFs in eight diverse healthcare markets across the United States. We used thematic analysis to examine their perspectives over time, including the perceived impact on staffing. Results include: 1) the impact of COVID-19 on staffing levels, and 2) strategies used in response to this crisis. Staffing levels have decreased throughout the pandemic, and struggles to maintain adequate staffing levels and patient census numbers have continued as the pipeline of potential new staff constricts. Facilities turned to agencies, many for the first time. Since agencies offer higher salaries, staff are drawn away from employment by SNFs, leading to a cycle of wage wars, and agencies are also challenged to provide staff. SNF administrators describe their responses to this crisis, such as flexible schedules, increased paid time off, sharing of non-direct-patient-care tasks, financial incentives (referral, sign-on, “no-call out”, and other general bonuses);wage analyses, and enhanced employee benefit packages. Some hire recruitment specialists, collaborate with nearby administrators, use creative advertising, or work with local schools. The vaccine mandate worries administrators;as one stated: “I can't afford to lose one person, let alone 20 because of this mandate...”. Given the dwindling pool of potential employees, we present NH administrators’ strategies to attract and retain staff.

2.
Innovation in aging ; 5(Suppl 1):1038-1038, 2021.
Article in English | EuropePMC | ID: covidwho-1602263

ABSTRACT

Skilled nursing facilities (SNFs) are on the front lines of changing policies regarding the COVID-19 pandemic. The most recent development is a potential vaccine mandate for staff working in SNFs. We use ongoing findings from 130 of 160 in-depth, semi-structured interviews in progress with administrators at 40 SNFs in eight diverse healthcare markets across the United States to understand the current landscape of COVID-19 in SNFs. Four repeated interviews at 3-month intervals provide a unique longitudinal perspective on the impact of COVID-19 and SNFs’ response to vaccinations, including the vaccine mandate. Rigorous thematic analysis reveals insights into administrator responses and creative approaches to address vaccine hesitancy, and future expectations for SNF operations in light of the vaccine and the mandate. Administrators express cautious hope that the vaccine will allow SNFs to return to a new normal of daily life for residents in terms of family visitations, communal dining, and resident activities. Overriding questions include how to overcome persistent vaccine hesitancy from SNF staff who cite fear of side effects despite education initiatives and how to stem staff retirement or transition to other healthcare settings. SNFs represent a microcosm of the country’s concerns as a whole. Insight into the evolving and complex dynamics shed important light on national trends and help provide solutions for moving forward. Findings from this study have implications for policymakers and SNF leadership as they consider ways to promote vaccination and retain staff amid vaccine mandates.

3.
Innovation in Aging ; 5(Supplement_1):270-270, 2021.
Article in English | PMC | ID: covidwho-1584687

ABSTRACT

Effective management of the perceived risks associated with delivering preference-based person-centered care (PBPCC) is historically challenging for nursing home staff. Existing research lacks the granularity needed to guide clinicians who fear negative health and safety outcomes for residents. This study examined direct-care nursing staff perceptions of outcomes associated with delivering PBPCC. Participants (N=27) worked in NHs experiencing 6-12 health citations, were mostly female (85%), and represented diverse ages, race, education, and collective work experience in NHs. Content analysis of verbatim transcripts from 12 focus groups identified an overarching theme of: “person-centered outcomes related to risk engagement”;and sub-themes of: harms to staff (e.g. fear, frustration, guilt);harms to residents (e.g. negative moods and behaviors, physical discomfort);and positive shared outcomes (e.g. building nurse-resident relationships, positive care environment). Implications for risk management that improves quality of care and life outcomes in a post-COVID era will be discussed.

4.
J Am Med Dir Assoc ; 22(10): 1989-1997, 2021 10.
Article in English | MEDLINE | ID: covidwho-1330933

ABSTRACT

Social functioning is defined as how a person operates in their unique social environment (ie, engagement in activities, connectedness with others, and contributions to social roles). Healthy social functioning is important for nursing home residents as they are at increased risk for loneliness and isolation. Social functioning has long been an underacknowledged aspect of nursing home residents' health, but now, with the COVID-19 pandemic, residents' risk for decreased social functioning is increased. Several reliable and well-validated tools are available to supplement routine care planning and delivery and track and improve changes in social functioning over time. The overarching aim of this article is to provide resources and recommendations for interdisciplinary team assessment related to social functioning for nursing home residents. We describe 2 domains of social functioning measures, care-planning measures and outcome measures, and provide recommendations for how to integrate said measures into practice. Healthy social functioning is needed to maintain nursing home residents' well-being and quality of life. Measures and recommendations outlined in this article can be used by nursing home staff to understand residents' social preferences and address social functioning during COVID-19 and beyond.


Subject(s)
COVID-19 , Quality of Life , Humans , Nursing Homes , Pandemics , SARS-CoV-2 , Social Interaction
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