Biomedical subjects
Publications and source records attributed to M D Cohn.
In order to maintain a productive workforce, organizations must acknowledge that many employees, particularly nurse aides, perform full-time care giving, both on and off the job. Competing demands between work and family can affect job performance, quality of care and bring on burnout.
The findings reported here are from a group of researchers identified by the authors for their leadership in the advancement of knowledge about nursing homes as organizations. Three themes were identified from the current research presented at the Roundtable. The first was a recognition of the pervasive which society's conflicting expectations about nursing homes create for those who staff them. The second related to the central, at times unsupervisable, role of non-professional staff. The third theme called attention to the reinforcement power of supervision and leadership in bringing about positive change in care giving staff. These issues and the research described had implications for both policy and practice. While far from a comprehensive treatment of organizational and managerial issues, the observations reported here represent new research interest in nursing homes be considered simple organizations with stable and predictable inputs. The processes of care and the way those processes are implemented vary from one facility to another and, indeed, among nursing units within the same facility. Broadbased practitioner-researcher collaborations are needed to promote usable research on the internal processes of nursing homes. Future collaborations will probably focus on how and why some procedures and structures produce better results for residents and others. Policy makers and administrators will benefit as the tools and methods of organizational research are used to identify the best structures and practices in the nursing home industry. Similarly, the knowledge base of long-term care administration will be enriched by contemporary reconsideration of the structure and processes of nursing homes as organizations.
Nurse's aides are the primary caregivers in nursing homes, a major receiving site for elders with behavioral and psychiatric problems. We describe the development, psychometric properties, and utility of a brief instrument designed to assess aides' knowledge of three specific mental health problems (depression, agitation, and disorientation) and behavioral approaches to them. The instrument was administered to 191 nurse's aides and 21 clinicians with training in behavioral management and experience with older residents. The nurse's aides averaged 11 of 17 correct answers, and the clinicians averaged 15 of 17 correct answers. Implications for staff training and consultation activities in nursing homes are discussed.
Nursing assistants are responsible for 80% to 90% of all direct resident care in nursing homes, but are the least well trained personnel. Even with currently mandated training, specific skills to meet mental health needs are not taught. Training in behavior management skills prepares aides to observe and respond to problem behaviors more effectively. Aides view their own use of skills as increased by this training. To be practically useful, mental health training programs for nurse aides should be provided by professional personnel in brief, concrete, self-contained units that model the skills they present.
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Scientific literature which links advanced maternal age to pregnancy outcome was critically appraised. Little evidence was found to support the pessimistic advice offered to older expectant mothers. Evidence is accumulating which suggests that emotional stress has a deleterious effect on obstetrical outcome, although the manner in which the deleterious effects are produced remains unclear.
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