Adapting Strategies for Optimal Intervention Implementation in Nursing Homes: A Formative Evaluation.

Background And Objectives: Nursing homes pose unique challenges for implementation of research and quality improvement (QI). We previously demonstrated successful implementation of a nursing home-led intervention to improve relationships between frontline staff and residents in 6 U.S.

Blended Facilitation as an Effective Implementation Strategy for Quality Improvement and Research in Nursing Homes.

Background: Blended facilitation, which leverages the complementary skills and expertise of external and internal facilitators, is a powerful strategy that nursing stakeholders and researchers may use to improve implementation of quality improvement (QI) innovations and research performed in nursing homes.

Problem: Nursing homes present myriad challenges (eg, time constraints, top-down flow of communication, high staff turnover) to QI implementation and research.

Approach: This methods article describes the theory and practical application of blended facilitation and its components (external facilitation, internal facilitation, relationship building, and skill building), using examples from a mixed QI and research intervention in Veterans Health Administration nursing homes.

Post-traumatic stress disorder and prediction of aggression in persons with dementia.

Objective: This prospective cohort study evaluated the potential of increased aggression in patients with dementia who had a preexisting diagnosis of post-traumatic stress disorder (PTSD) compared with those without a diagnosis of PTSD.

Methods: Patients more than 60 years of age with newly diagnosed dementia between 2001 and 2004 were identified from the Michael E. DeBakey Veterans Affairs (VA) Medical Center in Houston, TX.

Aggression in individuals newly diagnosed with dementia.

Aggression is often associated with dementia. In this study, aggression in veterans newly diagnosed with dementia was examined and characterized. Participants were >or=60 years diagnosed with dementia at the Michael E.

Mobilization-Observation-Behavior-Intensity-Dementia Pain Scale (MOBID): development and validation of a nurse-administered pain assessment tool for use in dementia.

Pain assessment in older persons with severe cognitive impairment (SCI) is a challenge due to reduced self-report capacity and lack of movement-related pain assessment instruments. The purpose of this article was to describe the development of the Mobilization-Observation-Behaviour-Intensity-Dementia Pain Scale (MOBID) and to investigate aspects of reliability and validity. MOBID is a nurse-administered instrument developed for use in patients with SCI, where presence of pain behavior indicators (pain noises, facial expression, and defense) may be observed during standardized active, guided movements, and then inferred to represent pain intensity.