Community Models of Care: A Scoping Review.

Nurse preparation and role in community models of care for older adults is not well documented. The purpose of the current structured scoping literature review was to identify nurse-led or nurse-involved community models of care for older adults, articulate the nurse's role and preparation in the model, and identify Triple Aim policy implications. Literature from 2008 through 2014 yielded 34 models identified in 51 articles.

Doing it my way.

Purpose: Historically, hotels and single-room occupancy residences have provided room, board, and social support services to elders, in particular the poor and the disenfranchised. This article presents the results of a case study drawn from a larger ethnographic community study that set forth to describe how and why elders from one rural community chose to live in a motel in that same rural community. The focus of this study is a description of 7 middle-income and affluent rural elders living in a motel setting as a housing option that enabled them to remain independent in their community.

Implications of electronic health record meaningful use legislation for nursing clinical information system development and refinement.

Purpose:  To describe what electronic health record meaningful use requirements mean for nursing clinical information system (CIS) development.

Conclusions:  The nursing CIS in many, if not most hospitals, has a number of critical design inadequacies that constrain the meaningful use of nursing data to ensure quality outcomes for patients and data-based maturing of the nursing profession.

Implications:  It is the responsibility and obligation of nurses to ensure that CISs are designed for the meaningful use of nursing clinical data.

Nursing clinical documentation data retrieval for hospitalized older adults with heart failure: part 2.

Purpose: The study aims to discuss the implications for retrieval of nursing data and building a multiorganizational data warehouse.

Methods: The method used was a descriptive comparative multisite study of documented care for 302 older adults with heart failure. Unit and patient level variables were retrieved.

Evaluation of outcome change scores for patients with pneumonia or heart failure.

This study was conducted to describe the variance in selected Nursing Outcomes Classification (NOC) outcome change scores of hospitalized older patients with pneumonia (n = 216) or heart failure (HF; n = 67) that could be explained by age, length of stay (LOS), number of comorbid conditions, number of nursing diagnoses, and number of nursing interventions. Investigators used a descriptive correlational design to analyze data sets from three U.S.

Most frequent nursing diagnoses, nursing interventions, and nursing-sensitive patient outcomes of hospitalized older adults with heart failure: part 1.

Purpose: Rank and compare the 10 most frequently documented nursing diagnoses, interventions, and patient outcomes using NANDA International, Nursing Interventions Classification, and Nursing Outcomes Classification for care of patients with heart failure (HF).

Methods: A descriptive comparative multisite study of documented care for 302 older adults with HF.

Findings: There were four common nursing diagnoses, two interventions, and only three common outcomes across three sites.

Measuring gerontological research intensity in schools of nursing.

Because of the urgent need for more gerontological nursing research, it is critical for more schools of nursing to develop research-intensive environments within which faculty can develop programs of gerontological nursing research. Unfortunately, many schools have limited resources for developing the needed infrastructures and for acquiring the required expertise in gerontology and research. Many also lack the expertise and methods for assessing their current status so they may increase their gerontological nursing research intensity.

Aging issues: nursing imperatives for healthcare reform.

The people of the United States sent a clear message in November 2008 that they wanted a change in the nation's priorities, including healthcare. The question is whether healthcare reform will extend to the care of older adults, especially in the face of complex needs in the last years of their lives. This article addresses this question by examining the demographics of the older adult population, the eldercare workforce, and the current inadequate patchwork of financing.

A trial of a comprehensive nursing rehabilitation program for nursing home residents post-hospitalization.

This pilot study examined the feasibility of implementing a comprehensive nursing rehabilitation program (CNRP) designed to promote the physical functioning of moderately frail nursing home residents post-hospitalization. The 4-week to 8-week CNRP incorporated three interventions: the Capacity Intervention (improving strength and balance), Performance Intervention (fostering daily mobility and activity), and Facilitating Intervention (providing education, support, and stress management). A longitudinal design was used with a convenience sample of 24 moderately frail residents.

Increasing nursing faculty research: the Iowa gerontological nursing research and regional research consortium strategies.

Purpose: Research development and regional consortium strategies are described to assist schools in all countries extend their gerontological nursing research productivity. The strategies, collaboration and mentoring experiences, and outcomes are also shared to illustrate a highly successful approach in increasing faculty programs of nursing research in a focused area of inquiry.

Design: A case description of gerontological nursing research development and regional consortium strategies in schools of nursing is used.

Everyday excellence. A framework for professional nursing practice in long-term care.

RNs make measurable contributions to the health and wellness of individuals living in nursing homes. However, most nursing homes do not employ adequate numbers of professional nurses with specialized training in the nursing care of older adults to positively affect resident outcomes. As a result, many people never receive excellent geriatric nursing while living in a long-term care facility.

Field testing, refinement, and psychometric evaluation of a new measure of quality of care for assisted living.

Field test results are reported for the Observable Indicators of Nursing Home Care Quality Instrument-Assisted Living Version, an instrument designed to measure the quality of care in assisted living facilities after a brief 30-minute walk-through. The OIQ-AL was tested in 207 assisted-living facilities in two states using classical test theory, generalizability theory, and exploratory factor analysis. The 34-item scale has a coherent six-factor structure that conceptually describes the multidimensional concept of care quality in assisted living.

Nursing home staffing and training recommendations for promoting older adults' quality of care and life: Part 2. Increasing nurse staffing and training.

In the second article of this two-part series, research supporting the need for more RNs and assisting staff (licensed practical nurses [LPNs] and certified nursing assistants [CNAs]) with gerontological nursing training in nursing homes is reviewed. Using the literature, time studies, the judgments of experts, and the expected quality and quantity of care older adults should rightfully receive, recommended standards are set forth for RN and assisting staff hours per resident day, their training, and compensation. Leadership training is recommended for RNs and increased gerontological nursing training is recommended for RNs and assisting staff.

Nursing home staffing and training recommendations for promoting older adults' quality of care and life: Part 1. Deficits in the quality of care due to understaffing and undertraining.

Caught between the inability or unwillingness of nursing home corporations and owners to redistribute revenue and the reluctance of federal and state agencies to increase payments to nursing homes, the nation's most vulnerable older adults are not receiving the care they deserve. Widespread recognition of substandard care and quality of life of older adults in nursing homes has existed for decades. In addition, there is substantial evidence that poor quality of care is related to inadequate numbers and training of nursing staff.

Nursing home staff's views on quality improvement interventions: a follow-up study.

Ongoing problems with nursing home care mandates understanding nursing home staff's perspectives on innovative quality improvement programs. This follow-up study used focus groups to examine the experiences of staff who participated in a clinical trial that involved Quality Indicator (QI) feedback reports, quality improvement training, and APN consultation. The authors found that QI reports provided staff with a benchmark to judge their care and a means to track problems; APN consultation was essential for staff to learn best practices; and staff questioned the validity of the QI reports, which hindered them from seeking new solutions to problems identified in the QI reports.

Variations across field settings in the use of the indicators for nursing outcomes classification outcomes.

The Nursing Outcomes Classification (NOC) includes with each outcome a set of indicators to provide concrete referents for measurement of the outcome. Not all indicators are relevant for all instances of the rating of an outcome. The choice of indicators to use varies by clinical setting.

Field testing, refinement, and psychometric evaluation of a new measure of nursing home care quality.

The primary aim of this NINR-NIH-funded field test in 407 nursing homes in 3 states was to complete the development of and conduct psychometric testing for the Observable Indicators of Nursing Home Care Quality Instrument (Observable Indicators, OIQ). The development of the OIQ was based on extensive qualitative and iterative quantitative work that described nursing home care quality and did initial validity and reliability field testing of the instrument in 123 nursing homes in 1 state. The scale is meant for researchers, consumers, and regulators interested in directly observing and quickly evaluating (within 30 minutes of observation) the multiple dimensions of care quality in nursing homes.

Building research productivity in an academic setting.

This article describes the methods that one academic nursing unit used to move from receiving no National Institutes of Health funding to a top-20 ranking. A 1995 school task force recommended changes to move toward greater research productivity, including increased external funding. The school created a research infrastructure to support both the scientific development of research studies and the production of high-quality external grant applications.

Care intervention for older adults with Alzheimer's disease and related dementias: effect of family involvement on cognitive and functional outcomes in nursing homes.

The purpose of this quasi-experimental study was to examine the effect of an intervention for caregivers of individuals with Alzheimer's disease and related dementias (ADRD) on nursing home residents' functional and cognitive status. Fourteen special care units (SCUs) in 14 midwestern nursing homes were paired according to size, ownership, and staff turnover. The paired nursing homes were randomly assigned to either experimental or control groups.