To see the other types of publications on this topic, follow the link: Home care quality.
Dissertations / Theses on the topic 'Home care quality'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Home care quality.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Cronsioe, Carl. "Optimization of Quality in Home Care." Thesis, KTH, Optimeringslära och systemteori, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-209671.
Full textAbstract:
As the older population grows larger there is a growing need to provide health care at home. This services are generally done without operational research. As more people will require home care there will be a need to increase the efficiency of the service while keeping the quality high. The purpose of this thesis is to investigate how we can use operation research in home care as well as define how we can model the quality and use those quality parameters in order to offer the best possible service. The model uses VRP with Time windows in order to schedule the routes and incorporates service requirements at the customers. A solution is obtained by first constructing an initial solution that fulfills the duration constraint. Then it uses a local search with a dynamic insertion heuristic to improve on the solution. Tabu search is used as a meta-heuristic to prevent the solution the get stuck in a local minima. The solver is used in order to optimize the quality parameters. The result obtained can be used to help home care providers to determine the level of quality they can supply with a limited budgetNär den äldre befolkningen blir större växer behovet av att tillhandahålla vård i hemmet. Denna tjänst använder i allmänhet inte systemteori. Eftersom fler människor kommer att behöva hemtjänst kommer det att finnas behov av att öka effektiviteten samtidigt som kvaliteten hålls hög. Syftet med denna avhandling är att undersöka hur vi kan använda systemteori och optimering inom hemtjänst samt definiera hur vi kan modellera kvaliteten och använda dessa kvalitetsparametrar för att erbjuda bästa möjliga service. Modellen använder VRP med Time windows för att schemalägga rutterna och inkorporerar servicebehov hos kunderna. En lösning erhålles genom att först bygga en initial lösning. Sedan använder den en lokal sökning med en dynamisk heuristisk för att förbättra lösningen. Tabu search används som en meta-heuristik för att förhindra att lösningen fastnar i lokala minima. Algoritmen används för att optimera kvalitetsparametrarna. Resultatet kan användas för att hjälpa leverantörer av hemtjänst att bestämma vilken kvalitetsnivå de kan leverera med en begränsad budget
2
Williams, Cynthia. "Home Care Quality Effects of Remote Monitoring." Doctoral diss., University of Central Florida, 2014. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/6383.
Full textAbstract:
Despite concerted efforts to decrease costs and increase public health, the embattled U.S. health care system continues to struggle to alleviate these widespread issues. Because the problem of hospital utilizations among patients with heart failure is posited to increase as the population ages, innovative methodologies need to be explored to mitigate adverse events. Remote monitoring harnesses the strength of advanced information and communication technology to affect positive changes in health care quality and cost. By reaching across geographical boundaries, remote monitoring may support increased access to less costly services and improve the quality of home health care.
The purpose of the study was to examine the home care quality effects of remote monitoring technology in patients with heart failure and to provide an economic justification for its adoption and diffusion. It compared remote monitoring as a potential intervention strategy to a standard no-intervention group (without remote monitoring). Specifically, it analyzed remote monitoring as a viable strategy to decrease hospital readmissions and emergency department visits. It also compared the cost of remote monitoring against the current standard-of-care.
The theoretical framework of Donabedian's Quality Model was used in the evaluation of remote monitoring. A retrospective posttest only, case control study design was used to test the degree which remote monitoring was effective in promoting health care quality (hospital readmissions and decreased emergency department visits). Retrospective chart reviews were performed using electronic medical records (EMR). Analysis of Variance, Path Analysis, Automatic Interaction Detector Analysis (Dtreg), and Cost Outcomes Ratio were used to test the hypotheses and validate the proposed theoretical model.
No significant difference was noted in remote monitoring and usual care groups. Results suggested that remote monitoring does not statistically lead to a decrease in heart failure-related hospital readmissions and all-cause emergency department visits. Results of the cost ratio analysis suggested that there was no statistically significant difference in the net income between usual care and remote monitoring; however, data suggest that there were significant increases in cost and intensity of nursing utilization for the remote monitoring intervention. The Automatic Interaction Detector Analysis showed that the unfavorable results in hospital readmissions were due to a decrease in collaborative care and patient education prior to the recommendation for hospitalization.
The role of nursing care, whether in hospital or community-based care, in heart failure management is critical to quality outcomes. As the field continues to consider the use of technology in health care, decision makers should think through the process of patient care such that preventable hospital readmissions are decreased and patients received quality care.Ph.D.
Doctorate
Health and Public Affairs
Public Affairs; Health Services Management and Research Track
3
Mee, Jenny. "Australian home care quality : a political tango." Thesis, Federation University Australia, 2020. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/179509.
Full textAbstract:
The performance of Australian home care and how it is enacted has been significantly impacted by the economic and political challenges since the announcement of the Aged Care Reforms in July 2012 and the launch of the National Disability Insurance Scheme in July 2013. As a result, the home care business arena has changed, and the effects are being felt as the marketplace shifts, and businesses adapt to new policy directions. The purpose of this research study was to investigate the social context of Australian home care, and to collect information regarding how home care (under the various auspices of government funded and privately funded) service provision is enacted in terms of quality during this time of change. The qualitative research process for this study involved critical reflexive practice and face-to-face semi-structured interviews of 10 home care business leaders from the states of Queensland and Victoria. In listening to the voices of the participants, this research study sought to develop new discursive approaches in order to understand the practice of caring for the Australian community’s most vulnerable people – those who are frail, aged, and for those who have ill-health or a disability. The analytical framework adopted for this study used a post-structural discourse analysis, which was informed by the work of French philosopher Michel Foucault and other contemporary theorists. The philosophical framework of governmentality and discourse analysis helped to situate the voice of the participants at a time when new ideas and the ways of conducting the business of home care are emerging. In using this approach to analyse the data, it became apparent that the discursive practices that had been instituted by government in the home care sector had been constructed to remove progressive inclusionary policies that were contrary to the democratic principles of governing. The research study’s findings reveal the problematic changes that impact on business but more so for consumers as the rules are interpreted. By using the metaphor of ice dancing, the study problematized the leadership of government and the challenges participants faced in maintaining quality service provision in the home care arena. What emerged was the dance of a political tango. These leaders in the arena revealed the importance of knowing when to lead and when to push back. Like the different genres of tango, there are different ways of viewing the world of home care and performing in its different spaces, and there are other ways of viewing quality in caring service provisions. By participating in the research, the participants highlighted the need of being inclusive to hearing and seeing all performers in the arena of home care regardless of social or geographical positioning. This research concludes that hearing and acting on the voices from the wider home care arena continues to be necessary in order to inform future policy direction for quality performance improvements for Australia’s consumers of home care and to move away from home care traditions of governing and ruling. The research additionally advocates for more inclusive governing approaches through more even distribution of power in consultative processes, research, oversight in the marketplace and access to resources for all groups. This thesis is a contribution to creating a new political dance in the space of Australia’s home care politics.Doctor of Philosophy
4
Scharpf, Tanya Pollack M. S. "Functional Status and Quality in Home Health Care." Case Western Reserve University School of Graduate Studies / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=case1112905040.
Full text
5
Lee, Hyang Yuol. "Quality of care: Impact of nursing home characteristics." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3352465.
Full textAbstract:
Thesis (Ph.D.)--University of California, San Francisco, 2009.Source: Dissertation Abstracts International, Volume: 70-04, Section: B, page: 2206. Advisers: Mary A. Blegen; Charlene A. Harrington. Includes supplementary digital materials.
6
Bostick, Jane E. "The relationship of nursing personnel and nursing home care quality." MU has:, 2002. http://wwwlib.umi.com/cr/mo/fullcit?3052150.
Full text
7
Mathews, Michelle C. "Measuring the quality of informal home-based care programs." Diss., Columbia, Mo. : University of Missouri-Columbia, 2006. http://hdl.handle.net/10355/5882.
Full textAbstract:
Thesis (Ph. D.)--University of Missouri-Columbia, 2006.The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file viewed on (March 2, 2006) Vita. Includes bibliographical references.
8
Nakrem, Sigrid. "Measuring quality of care in nursing home - what matters?" Doctoral thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for samfunnsmedisin, 2011. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-14729.
Full textAbstract:
Residential care in nursing homes continues to be necessary for those individuals who are no longer able to live safely and comfortably at home. The demographic change with increasing number of persons over 65 years in the next 20 years also means that the percentage of those who will require care in a nursing home some time before the end of their lives will increase. Therefore, anticipating this pressure to expand nursing home availability, it is critical that these services are developed from a profound understanding of what creates the best value. Nursing homes in developed countries have evolved over the past half-century from being places of mainly custodial care to facilities responsible for the management of an ever increasing range of complex nursing and medical conditions. Nursing home residents are frail older adults with complex needs, dependent on advanced nursing care. Determining what aspect of nursing homes should and can be measured is the current work of many national health care systems. However, uncovering what the nursing home residents perceive as the most important aspects of quality and how they experience living in a nursing home is necessary to develop effective person-centred care. The overall aim of the present thesis was to contribute to a deeper understanding of quality of care in nursing homes, integrating the professionals’, residents’ and family’s perspectives. The research design is a qualitative approach to explore the concept quality of care and its domains. The thesis comprises a review of internationally used nursing sensitive quality indicators for nursing homes. The indicators are evaluated for their validity as described in the literature. The thesis further describes the residents’ experiences with the interpersonal factors of nursing care quality, as well as the residents’ experiences of living in a nursing home. The thesis also explores the understanding and belief about nursing home quality held by family members of residents. The thesis is based on in-depth interviews of residents in four different nursing homes, and focus group interviews of family members of residents in two different nursing homes. The findings are that quality of care in long-term care in nursing homes encompasses at least four domains: quality of the living conditions, quality of the nursing staff, quality of direct nursing care, and quality of the social environment. Moreover, care quality is influenced by a range of external factors such as the national policy, laws and regulations, management of the organization and the physical building. The local community provides a context in which the nursing home is more or less integrated into. The review of internationally used quality indicators indicate that some factors of care processes and health outcomes for nursing home residents could be measured and give valid and reliable evaluation of the nursing home care quality. In the explorative qualitative study, residents and family placed more emphasis on physical and psychological well-being, interpersonal relationships and the social environment if quality of care is to result. Objective indicators of essential areas of resident-experienced quality need to be developed. This should be done in collaboration with the residents and their next-of-kin, in addition to professional expertise. Methodological and practical implications of the results are discussed.Sykehjem er en helsetjeneste som vil være nødvendig for eldre som ikke føler seg trygge eller kan få tilstrekkelig behandling, pleie og omsorg i eget hjem. Antall eldre over 65 år er økende i Norge, noe som innebærer et økt press på sykehjem i framtiden. Det er derfor av stor betydning at sykehjemstjenesten utvikles med tanke på å skape best mulig nytteverdi ut fra behov. Sykehjemmene har utviklet seg de siste 50 årene fra hovedsakelig et botilbud til helseinstitusjoner som gir avansert helsehjelp. Sykehjemsbeboere er skrøpelige eldre med komplekse problemstillinger, avhengig av avansert sykepleie. Kvalitetsindikatorer er kvantitative mål som reflekterer en profesjonell standard for pleie og omsorg, og slike mål benyttes i økende grad for å vurdere kvalitet i sykehjem. Imidlertid er det nødvendig å inkludere det som har størst betydning for sykehjemsbeboere i slike mål for å kunne gi god pasientsentrert sykepleie. Hovedmålsettingen med studien var å bidra til en dypere forståelse av sykehjemskvalitet, ut fra helsepersonellets, beboernes og pårørendes ståsted. Avhandlingen omfatter en oversikt over kvalitetsindikatorer som er i bruk internasjonalt. Videre beskriver avhandlingen beboernes erfaringer med mellommenneskelige faktorer ved sykehjemskvalitet, samt hvordan de erfarer å bo i et sykehjem og opplever kvaliteten på “hjemmet” sitt. I avhandlingen blir også pårørendes forståelse av og meninger om sykehjemskvalitet utforsket. Avhandlingen er basert på dybdeintervju av beboere ved fire ulike sykehjem, og fokusgruppeintervjuer med pårørende ved to av sykehjemmene. Funnene viser at kvalitet på pleie og omsorg i sykehjem omfatter minst fire hovedområder: Bokvalitet, personellkvalitet, helsetjenestekvalitet og sosial kvalitet. Videre er pleie- og omsorgskvaliteten påvirket av en rekke eksterne faktorer som nasjonale føringer, lovverk, ledelsesstruktur, bygningskonstruksjon og lokale forhold. Den internasjonale oversikten over kvalitetsindikatorer gir indikasjoner på at noen av dem kan brukes som pålitelige og gyldige evalueringer av kvaliteten på pleie og omsorg, samt helserelaterte resultater for beboerne. I den kvalitative intervjuundersøkelsen med beboere og pårørende, ble fysisk og psykisk velvære, mellommenneskelige forhold og det sosiale miljøet tillagt større betydning for kvaliteten. Objektive indikatorer for disse beboererfarte områdene for kvalitet må utvikles. For å sikre at disse er pasientsentrerte, bør utviklingen av kvalitetsindikatorer gjøres i tett samarbeid med sykehjemsbeboerne og pårørende, i tillegg til helsepersonell.
9
Bell, Mary Ann 1953. "Perceptions of quality of care in the nursing home." Thesis, The University of Arizona, 1992. http://hdl.handle.net/10150/291785.
Full textAbstract:
The purpose of this study was to determine the perceptions of residents, family members, and nursing staff regarding quality of care and the physical environment in the nursing home. Relationships among quality of care, the physical environment, and selected organizational characteristics were then described. The Quality of Care Scale (QoCS) and the Environment Description Scale (EDS) were given to a convenience sample of 100 subjects. A significant difference in perceptions of quality of care was found between the nurse assistants and residents. Significant relationships were obtained between perceptions of quality of care and the physical environment for Registered Nurses, Licensed Practical Nurses, and families. Defining quality of care and determining the significance of the physical environment from the consumer perspective may contribute to both quality of life and quality of care in the nursing home.
10
Hart, Rebecca Marie. "Hart's Home Away From Home: An Integrative Approach to Dementia Care." Miami University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=miami1311203360.
Full text
11
Free, Corinne. "Direct Assessment of Quality of Care in a Memory-Care Residential Setting: A Systematic Replication." Thesis, University of North Texas, 2018. https://digital.library.unt.edu/ark:/67531/metadc1404514/.
Full textAbstract:
The quality of care of residents in nursing homes receive is an important issue facing our society, and reliable methods to assess and measure important indicators of quality of care are necessary to ensure that nursing homes are providing adequate services. Previous researchers have developed methodologies to evaluate indicators of quality of care, including environmental conditions, resident conditions, resident activities, and staff activities using momentary-time sampling procedures across a variety of settings and populations. The purpose of the present study was to replicate and extend the time-sampling methodology used in previous research in two units in a nursing home.
12
Dillman, Jennifer L. "Geographic Distance, Contact, and Family Perceptions of Quality Nursing Home Care." Thesis, University of North Texas, 2010. https://digital.library.unt.edu/ark:/67531/metadc28412/.
Full textAbstract:
The effect of frequency of nursing home contact on family perceptions of quality care is the focus of this research. A family member characteristic, such as geographic distance from the nursing home, affects his or her frequency of contact with the nursing home. Frequency of contact, in turn, affects family perceptions of the care his or her loved one receives in the nursing home. The theoretical framework for this study is based on Allport's intergroup contact theory, which posits that when four contact conditions - institutional support, equal status, common goals, and intergroup cooperation - are present in an intergroup situation, a reduction in anxiety between groups is likely to occur. Regression analysis tested the stated hypotheses using survey data collected from 275 family members of residents in 10 Dallas-Ft. Worth area nursing homes. This study is among the first to quantify family geographic distance, finding that family geographic distance is a significant negative predictor of nursing home contact. Additionally, results build on Allport's theory by extending its' usefulness to nursing home organizations in two distinct ways. First, findings support Allport's premise that contact alone between groups - i.e., family members and nursing home staff - is insufficient for increasing or decreasing family perceptions of nursing home care. Second, three of the four contact conditions included in Allport's theory were statistically supported by the data. In sum, findings of this research provide nursing homes with an empirically tested model for improving family perceptions of quality nursing home care.
13
Lansmon-Winter, Erin Cready Cynthia M. "Family perception of quality in nursing home care impact of gender, level of involvement, and utilization of empowered CNA teams /." [Denton, Tex.] : University of North Texas, 2008. http://digital.library.unt.edu/permalink/meta-dc-9069.
Full text
14
Habjanic, A. (Ana). "Quality of institutional elderly care in Slovenia." Doctoral thesis, University of Oulu, 2009. http://urn.fi/urn:isbn:9789514291869.
Full textAbstract:
Abstract
Elderly people, because of the frail health condition and consequent problems, have in most cases substantial difficulties living at home. Despite the need for widened nursing home custody, the field of quality institutional elderly care in Slovenia in the past did not undergo comprehensive research.
The purpose of this two-part study was to investigate the quality of institutional elderly care and elderly care offered in Slovenian nursing homes. Additional purpose was to evaluate nursing staff members about their willingness, knowledge, skills and importance to meet residents’ physical and psychosocial nursing care needs. Also, a part of this research was bound for recognition of maltreatment and nursing staff members’ well-being.
The qualitative and quantitative research methods were used. The quality of institutional elderly care and elderly care offered were researched by interviewing the parties involved in elderly care, residents, relatives and nursing staff members (N=48). The data for quantitative research was collected by surveying nursing staff by using a structured questionnaire (N=148). All data have been collected in three public and one private nursing home located in two major cities of Ljubljana and Maribor. Collected data was examined by content analysis method and statistical analysis, to corroborate findings across data sets, reducing the impact of potential biases that can exist in a single study. Triangulation was used to approach to data analysis to synthesize data from multiple sources.
Main categories of quality institutional elderly were formulated as attentive care, optimal custody and holistic approach. The most important issue of quality institutional elderly care was formulated as meeting needs on time. Nursing staff members were found to be better skilled in meeting physical than psychosocial needs of residents. Maltreatment was recognised as neglect of care due to postponed duties or hastiness in nursing interventions resulting in discomfort of residents. Factors in connection to quality of institutional elderly care were expressed as quality of nursing care, friendly relationship, meaningful activities, pleasant dwelling environment and versatile assistance.
The obtained findings were presented in form of proposals to improve quality of institutional elderly care in Slovenian nursing homes, and could be used to develop institutional elderly care and improve dwelling. In addition many specific terms have been extracted during the analysis process that may contribute to development of gerontological nursing care rationale in Slovenia.
15
Morton, David Gerard. "A critical assessment of the quality of community home-based care." Thesis, Nelson Mandela Metropolitan University, 2012. http://hdl.handle.net/10948/1606.
Full textAbstract:
Volunteer home-based caregivers are critical role players in South Africa‘s health care system and in the South African government‘s strategy to fight HIV and AIDS. In order to achieve the aims that the government seeks to attain, it is important that the care and treatment provided to patients receiving community home-based care (CHBC) be of a high quality. While the need for quality care is supported by government and civil society, research indicates that it is not clear whether quality care is indeed being provided and therefore there is a need for research into the quality of CHBC. The research aimed to undertake a critical assessment of CHBC programmes to determine the quality of care provided by volunteer caregivers using social capital theory as a theoretical framework. The study examined the quality of CHBC by analysing the context of CHBC, by investigating the support that volunteer caregivers and their clients receive and by discussing the support that volunteer caregivers and their clients still need. The study used one-on-one in-depth interviews and focus groups to obtain relevant data. The participants included volunteer caregivers, clients and supervisors who took part in the one-on-one interviews. The focus groups consisted of key informants and supervisors respectively. The quantitative data consisted of descriptive statistics which helped describe the participants. The qualitative data was coded and themes and sub-themes were developed. The data was also analysed by an independent coder. The results showed that poverty, and the related problems of poor living conditions and a lack of food security affects the quality CHBC. In addition, unemployment and the problem of stipends also affect quality CHBC. Certain socio-economic factors were also found to lead people to choose to become volunteer caregivers and unemployment was found to be an important driving force behind the choice to undertake volunteer caregiving. Furthermore, the volunteer caregivers in the sample received organisational support from their supervisors and their fellow caregivers or peers. They also received social support from their families and their communities. Regarding the clients of the volunteer caregivers, it was found that they received a number of types of support including psycho- iv social counselling, spiritual counselling and care of a holistic nature. In addition, the study found that there is a need for standardised quality training of volunteer caregivers, which will equip them with multiple skills. It was also found that volunteer caregivers require mentoring and quality supervision in order to be able to provide quality CHBC to their clients. Government has the ability to put the necessary systems and structures in place, such as a scope of practice for volunteers, standardised training and monitoring and evaluation, to enable CHBC and its relevant role players to operate at optimum levels. It also has the authority to make the changes and to enforce rules. Furthermore, it has the ability to unite CHBC organisations and can create the necessary conditions that can lead to increased social capital. Furthermore, the study recommends that two additional dimensions of quality care be added to existing dimensions of quality in health care. The first is the holistic approach to caregiving and the second is social support systems, namely supervisor/mentor and peer support and family and community support. This second dimension is also closely linked to social capital and the networks that make up CHBC.
16
Momanyi, Kevin. "Enhancing quality in social care through economic analysis." Thesis, University of Aberdeen, 2019. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=240815.
Full textAbstract:
Population ageing has motivated policy makers around the world to focus on how best to organise health and social care services to meet an aniticipated growing demand on services. Two popular initiatives are reablement and telecare. Reablement is an approach within homecare that enables older individuals with social care needs to improve their functional performance and live independently. Telecare, on the other hand, involves use of devices to monitor individuals' health and safety, and provide response when needed. This thesis investigates the effectiveness of reablement and telecare by conducting a comprehensive review of the literature and undertaking three empirical studies. It is composed of six chapters. The first chapter presents a theoretical model that links the demand for reablement and telecare to various outcomes. The model is estimated using a strategy that controls for the effects of confounding variables and unobservable factors, and is general in the sense that it nests several other estimation strategies and study designs as special cases. The next chapter contains the literature review. Chapters 3, 4 and 5 present the three empirical studies. The first study investigates the effect of telecare on independent living at home; the second study determines the relationship between the use of telecare and admission to hospital, while the third study determines the relationship between telecare use and the length of stay in hospital. Chapter 6 concludes the thesis and provides some suggestions for further research. Unlike the results of the previous studies, the findings from this thesis suggest that the treatment effects are not homogenous across the poulation and also vary depending on the type of telecare device under consideration.
17
Hopson, Christopher Paul. "Alternative Models of Nursing Home Care: A Study of the Impact of the Teaching Nursing Home Model on Staff Quality and the Quality of Resident Care." Diss., Temple University Libraries, 2009. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/47128.
Full textAbstract:
Business AdministrationPh.D.
As the percentage of elderly adults within the U.S. continues to grow, long-term care options will increase. Facing increased competition from other forms of long-term care, many nursing homes are seeking innovative models to enhance management and clinical care practices. The Teaching Nursing Home model, first established in the 1970s, is one in which academic institutions partner with nursing homes to create information exchanges between the nursing home and the school. Currently, nursing schools throughout the country work with nursing homes to create clinical training sites for nursing students. The partnership is also used to encourage research among school faculty and to assist nursing homes in their management of best practices. This study examined the impact of these relationships on nursing home quality. Twenty teaching nursing homes were matched with twenty nursing homes that are not engaged in this practice. Using nursing home quality scores published by the Centers for Medicare and Medicaid Services, mean outcomes for the matched pairs were compared using T-tests. Regression analyses were also performed to test whether quality improves over time within a teaching nursing home. The results from the T-tests performed did not show overall quality differences between the matched pairs. However, when analyzed regionally, some significance was observed for teaching nursing homes in the Upstate NY region (p<0.1). The study discusses some of the differences in design of the teaching nursing homes within that region and the impact that may have on results. Time as a teaching nursing home did not appear to affect quality for nursing homes in this study. Possible explanations for these insignificant results are discussed in the Summary, Discussion and Limitations section of the study. Overall, the findings from this study suggest that the Teaching Nursing Home model can add value to nursing homes by offering them research and professional training opportunities with academic institutions. Within the study, recommendations are made to further explore the impact of these partnerships on nursing home quality and to encourage the development and use of the model through policy changes.
Temple University--Theses
18
Obioma, Chidiadi. "Improving the Quality of Nursing Documentation in Home Health Care Setting." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3500.
Full textAbstract:
Poor nursing documentation of patient care was identified in daily nurse visit notes in a health care setting. This problem affects effective communication of patient status with other clinicians, thereby jeopardizing clinical decision-making. The purpose of this evidence-based project was to determine the impact of a retraining program on the quality of documentation of patient care in nurses' notes in a home health agency in central Texas. A retrospective audit of quality of nursing documentation using the Nurse and Midwifery Content Audit Tool (NMCAT) was done. A pre- and posttest design was used. A convenience sample of de-identified nurses' notes (80 pre- and 80 post) was selected from active patient records in the agency (n = 160). Descriptive and inferential statistics from the project showed that there was improved quality for the 15 criteria representing quality nursing documentation. After the educational intervention, documentation of patient's status if changed or unchanged improved to 80%, and patient's response to treatment improved (57% to 85%), entries were written as incidents occurred improved (53% to 64%). The nurse refers to the patient by name improved (0% to 66%). These findings were an indication of practice change, validating the need for periodic audits of nurses' notes in the agency in order to demonstrate compliance with quality standards. Based on the project findings, a retraining program is recommended to improve structured nursing documentation in a home health agency. This project is likely to contribute to social change as it enhanced the information communicated to other health care providers, coordination of care, and patient outcomes.
19
Miller, Ellaine Kimbrough Bailey Abell Ellen Elizabeth. "Predictors of quality caregiving in the ""Family Child Care Partnerships"" home visitation program." Auburn, Ala., 2005. http://hdl.handle.net/10415/1267.
Full text
20
Goodson, Justin. "Assessing the quality of care in nursing homes through Bayesian belief networks." Diss., Columbia, Mo. : University of Missouri-Columbia, 2005. http://hdl.handle.net/10355/4286.
Full textAbstract:
Thesis (M.S.)--University of Missouri-Columbia, 2005.The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file viewed on (July 13, 2006) Includes bibliographical references.
21
Kennedy, Katherine A. "Is Nurse Aide Retention Associated with Nursing Home Quality?" Miami University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=miami1618591173416498.
Full text
22
Andersson, Agneta. "Health economic studies on advanced home care." Doctoral thesis, Linköping : Univ, 2002. http://www.ep.liu.se/diss/health_society/2002/002/index.html.
Full text
23
Lansmon-Winter, Erin. "Family Perception of Quality in Nursing Home Care: Impact of Gender, Level of Involvement, and Utilization of Empowered CNA Teams." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc9069/.
Full textAbstract:
As the United States' baby boom generation ages, the future of nursing home care becomes increasingly important. Through this study the researcher seeks to understand quality in nursing home care from the family's perspective. Surveys were collected at one North Texas nursing home, and data were analyzed to determine how gender and level of family involvement impact their concept of quality. Further, the information in this study is aimed at clarifying if interventions, specifically empowered CNA teams, have an impact on how family members view quality. Findings are identified and recommendations for future study are made.
24
Temple, April. "Factors Affecting the Utilization and Quality of Long-Term Care." Scholar Commons, 2009. https://scholarcommons.usf.edu/etd/45.
Full textAbstract:
The aging of the nation in the coming decades will contribute to an increased demand for long-term care. Given this trend, it is becoming increasingly important to understand utilization of services along the continuum of care and to determine factors that influence the provision of quality care. These insights are needed to reduce national expenditures on long-term care and to maximize independence and well-being among older adults.
The purpose of the present dissertation was to explore factors that influence the utilization and quality of long-term care by conducting three separate studies. The first study examined risk of nursing home (NH) placement in a frail sample of older adults receiving publicly-funded long-term care in two settings: home and community-based services (HCBS) or assisted living (AL). Specifically, it explored whether these settings of care modify the relationship between dementia and NH placement. The second study examined NH organizational characteristics and job characteristics of staff in relation to turnover of nursing assistants (NAs) in a nationally representative sample of NHs. Using the same sample, the final study examined the presence of employment-based benefits of NAs and explored the relationship between NH organizational characteristics and the availability of staff benefits.
Findings from this dissertation can contribute to a greater understanding of the use of long-term care services and the retention of staff to provide quality care. In the first study, AL was associated with longer time to NH placement for individuals with dementia when compared to HCBS. In the second study, the provision of competitive wages and benefits, involvement of NAs in resident care planning, and high levels of nurse staffing were associated with lower NA turnover, which may be important for quality of NH care. In the final study, for-profit ownership and high Medicaid occupancy were negatively associated with NA benefits whereas facility size, chain membership, occupancy level, union involvement, and education of the NH administrator were positively associated with benefits offered to these staff. Collectively, the findings from this dissertation may have important implications for policy makers, providers, and consumers of long-term care.
25
Abdollah, Shamshirsaz Sanaz. "Apply QFD methodology to capture 'unheard' voices of UK care home residents and translate them into quality measurement targets for future improvement." Thesis, Brunel University, 2015. http://bura.brunel.ac.uk/handle/2438/10559.
Full textAbstract:
In the planning and delivery of services the voice and choice of consumers have appeared as the foremost key factors. For a large number of organisations the received feedback from customers about the quality of services, which are the criteria and indication of their level of satisfaction play a crucial role in the improvement of quality. Although across developed western communities, the importance of customers’ views has gained acceptance, few studies have been dedicated to the exploration of the voice of the residents in care homes. The review of the literature regarding residents’ satisfaction and quality in care homes revealed that the voices of residents in care homes are usually not heard or are absent. Moreover, the adoption of quality improvement tools in health care has lagged behind that in other industries and there is generally a failure to use an appropriate methodology in care homes, one based on residents’ voice, for improving quality. As a result, the main aim of this research is to investigate residents’ voice regarding improving their satisfaction in care homes. Further, the researcher seeks to obtain data by using an appropriate methodology to assist care home managers in enhancing the quality of the services they offer by assigning weights to quality indicators pertaining to improving quality and residents’ levels of satisfaction. For this purpose, this research employs both qualitative and quantitative approaches to develop a research process entailing: (1) a comprehensive literature review to recognise the phenomenon; (2) interviews with fifteen older people who lived in three different care homes in order to discover the most important residents’ needs and requirements in such homes; (3) a resident survey with one hundred and two residents in thirty five care homes. These were conducted to assess their preferences for the importance of demanded qualities; their satisfaction with provided services and the attributes of each demanded quality based on the Kano model, in order to identify the priority of improvement. Next, (4) there was the development of the House of Quality (HoQ) to optimize quality to assure residents’ satisfaction; and finally, (5) an evaluation study was conducted with thirteen service providers, in order to assess the accuracy and appropriateness of the methodology. This research has contributed towards a better understanding of the residents’ voice, and applying it for enhancing quality and residents’ satisfaction in care homes. For the first time residents’ requirements are prioritised and classified in this context through accurate methods. Moreover, an understanding of the attributes of care home residents’ needs in relation to a Kano model has been elicited. The novelty of this proposed methodology is in utilising the Quality Function Deployment (QFD) in care homes to translate the voice of residents’ regarding their requirements into service planning. The research methodology and results facilitate care home managers with a hierarchy for improvement planning at both service and executive management levels.
26
Holup, Amanda A. "Care Setting of the Last Resort: Care Transitions for Nursing Home Residents Directly Admitted from the Community." Scholar Commons, 2016. http://scholarcommons.usf.edu/etd/6257.
Full textAbstract:
Since the late 1980s, policymakers have attempted to reduce the institutional bias of their long-term services and supports by investing in more accessible home and community-based services for older adults with long-term care needs and adults with disabilities. To further advance rebalancing discussions, this study examined the resident, facility, and state characteristics associated with the admission of community-dwelling older adults to the nursing home and the subsequent discharge of this population back to community settings. Data from the Minimum Data Set (MDS) 2.0 were used to construct episodes of care for all newly-admitted residents aged 65 and older to any free-standing U.S. nursing home. Several secondary datasets including the Online Survey, Certification, and Reporting Database (OSCAR), LTCFocus.org website, Nursing Home Compare, Nursing Home Data Compendium, and U.S. census estimates were used in the study analyses.
On average, approximately 5.3% of all newly admitted nursing home residents were admitted directly from home with substantial variations across states. Most residents admitted directly from home had limited to extensive dependency in activities of daily living and moderate cognitive impairment. The most common diagnoses on admission included dementia and diabetes. While 31% of residents admitted from home remained in the facility at least 365 days after admission, 32% were discharged to the community, 15% were discharged to the hospital, and 21% died. Most residents admitted from assisted living communities, either remained in the facility or died by the end of the study. Findings from multivariate analyses suggest that resident-level factors, including demographics and health status, influenced the community transition of nursing home residents. Facility characteristics, including ownership, deficiency scores, the ratio of Medicare and Medicaid residents, and urban location were associated with discharge to the community but the effect of these factors differed according to length of stay. The commitment of a state to home and community-based services was also predictive of community discharge. Collectively, findings suggest that resident, facility, and state characteristics influence the community discharge of residents admitted from home or assisted living communities. By understanding the reasons for admission to the nursing home and the factors influencing discharge from the facility, policymakers and administrators can better anticipate and care for community-dwelling older adults with long-term care needs.
27
Smith, Kelly M. "Broadening the Lens: A Systems Approach to Nursing Home Quality Improvement." Scholar Commons, 2018. https://scholarcommons.usf.edu/etd/7365.
Full textAbstract:
The National Quality Award Program, sponsored by the American Healthcare Association National Center for Assisted Living, was implemented to cultivate continuous quality improvement in nursing homes and assisted living facilities. Based upon the Baldridge Criteria for Performance Excellence, the program utilizes a systems-based or Big “Q” approach to quality and requires applicants to examine seven categories of their organizational environment including: 1) leadership, 2) strategy, 3) customers, 4) measurement, analysis, and knowledge management, 5) workforce, 6) operations, and 7) results. The subsequent dissertation examines whether award status is associated with better performance on publicly reported quality measures and financial performance within the nursing home setting. Findings suggest implementation of Baldridge principles may promote improved quality; however, further research is warranted to fully understand the relationship.
28
Davidson, Carrie Jane. "Profit Status and the Relationship between Medicaid Reimbursement and Nursing Home Quality in Ohio Nursing Homes." Connect to text online, 2006. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=case1138477611.
Full textAbstract:
Thesis (Ph. D.)--Case Western Reserve University, 2006.[School of Medicine] Department of Epidemiology and Biostatistics. Includes bibliographical references. Available online via OhioLINK's ETD Center.
29
Draper, Peter. "Promoting the quality of life of elderly people in nursing home care : a hermeneutical approach." Thesis, University of Hull, 1994. http://hydra.hull.ac.uk/resources/hull:3927.
Full textAbstract:
The research described in this thesis addresses two central issues. The first issue concerns the development of a series of practice standards that will promote the quality of the lives of older people who live in nursing homes. However, before this professional issue is addressed, it is necessary to explore the meaning of the underlying concept the quality of life, and this constitutes the second issue.The purpose of this research is therefore to develop a concept of the quality of life that can adequately support a series of practice standards. The thesis is presented in five parts. Part one outlines the theoretical context of the study. It contains two chapters. The first discusses philosophical hermeneutics, which forms the conceptual and methodological framework of the research; and the second reviews aspects of the literature of the quality of life and evaluates it in terms of the purposes of the research. Part two of the thesis describes the empirical phase of the research, including the approach to data collection and the analytical strategy that was used. In part three the findings are presented, and in part four their implications are discussed for the organisation of care, and practice standards are derived. Part five evaluates the research, paying particular attention to the usefulness of philosophical hermeneutics, and suggestions are made for further research.
30
Petersson, Andreas, and Carina Kvarnström. "Vuxna människors erfarenheter av att i livets slutskede vårdas av anhöriga i hemmiljö." Thesis, University of Kalmar, School of Human Sciences, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:hik:diva-60.
Full textAbstract:
Att befinna sig i ett terminalt skede i livet kan innebära en känsla av oro och ångest inför sjukdomen och döden. Möjligheten att då få tillbringa sin sista tid i hemmiljö med nära och kära kring sig genererar för många en trygghet. Syftet med denna uppsats är att belysa vuxna människors erfarenheter av att i livets slutskede vårdas av anhöriga i hemmiljö. Metoden som använts är systematisk litteraturstudie där aktuell forskning inom området sammanställts. Databaser som använts för sökningen var PsycINFO, Medline, Cinahl, Elin@kalmar och SweMed+. Artiklar som syftade till problemformuleringen kvalitetsgranskades och resultatet bygger på tio vetenskapliga artiklar. Resultatet visade att sociala relationer och stöd från familjen genererar livskvalitet och trygghet hos människan som vårdas i livets slutskede. Delaktighet i sin vård och känsla av att inte förlora kontrollen över sina symtom gjorde att människan kände hopp och att de klarade av situationen. Slutsatserna var att möjligheten att få bo kvar hemma ansågs mycket betydelsefullt. Sociala relationer bidrog till att människor hemma kände en lägre grad av symtom. Den sjuke uppskattade stödet från familjen men ville inte bli en börda för anhöriga. Information om stöd och en realistisk planering samt insikt i situationens allvar bidrog till att hon kände delaktighet och bättre kunde hantera situationen.
31
Morin, Diane. "The comparison of the impact two comprehensive geriatric assessment procedures on quality of life and service use." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1998. http://researchonline.lshtm.ac.uk/901043/.
Full textAbstract:
Home care of the elderly is of increasing concern not only to purchasers and providers of health care but also to the public and to those responsible for providing social care. As with any service, the aim must be to provide care that is appropriate for each individual. To achieve that, valid and reliable measures of a person's needs are required and resources are to be used as efficiently as possible. A considerable amount of work has been carried out to develop such normative-based measures for assessing the home care needs of the elderly in the form of comprehensive geriatric assessment (CGA). CGA is a commonly used technology which has been shown to be associated with improved health status and lower service use. Despite widespread use, however, the effectiveness of different CGAs has not yet been fully investigated. In the Province of Quebec, Canada, two CGAs which differ in comprehensiveness and resource requirements are being used to assess needs at entry to home care. The aim of this study is to compare the differential impact of these two CGA procedures on patient outcomes: the Systdme de mesure de l'autonomie fonctionnelle, the longer, more comprehensive and resourceintensive CGA, and the Admission au maintien d domicile which is a shorter and less resource-intensive form of CGA. In a prospective cohort study, 158 elderly patients aged 65 years or over were assessed at admission to home care using one or the other CGA and changes in health-related quality of life as well as service use were monitored and compared at the end of a 12-week follow-up. Costs related to the use of a long or a shortform CGA were also explored. These comparisons were made while controlling for patient (age, gender, living alone, quality of life at entry, depression), process (type and intensity of care received) and structural variables (budget and staff mix). Results from comparative and multivariate analyses are in favour of not rejecting the null hypothesis that both forms of CGAs are similarly associated with outcomes. Depression was the strongest predictor of changes in quality of life and high intensity of care and a low proportion of nurses on the home care teams were the strongest predictors of service use outside HC. These results lead us to discuss whether long or shortform CGAs were developed on a comparative rather than a normative definition of needs. The implications of these findings for home care policy and practice are discussed and suggestions for future research are presented.
32
Lapré, Frederik Albert Ludwig. "Service quality in nursing homes : a construct, measurement and performance model to increase client focus." Thesis, University of Bradford, 2012. http://hdl.handle.net/10454/5773.
Full textAbstract:
This thesis is concerned with the quality of care for the elderly in nursing homes, responding to a critical social and demographic imperative. The aim of this study is to provide a service quality construct for nursing homes to increase client focus and satisfaction. The research is underpinned by the service quality literature. It utilises the SERVQUAL construct to explore the nature of service quality in nursing homes through semi-structured interviews with nursing home residents and resident's families. A service quality scale was constructed comprising six dimensions and 27 scale items capturing service delivery in nursing homes. This scale was purified through a survey of residents and family members (n=263). Through exploratory factor analysis, six importance and four experience factors were identified. Regression analysis was used to identify relationships between the factors, service quality and satisfaction. The results indicate that importance does not predict perceived quality, though experience of responsiveness and hospitality and courtesy and personal approach are indicators of service quality. Furthermore, quality emerges as a predictor of satisfaction. From these outcomes, a service quality construct was developed which comprises of service marketing and service quality dimensions. This thesis contributes to the construction of the concept of service quality in nursing homes, its dimensionality and thus the precursors of satisfaction. These have considerable implications for the management of nursing home services.homes, its dimensionality and thus the precursors of satisfaction. These have considerable implications for the management of nursing home services.
33
Bjuresäter, Kaisa. "Home enteral tube feeding - from patients’, relatives’ and nurses’ perspectives." Doctoral thesis, Karlstads universitet, Avdelningen för omvårdnad, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-6325.
Full textAbstract:
Changes in the health-care system during the past decades have led to an increased transfer of health care to the home environment which also concerns patients treated with home enteral tube feeding (HETF). Research is scarce about how HETF care is functioning. Therefore, the overall aim with this thesis was to describe and explore HETF care and treatment from patients', relatives' and nurses' perspectives. Three qualitative and one quantitative study were used. The findings showed that the HETF treatment and care had a great impact on daily life for both patients and their relatives and implied many practical, emotional and social problems in their daily life, which they strived to manage. Side effects were common and the patients' reported low HRQL and general health. The amount and quality of received guidance and support from the health care, not least before discharge, turned out to have impact on the patients' and the relatives' daily life and how they could manage their situation. Lack of guidance and support meant insecurity, worries and distress. Cooperation in the care trajectory was found to be decisive for how well the care was running. Nurses' knowledge about tube feeding and discharge planning procedures, their commitment to the patients' care, as well as clarity regarding responsibility of HETF care were factors of crucial importance on how the cooperation worked, and the quality of the HETF care. This thesis shows the need of improvements regarding the care of HETF patients and their relatives.
34
Hercules, Carmen Zuleyma. "Family child care providers' perceptions of quality of training in the early head start program." Scholarly Commons, 2018. https://scholarlycommons.pacific.edu/uop_etds/3551.
Full textAbstract:
In order to give children quality child care, child care providers need appropriate training and coaching to develop effective teaching practices. Compared to center-based educators, family child care providers tend to have less education and training and offer fewer educational experiences. The purpose of this study was to investigate how family child care providers perceived the quality of Early Head Start training to support professional development, and to identify what professional areas and experiences or activities providers deemed crucial to their professional-development training. Bandura’s (1997) social-cognitive theory described the way people learn from each other, and identified four factors—mastery experiences, vicarious experiences, social persuasion, and psychological factors—that are related to self-efficacy. Interview questions and observational coding of teacher training pertained in part to Early Head Start trainees’ experiences of social-learning and self-efficacy during training.
35
Matlabi, Hossein. "The contribution of home-based technology to elderly people's quality of life in extra-care housing." Thesis, University of Sheffield, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.531166.
Full text
36
Eklund, Christoffer. "Kvalitet och konkurrens : En studie av konkurrensens effekter på den upplevda kvaliteten inom hemtjänsten." Thesis, Södertörns högskola, Institutionen för samhällsvetenskaper, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:sh:diva-30293.
Full textAbstract:
Sedan riksdagen beslut om Lag om valfrihetssystem även kallat LOV har hemtjänsten varit ett omstritt ämne i samhällsdebatten. Lagen om valfrihetssystem togs i bruk första januari 2009 med syftet att genom en fungerande konkurrenssituation så kan kvalitet och effektivitet öka samt möjliggöra nytänkande och mångfald. Enligt en rikstäckande undersökning av äldres uppfattning om kvalitén i hemtjänsten genomförd av Socialstyrelsen 2015 är bilden av äldreomsorgen generellt positiv i Sverige. Resultaten varier dock mellan olika kommuner och verksamheter. I en del kommuner och verksamheter är fler än tio procent ganska eller mycket missnöjda. Syftet med den här studien var att svara på frågan: Ger ett högre konkurrenstryck en bättre upplevd kvalitet för brukare av hemtjänst i Sveriges kommuner? Data och variabler som använts är ett kvalitetsmått som beroende variabel i form av upplevd kvalitet som är framtaget baserat på brukarundersökning inom hemtjänsten. Oberoende variabeln är konkurrenstrycket i varje kommun. Undersökningen genomfördes i två olika multipla regressionsmodeller. Först en modell för att undersöka skillnaden i effekten av egenskaperna lågt och högt konkurrenstryck mot referensgruppen inget konkurrenstryck. Det vill säga om den upplevda kvaliteten är högre i de kommuner som infört LOV och konkurrensutsatt sin hemtjänst än de som inte. Inget statistiskt signifikant resultat påvisades i regressionen. För att undersöka effekterna av konkurrenstryck, skillnaden mellan lågt och högt konkurrenstryck och vilka andra faktorer som påverkar den upplevda kvaliteten användes även en andra regressionsmodell för analys endast av de kommuner som infört LOV. Även i den analysen kunde inget statistiskt signifikant resultat påvisas att konkurrenstryck har någon signifikant effekt på den upplevda kvaliteten. Istället är det andra faktorer enligt den här studien som påverkar den upplevda kvaliteten. Av de övriga variablerna Personalomsättning, Genomförandeplan, Tätortsgrad, Medianinkomst hos 65+ befolkningen och ersättningsnivåerna för service, omvårdnad och landsbygdsersättning visar resultatet på att en högre andel genomförandeplaner, tätortsgrad och medianinkomst i kommunerna påverkar den upplevda kvaliteten negativt. Ersättningsnivån för omvårdnad har däremot en positiv effekt på den upplevda kvaliteten. För övriga variabler påvisade regressionen ingen signifikant effekt på den upplevda kvaliteten. Avslutningsvis kan inte resultaten i den här studien påvisa att ett högre konkurrenstryck leder till en högre upplevd kvalitet som ett av syftena med Lagen om valfrihet är.
37
Lai, Kam-yuk, and 賴錦玉. "Improving the quality of life for nursing home residents withdementia: a life story approach." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31228264.
Full text
38
Modikwane, Mmatladi Octavia. "Assessment of the quality of services provided by the home community based care programme to people infected and affected by HIV/AIDS / M.O. Modikwane." Thesis, North-West University, 2007. http://hdl.handle.net/10394/1827.
Full textAbstract:
The North-West Province has the fifth highest prevalence of HIV/AIDS in the country and has an estimated HIV prevalence of 22.9%. On the 24th November 1999 cabinet approved a special allocation of funds to finance a National integrated programme in the fight against the HIV/AIDS pandemic. They involved Departments of Social Services, Health, Education and Agriculture. The plan comprised three main components, which included the implementation of Home Community Based Care models for children and youth infected and affected by HIV/AIDS. The North-West Province was one of the provinces identified to pilot the programme and funds were allocated for the establishment of the programme.
This study was undertaken with the aim of assessing the quality of services provided by the Home Community Based Care Programme to people infected and affected by HIV/AIDS. An empirical survey as well as a literature study was undertaken to determine whether the caregivers that are part of the Home community based care programme play their set role. Forty-five beneficiaries of the programme were randomly selected as respondents. An evaluative research design was utilised to test the progress of the Programme and check whether the programme is consistent with programme design specifications. A structured self-administered coded questionnaire with descriptive questions was developed and self administered to 45 respondents in Ikageleng Location in Zeerust who were randomly selected from a list of beneficiaries. The findings of the study indicated that caregivers who are part of the Home Community Based Care Programme play their set role. The programme provides good quality services to beneficiaries. The programme provides palliative care services, material support, care and support services, awareness and education and income generation.Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2008.
39
Hasson, Henna. "Nursing Staff Competence, Psychosocial Work Environment and Quality of Elderly Care: Impact of an Educational Intervention." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis (AUU), 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7383.
Full text
40
Melin-Johansson, Christina. "Patients' quality of life : living with incurable cancer in palliative homecare /." Göteborg : Institute of Health and Care Sciences, The Sahlgrenska Academy at Göteborg University, 2007. http://hdl.handle.net/2077/7316.
Full text
41
Williams, Anthony R. "The nursing home five star rating: How does it compare to resident and family views of care?" Miami University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=miami1348673081.
Full text
42
Filmer, Tobias [Verfasser], and Britta [Akademischer Betreuer] Herbig. "Cross-cultural sensitivity and change of perspectives in home care nursing : the development and evaluation of a training intervention to improve the working conditions and quality of care in home care nursing services / Tobias Filmer ; Betreuer: Britta Herbig." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2020. http://d-nb.info/1228270619/34.
Full text
43
Hutchison, Rebecca. "The impact of acquired neurological oropharyngeal dysphagia on the health-related quality of life of care home residents." Thesis, University of Strathclyde, 2014. http://oleg.lib.strath.ac.uk:80/R/?func=dbin-jump-full&object_id=23565.
Full textAbstract:
Speech and Language Therapists (SLTs) have a key role in the management of oropharyngeal dysphagia. Dysphagia has many adverse consequences and negatively impacts quality of life (e.g. weight loss, embarrassment, depression). Dysphagia is prevalent among the care home population, affecting between 50% and 75% of residents. However, minimal research has explored the impact of dysphagia upon the health-related quality of life (HRQOL) of care home residents. Without such data, SLTs will be illequipped to meet the needs of this client group. This investigation sought to gain insight into the HRQOL issues for care home residents with oropharyngeal dysphagia caused by an acquired neurological disorder. A qualitative methodology based on the principles of descriptive phenomenology was adopted. Interviews, mealtime observations and reflexive discussions were used to collect data from seven residents with acquired neurological oropharyngeal dysphagia and six residents without dysphagia. In terviews and discussions were transcribed verbatim and common themes were identified using a framework for phenomenological analysis. Observational data were examined for corroborations/contradictions with participants' accounts. Participants with dysphagia described the physical, social and psychological impact of dysphagia, commented on their degree of satisfaction with diet modification and provided insight into their awareness of dysphagia and its overall impact. They also discussed other aspects of their mealtime experience, referring to their enjoyment of eating and mealtimes; barriers to mealtime enjoyment; choice at mealtimes and eating desire, findings which were similar to those obtained from the control participants. The observational data mainly corroborated with participants' accounts. Based on these findings, SLTs should ensure that they consistently adopt a holistic approach to the management of care home residents with acquired neurological oropharyngeal dysphagia collaborate with and provide education and training to care home staff.
44
Rwakonda, Munyaradzi Ephie. "Lived Experiences of Individuals Quality of Life on Prolonged Home Mechanical Ventilation." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4558.
Full textAbstract:
Improvements in technology have allowed people with tracheostomies to live at home on mechanical ventilation (HMV). Quality of life (QOL) for HMV users has been studied quantitatively, but few qualitative studies have been published. The purpose of this phenomenological study was to explore QOL for individuals with tracheostomies on prolonged HMV focusing on activities of daily living (ADLs) and the role of decision- making. The Roper, Logan, and Tierney activities of living theory were used to categorize activities. Ten participants, 18 years and older, with a tracheostomy and on HMV for at least 6 months were enrolled using purposive sampling. Data were collected through structured, in-depth, face-to-face interviews. Themes that emerged were (a) autonomy, (b) significance of ventilator for well-being, (c) feeling tied up, (d) creating meaning, (e) tipping point, (f) reminiscence, (g) building trust and confidence, (h) adjusting to technology, (i) family support and relationships, and (g) meaning of life. The participants were relatively healthy and their QOL was improved when they were on HMV compared to the hospital. The participants felt empowered that they had control in their daily lives at home when they had competent caregivers and family members for continuity of care. Recommendations for future research would include exploring improved methods of collaboration among health care workers and families in providing holistic care and reducing role strain and isolation in young HMV users. The study may promote positive social change through education for family, health care workers, and the public about strategies to promote independence and subsequent improvement in QOL for individuals on HMV.
45
Koski, Jenny. "God vårdkvalitet inom äldreomsorgen : Vilka kvalitetskrav ställer kommuner på utförare som bedriver hemtjänst i ett valfrihetssystem?" Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-208916.
Full textAbstract:
Andelen äldre personer i Sveriges befolkning ökar, vilket leder till större behov av väl fungerande äldreomsorg. Kommunerna har ansvar för äldreomsorgen oberoende om den utförs i offentlig eller privat regi. Den 1 januari 2009 trädde lagen om valfrihet i kraft som bland annat syftar till att öka individens möjlighet att välja hemtjänstutförare. Idag har privata aktörer större möjligheter att etablera sig inom hemtjänsten. Kontrakten som tecknas mellan kommunen och en privat utförare är den enda direkta legala möjligheten för den ansvariga kommunen att påverka kvaliteten i verksamheterna. Därför är det viktigt att kraven som ställs i kontrakten tydligt beskriver vad kommunen vill att de privata aktörerna ska utföra och vilken kvalitet dessa tjänster ska ha. Syftet med studien var därför att undersöka om och hur kommunernas kontrakt med de privata utförarna fångar upp centrala aspekter av omsorgskvalitet inom hemtjänsten. En kvalitativ deduktiv ansats användes och en innehållsanalys genomfördes för att besvara frågeställningarna. Med hjälp av en utformad analysmodell besvarades vilken typ av kvalitetskrav som ställs i kontrakten. Resultaten visade att majoriteten av de identifierade kvalitetskraven i kontrakten beskrev hur omsorgstjänsterna ska utföras. Kraven utifrån de sex kategorierna, som ingick i analysmodellen, diskuterades i kontrakten. De flesta av kraven som ställdes i kontrakten var specificerade och uppföljningsbara. Dock visade det sig att det inte gick att mäta i vilken grad kraven var uppnådda. Utifrån studiens resultat verkar svårigheterna för kommunerna vara att formulera tillräckligt omfattande och mätbara krav, vilket kan försvåra styrningen av kvaliteten inom äldreomsorgen.The elderly population in Sweden is growing, which means that more efforts by the home care services are needed. The municipality is responsible to ensure that their population gets the services they need by public or private home care agencies. In January 2009 the law of system of choice was introduced. One aim of the law was to give the individual more freedom to choose home care provider. The only legal way for the municipality to control the quality in private services is to establish a contract between them. Therefore it is important that the contract is well written, and that the municipality clearly expresses what quality they expect the home care provider to perform. The aim of this study was to examine how the contracts are written and what kind of quality the text expresses. A qualitative deductive approach was used and a content analysis was made to examine the contracts. A model for analysis was developed with the purpose to examine the contracts. The results showed that the majority of the text about the quality in the contracts described specific how the services should be performed. The six categories, included in the model of analysis, were represented in the contracts. However, the requirements described in the text were not designed to be measurable. The results showed that it seems difficult for the municipality to formulate requirements that are measurable. This can be a reason for the difficulties for the municipality to control the quality in the elderly care.
46
Ai-Cheng, Li, and 李愛誠. "Quality of Care in Home Care and Nursing Home." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/12111248590566418717.
Full textAbstract:
碩士亞洲大學
健康產業管理學系長期照護組
99
Objective: The problem of long-term healthcare for a disabled and aging population has gradually become a point of concern in many countries. Improvement of the quality of long-term healthcare is a topic that requires urgent focus. Thus, this study used the National Health Insurance (NHI) Claim Database to investigate differences in quality of care with regard to home care and nursing home services. Methods: This study obtained data on 2006 inpatient and outpatient medical claims from the data of one million people in 2005 Health Insurance Database. A sample of 1,564 users of home care and nursing home services was taken. This study then investigated the difference in quality indicators of healthcare, drug use, and healthcare utilization among these users within a two-year period. Results: Observation of users of home care services showed the following statistics: 4.5 % sought medical care due to depressive illnesses in the first year; 49.8 % sought medical care due to urinary tract infection (UTI) in the second year; 4.6 types of drugs were issued on average at each outpatient visit, and the average number of outpatient visits per year was 34.Observation of users of nursing home services showed the following statistics: 9.6 % sought medical care due to depressive illnesses in the first year; 62.1 % sought medical care due to urinary tract infection (UTI) in the second year; 4.2 types of drugs were issued on average at each outpatient visit, and the average number of outpatient visits per year was 49. The differences among users of home care services and users of nursing home services reached statistical significance. After other variables had been controlled, logistic regression analysis showed that the probability of depression (first year) and UTI (second year) among users of nursing home services was 2.62 and 1.54 times that of users of home care services, respectively. Conclusion: Although NHI in Taiwan affords a similar degree of disability benefits to users of home care services and nursing home services, the quality of the two service models differs. Related medical referral units and service providers should plan health education and guidance, and improve index management and care processes as soon as possible, to enhance the quality of healthcare services.
47
Hudson, Kathleen Marie. "The meaning of quality nursing care in the nursing home /." 1991. http://wwwlib.umi.com/dissertations/fullcit/9218754.
Full text
48
JUNG-LIN and 林絨. "Quality of care in Psychiatric Nursing Home." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/72172751296314988898.
Full textAbstract:
碩士佛光大學
管理學研究所
95
This study aims to investigated Quality of care in the Psychiatric Nursing Home from the view points of residents, families, nursing aides, expert and nurses. By purposive sampling of a qualitative research method and in-depth interviews with the Psychiatric Nursing Home in the eastern part of Taiwan, we examined 28 participants, including nine residents,four families, five nursing aides, five expert and five nurses. The study present 9 categories of quality of care for psychiatric nursing home including of environment, rights safeguard, quality assurance, social reconcile, direct care competencies, complete medical serve, classification care, occupation rehabilitation and needs satisfaction. The results of the research will provide a reference material for the team workers and the common indicators for establishing the instrument of care in the Psychiatric Nursing Home.
49
Grabowski, David C. "Medicaid reimbursement and the quality of nursing home care /." 1999. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:9951790.
Full text
50
Li-Chuan, Chen, and 陳麗娟. "Using “ The Observable indicators of Nursing Home Care Quality”instrument to measure quality of nursing home care– in Taichung City." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/71410947259812763774.
Full textAbstract:
碩士亞洲大學
長期照護研究所
96
Abstract Long term care is an important issue of a country with aged population, and the old age population in Taiwan reached 10% at the end of 2006. Due to the increase of aged and disabled population, the need for long-term care increases as well, and so does the number of nursing homes. Therefore, how to ensure the quality of nursing home care is an important task today. The registered nursing homes in Taichung City is what the research aimed at, and “the observable indicators of nursing home care quality” instrument was used as a tool, and the researcher used structural questionnaires and on-site observation method to collect the data, and the purpose of this research is to evaluate the level of consistency between “the accreditation survey for nursing homes” instrument and “the observable indicators of nursing home care quality” instrument. The total number of nursing home evaluated is 12, and the highest, the lowest and the average scores measured by “the observable indicators of nursing home care quality” instrument are 172, 115 and 139.33 respectively. The average scores for dimensions of instrument from the highest to the lowest are in the order of “staff”, “environment”, “care ”, “communication ” and “home/family involvement”. The level of consistency between ““the accreditation survey for nursing homes” instrument and “the observable indicators of nursing home care quality” instrument was evaluated by 0.167 kappa value, and it does not have an significant meaning, and it means that the result measured from “the accreditation survey for nursing homes” instrument is not consistent with the result from “the observable indicators of nursing home care quality” instrument. But the measured result of “staff” dimension in OIQs is consistent with the result of “health” and “daily life care”; the result of “staff” dimension in OIQs is consistent with the result of “health” and “daily life care”; the result of “environment” dimension in OIQs is consistent with the result of “safety and environment setting”; the result of “homelike/family involvement” dimension in OIQs is consistent with the result of “safety and environment setting”. The result of “communication” dimension in OIQs is not consistent with the result of “health”; the result of “staff” dimension in OIQs is not consistent with the result of “institute and staff management”. This research suggests that when the quality of a nursing home care is measured by “the observable indicators of nursing home care quality” instrument, other evaluation tools should be also used to ensure a complete and comprehensive evaluation. And the supervising authorities could use this instrument to evaluate the quality of a nursing home care periodically in order to continuously control the quality.