Impact of STAR-VA on Staff Injury and Disruptive Behavior Reports in VA Nursing Homes |
| |
| Institution: | 1. Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA, USA;2. Department of Health Policy and Management, Boston University School of Public Health, Boston, MA, USA;3. VA Western New York Healthcare System, Center for Integrated Healthcare, Buffalo and Batavia, NY, USA;4. Serious Mental Illness Treatment Resource and Evaluation Center, Office of Mental Health and Suicide Prevention, Department of Veterans Affairs, Ann Arbor, MI, USA;5. Center of Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, RI, USA;6. Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA;7. Department of Veterans Affairs, Geriatrics & Extended Care Data Analysis Center, Finger-Lakes Healthcare System, Canandaigua, NY, USA;8. Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA;9. Office of Mental Health and Suicide Prevention, Department of Veterans Affairs Central Office, Washington, DC, USA;10. Workplace Violence Prevention Program, Office of Mental Health and Suicide Prevention, Veterans Health Administration Central Office, Washington, DC, USA;11. Lexington VA Health Care System, Lexington, KY, USA;1. Department of Forensic Medicine, Monash University, Melbourne, Victoria, Australia;2. Office of the Public Advocate (Victoria), Melbourne, Victoria, Australia;3. Department of Forensic Medicine, Monash University, Melbourne, Victoria, Australia;1. Robert M. LaFollette School of Public Affairs, University of Wisconsin–Madison, Madison, WI, USA;2. UCLA/VA Los Angeles Division of Geriatrics at UCLA Borun Center and VA GRECC, Los Angeles, CA, USA;3. Department of Medicine, Division of General Internal Medicine, iTEQC Research Program, University of California, Irvine, CA, USA;1. School of Medicine, Vanderbilt University, Nashville TN, USA;2. Cecil G. Sheps Center for Health Services Research and Departments of Family Medicine and Internal Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;3. Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;4. Duke University Health System, Durham NC, USA;5. School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;1. Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan;2. Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan;3. Department of Rehabilitation, Niigata University of Rehabilitation, Niigata, Japan;4. Department of Health and Nutrition, Niigata University of Health and Welfare, Niigata, Japan;5. Department of Food Science and Nutrition, Nara Women''s University Graduate School of Humanities and Sciences, Nara, Japan;6. National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan;7. Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan;8. Murakami Public Health Center, Niigata, Japan;9. Niigata Prefectural Office, Niigata, Japan;10. Department of Orthopaedic Surgery, Niigata University Medical and Dental Hospital, Niigata, Japan |
| |
| Abstract: | ObjectivesWorkplace disruptive behavior incidents can be costly for organizations, employees, and customers. Persons with dementia living in long-term care settings have a high risk of exhibiting distressed behaviors. We examined whether a resident-centered, behavioral intervention for residents with dementia led to a reduction in reported workplace disruptive behaviors and staff injury rate due to assault. Impactful interventions are important for quality of care.DesignWe examined whether a team-based behavioral program in community living centers (CLCs), where a nurse champion and behavioral coordinator were trained to work with the clinical team to understand and manage distressed behaviors commonly associated with dementia, was associated with reductions in behavior incidents.Setting and ParticipantsThe setting was Veterans Health Administration CLCs. The sample consisted of 120 aggregated CLCs operating between 2012 and 2017 with 62 completing training. CLCs were distributed across the United States.MethodsOutcomes included CLC-level rates of staff injury and number of workplace disruptive behavior incidents. Outcomes were regressed on measures of intervention completion, time since intervention, and several CLC characteristics.ResultsThe intervention was significantly associated with lower incidence of assault with staff injury rates overall, particularly following the first year of training, but not with other reported workplace disruptive behavior incident rates.Conclusions and ImplicationsA team-based behavioral intervention was associated with reduction of employee assaults, a critical repercussion of distressed behavior in dementia. Given rapid growth in patients with dementia in nursing homes, effective treatment practices, such as interdisciplinary behavioral management approaches may be impactful and valuable to implement. |
| |
| Keywords: | Dementia veterans long-term care distress behavior safety |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
