Biomedical subjects

S F Simmons

Publications and source records attributed to S F Simmons.

22 records · Page 2Linked to original sources

PubMed1993

The nighttime environment, incontinence care, and sleep disruption in nursing homes.

OBJECTIVE: To evaluate the association between noise, light, nursing care practices, and nighttime awakenings in incontinent nursing home residents. DESIGN: Cross-sectional survey. SETTING: Four long-term care nursing facilities. PARTICIPANTS: One hundred eighteen incontinent nursing home residents. MEASUREMENTS: Over two nights, bedside monitoring equipment recorded wrist activity, resident bed movements, and environmental noise and light changes in consecutive 2-minute intervals. Changes in sleep and bed movement were compared with changes in noise and light that occurred within the same or proximal 2-minute intervals. Noise and light changes in combination with large resident movement at the hip and shoulder were interpreted as related to incontinence care based on observational measures. Specific outcome measures were: (1) the number of noise and light changes as well as staff care practices that did not wake the resident during periods of consecutive sleep, ie, sleep lasting a minimum of 10 minutes; (2) the number of noise and light changes as well as staff care practices that occurred immediately before or during the 2-minute intervals during which a resident woke from a period of consecutive sleep; and (3) the number of such staff care practices that were related to incontinence care. RESULTS: Noise and light changes associated with both general environmental events and more specific nurse care practices were associated with 50% of all waking episodes of 4 minutes or longer and 35% of all waking episodes of 2 minutes or shorter. The major sources of all noise were traced to nursing staff. Eighty-seven percent of all incontinence care practices were associated with episodes of waking. CONCLUSION: The data reported in this paper document that general environmental noise and incidents of nursing care practices, particularly those related to incontinence care, are responsible for a substantial amount of the sleep fragmentation that is common among nursing home residents.

Aged↗

PubMed1992

Risk factors that predict staff failure to release nursing home residents from restraints.

This study identifies resident characteristics related to nursing staff failure to provide consistent release from physical restraints as required by regulation. The lengths of intervals during which residents were restrained were measured and correlated with the staff's perception of degree of care burden and resident behavioural characteristics in order to identify risk factors related to the absence of consistent release. Staff perceptions of residents' verbal aggressiveness (multiple R = -.30, p < .01), physical aggressiveness (multiple R = -.25, p < .03) and unpleasantness (multiple R = -.25, p < .03) are the three characteristics most predictive of the length of time residents continuously remain restrained.

Aged↗

PubMedDate not supplied

The effect of dining location on nutritional care quality in nursing homes.

BACKGROUND: Nutritional care quality in nursing homes (NHs) is often characterized by inadequate and poor quality feeding assistance and inaccurate medical record documentation of residents' oral food and fluid intake. OBJECTIVE: To describe the effect of dining location on indicators of nutritional care quality in NH residents. DESIGN AND METHODS: A cross-sectional study in 34 NHs with 761 residents. RESULTS: Nutritional care quality was significantly better according to two of four indicators if a resident ate meals in the dining room compared to their rooms. First, residents who were rated by NH staff as requiring assistance to eat were more likely to receive assistance in the dining room compared to their rooms. Second, NH staff medical record documentation of oral food and fluid consumption was more accurate when residents ate in the dining room. CONCLUSIONS: Residents at risk for unintentional weight loss should eat their meals in a common area, such as the dining room, to promote adequate feeding assistance care provision and accurate medical record documentation of oral food and fluid consumption.

Aged↗

PubMedDate not supplied

The effect of staff care practices on nursing home residents' preferences: implications for individualizing care.

PURPOSE: To examine the effect of staff care practices on nursing home residents' preferences for dining location. METHODS: A cross-sectional study was conducted with 304 long-stay residents in six skilled nursing homes. Research staff conducted direct observations during meals for two days and interviewed residents on the same two days about their preferences for dining location for each scheduled meal (breakfast, lunch and dinner). RESULTS: Staff care practices were significantly related to residents' preferences to eat in the dining room for all meals after adjusting for resident characteristics and nurse aide staffing level. For each unit increase in the proportion of residents taken to the dining room for meals by staff, residents' preferences to eat in the dining room also significantly increased by approximately three to four percent for each mealtime period. DISCUSSION: Staff care practices may influence residents' reported preferences for dining location. Daily care practices may be inappropriately justified by residents' preferences, which are shaped by their nursing home care experience and reduced expectations. In efforts to individualize resident care, nursing home staff should consider the influence of established care practices on residents' reported preferences for daily care.

Aged, 80 and over↗