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At least 19 recordsLinked to original sources

Changes in use of voluntary workers in nursing homes: United States, 1985 and 1999.

OBJECTIVE: This report describes changes in the use of voluntary workers in nursing homes between 1985 and 1999. Statistics are presented on selected characteristics of nursing homes using voluntary workers and the services they perform. Factors that may contribute to the increased use of voluntary workers are also discussed. METHODS: The data presented in this report were collected from the 1985 and 1999 National Nursing Home Surveys (NNHS). NNHS is a part of the National Health Care Survey, which measures health care utilization across various types of providers. Conducted periodically since 1973, NNHS obtains information from a nationally representative sample of nursing home facilities based on interviews with administrators and staff. Sample data are weighted to produce annual national estimates. RESULTS: In 1999, 87 percent of all nursing homes reported using voluntary workers, up from 78 percent in 1985. In 1985, unpaid workers were most likely found in large nursing homes (100 beds or more). By 1999, about the same proportion of nursing homes, large and small, reported their use. In 1999, the Northeast region had the greatest proportion of nursing homes that used volunteers--93 percent. Chain-affiliated and independent facilities used volunteers with about the same frequency, and about the same percentage of nursing homes not certified by either Medicaid or Medicare used voluntary workers as did dually-certified facilities. However, in 1999, proportionately fewer proprietary (for-profit) nursing homes reported having volunteers (85 percent) than did nonproprietary facilities (93 percent).

Humans↗

Teaching front-line health and voluntary workers to assess and manage suicidal patients.

BACKGROUND: To devise and evaluate the retention of a new brief training package for non-psychiatrically trained multidisciplinary staff to assess suicide risk and manage suicidal patients, including referral of patients at significant risk to psychiatric staff. METHOD: 8 h of interview skills training, using role play with modelling and video feedback, was taught to 33 health and voluntary workers. Evaluation used a controlled before and after training design. Performance of the interview skills was assessed blindly by raters using predetermined criteria from videotaped role played interviews with actors. Self-rated questionnaires (SIRI-2 and visual analogue scales) were used to assess the clinical skills and confidence respectively of the front-line workers. RESULTS: Suicide risk assessment and management skills such as problem solving, future coping and provision of immediate support were significantly improved at 1 month after training. Training did not significantly improve general interview skills, combating hopelessness nor the removal of lethal weapons. Performance on the SIRI-2 and confidence significantly improved after training. The assessment procedure itself did not improve clinical skills nor confidence. LIMITATIONS: Performance among individual health disciplines was not assessed. Design was not a randomised controlled trial with short follow up and no patient outcome data. CONCLUSIONS: A brief training package is available which is effective in teaching suicide risk assessment and clinical management skills.

Adult↗