Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-22T22:40:07.300Z Has data issue: false hasContentIssue false
  • English
  • Français

Implementation of Mental Health Huddles on Dementia Care Units*

Published online by Cambridge University Press:  07 August 2014

Laura M. Wagner ,
Maria Huijbregts ,
Lisa G. Sokoloff ,
Renee Wisniewski ,
Leenah Walsh ,
Sid Feldman  and
David K. Conn
Laura M. Wagner*
Affiliation:
Department of Community Health Systems, University of California, San Francisco School of Nursing, San Francisco, CA Kunin-Lunenfeld Applied and Evaluative Research Unit-Baycrest, Toronto
Maria Huijbregts
Affiliation:
Research, Evaluation & Planning, Family Service Toronto
Lisa G. Sokoloff
Affiliation:
Departments of Health Disciplines and Academic Education, Baycrest, University of Toronto Department of Speech Pathology, Faculty of Medicine, University of Toronto
Renee Wisniewski
Affiliation:
New York University
Leenah Walsh
Affiliation:
Halton Region Emergency Medical Services, Ontario
Sid Feldman
Affiliation:
Department of Family and Community Medicine, University of Toronto
David K. Conn
Affiliation:
Department of Psychiatry, Baycrest and Faculty of Medicine, University of Toronto
*
†La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Laura M. Wagner, R.N., Ph.D.UCSF School of Nursing 2 Koret Way Room N505, Box 0608 San Francisco, CA 94143 ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Client-responsive behaviours occur commonly among residents in long-term care (LTC) settings; direct-care staff, however, receive little education, support, or opportunities to discuss and collaborate on managing such behaviours. Our participatory action project introduced mental health huddles to support staff in discussing and managing client-responsive behaviours in long-term care. This research project engaged direct-care staff (e.g., personal support workers, registered practical nurses, housekeeping staff, and registered nurses) in learning how to use these huddles. Staff workers used huddles as a forum to stay informed, review work, problem solve, and develop person-centered action plans. Fifty-six huddles occurred over a 12-week period; two to seven direct-care staff participated in each huddle. Focus groups indicated improved staff collaboration, teamwork, support, and communication when discussing specific responsive behaviours. Huddles provided LTC staff with the opportunity to collaborate and discuss strategies to optimize resident care. Further research on how huddles affect resident care outcomes is needed.

Résumé

Les comportements réactifs sont communs chez les résidents des unités de soins de longue durée (SLD), mais le personnel en soins directs reçoit peu de formation, de support ou d’opportunités de discuter et de collaborer pour gérer ces comportements. Pour ce projet de recherche-action participative, nous avons utilisé la technique du caucus de santé mentale pour faciliter la discussion et la gestion des comportements réactifs. Nous avons impliqué des membres du personnel en soins directs (p. ex., travailleurs de soutien personnel, infirmières autorisées et auxiliaires autorisées, personnel d’entretient) dans l’apprentissage de l’utilisation des caucus. Ces caucus ont servi de forums pour informer le personnel, résoudre des problèmes et développer des plans d’action centrés sur le client. Cinquante-six caucus ont eu lieu sur une période de 12 semaines, chacun impliquant de deux à sept membres du personnel en soins directs. Des groupes de discussion auxquels ont pris part nos participants ont indiqué une amélioration de la collaboration, du travail d’équipe, du support et de la communication au sein du personnel lors de la discussion de comportements réactifs spécifiques. Les caucus de santé mentale ont offert au personnel en SLD l’opportunité de collaborer et d’aborder des stratégies pour optimiser les soins du client. Des études supplémentaires sur l’impact des caucus sur les soins du client sont nécessaires.

Keywords

agingresponsive behaviourscognitive impairmentAlzheimer’s diseasemental healthlong-term carevieillissementcomportements réactifsdéficits cognitifsmaladie d’Alzheimersanté mentalesoins de longue durée
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 33 , Issue 3 , September 2014 , pp. 235 - 245
Copyright
Copyright © Canadian Association on Gerontology 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

This project was funded by a grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC) Academic Health Sciences Centres (AHSC) Alternate Funding Plan (AFP) Innovation Fund.

References

Agency for Healthcare Research and Quality. (2012). Nursing home survey on patient safety culture. Retrieved 25 June 2014 fromhttp://www.ahrq.gov/qual/nhsurvey08/nhsurvey.pdfGoogle Scholar
Alzheimer Society of Canada. (2010). Rising tide: The impact of dementia on Canadian society. Retrieved 25 June 2014 fromhttp://www.alzheimer.ca/∼/media/Files/national/Advocacy/ASC_Rising%20Tide_Full%20Report_Eng.ashxGoogle Scholar
Berg, B. L. (2001). Qualitative research methods for the social sciences (4th ed.). Boston: Allyn and Bacon.Google Scholar
Brickell, T. A., Nicholls, T. L., Procyshyn, R. M., McLean, C., Dempster, R. J., Lavoie, J. A. A., et al. (2009). Patient safety in mental health. Edmonton, AB: Canadian Patient Safety Institute and Ontario Hospital Association. Retrieved 25 June 2014 fromhttp://cpsi.sharepoint.ms/English/research/commissionedResearch/mentalHealthAndPatientSafety/Documents/Mental%20Health%20Paper.pdfGoogle Scholar
Brown, C. W., & Davies, S. (2009). Using relationships in care homes to develop relationship centred care – the contribution of staff. Journal of Clinical Nursing, 18, 1746–1755.Google Scholar
Canadian Coalition for Seniors’ Mental Health [CCSMH]. (2006). National Guidelines for Seniors Mental Health: Assessment and treatment of mental health issues in long term care homes. Available from CCSMH, 3560 Bathurst St., Room 311, West Wing, Old Hospital, Toronto, ON M6A 2E1.Google Scholar
Canadian Institute for Health Information. (2010). Caring for seniors with Alzheimer’s disease and other forms of dementia. Retrieved 25 June 2014 fromhttps://secure.cihi.ca/free_products/Dementia_AIB_2010_EN.pdfGoogle Scholar
Care Practice Workplace Practice Environment. (2010). Change ideas for consistent assignment. Retrieved 25 June 2014 fromwww.sdfmc.org/ClassLibrary/Page/Information/DataInstances/283/Files/1672/Change_Ideas_for_Consistent_Assignment_040705_smassaroco.pdfGoogle Scholar
Castle, N. G. (2011). The influence of consistent assignment on nursing home deficiency citations. The Gerontologist, 51(6), 750–760.Google Scholar
Chapman, K. B. (2009). Improving communication among nurses, patients, and physicians. American Journal of Nursing, 109(Suppl. 11), 21–25.Google Scholar
Cohen-Mansfield, J. (2000). Approaches to the management of disruptive behaviors. In Lawton, M. P., & Rubinstein, R. L. (Eds.), Interventions in dementia care: Toward improving quality of life (pp. 39–63). New York: Springer.Google Scholar
Coogle, C. L., Head, C., Parham, I., & Zeman, S. (2004). Person-centered care and the workforce crisis: A statewide professional development initiative. Educational Gerontology, 30, 1–20.Google Scholar
Dupuis, S., & Luh, J. (2005). Understanding responsive behaviours: The importance of perceiving triggers that precipitate residents’ responsive behaviours. Nursing Home Magazine, 16, 29.Google Scholar
Dupuis, S., Wiersma, E., & Loiselle, L. (2012). Pathologizing behaviour: Meanings of behaviours in dementia care. Journal of Aging Studies, 26(2), 162–173.Google Scholar
Estabrooks, C. A., Squires, J. E., Cummings, G. G., Teare, G. F., & Norton, P. G. (2009). Study protocol for the translating research in elder care (TREC): Building context – An organizational monitoring program in long term care project (Project One). Implementation Science, 4(52), 1–13.Google Scholar
Hale, K. L., & Frank, J. (2011). Dementia overview [Data file]. Retrieved 25 June 2014 fromhttp://www.emedicinehealth.com/dementia_overview/article_em.htmGoogle Scholar
Hayden, G., Rockey, W., Ware, J., & Smith, M. (2008). Protecting a healthy work environment despite change: Shift huddles enhancing team communication and patient safety. Critical Care Nurse, 28(2), 41.Google Scholar
Huijbregts, M., Sokoloff, L., Feldman, S., Conn, D. K., Simons, K., Walsh, L., et al. (2012). Implementation of a mental health guideline in a long-term care home: A participatory action approach. Journal of Research in Interprofessional Education and Practice, 2(2), 134–151.CrossRefGoogle Scholar
Hung, L., & Chaudhury, H. (2011). Exploring personhood in dining experiences of residents with dementia in long-term care facilities. Journal of Aging Studies, 25, 1–12.Google Scholar
Janes, N., Sidani, S., Cott, C., & Rappolt, S. (2008). Figuring it out in the moment: A theory of unregulated care providers’ knowledge utilization in dementia care settings. Worldviews on Evidence-Based Nursing, 5(1), 13–24.CrossRefGoogle Scholar
Krueger, R. A. (1994). Focus groups: A practical guide for applied research (2nd ed.). Thousand Oaks, CA: Sage.Google Scholar
McCormack, B., Dewing, J., & McCance, T. (2011). Developing person-centred care: Addressing contextual challenges through practice development. The Online Journal of Issues in Nursing, 16(2), Manuscript 3.Google Scholar
Minkler, M., & Wallerstein, N. (2008). Community-based participatory research for health: From process to outcomes (2nd ed.). San Francisco: Jossey-Bass.Google Scholar
Murray Alzheimer Research and Education Program. (2012). Responsive behaviours: Definition and philosophy of responsive behaviours. Retrieved 25 June 2014 fromhttps://uwaterloo.ca/murray-alzheimer-research-and-education-program/research/projects/responsive-behavioursGoogle Scholar
Ontario Ministry of Health and Long-Term Care (2007). A guide to the long-term care homes act, 2007 and regulation 79/10. Section 2–33. Retrieved 25 June, 2014 fromhttp://www.health.gov.on.ca/en/public/programs/ltc/docs/ltcha_guide_phase1.pdfGoogle Scholar
Quigley, P. A., Hahm, B., Collazo, S., Gibson, W., Janzen, S., Powell-Cope, G., et al. (2009). Reducing serious injury from falls in two veterans’ hospital medical-surgical units. Journal of Nursing Care Quality, 24(1), 33–41.Google Scholar
Rahman, A. N., & Schnelle, J. F. (2008). The nursing home culture-change movement: Recent past, present, and future directions for research. The Gerontologist, 47(3), 323–339.Google Scholar
Ryan, K., Mericle, J., & Meliones, J. (2008). Huddle up! Creating a morning huddle to get everyone in the same movie. Critical Care Nurse, 28(2), 9.Google Scholar
Shura, R., Siders, R. A., & Dannefer, D. (2011). Culture change in long-term care: Participatory action research and the role of the resident. The Gerontologist, 51, 212–225.Google Scholar
Sidani, S., & Braden, C. J. (1998). Evaluating nursing interventions: A theory-driven approach. Thousand Oaks, CA: Sage.Google Scholar
Sidani, S., & Epstein, D. R. (2003). Clinical relevance of RCT findings. International Nursing Perspectives, 3(1), 49–56.Google Scholar
Simpson, D. D., & Flynn, P. M. (2007). Moving innovations into treatment: A stage-based approach to program change. Journal of Substance Abuse and Treatment, 33(2), 111–120.Google Scholar
Statistics Canada. (2011). Residential care facilities 2009/2010. Retrieved 25 June 2014 fromwww.statcan.gc.ca/pub/83-237-x/83-237-x2012001-eng.pdfGoogle Scholar
Tellis-Nayak, V. (2007). A person-centered workplace: The foundation for person-centered caregiving in long-term care. Journal of the American Medical Directors Association, 8(1), 46–54.Google Scholar
U.S. Department of Health and Human Services Administration on Aging. (2010). A profile of older Americans [Data file]. Retrieved 25 June 2014 fromhttp://www.aoa.gov/aoaroot/aging_statistics/Profile/2010/docs/2010profile.pdfGoogle Scholar
U.S. Department of Veterans Affairs. (2010). Safety huddle [Data file]. Retrieved 25 June 2014 fromhttp://www.visn8.va.gov/PatientSafetyCenter/safePtHandling/safetyhuddle_021110.pdfGoogle Scholar
Verschoor, K. N., Taylor, A., Northway, T. L., Hudson, D. G., Stolk, Van, , D. E., Shearer, K. J., et al. (2007). Creating a safety culture at the children’s and women’s health centre of British Columbia. Journal of Pediatric Nursing, 22(1), 81–86.Google Scholar
Wagner, L. M., Damianakis, T., Mafrici, N., & Robinson-Holt, K. (2010). Communication processes regarding falls management in long term care settings. Clinical Nursing Research, 19(3), 311–326.CrossRefGoogle ScholarPubMed
Watters, J., & Comeau, S. (2010). Participatory Action Research: An educational tool for citizen-users of community mental health services. Retrieved 25 June 2014 fromhttp://umanitoba.ca/faculties/medicine/units/medrehab/media/par_manual.pdfGoogle Scholar