"The Way We Do Things Around Here": An International Comparison of Treatment Culture in Nursing Homes

C Hughes, A Donnelly, SA Moyes, K Peri, S Scahill, C Chen, Brendan McCormack, N Kerse

    Research output: Contribution to journalArticle

    11 Citations (Scopus)

    Abstract

    OBJECTIVES: In this study, we sought to measure treatment culture (beliefs, values, and normative practices associated with medication prescribing and administration) in two samples of nursing homes (in Northern Ireland and New Zealand) and to document the range of scoring achieved by staff in both countries. Responses between nurse managers and registered nurses were also compared.DESIGN: A cross-sectional study using an adapted treatment culture questionnaire was distributed by mail (in June and September 2008) to 159 nursing homes in Northern Ireland and completed by the nurse manager and registered nurses. In New Zealand, staff in 14 facilities participated and questionnaires were distributed by a research assistant who visited the homes (March to November 2008).MEASUREMENTS: Completed questionnaires were scored using a prespecified scoring system, with a higher score indicating a more resident-centered treatment culture and a lower score indicating a more traditional approach to care. The maximum score possible was 75. Scores were compared between countries and between different categories of staff. Views were also sought and knowledge tested (from structured questions) on the use of psychotropic prescribing in the nursing home environment.RESULTS: The response rates for nurse managers and nurses in Northern Ireland were 35.5% and 10.1%, respectively; in New Zealand, the response rate was 90.9% for managers and 71% for nurses. The mean score for the Northern Ireland and New Zealand homes was 39.5 and 39.1, respectively (P > .05). There were also no differences between scores achieved by nurse managers and registered nurses between and across both countries. There were some cross-country differences on the approach to challenging behavior in residents and nurses (in both countries) were more likely than nurse managers to report (incorrectly) that haloperidol is indicated for short-term insomnia.CONCLUSION: This quantitative assessment has raised interesting issues in relation to the measurement of treatment culture in the nursing home setting in two countries. Further insights into the importance of treatment culture will be pursued in qualitative studies.
    LanguageEnglish
    Pagesin press
    JournalJournal of the American Directors Association
    Volumein pre
    Publication statusPublished - Apr 2012

    Fingerprint

    Nurse Administrators
    Nursing Homes
    Northern Ireland
    Nurses
    New Zealand
    Therapeutics
    Sleep Initiation and Maintenance Disorders
    Postal Service
    Haloperidol
    Cross-Sectional Studies
    Research
    Surveys and Questionnaires

    Cite this

    Hughes, C., Donnelly, A., Moyes, SA., Peri, K., Scahill, S., Chen, C., ... Kerse, N. (2012). "The Way We Do Things Around Here": An International Comparison of Treatment Culture in Nursing Homes. in pre, in press.
    Hughes, C ; Donnelly, A ; Moyes, SA ; Peri, K ; Scahill, S ; Chen, C ; McCormack, Brendan ; Kerse, N. / "The Way We Do Things Around Here": An International Comparison of Treatment Culture in Nursing Homes. 2012 ; Vol. in pre. pp. in press.
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    abstract = "OBJECTIVES: In this study, we sought to measure treatment culture (beliefs, values, and normative practices associated with medication prescribing and administration) in two samples of nursing homes (in Northern Ireland and New Zealand) and to document the range of scoring achieved by staff in both countries. Responses between nurse managers and registered nurses were also compared.DESIGN: A cross-sectional study using an adapted treatment culture questionnaire was distributed by mail (in June and September 2008) to 159 nursing homes in Northern Ireland and completed by the nurse manager and registered nurses. In New Zealand, staff in 14 facilities participated and questionnaires were distributed by a research assistant who visited the homes (March to November 2008).MEASUREMENTS: Completed questionnaires were scored using a prespecified scoring system, with a higher score indicating a more resident-centered treatment culture and a lower score indicating a more traditional approach to care. The maximum score possible was 75. Scores were compared between countries and between different categories of staff. Views were also sought and knowledge tested (from structured questions) on the use of psychotropic prescribing in the nursing home environment.RESULTS: The response rates for nurse managers and nurses in Northern Ireland were 35.5{\%} and 10.1{\%}, respectively; in New Zealand, the response rate was 90.9{\%} for managers and 71{\%} for nurses. The mean score for the Northern Ireland and New Zealand homes was 39.5 and 39.1, respectively (P > .05). There were also no differences between scores achieved by nurse managers and registered nurses between and across both countries. There were some cross-country differences on the approach to challenging behavior in residents and nurses (in both countries) were more likely than nurse managers to report (incorrectly) that haloperidol is indicated for short-term insomnia.CONCLUSION: This quantitative assessment has raised interesting issues in relation to the measurement of treatment culture in the nursing home setting in two countries. Further insights into the importance of treatment culture will be pursued in qualitative studies.",
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    Hughes, C, Donnelly, A, Moyes, SA, Peri, K, Scahill, S, Chen, C, McCormack, B & Kerse, N 2012, '"The Way We Do Things Around Here": An International Comparison of Treatment Culture in Nursing Homes', vol. in pre, pp. in press.

    "The Way We Do Things Around Here": An International Comparison of Treatment Culture in Nursing Homes. / Hughes, C; Donnelly, A; Moyes, SA; Peri, K; Scahill, S; Chen, C; McCormack, Brendan; Kerse, N.

    Vol. in pre, 04.2012, p. in press.

    Research output: Contribution to journalArticle

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    T1 - "The Way We Do Things Around Here": An International Comparison of Treatment Culture in Nursing Homes

    AU - Hughes, C

    AU - Donnelly, A

    AU - Moyes, SA

    AU - Peri, K

    AU - Scahill, S

    AU - Chen, C

    AU - McCormack, Brendan

    AU - Kerse, N

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    N2 - OBJECTIVES: In this study, we sought to measure treatment culture (beliefs, values, and normative practices associated with medication prescribing and administration) in two samples of nursing homes (in Northern Ireland and New Zealand) and to document the range of scoring achieved by staff in both countries. Responses between nurse managers and registered nurses were also compared.DESIGN: A cross-sectional study using an adapted treatment culture questionnaire was distributed by mail (in June and September 2008) to 159 nursing homes in Northern Ireland and completed by the nurse manager and registered nurses. In New Zealand, staff in 14 facilities participated and questionnaires were distributed by a research assistant who visited the homes (March to November 2008).MEASUREMENTS: Completed questionnaires were scored using a prespecified scoring system, with a higher score indicating a more resident-centered treatment culture and a lower score indicating a more traditional approach to care. The maximum score possible was 75. Scores were compared between countries and between different categories of staff. Views were also sought and knowledge tested (from structured questions) on the use of psychotropic prescribing in the nursing home environment.RESULTS: The response rates for nurse managers and nurses in Northern Ireland were 35.5% and 10.1%, respectively; in New Zealand, the response rate was 90.9% for managers and 71% for nurses. The mean score for the Northern Ireland and New Zealand homes was 39.5 and 39.1, respectively (P > .05). There were also no differences between scores achieved by nurse managers and registered nurses between and across both countries. There were some cross-country differences on the approach to challenging behavior in residents and nurses (in both countries) were more likely than nurse managers to report (incorrectly) that haloperidol is indicated for short-term insomnia.CONCLUSION: This quantitative assessment has raised interesting issues in relation to the measurement of treatment culture in the nursing home setting in two countries. Further insights into the importance of treatment culture will be pursued in qualitative studies.

    AB - OBJECTIVES: In this study, we sought to measure treatment culture (beliefs, values, and normative practices associated with medication prescribing and administration) in two samples of nursing homes (in Northern Ireland and New Zealand) and to document the range of scoring achieved by staff in both countries. Responses between nurse managers and registered nurses were also compared.DESIGN: A cross-sectional study using an adapted treatment culture questionnaire was distributed by mail (in June and September 2008) to 159 nursing homes in Northern Ireland and completed by the nurse manager and registered nurses. In New Zealand, staff in 14 facilities participated and questionnaires were distributed by a research assistant who visited the homes (March to November 2008).MEASUREMENTS: Completed questionnaires were scored using a prespecified scoring system, with a higher score indicating a more resident-centered treatment culture and a lower score indicating a more traditional approach to care. The maximum score possible was 75. Scores were compared between countries and between different categories of staff. Views were also sought and knowledge tested (from structured questions) on the use of psychotropic prescribing in the nursing home environment.RESULTS: The response rates for nurse managers and nurses in Northern Ireland were 35.5% and 10.1%, respectively; in New Zealand, the response rate was 90.9% for managers and 71% for nurses. The mean score for the Northern Ireland and New Zealand homes was 39.5 and 39.1, respectively (P > .05). There were also no differences between scores achieved by nurse managers and registered nurses between and across both countries. There were some cross-country differences on the approach to challenging behavior in residents and nurses (in both countries) were more likely than nurse managers to report (incorrectly) that haloperidol is indicated for short-term insomnia.CONCLUSION: This quantitative assessment has raised interesting issues in relation to the measurement of treatment culture in the nursing home setting in two countries. Further insights into the importance of treatment culture will be pursued in qualitative studies.

    M3 - Article

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    Hughes C, Donnelly A, Moyes SA, Peri K, Scahill S, Chen C et al. "The Way We Do Things Around Here": An International Comparison of Treatment Culture in Nursing Homes. 2012 Apr;in pre:in press.