"Wish we would have known that!" Communication Breakdown Impedes XXXX -Centered Care.

@entity1 @entity227 @entity146 @entity303 @entity2133
PURPOSE: To understand how nursing home staff obtain information needed for implementing @entity1 -centered care (PCC) to residents with @entity303 who exhibit @entity146 ( @entity146 ), and how they communicate this information to other staff. Barriers to PCC and information exchange were also explored. DESIGN AND METHODS: @entity1 were 59 staff from two nursing homes. Focus group methodology captured discussions in eight 1-hr sessions. Sessions were audiotaped and transcribed. Data were analyzed using qualitative content analysis to provide a comprehensive summary of real world context of implementing PCC. RESULTS: To deliver PCC staff identified a need for access to psychosocial/medical history of the resident and knowledge of strategies families used for managing @entity146 in the past. However, resident information is not routinely shared with all staff and written documentation systems for communicating resident-specific information do not support the time-pressured work pattern of certified nursing assistants (CNAs). @entity2133 was considered more reliable and expedient than educational sessions. CNAs described themselves as @entity227 who prefer educational programs addressing individual resident emergent behaviors and programs that are scheduled at dedicated times. IMPLICATIONS: To improve PCC the flow of information exchange requires: inclusion of all staff, particularly CNAs; systems of communication that consider the time and resource constraints of nursing homes; development of educational programs for @entity146 that are responsive to staff learning styles; administrative investment in nursing leadership to effect these changes; and reimbursement approaches to encourage culture change investments.
