Cultural Transformation in Extended Care Nursing Homes - Term Paper Example

?Running head: Cultural Transformation in Extended Care Nursing Homes Cultural Transformation in Extended Care Nursing Homes Insert Insert GradeCourse Insert Tutor’s Name February 9, 2012 Cultural Transformation in Extended Care Nursing Homes Introduction The environment in which nursing care is provided, as well as the work practice adopted by the care providers affects the quality of care given to the veterans in these centers. The combined factors contribute significantly to the recovery of the patients and their ability to develop social and domestic skills. Quality care at these homes can be achieved if the care providers put social, psychological, and emotional needs of the clients as the first priority. Cultural transformations in a nursing environment refer to the changes in the perceptions of the care providers on the mode of delivery of services to their clients - the residents (Hojlo, 2010). The transformations are necessary due to the need for improved services at the centers. The cultural transformation process is not a simple change but a paradigm shift involving three main stages namely, ‘a time of chaos and confusion, crisis, and acceptance’ (Hojlo, 2010, p.45). This paper illustrates the contribution of nursing to cultural transformation for improved services. It makes use of a practical project that has proved effective towards this objective. Introduction to the project The project is a step towards creating a friendlier environment for the residents in these nursing homes. The entire transformation process is systematic and bound occur in phases. This project focuses on three main issues; the choice of food menu by the residents, engagement in social activities like sports, and involving families in various service plans -developing a meal menu that is corresponds to the needs and preferences of the residents Background of the issues and possible resolutions The main purpose of the project is to provide a safe and friendly environment for the residents to improve on the quality of care given. It aims at developing a homelike environment for the patient. The interventions are necessary due to the increasing needs of the patients to have a more relaxed environment different from the traditional hospital-like environment. There is need for a more one-on-one correspondence between residents and the nursing assistants. On one hand, residents have affairs that require privacy at certain points and on the other hand, there is a need for the residents to engage in some organizational activities. The move is driven by the provisions on the Bill of Rights for the residents in these nursing homes. Just like the other ordinary healthy people, the residents are entitled to good housing environment and follow his or her choice and preferences in various daily requirements. The individuals are entitled to us basic commodities that are in their living environment. The individuals also have the rights to privacy. Overview of the project The project takes on three different dimensions. The first initiative is choice of items in the food menu. It involves discussing with residents and families on the schedule of food items depending on their preference and the bodily requirements. Another initiative is introduction of various sporting activities. The third component of the project is conducting a get-together occasion in which the residents share their experiences with families, friends, professionals, and other patients. Literature Review The cultural transformations in the nursing homes are inevitable due to the changing needs of the residents in such homes. Person-directed care has a central focus on the needs, interests and the lifestyles preferred by an individual (HealthInsight New Mexico, 2012). This is because every individual has unique needs, strengths, and relationships that should be addressed. The provision of strong health care services requires high levels of competency and professionalism with a major focus on the quality of life and the quality of care given to the residents at the nursing center (Hojlo, 2010). Various tools and resources can be used to facilitate person-directed care. these include a good night’s sleep, daily pleasures, morning routine group exercises, mystery game group exercises, organizational assessment, relational building, identifying the personality in an individual and his values (HealthInsight New Mexico, 2012). Effective cultural transformation requires the NAs to be creative and innovative to come up with new ideas for operations. The decision-making processes in the settings should be inclusive of all parties. The nurses are required to establish a strong relationship with residents as the prime priority. Effective decision-making involves a critical analysis of the possible courses of action and choosing on the course of action that removes or reduces the uncertainty (Marquis & Huston, 2009). Thus, all the parties need to be consulted. The decision-making processes should involve the young veterans, elders, families, and caregivers. The Bill of Rights provides that each of the residents deserves being involved in the development of the plans to provide for his/her health needs. He or she should participate in developing how the needs should be met. However, the nurses are not ethically allowed to honor all the needs of the patients some of which are ill minded like active euthanasia or assisted suicide (Moser & Riegel, 2007). There should be a point of compromise on the objectives and consequences of a planned action. Thus, the provider should facilitate cooperation between different individuals and departments in the health care system. Besides, the nurses need to develop ways of assessing the ability of the veterans to involve highly in organizational activities. The interventions enhance self-awareness, inspiration and motivation, and developing a vision (HealthInsight New Mexico, 2012). There is need for team driven activities and processes that enable individuals to develop leadership, responsibility and management skills (New Mexico Medical Review Association, n.d, p.19). The nursing assistants have to act like leaders for this team through demonstration of leadership skills that include ‘modeling the way, inspiring a shared vision, challenging, enabling the others to act, and leading with the heart’ (Fulton and Lyon, 2009, p.156). Theoretical Framework for the project Cultural transformation in a nursing setting is a shift from institutional care to person-directed care and community living centers. The implementation of transformations in a nursing home system can take different dimensions. The Centers for Medical and Medicaid Services (CMS) had developed and adopted such an implementation framework, named the Hatch model. The needs of the patient is the major center of focus This model has three concentric circles that converge at the center (Hojlo, 2010). The three circles represent the care practices, the work practices, and the environment of care respectively (New Mexico Medical Review Association, n.d). The three circles are enclosed in a larger circle that represents the institutional leadership and how it is influenced by the other external forces like government regulations (Hojlo, 2010). The staffs have to understand the choices and preferences of the residents. This can be achieved through sharing information. Poor communication or lack of shared perception between a leader and the followers often lead to vertical conflicts among these people (Rigolosi, 2005). A change work practices may include allowing the care providers and to personalize and schedule service plans with the patient (Hojlo, 2010, p.47). The nursing assistants may need to go around the resident units regularly. There is also a need for transformation in the care environment through renovation and establishment of modern socio-cultural facilities. CMC has a provision that all the newly built and the renovated nursing homes should have sprinklers (The American Health and Quality Association, 2006). Conclusion to the project It is possible to learn and adopt the choice and tastes of the residents through engaged communication. The measures involve allowing cooking and baking by the members in the residential units and dining services to the visiting families. The social development will be enhanced through creating a sports facility for various sporting activities to encourage individuals to participate in social groups. The get-together will be a continuous program to be carried out semi-annually. Conclusion Cultural transformation in a nursing home is a long-term initiative that takes various phases. Its success depends on the creative and innovative abilities of the care providers to bring in new ideas on board. The major concern of these transformations is to replace the earlier system in which the focus was on the hospital facilities and professions to a system in which the institution is changed to adapt to the needs of the patients. In the earlier setting, the patients had to adapt to the provisions of the institutions. References Fulton, J.S. and Lyon, B. (2009). Foundations of Clinical Nurse Specialist Practice. New York: Springer Publishing Company Hojlo, C. (2010). GENERATIONS. Journal of the American Society on Aging, Vol. 34 .No. 2; 43-48. HealthInsight New Mexico. (2012). Person-directed Care Resources and Tools. Retrieved from http://www.nmmra.org/resources/?group=159 Marquis, B.L., & Huston, C.J. (2009). Leadership Roles and Management Functions in Nursing. Theory and Application. PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. Moser, C. & Riegel, B. (2007). Mosby's Nursing Consult - Cardiac Nursing. An Imprint of Elsevier. Retrieved from http://www.nursingconsult.com/nursing/books/978-1-4160-2934-2/full-text?isbn=978-1-4160-2934-2&eid=4-u1.0-B978-1-4160-2934-2..50094-5--cesec6&fromList=searchListPage&from=search&isPageEid=true#hash_4-u1.0-B978-1-4160-2934-2..50094-5--cesec13 New Mexico Medical Review Association. (N.d). Nursing Home Quality Improvement (NHQI) Collaborative: Transforming Nursing Home Culture through Person-directed Care (PDC). Retrieved from http://www.nmmra.org/resources/Patient_Safety/153_1499.pdf Rigolosi, E. (2005). Management and leadership in nursing and health care: an experiential approach. New York: Springer Publishing Company. The American Health and Quality Association. (2006). Democrats Take Control of Congress. AHQA Matters, Vol.7 No.23. Retrieved from http://www.nmmra.org/resources/articles/AHQA_Matters_061109.pdf - Read More