Skip to main content
Journal of Applied Behavior Analysis logoLink to Journal of Applied Behavior Analysis
. 1995 Winter;28(4):435–448. doi: 10.1901/jaba.1995.28-435

Direct assessment of quality of care in a geriatric nursing home

Bridget A Shore 1, Dorothea C Lerman 1, Richard G Smith 1, Brian A Iwata 1, Iser G Deleon 1
PMCID: PMC1279849  PMID: 16795874

Abstract

Direct observation was used to examine multiple aspects of care provided in a proprietary nursing home. The samples were taken at random intervals, 7 days per week for 5 weeks, across several categories of environmental and resident conditions as well as staff and resident activity. Results showed a high degee of compliance with predefined standards (based on current federal regulations) for environmental and resident conditions. Overall distributions of resident and staff activity showed results similar to those found in previous studies, with residents spending most of their time engaged in nonsocial activity and staff spending the majority of their time engaged in nonresident work. When data were analyzed across areas of the facility, times of day, and weekdays versus weekends, some differences were noted. Weekend versus weekday comparisons showed higher resident:staff ratios on weekends and more resident inactivity, but no significant differences in environmental or resident conditions. In addition, more frequent resident care, resident interaction, and resident activity were observed in Medicare units than in non-Medicare units. Results are discussed in terms of federal requirements for monitoring the quality of care in nursing homes and the potential use of time sampling expressly for this purpose.

Keywords: assessment, gerontology, nursing home, time sampling

Full text

PDF
436

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alevizos P., DeRisi W., Liberman R., Eckman T., Callahan E. The Behavior Observation Instrument: a method of direct observation for program evaluation. J Appl Behav Anal. 1978 Summer;11(2):243–257. doi: 10.1901/jaba.1978.11-243. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Baltes M. M., Honn S., Barton E. M., Orzech M., Lago D. On the social ecology of dependence and independence in elderly nursing home residents: a replication and extension. J Gerontol. 1983 Sep;38(5):556–564. doi: 10.1093/geronj/38.5.556. [DOI] [PubMed] [Google Scholar]
  3. Burgio L. D., Engel B. T., Hawkins A., McCormick K., Scheve A. A descriptive analysis of nursing staff behaviors in a teaching nursing home: differences among NAs, LPNs, and RNs. Gerontologist. 1990 Feb;30(1):107–112. doi: 10.1093/geront/30.1.107. [DOI] [PubMed] [Google Scholar]
  4. Curry T. J., Ratliff B. W. The effects of nursing home size on resident isolation and life satisfaction. Gerontologist. 1973 Autumn;13(3):295–298. doi: 10.1093/geront/13.3_part_1.295. [DOI] [PubMed] [Google Scholar]
  5. Greene V. L., Monahan D. J. Structural and operational factors affecting quality of patient care in nursing homes. Public Policy. 1981 Fall;29(4):399–415. [PubMed] [Google Scholar]
  6. Lemke S., Moos R. H. Ownership and quality of care in residential facilities for the elderly. Gerontologist. 1989 Apr;29(2):209–215. doi: 10.1093/geront/29.2.209. [DOI] [PubMed] [Google Scholar]
  7. Moos R. H., David T. G., Lemke S., Postle E. Coping with an intra-institutional relocation: changes in resident and staff behavior patterns. Gerontologist. 1984 Oct;24(5):495–502. doi: 10.1093/geront/24.5.495. [DOI] [PubMed] [Google Scholar]
  8. Reid D. H., Parsons M. B., Green C. W., Schepis M. M. Evaluation of components of residential treatment by Medicaid ICF-MR surveys: a validity assessment. J Appl Behav Anal. 1991 Summer;24(2):293–304. doi: 10.1901/jaba.1991.24-293. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Repp A. C., Barton L. E. Naturalistic observations of institutionalized retarded persons: a comparison of licensure decisions and behavioral observations. J Appl Behav Anal. 1980 Summer;13(2):333–341. doi: 10.1901/jaba.1980.13-333. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Repp A. C., Deitz D. E. Improving administrative-related staff behaviors at a state institution. Ment Retard. 1979 Aug;17(4):185–192. [PubMed] [Google Scholar]
  11. Saudargas R. A., Zanolli K. Momentary time sampling as an estimate of percentage time: A field validation. J Appl Behav Anal. 1990 Winter;23(4):533–537. doi: 10.1901/jaba.1990.23-533. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Applied Behavior Analysis are provided here courtesy of Society for the Experimental Analysis of Behavior

RESOURCES