Presenters
- Jessica Goodman, PhD, Postdoctoral Fellow, University of Rochester, Rochester, NY
- Lauren Decaporale-Ryan, PhD, Assistant Professor, Departments of Psychiatry, Medicine, & Surgery, University of Rochester, Rochester, NY
- Joseph Nicholas, MD, MPH, Associate Professor, Department of Medicine, University of Rochester, Rochester, NY, Medical Director, Highlands at Brighton Transitional Care Facility, Rochester, NY
- Marguerite Janto, BSN, Nurse Manager, Highlands at Brighton, Rochester, NY
Summary
Though significant attention has been paid to burnout in healthcare workers, the predominant focus has been on the physician experience with lesser attention to other members of the team. This is particularly concerning in long-term care (LTC), where thirty-seven percent of nursing staff report experiencing burnout, compared to just 22 percent of nurses working in other settings. Burnout has been linked to elevated turnover, absenteeism, and poorer mental and physical health outcomes for health care workers, but also poorer safety and quality for patients, and increased costs to employers. LTC staff report that one of the greatest contributing factors to burnout is challenging patient behaviors. This is particularly salient given that over the past ten years, adults ages 31 to 64 have been the fastest growing population in nursing homes, and they are more likely to have experienced additional social determinants of health–leading to more complex care needs–including developmental disabilities, trauma, psychiatric diagnoses, and inpatient stays in psychiatric facilities. At our facility, behavioral health specialists have long served as physician educators and delivered brief interventions to patients. Yet no supports to increase nursing knowledge or comfort working with behavioral challenges existed. As a result, a needs assessment was conducted with nursing staff in one multi-unit LTC to identify potential benefits of providing interdisciplinary teaching on these topics to support patient care and reduce rates of staff burnout. Nurses identified a need for additional training focused on addressing challenging patient behaviors and family interactions. In response, a twelve-month training program was created by a team which included medical family therapy, behavioral, and geriatric expertise and was delivered to all nursing staff of a 40-resident LTC unit. Pre-training, mid-point, and end-of-training-year measures were collected to determine training impacts on clinical and operational outcomes for patients, staff, and the facility, including staff burnout. The interdisciplinary healthcare team that designed and supported the program will describe the needs assessment design, development and implementation of the program, and evaluation methodology and results.
Objectives
- Identify the need for LTC nursing staff training to address challenging patient behaviors and family interactions
- Describe the didactic content and session organization associated with a novel training program to address these needs
- Discuss factors associated with the success of an interdisciplinary LTC team, incorporating members beyond physicians and behavioral health clinicians to include nurses, physical therapy, occupational therapy, and others
