Dissertation/Thesis Abstract

Pilot Testing Feasibility and Initial Effect of a Coaching Intervention to Improve Certified Nursing Assistants Dressing Assistance in Nursing Homes
by Jordan, Kerry Jean, Ph.D., University of Arkansas for Medical Sciences, 2017, 139; 10281868
Abstract (Summary)

Background: Nursing home resident’s independence in activities of daily living (ADLs) is important for quality care. Level of Assistance (LoA) strategies promote independence but are used inconsistently in nursing homes. Although staff coaching may promote use of LoA strategies, research is lacking on the efficacy of coaching Certified Nursing Assistants (CNAs) in nursing homes. This pilot randomized controlled trial (RCT) tested the feasibility and initial effect of a coaching intervention for CNAs in nursing homes on CNA performance of LoA strategies and independence of nursing home residents with dementia during dressing.

Methods: The principal investigator (PI) randomized seventeen CNA/resident dyads to experimental (three coaching sessions) or control (25-minute traditional lecture) groups. The PI used a Post Intervention Evaluation form to determine acceptability and feasibility of randomizing within each home. Ease of obtaining the sample and retention rates determined feasibility of recruitment and retention. The Appropriate Use of LoA by CNA tool and Beck Dressing Performance Scale (BDPS) were used to measure CNA use of LoA strategies and independence of residents during dressing.

Results: Coaching intervention satisfaction scores ranked high (m = 4.5 out of 5). Most CNA comments (18 of 22) were positive. The PI recruited six dyads per home within the 60-day benchmark. CNA and resident retention rates were 89.47% and 85%. Contamination occurred by 88.89% of intervention group CNAs. Differences in the Appropriateness of LoA Use by CNA and BDPS scores between groups were not significant. Experimental group median improvements between the pre-test and post-test were significant for both Appropriateness of LoA Use by CNA (p = .004) and BDPS (p = .004). Control group median improvements between the pre-test and post-test were not significant for either of the dependent variables.

Discussions/Conclusions: The coaching intervention is feasible for a larger study. Initial effects indicate coaching is effective in improving appropriate use of LoA strategies by CNAs and independence of resident dressing. A larger study with different randomization methods is needed.

Indexing (document details)
Advisor: Tsai, Pao-Feng
Commitee: Bai, Shasha, Beck, Cornelia, Dailey, Deborah, Heo, Seongkum
School: University of Arkansas for Medical Sciences
Department: Nursing Science
School Location: United States -- Arkansas
Source: DAI-B 78/12(E), Dissertation Abstracts International
Subjects: Nursing
Keywords: Ceritified nursing assistants, Coaching, Level of assistance strategies, Nursing homres, Prompts
Publication Number: 10281868
ISBN: 9780355068009
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