College Library Proxy

Response 1

 Your reply posts should be 100 to 150 words, with a minimum of one supporting reference included. 

The idea of cultural change in long-term care organizations is to revitalize the concept of care.  The goal is to make the care facilities more like being at home or on a vacation.  This concept made the healthcare more resident centered care. (Regis College Library Proxy: Login to Access Databases, n.d.)  When implementing reform to focus on RCC there were barriers on both the higher and lower income level facilities.  These culture change initiatives generally include a combination of the following types of factors: resident-directed activities, homelike atmosphere, close relationships between the staff and residents and their families, empowerment of staff to respond to resident needs and desires, collaborative decision making, and established processes for quality improvement.  (Press, n.d.) One of the largest barriers is staffing.  With inadequate staffing, there is not enough time to dedicate to each resident.  This includes when staff calls out of work on an already taxed shift.  When staff is taxed and overworked there are not enough resources to provide both quality and clinical care. (Regis College Library Proxy: Login to Access Databases, n.d.) Another barrier is the residence themselves.  It only takes one high acuity resident to take all the time from one facility member.  With low staffing, little resources, and high acuity residence there is no time to provide RCC.  To overcome the barriers in implementing RCC there have to be available resources.  Particular focus on utilizing mental health providers in roles that assist staff in training, communicating, problem-solving, and understanding resident values and perspectives may be helpful in organizations striving to provide care that is both resident-centered and high in quality.  (Regis College Library Proxy: Login to Access Databases, n.d.)Long term care facilities are usually driven by private enterprises.  This makes it difficult for all residents to be members.  More government regulations need to be put in place to provide aid for all aging adults to have adequate housing and care. With proper funding, the facilities would have the proper staffing and resources to provide RCC to all residence. 

Response 2

 Your reply posts should be 100 to 150 words, with a minimum of one supporting reference included. 

The general notion of cultural change in long-term care organizations especially nursing homes is a long-overdue change. As a wound ostomy and continence care nurse (WOCN), I constantly see elderly clients who are admitted to the hospital from nursing homes with multiple pressure ulcers and it makes me wonder if nursing homes are safe for our senior citizens. The only explanation for this type of trend is either there are not enough staff to provide care to the residents or lack of training.

Cultural change in long-term care organizations can be achieved with support from leaders in health care organizations and from the government. Health care reforms can lead to culture change in long-term care facilities. The affordable care act (ACA) of 2010 has helped to provide greater access to health care for our seniors and also to improve the quality of services delivered. According to Harris (2018), ACA can be improved by supporting efforts at the state level to expand Medicaid eligibility to 133 percent of the federal poverty level. This will ensure that ethical and racial disparities are currently in our long-term care facilities are minimized or eliminated.

There are multiple-barriers that can affect culture change in nursing homes. One barrier to be expected is push back from staff and some lower leadership. There are people that hate change and will do everything in their power to resist it.; But change is inevitable in life. Dr. Spencer made this know in his book “who moved my cheese”, and if we are willing to adapt to change, it will help us to continue to grow in every aspect of life. The biggest barrier to change will be financial barriers. To successfully implement change in long-term care facilities, the residents need to be willing to pay more. According to Chishom et al. (2018), the adoption of culture change in nursing homes requires facilities to have resources to invest in meaningful adoption of practices and Medicaid-reliant nursing homes may have difficulty implementing culture change practices. This means that for us to see more culture change in long-term facilities, there need to be health care reforms that provide more funding to these facilities for Medicaid recipients. Grabowski et al. (2014) reported that states experienced a greater culture change implementation when they paid a higher Medicaid per diem.

As a service provider for aging adults, I will focus on making changes with the resources I have available. The culture change will begin with the leadership team because they will lead the change. To prove that more funding is necessary, I will collaborate with other long term care leaders, who are willing to adapt to the culture change to propose and support policy changes in Medicare and Medicaid to increase funding. I will also work hard to provide evidence of quality improvement practices to health authorities. I will transform the facility into more of a person-centered system and solicit for more funding from the government to implement it.