Browsing by Author "Murphy, Sara"
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Item Burnout in CNAs in Nursing Homes Coming out of COVID(2024-03-21) Lemack, Bergen; Murphy, Sara; Davis, SandraBACKGROUND: Certified Nursing Assistants (CNAs) in nursing homes often face high levels of stress and burnout, adversely impacting their health and the quality of care they provide. The need for a comprehensive understanding of their specific challenges is vital for developing targeted interventions. METHODS: Participants completed the "Collaborative Implementation Strategy to Increase COVID-19 Education and Training" offered by UNTHSC, which consisted of 8 modules that reinforced the skills and knowledge necessary for delivering high-quality and safe care to residents. One module from the training included the Maslach Burnout Inventory, a tool designed to assess three burnout dimensions: emotional exhaustion, depersonalization, and personal accomplishment. Thirty-two CNAs completed the survey, sharing experiences and feedback on various aspects of their work life. De-identified demographic data was collected from each participant before completing the training. Demographic data included age, gender, race, military history, profession, primary work setting (skilled nursing facility, dementia center, assisted living facility, etc.) and self-reported information regarding ethnicity, and presence or absence of disadvantaged background and rural upbringing. RESULTS: Findings reveal moderate levels of emotional exhaustion but low depersonalization levels, indicating empathy towards patients remains intact despite challenges. CNAs demonstrated high personal accomplishment scores, pointing towards resilience and effective coping mechanisms in the face of high-stress environments. CONCLUSIONS: The study underlines the importance of targeted interventions that address the unique stressors CNAs face and emphasize supportive environments, reasonable workloads, and personal accomplishment enhancement strategies. The results, despite the study's limitations, provide crucial insights into burnout experiences among CNAs and affirm the necessity of continual research in this field for improving the healthcare industry's long-term care sector.Item Consumer Needs for Long-Term Services and Supports and the Road to Improving the Texas No Wrong Door System(2024-03-21) Anaab, Esme; Murphy, Sara; Yockey, Robert; Severance, JenniferPurpose: Long-term services and supports (LTSS) encompass a broad range of medical and personal care assistance needed by individuals who are unable to perform self-care tasks due to aging, chronic illness, or disability. The No Wrong Door (NWD) System is a statewide network that coordinates the system of access to long-term services and supports. As an offshoot of the person-centered planning movement, the NWD System is premised on ensuring that no matter where individuals first interact with the system, they are guaranteed comprehensive information, assessment, and services. The primary goal of this work is to identify strategies to optimize coordination between and awareness of the entry points of this system. The evaluation will help the Texas Health and Human Services Commission create a consumer-driven, cost-effective, and efficient system. Methods: Qualitative input was captured through listening sessions in five Texas cities (i.e. Amarillo, El Paso, Fort Worth, Pharr, and San Antonio) which were supplemented with a statewide survey launched in September 2023 to derive understanding from experiences with the NWD System. Target audiences included people with disabilities, veterans, adults aged 50 and over, family caregivers, and LTSS providers. Several tools (e.g., telephone, mail, and Internet) were utilized for increased survey accuracy and response rate. The survey was distributed in both English and Spanish, and a specific QR code and survey link was incorporated to track responses. Results: Of 4,185 survey respondents, 69% self-identified within the target group (excluding LTSS providers), and 61% expressed a need for LTSS in the past year. Of the 52% who applied for LTSS, 44% stated use of LTSS daily, and 14% weekly. The top three problems accessing LTSS include a confusing system, long wait times for services, and not knowing where to get help. 79% of consumers were unaware of the NWD System; 2% unsure. Of the 19% aware, 45% felt very or somewhat uninformed about the system in their community. The reasonability of time spent applying for services, ease of applying for services, and timeliness in handling service concerns were among the lowest-scoring statements regarding the system. Conclusions: Our results form the blueprint for facilitating access to care at the community and agency levels throughout Texas to ensure vulnerable populations obtain a high quality of life. Recommendations for the NWD system include effective community outreach and streamlined application processes for services and supports.Item Evaluating A Matter of Balance Series for Fall Prevention in Rural Texas: Findings and Implications(2024-03-21) Lemack, Bergen; Murphy, Sara; Crocker, Andrew; Severance, JenniferPurpose: Nearly one-third of US adults over age 65 fall annually (CDC, 2023) and falling continues to be among the leading causes of unintentional injury death in Texas (Texas DSHS, n.d.), necessitating interventions that address confidence, physical activity, and awareness. In response to these challenges, the A Matter of Balance series has been designed to enhance the well-being of participants in rural Texas by addressing these crucial components. This study seeks to evaluate the effectiveness of the A Matter of Balance series in mitigating the impact of falls among older adults in rural communities. Methods: A secondary analysis was conducted on 164 surveys collected from A Matter of Balance participants in 2023. All participants were from counties meeting the Health Resources and Services Administration (HRSA) definition of rural, and the project received grant funding from HRSA. A paired t-test was used to compare scores on a pre-post test design. The study focused on measuring improvements in knowledge about ways to reduce falls, protecting yourself if you fall, increasing physical strength, becoming steadier on your feet, and getting up if there is a fall. The analysis aimed to provide insights into the impact of the A Matter of Balance series on the well-being of participants. Results: The findings of the study indicate significant improvements in participants' well-being because of their engagement in the A Matter of Balance series. Statistical analyses demonstrated substantial enhancements in knowledge about ways to reduce falls (p <.001), protect yourself if you fall (p <.001), increase physical strength (p <.001), becoming steadier on your feet (p <.001), and getting up if there is a fall (p <.001). These results collectively underscore the effectiveness of the A Matter of Balance series in addressing key parameters related to fall prevention. Conclusion: In conclusion, the A Matter of Balance series proves to be a successful intervention in enhancing the well-being of participants in rural Texas. By adopting increased confidence, reducing concern, and promoting physical activity, the program addresses the challenges associated with falls among older adults. These positive outcomes support the continued dissemination of the A Matter of Balance series, emphasizing its potential to contribute to the overall health and quality of life of older adults in rural communities.Item Geriatric Practice Leadership Institute (GPLI): An Age-Friendly Program(2023) Murphy, Sara; Soto, Maria; Camp, Kathlene E.; Severance, Jennifer; Fairchild, ThomasPurpose According to the Institute of Medicine, immediate steps must be taken to educate and train both the current and future health care workforce to work collaboratively in addressing the diverse needs of the growing older adult population. Most healthcare professionals had very little education or clinical training in the care of older adults nor the most effective ways to work as a clinical team. Methods The Geriatric Practice Leadership Institute (GPLI) is a collaboration between two universities providing interprofessional teams of early and mid-career professionals with the skills and knowledge needed to leverage leadership skills to effectively work within interdisciplinary teams to provide age-friendly care to older adults. The GPLI incorporates the Institute for Healthcare Improvement (IHI) Age-Friendly Health Systems 4Ms’ Framework into the training. The GPLI is an on-line, team-based program which engages 5-7 teams each session. Module topics include Age-Friendly Health Systems, organizational culture, leading self, leading interprofessional teams, and quality improvement. Additionally, teams select and complete a quality improvement project based on the Age-Friendly Health Systems 4Ms and submit final report and presentation. The teams are also assigned a coach for support. Continuing education credits and a micro-credential are available to participants. Participants complete a survey following the completion of the program. The GPLI has been funded by the Health Resources and Services Administration (HRSA) Geriatrics Workforce Enhancement Program grant (numberU1QHP2873), which currently covers all costs for participants. Results The GPLI has trained over 175 healthcare professionals during the past 7 years with teams representing ambulatory to emergency responder organizations. Participants were all asked to complete a survey to gauge the program's success. When asked about how valuable the information was in the program in a post-completion survey, 100% of participants answered 'very’ or 'extremely’ valuable. Additionally, all participants answered either 'very’ or 'extremely’ valuable when asked how useful their executive sponsor was in supporting their team's involvement and project. Conclusion After many years of offering the program, many lessons have been learned, and consistent themes have emerged from the teams who have been the most successful. These include team representation from all levels of the organization, a focus on culture change, and flexibility to change and adjust, especially during the COVID-19 pandemic.