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dc.contributor.authorDubé, Catherine E
dc.contributor.authorNielsen, Natalia
dc.contributor.authorMcPhillips, Emily
dc.contributor.authorLee Hargraves, J
dc.contributor.authorCosenza, Carol
dc.contributor.authorJesdale, Bill
dc.contributor.authorLapane, Kate L
dc.date.accessioned2024-01-22T16:52:19Z
dc.date.available2024-01-22T16:52:19Z
dc.date.issued2023-12-19
dc.identifier.citationDubé CE, Nielsen N, McPhillips E, Lee Hargraves J, Cosenza C, Jesdale B, Lapane KL. U.S. nursing home leadership experiences with COVID-19 and its impact on residents and staff: A qualitative analysis. PLoS One. 2023 Dec 19;18(12):e0293336. doi: 10.1371/journal.pone.0293336. PMID: 38113231; PMCID: PMC10729989.en_US
dc.identifier.eissn1932-6203
dc.identifier.doi10.1371/journal.pone.0293336en_US
dc.identifier.pmid38113231
dc.identifier.urihttp://hdl.handle.net/20.500.14038/52999
dc.description.abstractObjectives: To explore experiences of U.S. (United States) nursing home leadership during the COVID-19 pandemic in their efforts to address resident loneliness and social isolation and to elicit stories about personal and professional impacts on themselves and staff. Design: Qualitative inquiry via three optional open-ended questions appended to a national self-administered survey of American nursing home leaders was employed. Textual data was analyzed using an iterative reflexive thematic approach. Setting and participants: A stratified sample frame defined by facility size (beds: 30-99, 100+) and quality ratings (1, 2-4, 5) was employed. Web survey links and paper surveys were sent to 1,676 nursing home directors of nursing between February and May 2022. Results: Open text responses were collected from 271 nursing homes. Broad themes included: 1) Addressing needs of residents & families; 2) Challenges; and 3) Personal experiences of nursing home leadership/staff. Respondents described trauma to residents, staff, and leadership. Resident loneliness was addressed using existing and newer technologies and innovative indoor and outdoor activities. Residents experienced fear, illness, loss, and sometimes death. Isolation from family and lack of touch were particularly difficult. Regulations were seen as punitive while ignoring emotional needs of residents. Staffing challenges and pressures to do more with less created additional stress. Leadership and staff made significant sacrifices resulting in physical, social, and emotional consequences. Beneficial outcomes included staff bonding, professional growth, and permanent implementation of new interventions. Conclusions and implications: New and creative interventions were successfully implemented to address social isolation and loneliness. Improved Wi-Fi and other nursing home infrastructure upgrades are needed to maintain them. Reimagining often conflicting overlapping federal, state, and local regulations, grounding them in good clinical judgement, and incentivizing performance improvement should be considered. Trauma experienced by staff needs to be addressed to deal with current and future workforce needs.en_US
dc.language.isoenen_US
dc.relation.ispartofPLoS Oneen_US
dc.relation.urlhttps://doi.org/10.1371/journal.pone.0293336en_US
dc.rightsCopyright: © 2023 Dubé et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_US
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.titleU.S. nursing home leadership experiences with COVID-19 and its impact on residents and staff: A qualitative analysisen_US
dc.typeJournal Articleen_US
dc.source.journaltitlePloS one
dc.source.volume18
dc.source.issue12
dc.source.beginpagee0293336
dc.source.endpage
dc.source.countryUnited States
dc.identifier.journalPloS one
refterms.dateFOA2024-01-22T16:52:21Z
dc.contributor.departmentFamily Medicine and Community Healthen_US
dc.contributor.departmentMorningside Graduate School of Biomedical Sciencesen_US
dc.contributor.departmentPopulation and Quantitative Health Sciencesen_US
dc.contributor.studentNatalia Nielsen


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Copyright: © 2023 Dubé et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Except where otherwise noted, this item's license is described as Copyright: © 2023 Dubé et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.