McAiney Carrie A, Stolee Paul, Hillier Loretta M, Harris Diane, Hamilton Pam, Kessler Linda, Madsen Victoria, Le Clair J Kenneth
Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada.
Int Psychogeriatr. 2007 Oct;19(5):842-58. doi: 10.1017/S1041610206004443. Epub 2006 Oct 27.
This paper describes an innovative education program for the management of mental health problems in long-term care (LTC) homes and the evaluation of its longer-term sustainability. Since 1998, the "Putting the P.I.E.C.E.S. Together" learning initiative has been providing education sessions and related learning strategies aimed at developing the knowledge and skills of health professionals who care for older persons with complex physical and mental health needs and associated behaviors, in Ontario, Canada. A major focus of this province-wide initiative was the development of in-house Psychogeriatric Resource Persons (PRPs). Evaluation of this initiative included the completion of pre- and post-education questionnaires (over three data collection time periods) assessing learner confidence (N = 1,024 and 792, for pre- and post-education, respectively) and session evaluation questionnaires gathering feedback on the session (N = 2,029 across all sessions). A survey of LTC homes in Ontario (N = 439, 79% of the homes in the province) was conducted to assess longer-term sustainability.
Ratings of the sessions indicated that they were relevant to learners' clinical practice. There were significant increases in ratings of ability to recognize and understand challenging behaviors and mental health problems, and in ability to use a variety of assessment tools. Few homes (15%) do not have a PRP; over 50% of the staff who completed the first session in 1999 continue to serve as a PRP and to apply learned skills.
A learning initiative with supportive and reinforcing strategies can develop in-house PRPs to enhance the care of the elderly in LTC. Incorporation of PRP functions into job descriptions and management support contributed to the success of this initiative. This study highlights the importance of work environments that support and reinforce the use of learned skills to the success of continuing education and quality improvement initiatives in LTC.
本文介绍了一项针对长期护理（LTC）机构中心理健康问题管理的创新教育计划及其长期可持续性评估。自1998年以来，“整合碎片”学习倡议一直在加拿大安大略省提供教育课程及相关学习策略，旨在培养照顾有复杂身心健康需求及相关行为的老年人的健康专业人员的知识和技能。这项全省范围倡议的一个主要重点是培养内部老年精神科资源人员（PRP）。该倡议的评估包括完成教育前后问卷（在三个数据收集时间段内），评估学习者的信心（教育前N = 1024，教育后N = 792），以及收集关于课程反馈的课程评估问卷（所有课程N = 2029）。对安大略省的长期护理机构进行了一项调查（N = 439，占该省机构的79%），以评估长期可持续性。
对课程的评分表明它们与学习者的临床实践相关。在识别和理解具有挑战性的行为及心理健康问题的能力评分，以及使用各种评估工具的能力评分方面有显著提高。很少有机构（15%）没有PRP；1999年完成第一期课程的员工中，超过50%继续担任PRP并应用所学技能。
一项具有支持和强化策略的学习倡议可以培养内部PRP，以加强长期护理机构中对老年人的护理。将PRP职能纳入职位描述和管理支持有助于该倡议的成功。本研究强调了支持和强化所学技能应用的工作环境对长期护理机构中继续教育和质量改进倡议成功的重要性。
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