Elsevier

Nursing Outlook

Volume 45, Issue 2, March–April 1997, Pages 64-72
Nursing Outlook

The effect of staffing on the quality of care at mealtime

https://doi.org/10.1016/S0029-6554(97)90081-6Get rights and content

Abstract

Inadequate staffing has serious consequences for the nutritional care of nursing home residents. A sufficient number of well-educated and supervised staff members are critical to improving care.

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      Previous research has suggested that higher levels of organizational commitment are associated with more favorable perceptions of organizational culture and greater job satisfaction, which is then significantly linked to decreased nursing home staff turnover (Karsh et al., 2005; Sikorska-Simmons, 2005). Decreased staff education and training has also been associated with under-diagnosis and recognition of dysphagia and its symptoms, leading to more negative mealtime experiences (Kayser-Jones and Schell, 1997). More comprehensive education for nursing assistants related to dysphagia, beyond basic feeding skills, has been previously recommended (Pelletier, 2004), but is clearly still a relevant issue as demonstrated here.

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      In the significant number of ethnographic studies focusing on the residential care setting published over the past three decades, observational studies particularly have highlighted the overwhelming impact a focus on process, organisational systems, and structure can have on mealtimes in residential care (Barnes, Wasielewska, Raiswell, & Drummond, 2013; Kayser-Jones & Schell, 1997; Moore, 1999; Pierson, 1999; Ullrich, McCutcheon, & Parker, 2014). As a result, staff are often ‘task driven’ and focused on moving through organisational systems successfully, rather than responding to the experience of residents leading to their individual needs for physical and social care being lost (Henkusens, Keller, Dupuis, & Schindel Martin, 2014; Kayser-Jones & Schell, 1997; Moore, 1999; Pierson, 1999). Dining rooms are often noisy, crowded, busy, and confusing places, with complex explicit and implied rules for resident to staff and resident to resident interactions (Henkusens et al., 2014; Kofod, 2012; Moore, 1999; Pasman, The, Onwuteaka-Philipsen, Van Der Wal, & Ribbe, 2003; Pierson, 1999).

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    Supported by the National Institute on Aging (National Institutes of Health) grant no. AG10131-03 and the National Institute of Dental Research (National Institutes of Health) contract no. 2262-MD338998-1.

    1

    Jeanie Kayser-Jones is a professor in the Department of Physiological Nursing and Medical Anthropology Program at the University of California-San Francisco.

    2

    Ellen Schell is an assistant research nurse in the Department of Physiological Nursing at the University of California-San Francisco.

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