A staff intervention targeting resident-to-resident elder mistreatment (R-REM) in long-term care increased staff knowledge, recognition and reporting: Results from a cluster randomized trial

Elder abuse in long-term care has received considerable attention; however, resident-to-resident elder mistreatment (R-REM) has not been well researched. Preliminary findings from studies of R-REM suggest that it is sufficiently widespread to merit concern, and is likely to have serious detrimental...

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Bibliographic Details
Published in:International journal of nursing studies 2013-05, Vol.50 (5), p.644-656
Main Authors: Teresi, Jeanne A., Ramirez, Mildred, Ellis, Julie, Silver, Stephanie, Boratgis, Gabriel, Kong, Jian, Eimicke, Joseph P., Pillemer, Karl, Lachs, Mark S.
Format: Article
Language:English
Subjects:
Adult abuse & neglect
Aged
Case-Control Studies
Clinical trials
Cluster Analysis
Elder Abuse
Humans
Inpatients - psychology
Interpersonal Relations
Long term health care
Long-Term Care
Medical malpractice
New York City
Nursing Homes
Nursing Staff - psychology
Older people
Prospective Studies
Resident-to-resident elder mistreatment (R-REM)
Staff education
Staff training
Training
Workforce
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Summary:Elder abuse in long-term care has received considerable attention; however, resident-to-resident elder mistreatment (R-REM) has not been well researched. Preliminary findings from studies of R-REM suggest that it is sufficiently widespread to merit concern, and is likely to have serious detrimental outcomes for residents. However, no evidence-based training, intervention and implementation strategies exist that address this issue. The objective was to evaluate the impact of a newly developed R-REM training intervention for nursing staff on knowledge, recognition and reporting of R-REM. The design was a prospective cluster randomized trial with randomization at the unit level. A sample of 1405 residents (685 in the control and 720 in the intervention group) from 47 New York City nursing home units (23 experimental and 24 control) in 5 nursing homes was assessed. Data were collected at three waves: baseline, 6 and 12 months. Staff on the experimental units received the training and implementation protocols, while those on the comparison units did not. Evaluation of outcomes was conducted on an intent-to-treat basis using mixed (random and fixed effects) models for continuous knowledge variables and Poisson regressions for longitudinal count data measuring recognition and reporting. There was a significant increase in knowledge post-training, controlling for pre-training levels for the intervention group (p
ISSN:0020-7489
1873-491X
DOI:10.1016/j.ijnurstu.2012.10.010