It is estimated that by 2020 there will be 2.8 million long-term care beds in residential facilities, staffed primarily with nursing assistants as the front-line care providers. The American Healthcare Association 2012 staffing survey showed that the median annual turnover rate for nursing assistants in the United States is 51.5%. High rates of turnover are associated not only with poorer quality of care but also with increased costs for facilities. The purpose of this project was to understand characteristics that are associated with long-term employment in the nursing assistant role by describing the personality characteristic of empathy in the nursing assistant population with career longevity. The practice-focused question focused on the level of empathy among nursing assistants in long-term care who have been in their role 3 years or longer. The purposive sample group included 60 nursing assistants from 10 long-term care facilities in New Jersey. Data were collected using the Interpersonal Reactivity Index instrument, which comprises 4, 7-item subscales that consider aspects of the global concept of empathy. The overall findings of this study did not establish a significant relationship between empathy and retention; however, notable shifts in the empathy subscale scores of participants related to gender and length of tenure were noted. The results of this study could promote positive social change by helping administrators select nursing assistants suited to working in long-term care facilities, which may result in lower turnover and improved patient outcomes among the population in long-term care.

Employee turnover costs long-term care facilities billions of dollars on an annual basis. The purpose of this correlational study was to examine the relationships between employee turnover intention of certified nursing assistants (CNAs) in the long-term care industry and employee compensation, engagement, job satisfaction, motivation, and work environment. The predictor variables were employee compensation, engagement, job satisfaction, motivation, and work environment. The criterion variable was employee turnover intention. The population of interest consisted of CNAs who were residents of Florida, over the age of 18 years, and employed in the long-term care industry. The theoretical framework that grounded this study was the motivational-hygiene theory. For this study, a sample of 157 participants completed an electronic survey. Multiple linear regression analyses predicted the dependent variables, R-² = .34, F(5, 151) = 15.22, p < .0001. The multiple regression model with 4 of the 5 predictors accounted for significantly more variance in turnover intention than would be expected by chance. Correlation tests resulted in statistically significant inverse relationships between employee turnover intention and employee compensation, engagement, job satisfaction, and work environment. The negative correlation observed between motivation and turnover intention was not statistically significant. The findings in this study may contribute to positive social change by reducing turnover intention while improving the quality of care and reducing costs of care that affect the lives of the long-term care residents, concerned family members, and significant others.

The relationship between learning styles and achievement has been thoroughly studied by many researchers. However, the nursing assistant population is under represented in these studies. Hence, the purpose of this study was to understand the relationship between learning styles, demographics, and achievement of nursing assistant students in Illinois. The sample for the study consisted of 916 nursing assistant students' in Illinois. The VARK learning style inventory was used to measure the students' learning styles, and a demographic questionnaire was used to gather demographic data. The Illinois Nurse Aide Competency Test score was used to measure the achievement of students. The findings showed that there was a relationship between learning styles and achievement of nursing assistant students. Also, there was a relationship between demographics and learning styles. The dominant learning style was the multimodal all four (VARK) preference. Females were the highest representation in the sample and the majority of students were in age ranges 18-25.

Alzheimer's Disease (AD) is more prevalent than any other disease under the umbrella of dementia (Alzheimer's Association, 2013). Certified Nursing Assistants (CNAs) are the typical front-line care staff who care for individuals in aging care (Sengupta, Harris-Kojetin, & Ejaz, 2010). The present study investigated the use of a pyramidal training model to teach aging facility staff to be able to conduct trainings and to teach direct care staff antecedent strategies shown to be effective when communicating with individuals with AD. Pyramidal training resulted in two tiers of staff successfully implementing training for subsequent tiers of staff and subsequent staff demonstrated mastery of the trained material. However, during maintenance observations, some decreases were observed both with regard to training integrity as well as implementation of the trained material.

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O setor de serviços tem fundamental importância para a economia global, porém o layout de organizações deste setor tipicamente não é abordado com a mesma intensidade com que se discute arranjo físico em ambientes industriais. O objetivo desta dissertação reside na aplicação de sistemáticas de concepção de layout com vistas ao planejamento e aprimoramento do arranjo físico e agrupamento de recursos de uma biblioteca. Como objetivos específicos, traz a aplicação do planejamento sistemático de layout (SLP) para o posicionamento de recursos e organização dos fluxos de uma biblioteca, e a adaptação do algoritmo Close Neighbor para agrupamento de materiais bibliográficos (livros) em prateleiras de acordo com sua área de abrangência. Para tanto, inicialmente apresentam-se as características da Biblioteca da Faculdade de Farmácia da UFRGS (local de aplicação do estudo), a análise da movimentação de pessoas e de materiais, a abordagem proposta e as diretrizes para organização do arranjo físico da biblioteca e do acervo de livros. Dentre outros procedimentos operacionais, fez-se necessária a realização de reuniões com a equipe da biblioteca e com a direção da Faculdade de Farmácia, visando a estabelecer prioridades e definir características desejadas para o arranjo físico do espaço em estudo. Na sequência, implantou-se a proposta de layout selecionada, seguida de uma discussão acerca do desempenho da biblioteca antes e depois da implantação do novo layout; tal discussão foi baseada tanto em resultados numéricos (análise quantitativa) como na percepção da equipe envolvida (análise qualitativa). / The service sector is of fundamental importance to the global economy, but the layout of organizations in this sector is typically not approached with the same intensity with which physical arrangement is discussed in industrial environments. The objective of this dissertation is to apply layout design systematics with a view to planning and improving the physical arrangement and grouping of library resources. As a specific goal, the application of systematic layout planning (SLP) for the positioning of resources and organization of a library's flows, and the adaptation of the Close Neighbor algorithm for grouping bibliographic materials (books) into shelves according to their area of comprehensiveness. In order to do so, the characteristics of the Library of the Faculty of Pharmacy of UFRGS (place of application of the study), the analysis of the movement of people and materials, the proposed approach and the guidelines for the organization of the physical arrangement of the library and of the collection of books. Among other operational procedures, it was necessary to hold meetings with the library staff and the Faculty of Pharmacy, in order to establish priorities and define desired characteristics for the physical arrangement of the space under study. Next, the selected layout proposal was implanted, followed by a discussion about the library's performance before and after the implementation of the new layout; such a discussion was based on both numerical results (quantitative analysis) and the perception of the team involved (qualitative analysis).

Hard-to-heal ulcers are resource intensive due to the fact that they are difficult to treat and especially vulnerable to bacterial invasion. The bacterial culture contaminating these wounds often consist of several different bacterial organisms that originate from endogenous sources. Necrotic material in ischemic ulcers provide nutrition which support bacterial reproduction, increasing the risk of infection. Determining causative pathogen in infected ulcers proves to be difficult when culturing swab samples, however Staphylococcus aureus and hemolytic streptococci generally act as primary pathogens.     The aim of the study was to investigate if the detection rate increased for S. aureus and hemolytic streptococci when culturing swab samples from ulcers on Columbia CNA; a media selective for gram-positive bacteria. In the experimental procedure the inhibitory action of CNA upon gram-negative bacterial growth was evaluated, using simulated ulcer samples (n=6) containing bacterial quality control strains in arbitrary concentrations. Additionally, patient samples (n=51) were cultured and screened for primary pathogens to investigate differences in the detection rate for CNA and the current culture media; Blood agar, Chocolate agar, Gentian violet blood agar and CLED agar.    Results from simulated ulcer samples showed excellent inhibitory function regarding the antibiotic substances of the CNA agar. Culturing patient samples from lower leg- and pressure ulcers on CNA, provided indications of diverse circumstances yielding higher respectively lower detection rate concerning S. aureus and hemolytic streptococci. Samples containing mixed flora with gram-negative bacteria generated higher detection rate and samples containing S. aureus yielded a lower detection rate when culturing on CNA, compared with that of the routine method.

O setor de serviços tem fundamental importância para a economia global, porém o layout de organizações deste setor tipicamente não é abordado com a mesma intensidade com que se discute arranjo físico em ambientes industriais. O objetivo desta dissertação reside na aplicação de sistemáticas de concepção de layout com vistas ao planejamento e aprimoramento do arranjo físico e agrupamento de recursos de uma biblioteca. Como objetivos específicos, traz a aplicação do planejamento sistemático de layout (SLP) para o posicionamento de recursos e organização dos fluxos de uma biblioteca, e a adaptação do algoritmo Close Neighbor para agrupamento de materiais bibliográficos (livros) em prateleiras de acordo com sua área de abrangência. Para tanto, inicialmente apresentam-se as características da Biblioteca da Faculdade de Farmácia da UFRGS (local de aplicação do estudo), a análise da movimentação de pessoas e de materiais, a abordagem proposta e as diretrizes para organização do arranjo físico da biblioteca e do acervo de livros. Dentre outros procedimentos operacionais, fez-se necessária a realização de reuniões com a equipe da biblioteca e com a direção da Faculdade de Farmácia, visando a estabelecer prioridades e definir características desejadas para o arranjo físico do espaço em estudo. Na sequência, implantou-se a proposta de layout selecionada, seguida de uma discussão acerca do desempenho da biblioteca antes e depois da implantação do novo layout; tal discussão foi baseada tanto em resultados numéricos (análise quantitativa) como na percepção da equipe envolvida (análise qualitativa). / The service sector is of fundamental importance to the global economy, but the layout of organizations in this sector is typically not approached with the same intensity with which physical arrangement is discussed in industrial environments. The objective of this dissertation is to apply layout design systematics with a view to planning and improving the physical arrangement and grouping of library resources. As a specific goal, the application of systematic layout planning (SLP) for the positioning of resources and organization of a library's flows, and the adaptation of the Close Neighbor algorithm for grouping bibliographic materials (books) into shelves according to their area of comprehensiveness. In order to do so, the characteristics of the Library of the Faculty of Pharmacy of UFRGS (place of application of the study), the analysis of the movement of people and materials, the proposed approach and the guidelines for the organization of the physical arrangement of the library and of the collection of books. Among other operational procedures, it was necessary to hold meetings with the library staff and the Faculty of Pharmacy, in order to establish priorities and define desired characteristics for the physical arrangement of the space under study. Next, the selected layout proposal was implanted, followed by a discussion about the library's performance before and after the implementation of the new layout; such a discussion was based on both numerical results (quantitative analysis) and the perception of the team involved (qualitative analysis).

O setor de serviços tem fundamental importância para a economia global, porém o layout de organizações deste setor tipicamente não é abordado com a mesma intensidade com que se discute arranjo físico em ambientes industriais. O objetivo desta dissertação reside na aplicação de sistemáticas de concepção de layout com vistas ao planejamento e aprimoramento do arranjo físico e agrupamento de recursos de uma biblioteca. Como objetivos específicos, traz a aplicação do planejamento sistemático de layout (SLP) para o posicionamento de recursos e organização dos fluxos de uma biblioteca, e a adaptação do algoritmo Close Neighbor para agrupamento de materiais bibliográficos (livros) em prateleiras de acordo com sua área de abrangência. Para tanto, inicialmente apresentam-se as características da Biblioteca da Faculdade de Farmácia da UFRGS (local de aplicação do estudo), a análise da movimentação de pessoas e de materiais, a abordagem proposta e as diretrizes para organização do arranjo físico da biblioteca e do acervo de livros. Dentre outros procedimentos operacionais, fez-se necessária a realização de reuniões com a equipe da biblioteca e com a direção da Faculdade de Farmácia, visando a estabelecer prioridades e definir características desejadas para o arranjo físico do espaço em estudo. Na sequência, implantou-se a proposta de layout selecionada, seguida de uma discussão acerca do desempenho da biblioteca antes e depois da implantação do novo layout; tal discussão foi baseada tanto em resultados numéricos (análise quantitativa) como na percepção da equipe envolvida (análise qualitativa). / The service sector is of fundamental importance to the global economy, but the layout of organizations in this sector is typically not approached with the same intensity with which physical arrangement is discussed in industrial environments. The objective of this dissertation is to apply layout design systematics with a view to planning and improving the physical arrangement and grouping of library resources. As a specific goal, the application of systematic layout planning (SLP) for the positioning of resources and organization of a library's flows, and the adaptation of the Close Neighbor algorithm for grouping bibliographic materials (books) into shelves according to their area of comprehensiveness. In order to do so, the characteristics of the Library of the Faculty of Pharmacy of UFRGS (place of application of the study), the analysis of the movement of people and materials, the proposed approach and the guidelines for the organization of the physical arrangement of the library and of the collection of books. Among other operational procedures, it was necessary to hold meetings with the library staff and the Faculty of Pharmacy, in order to establish priorities and define desired characteristics for the physical arrangement of the space under study. Next, the selected layout proposal was implanted, followed by a discussion about the library's performance before and after the implementation of the new layout; such a discussion was based on both numerical results (quantitative analysis) and the perception of the team involved (qualitative analysis).

Many long-term care (LTC) facilities within the United States have replaced the institutional model of care with one that accepts person-centered care (PCC) as the guiding standard of practice. Quality training ensures that direct care staff have the skills and the knowledge in the delivery of quality PCC. However, many nurses and nursing assistants have expressed the desire for further training in PCC practices to effectively deliver quality care. The purpose of this study was to explore the types and length of training and education provided based on the perceptions and experiences of direct care staff related to their implementation of PCC practices. The theoretical framework for this study consisted of Rogers’ PCC approach theory and philosophy. A qualitative interpretative phenomenological design was used to examine the perceptions of training and education of 20 certified nursing assistants using semistructured interviews. Once the interviews were conducted and transcribed, the data were coded into superordinate themes that stemmed from participant responses. Themes of PCC practices, teaching modalities, learner type, length, and introduction of training were identified as a result of the data analysis. The data also revealed that it is important for LTC facilities to be aware of how they are providing PCC education and training to their staff so that they may provide their residents with quality individualized care that emphasizes the whole person. Study findings may inform LTC administrators, leaders, and managers on the deliverance of effective training and educational practices when implementing PCC models within their facilities. The results may also spur national LTC organizations to refocus their core beliefs, values, and culture towards a culture that considers the whole person.