Thesis (M.S.)--University of Wisconsin-Madison, 1993. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 36-38).

Thesis (Ph. D.)--University of Washington, 2004. / Vita. Includes bibliographical references (leaves 236-258).

Thesis (M.H.A.)--University of Michigan, 1964.

Thesis (M.H.A.)--University of Michigan, 1964.

The objective of this study was to determine whether provincial health policies influence the supply of long-term care in a province, and the care received by residents that require it. This was achieved by first conducting a comprehensive review and comparative analysis of the long-term care policies of Alberta and Ontario, and then comparing health conditions of long-term care and assisted living/retirement home residents in both provinces. The latter comparisons used information collected from comparable versions of the Resident Assessment Instrument – Minimum Data Set (RAI-MDS) and the RAI-MDS Home Care. The study hypothesis was that provinces with health policies favouring institutional over community care would have a higher proportion of residents with lower care requirements in institutional settings. The results show that this is not the case, and that institutional settings house those with high care needs in both provinces.

The objective of this study was to determine whether provincial health policies influence the supply of long-term care in a province, and the care received by residents that require it. This was achieved by first conducting a comprehensive review and comparative analysis of the long-term care policies of Alberta and Ontario, and then comparing health conditions of long-term care and assisted living/retirement home residents in both provinces. The latter comparisons used information collected from comparable versions of the Resident Assessment Instrument – Minimum Data Set (RAI-MDS) and the RAI-MDS Home Care. The study hypothesis was that provinces with health policies favouring institutional over community care would have a higher proportion of residents with lower care requirements in institutional settings. The results show that this is not the case, and that institutional settings house those with high care needs in both provinces.

Thesis (Ph. D.)--University of Missouri--Columbia, 1999. / "May 1999." Typescript. Vita. Includes bibliographical references (leaves 103-107). Also available on the Internet.

New graduate nurses often lack clinical skill competency. In a single year, a long-term care facility located in the midwestern region of the United States reported 25 clinical errors, each costing the facility approximately $10,000. Root-cause analysis revealed 85% of those errors were made by nurses in their 1st year of practice. The increase in clinical errors were attributed to insufficient clinical preparation prior to independent practice. A review of the current scholarly literature suggested simulation had demonstrated efficacy in the development and maintenance of clinical nursing skills and answered the practice-focused question: Development of a skills simulation program for incorporation into nursing orientation will likely increase skill competency among new graduate nurses. Benner's novice to expert theory and the John Hopkins nursing evidence-based practice model were used to develop and evaluate an evidence-based curriculum for a clinical skills simulation program. Using a validated tool, the proposed curriculum was evaluated by a panel of five subject matter experts. Synthesis and analysis of that evaluation suggested implementation of the proposed curriculum would increase basic nursing skill competency; therefore, the recommendation was made to incorporate the program into new hire nursing orientation. The curriculum can be used to develop or maintain general or specialty-specific clinical skill sets and implemented in most any type facility requiring the use of clinical nursing skills. Clinical skill competency reduces the number of clinical errors, decreases patient morbidity and mortality, increases the quality of care, and reduces the overall cost of care, thereby promoting positive social change.

In this thesis, the overall purpose was to investigate the role of regulation in the care of older people with depression living in long-term care (LTC). The first manuscript in this thesis is a systematic scoping review protocol which was published in BMJ open, using Arksey and O'Malley's scoping review methodology as a guide. In the second manuscript which was submitted to BMC Geriatrics, a systematic scoping review was conducted, exploring the concepts of regulation, older people, depression, and long-term care. The search yielded 778 unique articles, of which 21 were included in the final analysis. The scoping review revealed that the highly regulated environment of LTC poses significant challenges which can influence the quality of care of residents with depression. Despite evidence of high prevalence and improved treatment, regulation appears to have failed to capture best practice and contemporary knowledge. The scoping review demonstrated a need for further empirical research to explore these issues. Findings from this study, which explored the role of regulation on the quality of care of older people living with depression in LTC are presented, and which were the basis of the third manuscript, to the Canadian Journal of Aging. Using instrumental case study methodology, I interviewed managers, staff, informal carers and residents, and reviewed documents and clinical charts. I found that Ministry of Health and Long-Term Care regulations influenced strategic planning, educational priorities, resourcing decisions and direct care. The findings from the study suggest an alternative approach to regulation is needed in this sector, which places accountability for standards of care at a provincial level and which has a more supportive and collaborative approach to regulations. The research findings showed that the staff working in the LTC home are committed to the care of residents with depression, but they had little time to implement additional quality initiatives outside of the identified mandated areas. The study concludes by suggesting that in its current state, the care of residents with depression in LTC homes is not reflected in Ministry of Health and Long-Term Care regulations and inspections, which make little difference to the care of older people living with depression living in LTC. In contributing to the existing knowledge and practice the study along with the findings from the scoping review, finds an alternative model of inspection could be implemented in partnership with the province. An alternative approach to inspection might adopt an extended approach to quality, along with an individualized approach to inspections to meet the requirements set out in regulation, but at the same time offering flexibility and a more collaborative approach to improving quality in the LTC sector.

This thesis explores Korean-Chinese migrant workers’ local experiences of the global phenomenon of international migration of care labour, focusing on how the care labour of migrant workers is being constructed through the intertwined social and political processes in South Korea’s shifting long-term care sector for the elderly. The thesis uses a qualitative case study method and relies on data collected through participant observation, interviews, and textual analysis during field research between November 2009 and May 2010. The analysis is based on a global economy of care framework, which understands care work as being made of products that are socially and politically constructed in the global processes. My study findings illuminate the roles and relations of the state, the employers, and the workers in producing a huge migrant workforce in South Korea’s segregated elder care labour market. The policy analysis at the intersection of elder care, labour market, and immigration policies shows that, over the last decade, the South Korean government has significantly reconstructed the boundaries of elder care work through the expansion of publicly-funded programmes for the elderly and the institutionalisation of care work in those programmes. In the institutionalisation process, the government’s ignorance about the care work performed in the private care sector has resulted in different regulations and working conditions for care workers in the publicly-funded versus the private sector. My empirical findings highlight how employers’ search for ‘cheap’ and ‘flexible’ labour and older female migrants’ disadvantageous status in the labour market have placed these workers in the less regulated private sector and their pay and working conditions at the bottom of hierarchical elder care workforce. In advocating for migrant care workers’ labour rights, this thesis challenges the current discriminative employment practices and the government’s lack of protection and regulation of care work in the private sector.