Résumés
Abstract
Introduction: The PIECES approach has been utilized for over 25 years across various Canadian healthcare settings, including long-term care (LTC). PIECES fosters a team-based, person-centred approach to addressing responsive behaviors—such as yelling and restlessness—often linked to unmet personal needs. Objective: This study aimed to explore, with implementation of the virtual version of PIECES: (a) the experiences of LTC staff, focusing on challenges, facilitators, and recommendations; and (b) resilience and interprofessional collaboration among LTC staff. Methods: A convergent mixed method approach used focus groups with registered practical nurses (RPNs), managers, PIECES-trained RPN champions and PIECES mentors to gather their experiences. Surveys at baseline and post-intervention assessed individual and workplace resilience, and team collaboration. Results: Themes identified through reflexive thematic analysis included increased team collaboration and efficacy to manage responsive behaviors through PIECES care planning. Formalized processes supported by leadership with input from family/care partners enhanced nurses’ ability to provide the needed care for responsive behaviors. Primary challenges to PIECES implementation were unfamiliarity with technology and staff shortage. Recommendations included embedding technology in usual care, ongoing support with referral process and continued virtual PIECES training. Standard outcome measures revealed reduced personal and workplace resilience, and team collaboration. Discussion and Conclusion: The RPN-led referral algorithm for the virtual PIECES approach invested the LTC staff together during the difficult COVID period and challenged their existing skills and knowledge of technology.
Keywords:
- older adults,
- families,
- long-term care,
- care planning,
- responsive behaviors
Résumé
Introduction : L’approche PIECES est utilisée depuis plus de 25 ans dans divers milieux de soins de santé canadiens, y compris dans les foyers de soins de longue durée (SLD). PIECES favorise une approche d’équipe centrée sur la personne pour apaiser les comportements réactifs (ex. : cris, agitation) souvent liés à des besoins non satisfaits. Objectif : Cette étude visait à explorer, avec la mise en oeuvre de la version virtuelle de PIECES : (a) les expériences du personnel en SLD, en particulier les défis, les facilitateurs et les recommandations; et (b) la résilience et la collaboration interprofessionnelle au sein de ce personnel. Méthodes : Une approche convergente de méthodes mixtes a été utilisée. Des groupes de discussion (infirmières auxiliaires autorisées (IAA), gestionnaires, championnes IAA formées à PIECES, mentors PIECES) ont permis de recueillir leurs expériences. Des questionnaires avant et après l’intervention ont évalué la résilience individuelle et organisationnelle, et la collaboration en équipe. Résultats : L’analyse thématique réflexive a montré une collaboration d’équipe et une efficacité accrues envers les comportements réactifs. Des processus formalisés ont amélioré la capacité des IAA à prodiguer les soins nécessaires aux comportements réactifs. Les principaux défis : la méconnaissance de la technologie et le manque de personnel. Les recommandations incluaient l’utilisation de la technologie dans les soins courants, un soutien continu au processus, ainsi qu’une formation continue en PIECES virtuelle. Les mesures de résultats standards ont révélé une réduction de la résilience personnelle et organisationnelle ainsi que de la collaboration en équipe. Discussion et conclusion : L’approche virtuelle PIECES a réuni le personnel en SLD pendant la période difficile de la COVID, mettant à l’épreuve leurs compétences et connaissances de la technologie.
Mots-clés :
- personnes âgées,
- familles,
- soins de longue durée,
- planification des soins,
- comportements réactifs
Parties annexes
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