According to a report by researchers from the University of British Columbia and the BC Care Providers Association, the province needs to improve guidelines for safe long-term care staffing and involving families in care decisions. pandemic strategy.
According to the report, approximately 85% of COVID-19 deaths in Canada occurred in long-term care homes during the first wave of the pandemic.
The co-leads of the study said they prioritized the report’s recommendations for reviewing safe staffing levels and emergency staffing plans in times of crisis. Although the province is not seeing the same number of deaths and new infections as before, the report was written to address long-term care issues to prepare for unforeseen short- and long-term events.
Currently, a nurse could be responsible for a range of 20 to 40 residents, and this long-standing problem has been compounded by increased pandemic workloads, said Farinaz Havaei, a professor at the School of Nursing. UBC and lead researcher at Black Press Media.
“One of the recommendations that is probably key, there is a relatively urgent need to reassess the staffing requirements – the hours of care per resident per day – for the sector in light of some of these changes in the context of the pandemic. ”
Currently, provincial guidelines state that each long-term resident should receive 3.36 hours of direct care per day.
Study co-lead and care home CEO David Keselman said a reassessment of safe staffing was long overdue. Long-term care was an undesirable place to work when he became a nurse almost 30 years ago because nurses had too many residents to care for at the same time.
Resident needs have become more complex over the past decade and during the pandemic – but staffing levels have never adapted to the new realities of care, he said, adding that long-term care professionals duration knew that the system was not ready for the crisis before and during the pandemic.
“Why are we all surprised that what happened during the pandemic actually happened? We weren’t prepared. And we are still unprepared,” Keselman said.
“Now either you’re going to have to commit to fixing it or some might say ‘we can’t do anything about it, it’s too expensive’. So don’t be surprised when the next pandemic hits and you’ll have problems again. terrible results.”
Although Keselman wasn’t optimistic about a rapid increase in staffing, he hopes the staffing guidelines and standards will change now that more people understand why it’s important to review them.
The recommendations outlined in the report are achievable and some care homes are already testing solutions.
“We are a group working on this… These are not recommendations that are going to be lost,” Havaei said.
The Public Health Agency of Canada has been rolling out pandemic management strategies for long-term care for the past two and a half years. These strategies have done a good job of preventing deaths from COVID-19, but have had unintended consequences, according to the report.
For residents and their families, the biggest issue was not being consulted on pandemic management strategy, including visiting policies, according to the study.
Increased consultation with resident and family councils could improve the situation, and the Department of Health could create a provincial association of councils to advise on pandemic policies in the future, Havaei said. Resident and Family Councils are working groups of residents and relatives of residents, primarily communicating concerns and working on projects to improve residents’ lives.
Keselman said the report’s other observations and priorities also align with what he observes daily.
Recommendations from experts, advocates
The report makes recommendations on six topics, including staffing, workplace support, communication, visits, infection control, testing and infrastructure.
Some may take longer to deploy than others, Havaei said, such as facility modifications, which can be costly. However, more mental health resources for long-term care nurses and managers could be created fairly quickly, they added.
The report also recommends increasing the number of mental health interventions available to long-term care staff, while improving working conditions – in which the biggest barrier to implementing each of the solutions is the resource limitation, Havaei said.
For the study, the Havaei team assembled an advisory group made up of representatives from the Department of Health, the BC Care Providers Association, long-term care facilities, and residents and their families.
The study conveyed information from a survey of long-term care providers to discussion forums with health authority representatives, which was reviewed in a virtual meeting with the advisory group and providers health care.
In an emailed statement to Black Press Media, the Department of Health said it has increased investments in the training, recruitment and retention of healthcare workers since the province announced a recruitment initiative in September 2020. This initiative has filled 7,000 health professional positions in the senior sector. , with more than 1,500 of these jobs promoting safe visits.
The Department of Health also said this year’s budget includes $25 million to train long-term care assistants, following a $75 million investment in such programs last year. Last year, the province also allocated $585 million over three years to the Health Careers Access Program, which provides paid employment and training as health care assistants to people without health care training. health.
The full report can be found on the BC Care Association website.
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