key: cord-0811245-zvusvlpl
authors: Vu, Thi; Frye, Noelle; Valeika, Sarah; Monin, Joan K.; Wallhagen, Margaret; Marottoli, Richard A.
title: Communication technology improved staff, resident, and family interactions in a skilled nursing home during COVID-19
date: 2022-03-08
journal: J Am Med Dir Assoc
DOI: 10.1016/j.jamda.2022.02.019
sha: 911ee2d4f7dc6c087823d56e97b0f0d05ef3636a
doc_id: 811245
cord_uid: zvusvlpl

We implemented simple intervention to increase the amount of communication technology for residents in a nursing home during COVID-19 restrictions. The additional technology not only saved staff time, but also increased resident and family engagement. All staff and residents quickly learned to use the new technology with no major issues, suggesting that resident unfamiliarity with new technology and concerns about adding to staff burden may be small barriers to overcome in implementing communication technology interventions.

Long-term care (LTC) settings have implemented family visitor restrictions amidst the 4 COVID-19 pandemic that may exacerbate isolation and loneliness among residents, 1-2 which 5 have been linked to worse health outcomes such as increased risk for cardiovascular disease 6 and depression. 3 Additionally, visitor restrictions have been associated with increased stress 7 and anxiety among family members. 4 Incorporating communication technology, such as tablets 8 and laptops, for residents to interact virtually with their families has been shown to increase 9 social support and well-being. 5 However, many long-term care facilities do not have enough 10 communication technology equipment to support residents' needs. 3,6 Therefore, we 11 implemented a simple intervention at a skilled-nursing setting that increased the quantity of 12 available technology to help staff and residents engage with families and other medical 13 professionals during COVID-19 restrictions. 14

This intervention took place at an urban skilled-nursing home with 69 beds and 174 16 staff. We conducted a focus group with staff in February 2021 to determine types and 17 quantities of equipment that were needed. Fifteen weeks after the facility received the 18 equipment, we conducted a second focus group and distributed an electronic survey to staff to 19 assess use and satisfaction. This study was deemed exempt by a university institutional review 20 board (#1511016844). new equipment improved communication. Equipment-specific ratings can be found in Figure 1 . 24 A total of 10 staff participated in the focus group where they highlighted several positive 25 outcomes. First, technology increased family engagement during care plan meetings. Staff 26 expressed that being "able to put a face to a name and [families] are able to see us and interact 27 with us versus just doing a phone conference," made the care process more personal. One staff, 28 for example, highlighted how the therapy team now uses the video technology to show families 29 exactly the type of therapy the resident is receiving. Enhanced communication helped families 30 become more familiar with the residents' care needs and goals during discharge. One staff 31 member even suggested that resident and family engagement provided by the increased 32 technology may shorten length of stay because families feel more prepared to provide care at 33 home. Additional technology also made it easier for residents to connect virtually with outside 34 consulting physicians, thereby saving time and transportation costs. 35

Residents enjoyed the increased privacy resulting from extra technology during calls 36 with their family. Once staff set the equipment up, they could leave the tablet in front of the 37 resident because it had a holder. Additionally, extra equipment freed up staff time because 38 they did not have to search for equipment or be physically next to the resident to hold the 39 equipment. This also allowed the residents to speak with their families for longer periods. 40

Lastly, all equipment was user-friendly such that staff and residents with different 41 comfort levels using technology were able to use them with no major issues. Staff also reported 42 that all residents were receptive to trying the technology. Overall, the increased technology technology use to help residents connect with providers and families. 6 

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Breaking Social Isolation Amidst COVID-19: A Viewpoint on Improving 91

Access to Technology in Long-Term Care Facilities

Social isolation, loneliness and health in old age: a scoping 94 review

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Telemedicine in Long-Term Care Facilities During and 102

Beyond COVID-19: Challenges Caused by the Digital Divide

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Overcoming the Challenge of Family Separation From Nursing Home 111

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Barriers to learning a new technology to go online among 114 older adults during the COVID-19 pandemic