18P
Training Needs of Nursing Home Social Workers Discharging Short Stay Individuals

Schedule:
Thursday, January 15, 2015
Bissonet, Third Floor (New Orleans Marriott)
* noted as presenting author
Elise Beaulieu, PhD, Consultant, Simmons College, Boston, MA
Background: Skilled nursing facilities occupy an important link between hospitals and community care in the overall health care system and 85% of social workers regularly engage in discharge planning. This study examined the need for greater training in areas of discharge planning from nursing facilities to the community.

Methods: Data were collected from an electronic quantitative questionnaire format. Respondents represented for-profit, non-profit, and government-owned facilities across the country (N= 218) and were recruited through a voluntary listserv, several for-profit companies, and a government agency. Almost half (49.5%) of the respondents’ facilities had a short stay focus. Respondents (71.1%; n=157) had three or more years experience working in SNF settings. Almost half (46.8%; n=102) had received an MSW and the majority (59.6%; n=130) had social work licenses. Finally, the majority (63.8%) worked alone or had only one other additional worker.

The study questions encompassed six major groupings: community resources: length of stay and multiple health care transitions; resident/patient/client/consumer characteristics; challenges of family caregivers; mental health and cognition; and Medicare and insurances. The Pearson chi square looked to see how the activities were distributed through the nursing facility focus (long-term or short-term) and compared individual respondent categories, e.g. facility size, number of discharges, respondent education, experience to determine if they were significantly (<.05 level) related.

Results: Respondents in this study reported a median of 6-13 discharges (26.1%; n=57) per month and 15.1% reported that their facility completed more than 25 discharges per month. A chi-square analysis described the association between facility size and number of discharges. Results indicated these were significantly associated. Larger facilities were likely to have greater numbers of monthly discharges. Almost one-third of 20 or more monthly discharges occur in facilities with 50-119 beds, a facility size that is likely to have at the most 2 social workers.

A series of chi-square analyses were conducted to determine whether need for training was associated with respondents’ education. Results revealed a significant association between education level and area of training need, addressing behavior issues, “difficult, demanding, or overly anxious.” Greater percentages of respondents with a bachelor’s degree (n = 23; 27.4%) indicated that they would like training in contrast to those with a master’s degree (n = 18; 15.7%).

Over a third (33.9%) of respondents were trained on the Minimum Data Set 3.0, Section Q Discharge. Other areas such as assessment for assisted living, or risk assessment for readmission to a hospital were evenly matched for respondent training over a three-year period of time. Only three percent of respondents were likely to have training in care transition models over the past year.

Implications: These findings suggest that many nursing facilities, previously focused on long-term care, are regularly engaged in the tasks of discharge planning. Social workers in these settings need opportunities for greater training in these settings. Future studies could examine the most effective and efficient ways for on-the-job training to be provided for this group that include experienced workers.