Numerous studies have shown that research-based nursing care best practice protocols can improve the quality of care in nursing homes. However, such protocols rarely continue after research ends. This research proposes to test a partnership Approach that simultaneously involves managers, staff, residents, and families as partners in an action research process that uses research-based strategies to change the nursing home's organizational environment to sustain nursing care best practice protocols. The primary aim is to evaluate the effect of the Partnership Approach on sustaining use of a nursing care best practice protocol for incontinence through testing two hypotheses: 1) The percentage of eligible residents appropriately enrolled in the nursing care best practice protocol for incontinence will be significantly greater in the experimental home than in the comparison home at 3, 6, 9, 12, and 15 months after the nursing care best practice protocol is implemented; and 2) The incontinence scores of eligible residents in stable health in the experimental home will be significantly better at 3, 6, 9, 12, and 15 months after the nursing care best practice protocol is implemented than scores of similar residents in the comparison home. In addition, we will track the cost of the Partnership Approach, and compare the costs of implementing the nursing care best practice protocols under Partnership Approach conditions and usual nursing home conditions. Our pretest-posttest comparison group design with repeated measures will use an experimental and comparison nursing home and test prompted voiding as our nursing care best practice protocol we will use Stream Analysis to operationalize action research. Nursing home care consumes 12% of our national health care expenditures and yet serious concerns remain about the quality of care provided in these settings. This study holds the promise of improving care in nursing homes by testing an organizational-level change intervention to sustain the use of nursing care best practice protocols and thus improve the quality of care.
| Beck, Cornelia; Heacock, Patricia; Mercer, Susan O et al. (2005) Sustaining a best-care practice in a nursing home. J Healthc Qual 27:5-16 |
