Because Americans are living longer, the population over the age of 65 and the utilization of long-term care services will continue to grow. Quality of care and quality of life continue to be serious concerns regarding long-term care residents. Providing resident-centered care (RCC) is seen by long-term care stakeholders as a promising strategy for achieving higher quality of care and quality of life in nursing homes (NHs). However, there is a lack of clarity about what RCC is, how it should be implemented and how it differs from traditional NH care. Furthermore, the delivery of RCC, although seemingly desirable, lacks a strong empirical foundation; therefore, this type of care needs to be studied further to show that RCC indeed positively impacts NH residents' quality of life.
The specific aims of this study are to examine: 1) how the specific principles of RCC are implemented by nurses in nursing homes, 2) how nurse implementation of RCC varies within facilities, 3) how implementation of RCC differs across specific approaches, 4) how implementation of RCC is conceptualized and facilitated (or impeded) by upper-level nurse managers, and 5) whether nurse implementation of RCC has an impact on NH residents' perceived quality of life. Data will be collected through field observation and in-depth interviews. A total of 16 nurses, 8 upper level nurse managers and 16 nursing home residents from 4 nursing homes will be interviewed. Nursing homes will be selected to represent the three most commonly implemented approaches to RCC. The fourth NH will be used for comparative purposes only and will have a traditional model of care, not one of the common approaches to RCC. Data will be analyzed using grounded theory and a model will be constructed to explain nurse implementation of RCC across approaches and the impact of how nurses implement RCC on NH residents' perceived quality of life. The grounded theory method of research is well suited for the areas of study I have chosen, because this method focuses on meaning of concepts and phenomena as they are perceived by research participants. A grounded theory study of issues relating to implementation of RCC will provide rich information on how the concepts relating to RCC are perceived and implemented by nurses and upper level nurse managers, comparing these perceptions with those of NH residents. This comparative analysis will lend new insights into how nurse implementation of RCC impacts NH residents' perceived quality of life and will allow me to expand and revise the model developed during the preliminary study. In the long-term, this research will have implications for nurse training and will serve as a framework for intervention research to improve the effectiveness and efficiency of implementation of RCC. ? ? ?
| Krause, Melanie R (2012) Director of nursing current job tenure and past experience and quality of care in nursing homes. Health Care Manage Rev 37:98-108 |
| Krause, Melanie R; Palmer, Janice L; Bowers, Barbara J et al. (2011) Responding to poor-quality care during research in nursing homes. Res Gerontol Nurs 4:47-52 |
| Harahan, Mary F; Sanders, Alisha; Stone, Robyn I et al. (2011) Implementation and Evaluation of LVN LEAD. A leadership and supervisory training program for nursing home charge nurses. J Gerontol Nurs 37:26-33 |
| Krause, Melanie R; Serlin, Ronald C; Ward, Sandra E et al. (2010) Testing mediation in nursing research: beyond Baron and Kenny. Nurs Res 59:288-94 |
