‘Applying QI to Care in Nursing Homes’: A Nurse’s Take on the Tools Needed for Change

nursing homeA colleague once remarked, “Isn’t it strange that the universal response to hearing that someone has gone into a nursing home is ‘Ugh’?”  As nurses, we might hazard a guess as to what kind of care the new resident may receive. But is there a way to reenvision the care that we provide in nursing homes?

In AJN‘s April Viewpoint essay, NP Heather Walker argues that there is, and that quality improvement (QI) can be an effective tool for change. Walker suggests that QI can do for nursing homes what it has done for acute care: focus attention on the systemic issues that stand in the way of good nursing. As she says in the article,

“QI doesn’t negate personal responsibility, but it broadens the focus so that systemic problems are taken into account.”

The QI process fosters reflection, accountability, and teamwork, which in themselves can improve the work environment and residents’ living experience. For more information about this approach, read the short article, here.—Betsy Todd, AJN clinical editor, MPH, RN, CIC

 

2016-11-21T13:01:19-05:00March 31st, 2016|career, Nursing|0 Comments

What Our Readers Had to Say About RN Staffing in Nursing Homes

By Maureen Shawn Kennedy, AJN editor-in-chief

nursing homeEarlier this month, AJN’s managing editor Amy Collins wrote a post about nursing homes, basing her discussion on a New York Times article by Paula Span at the paper’s New Old Age blog that examined efforts to address the inadequate number of registered nurses (RNs) in nursing homes. While federal regulations for agencies that receive Medicare or Medicaid require 24-hour nursing services, they only require an RN to be on site for eight hours daily. According to Span, 11.4% of nursing homes did not meet this requirement.

Collins found confirmation of this information in her own experiences visiting her grandmother in nursing homes:

“There always seems to be a lack of staff—and with so many residents these days suffering from varying levels of dementia and memory problems, staff are needed more than ever.”

We linked to the blog post on our Facebook page and received a tremendous number of comments on both sites. While both Span and Collins emphasized that increases in all levels of nursing personnel are needed, some LPNs responded to our post to assert that they too have valuable skills, as well as extensive experience, in this setting—and that a broader underlying problem is inadequate staffing tied to corporate cost-cutting.

Few people would argue with these assertions. Most LPNs do the best […]

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