BackgroundPerson-centered care is widely recognized as a gold standard and is based on a supportive psychosocial climate for both residents and staff in nursing homes. Residents and staff may have different perspectives as to whether the climate in which they interact is person-centered, perhaps due to their different expectations of the nursing home environment and the provision of care services. The aim of this study was to explore and compare resident and staff perspectives of person-centered climate in aged care nursing homes.MethodsThis is a descriptive cross-sectional study using a cluster random sampling method. The study collected data in 2016 from residents (n = 251) and nursing staff (n = 249) in 23 nursing homes using a Person-centered Climate Questionnaire-Patient version and Person-centered Climate-Staff version. T-tests for independent-samples were used to compare scores ranked by nursing staff and residents.ResultsThe mean scores of ‘A climate of safety’ subscale and ‘A climate of everydayness’ subscale rated by residents were significantly lower than those rated by nursing staff. The mean scores of ‘A climate of hospitality’ rated by residents were very low among the three subscales, an indicator of the need to improve a more home-like environment for residents. Residents in larger size nursing homes showed a higher score of person-centered climate compared with their counterparts in small size nursing homes.ConclusionsThis study reveals that the perspectives and perceptions of person-centered climate differ between residents and nursing staff. Therefore, both resident and staff perspectives should be taken into account in attempting to improve person-centered climate for better care outcomes.

BackgroundResidents living in nursing homes usually have complex healthcare needs and require a comprehensive care approach to identifying and meeting their care needs. Suboptimal quality of care is reported in nursing homes and is associated with the poor health and well-being of the residents, the burden on acute care hospitals and the high costs of healthcare for the government.The aim of this study is to test the hypothesis that an Aged Care Clinical Mentoring Model will create and sustain evidence-based quality improvement in priority areas and will be cost-effective in nursing homes in Hunan Province, China.MethodsA cluster randomized controlled trial will be applied to the study. Fourteen nursing homes will be randomly allocated to either the intervention group (n = 7) or the control group (n = 7). Forty staff will be recruited from each nursing home and the estimated sample size will be 280 staff in each group. The intervention includes a structured, evidence-based quality improvement education program for staff to facilitate knowledge translation in evidence-based quality improvement targeting urinary incontinence, pressure injury and falls prevention. The primary outcomes are nursing homes’ capacity to create and sustain quality improvement, staff perceptions of person-centered care, self-reported quality of care by residents and selected quality indicators at 12 months follow-up adjusted for baseline value. Secondary outcomes are residents’ quality of life, residents’ unplanned admissions to acute care hospitals, quality of care reported by staff, staff job satisfaction and staff intention to leave adjusted for baseline value. A mixed linear regression model will be adopted to compare the significant differences between groups over a 12-month period.DiscussionAlthough the Aged Care Clinical Mentoring Model has been tested as an effective model to bring positive changes in nursing homes in a high-income country, factors affecting the adaptation of the model in nursing homes in low- and middle-income countries are unknown. The carefully planned intervention protocol enables the project team to consider enablers and barriers when adapting the Model. Therefore, strategies and resources will be in place to manage challenges while demonstrating best practice in this study.Trial registrationProspectively registered via Chinese Clinical Trial Registry (ChiCTR), ChiCTR-IOC-17013109, Registered on 25 October 2017.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3596-6) contains supplementary material, which is available to authorized users.

Background: Confounding factors, such as staff characteristics and organizational features, are neglected in most studies when assessing the relationship between staffing levels and quality of care,and previous research provides inconsistent conclusions.The aim of this study wasto examine the quality of care perceived by nursing staff and its relationship with the staffing and organizational climate in nursing homes. Methods: A cross-sectional study was conducted. This study included 358 nursing staff from 52 units in 26 nursing homesin Hunan Province, China. Organizational climate was assessed with the Nursing Home adaptation Shortell scale and work stress scale. Staffing levels were studied by interviewing unit managers. Self-reported quality of care was measured with a single item. Results: The interaction effect between nursing staff to resident ratio and physician to resident ratio was significant on quality of care (p<0.05). Higher score on the relationships and communication scale (OR=4.771, p=0.002) and lower score on the work stress scale (OR=0.980, p=0.050) were also associated with better quality of care. More work experience was related to lower quality of care