Quality of care is what we make of it: a qualitative study of managers’ perspectives on quality of care in high-performing nursing homes

Asante, Brigitte Lalude; Zúñiga, Franziska; Favez, Lauriane

doi:10.1186/s12913-021-07113-9

Cited by 5 publications

(4 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The nursing homes delivered generalized or specialized long‐term care. We included managers in the sample due to their significant influence on the design and quality of care (Asante et al, 2021; Backman et al, 2018). To include perspectives from various settings, we applied a purposive sampling strategy and recruited 13 participants from 12 nursing homes.…”

Section: Methodsmentioning

confidence: 99%

Nurses' experiences of an outreach interprofessional mental health service for nursing homes: a qualitative descriptive study

Fuchs

Vögeli

Schori

et al. 2022

Psychiatric Ment Health Nurs

View full text Add to dashboard Cite

Accessible Summary What is known on the subject? Treatment and mental health care in familiar environments are beneficial for older people experiencing mental health issues. But there are not enough qualified and specialized nurses who can meet the complex needs of nursing home residents experiencing mental health issues. The University Hospital of Psychiatry Zurich, Switzerland, established an outreach interprofessional mental health service to foster the care for residents experiencing mental health issues in nursing homes. Based on existing studies, little can be said about whether nurses in nursing homes find these types of services helpful. What does this paper add to existing knowledge? Nurses in nursing homes caring for residents experiencing mental health issues felt relieved by having inclusive support from the interprofessional mental health service. Nurses appreciated the mental health team and felt accompanied and more confident in their daily work. Results showed that nurses wanted to be included in the care and treatment processes and to work as partners on an equal footing with the mental health team. What are the implications for practice? Outreach interprofessional mental health services for nursing homes should take into account nurses' views and professional experience, and value and respect their role as nurses. Outreach interprofessional mental health services for nursing homes should offer further training in psychiatric nursing, include an accessible contact person in the team, and develop clear processes and responsibilities. Abstract Introduction Outreach interprofessional mental health services for nursing homes can increase the quality of care for residents experiencing mental health issues but research on how nurses in nursing homes experience such a service is lacking worldwide. Aim To describe how nurses experience the involvement of an outreach interprofessional mental health team in the care for older people experiencing mental health issues in nursing homes and to identify barriers to and facilitators of interprofessional collaboration. Method Qualitative descriptive analysis based on 13 semi‐structured interviews. Framework analysis and complex adaptive systems theory were applied. Results One core theme with two main categories: Nurses experienced relief from burden through inclusive support provided by the mental health team. Main categories were feeling accompanied and confident as a nurse and partnership‐based collaboration. Discussion Results showed for the first time that nurses felt supported by the mental health team and were encouraged to find new ways of coping with challenging situations. Implications for Practice To empower nurses, mental health teams should take into account nurses' perceptions in the treatment process, value and respect their role as nurses, transfer knowledge in both formal and informal settings, establish a steady and reliable contact person, and define processes and responsibilities.

show abstract

Section: Methodsmentioning

confidence: 99%

Nurses' experiences of an outreach interprofessional mental health service for nursing homes: a qualitative descriptive study

Fuchs

Vögeli

Schori

et al. 2022

Psychiatric Ment Health Nurs

View full text Add to dashboard Cite

show abstract

“…As argued by Dixon-Woods (2019) the success of improvement depends not just on the interventions, but also on environment: improving processes may take us so far, but stops if the basics of structure and resources are not in place. This is supported by a recent study that concludes that the shift in healthcare culture towards person-centredness requires not only full commitment on the part of managers but also adequate financial and human resources (Asante et al, 2021).…”

Section: Monitoring and Sustainability Of The Leadership Interventionmentioning

confidence: 78%

Exploring the role of managers in quality and safety work in nursing homes and homecare services; A multiple case study

Johannessen¹

2022

View full text Add to dashboard Cite

Introduction: Working on quality and safety in nursing home and homecare services is difficult. Ever-increasing demands from an ageing population and political pressure to keep patients at home are among the challenges facing nursing homes and homecare. There is less knowledge of patient safety risks and adverse events in primary care than in specialised healthcare. Aim: This thesis explores the role of managers in quality and safety work in nursing homes and homecare services. Moreover, the thesis designs, implements, and evaluates a leadership intervention in nursing homes and homecare services to support managers’ quality and safety work. Methods: This study was designed as a two-phase longitudinal multiple case study consisting of design and pilot testing; and implementation and evaluation of the SAFE LEAD intervention. The intervention is based on a leadership guide and includes several workshops and learning activities facilitated by researchers. In phase 1, the intervention was designed with researchers, co-researchers and managers from two nursing homes and one homecare service. The pilot test of the leadership intervention was conducted in one nursing home and one homecare service. Data collection consisted of focus group interviews and observation of managers. Phase 2 started by exploring quality and safety challenges as perceived by managers and employees in two nursing homes and two homecare services prior to participation in the leadership intervention. The study then continued with a longitudinal study of the implementation and evaluation of the leadership intervention and its influence on managers quality and safety work. Data collection in phase 2 included focus group interviews, observations, workshops and site visits with managers and employees. Data analyses in phases 1 and 2 included deductive content analysis and interweaving of observation and interview data. Results: The results describe all activities from development to evaluation of a leadership intervention and its influence on managers’ quality and safety improvement work in nursing homes and homecare services. Paper I detailed the involvement of stakeholders and demonstrated how a participatory approach was important for adaptations of a leadership guide to nursing home and homecare contexts. An intervention that managers could use in their work practice was developed and pilot tested in one nursing home and one homecare service. A key finding in Paper I is the role of context and the need to tailor intervention material (web and booklet) to the context and to the needs, time constraints, language, and interests of managers. Paper II explored managers’ and employees’ perceptions of quality and safety challenges in two nursing homes and two homecare services before the intervention took place. Managers and employees found that quality and safety challenges depended on several factors and implied multiple trade-offs. Managers struggled with external change processes, budget cuts that affected common understanding of and commitment to quality and safety improvement at managerial and staff levels. Paper III showed that the intervention workshops and leadership guide contributed to a common understanding and commitment to quality and safety in the management teams. The leadership intervention influenced managers’ work practice in different ways depending on capacity and needs in the organisations. The leadership guide and the workshops created a social and reflexive arena for quality and safety work in which managers could focus on these topics. Moreover, it provided the managers with a tool for clearer sense of quality and safety work in different settings. Managers found it important that someone established a structure and took responsibility for scheduling and organising quality meetings. However, management continuity and the establishment of structures were crucial for the intervention to be adopted. Conclusion: The longitudinal insight in this thesis broadens the understanding of contextual impact on quality and safety work in nursing homes and homecare services and showed the comprehensive work with translating knowledge into practice. The thesis demonstrates the importance of participatory approach and involvement of stakeholders when designing a leadership intervention. Managers and employees perceived interrelated quality and safety challenges and found context work to be time consuming to make quality and safety improvement common efforts in the organisations. The leadership intervention created a place for reflection for managers and brought a more structured process and commitment to organisational quality and safety work.

show abstract

“…However, few studies have explored the views of senior management on how to ensure that residents receive high-quality care. This is also one of our future research directions to improve the quality of care [ 8 ]. Moreover, Our trial sample is still small and has limitations for experimental analysis, and we will expand the study in the future to provide better support for nursing interventions.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Effectiveness of Nursing Interventions in Critically Ill Patients in Respiratory Medicine

Wu¹,

Jiao²,

Wang³

et al. 2022

Journal of Healthcare Engineering

View full text Add to dashboard Cite

Objective. To enhance and analyze the clinical effectiveness of implementing quality nursing interventions in the clinical care of critically ill patients in respiratory medicine. Methods. Clinical data of respiratory medicine patients treated in our hospital over the years were collected and 96 patients who met the requirements of the purpose of this study and the sample inclusion criteria were selected as the study subjects from the patients treated between April 2019 and January 2020. According to the care methods received by the patients in our hospital, 48 of them who implemented conventional care were used as the control group, and another 48 patients who were given quality care interventions were used as the observation group. The data were statistically recorded and comparatively analyzed for the indicators such as nursing oxygen index, heart rate, and clinical treatment efficiency of patients in both groups. Results. Compared with the control group, patients in the observation group who received quality nursing intervention had more significant improvement in blood oxygen index and heart rate after nursing care; the clinical treatment efficiency of patients in the observation group was significantly higher than that of the control group (95.83% vs. 81.25%). The data comparison between the groups showed a significant difference, P < 0.05, which was statistically significant. Conclusion. Adding quality nursing interventions to the implementation of conventional care for patients with respiratory diseases can better improve patients’ clinical symptoms, accelerate their clinical recovery, improve and enhance prognosis, and further improve clinical outcomes.

show abstract

Quality of care is what we make of it: a qualitative study of managers’ perspectives on quality of care in high-performing nursing homes

Cited by 5 publications

References 29 publications

Nurses' experiences of an outreach interprofessional mental health service for nursing homes: a qualitative descriptive study

Nurses' experiences of an outreach interprofessional mental health service for nursing homes: a qualitative descriptive study

Exploring the role of managers in quality and safety work in nursing homes and homecare services; A multiple case study

Analysis of the Effectiveness of Nursing Interventions in Critically Ill Patients in Respiratory Medicine

Contact Info

Product

Resources

About