Should Long-Term Care Facilities Be ‘Mini-Nursing Schools?’

The question of whether a long-term care facility should be a mini-nursing school was raised by my colleague, David Hoffman, JD, a former federal prosecutor and current compliance specialist. He had a vision that nursing homes could and should provide staff at all levels with ongoing educational support.

The idea of using education as the basis of person-centered care for residents and staff was echoed in a recent article by Brigitte Lalude Asante, et al. The article found that high-quality facilities valued efforts to enhance the education of staff by working with staff to determine what their perceived learning needs were and how best to access the information. The administrators and directors of nursing identified that mistakes in the provision of care were inevitable, but the solution was to turn the error into a learning experience rather than having a punitive response, which is seen more often in our long-term care facilities.

Although the study involved Swiss long-term care facilities, the definitions of high-quality providers was somewhat similar to the Five-Star rating system used in the United States. The definitions focused on the avoidance of restraints, weight loss, pain management, and polypharmacy.

If we are truly committed to the highest quality of care in our facilities, the goal should be resident-centered as well as staff-centered care. An important component includes the commitment to collaboration, a sense of community, and attention to the granular issues involved in providing care. Education is a common theme that runs through all aspects of a high-quality long-term care environment; however, the specific teaching must focus on the expressed needs of the staff which go far beyond the repetitive mandatory education required by state regulations. Redundancy needs to be replaced with innovation, particularly when it comes to the delivery of care to our residents.

Reference:
Asante BL, Zúñiga F, Lauriane F. Quality of care is what we make of it: A qualitative study of managers’ perspectives on quality of care in high-performing nursing homes. BMC Health Serv Res. 2021 Oct 13;21(1):1090. doi:10.1186/s12913-021-07113-9