Forming Nursing Home Practices That Support Quality of Care for Residents. A Qualitative Observational Study

Abstract

Background

Residents of nursing homes are increasingly frail and dependent. At the same time, there are increased demands for quality of care and social life for individual residents. In this article, we explore how care workers contribute to quality of care and social life in shared living rooms in nursing homes.

Methods

An ethnographically inspired design was applied, and a purposive sample of six units for long-term care in three nursing homes in Norway was included in the study. Data were collected by participant observation, including informal conversations with the staff and residents, and the data were analyzed using thematic analysis.

Results

The analysis identified three main themes: working within the given context, creating care practices and organizing activities. The empirical findings demonstrate that care work focuses on meeting both the residents’ physical and social needs and aiming for high-quality care and social life for the residents in nursing homes.

Conclusion

The results of this study illustrate that nursing home practices are focused on residents as a group. However, care workers take advantage of personal skills and resources to work towards person-centred care within the given context. The quality of care is recognized in terms of how care workers meet individual residents’ needs. The quality of care seems highly related to the capability and skills of individual care workers.

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Keywords:

• nursing home
• quality of care
• person-centred care
• social needs
• activity
• qualitative study
• participant observation

Data Sharing Statement

The NVivo dataset used and analysed for this study is not made publicly available to protect participants’ privacy but anonymized material is available from the corresponding author upon reasonable request.

Ethics

For this study, approvals on the protection of privacy were obtained from the delegated IRB, the Norwegian Centre for Research Data (NSD), project number 59957, and the municipality involved.

Consent for Publication

The care workers, residents and their next of kin received written and oral information about the project before and during the data collection following the approvals from the Norwegian Centre for Research Data. This included information regarding the aim of the study, data confidentiality, that their participation was voluntary, that they had the right to withdraw at any time without stating a reason, and that the participants informed consent included publication of anonymized responses. Verbal informed consent was obtained from all participants before and during the study for permission to observe their everyday life in common areas of the nursing homes. Verbal consent was chosen as this study took place in the common areas of nursing homes, which are public areas, and the persons present are many and vary during the day and from day to day. Written consent was not obtained because of the fluctuation of people in and out of public areas. This was approved by the Norwegian Centre for Research Data and the municipality. The individual participant could refuse to be observed, however, no one chose to withdraw during or after data collection.

Acknowledgments

The authors would like to thank all the participants of this study.

Disclosure

The authors declare that they have no financial or non-financial competing interests for this work.

Additional information

Funding

This work was supported by the Research Council of Norway grant number 256570. The council did not take part in the design or any other preparation of this manuscript.