Nursing in long-term institutional care: An examination of the process of care

Nursing care in nursing homes
In the past decades, the amount and complexity of care in long-term institutional care for the older population have increased. At the same time, its quality is cause for concern. Shortcomings are often associated with the number and composition of nursing staff. Research into the relationship between nursing staff and quality of care primarily rely on secondary survey data that do not take into account what is being done during the process of caregiving. Since quality of care outcomes are highly affected by nursing care, the aim of this dissertation was to provide insight into what type of nursing interventions are performed and by whom. An important finding was that nursing interventions mainly concerned the physical care needs of residents. Limited time was spent on, for example, psychosocial nursing interventions. Since nursing homes’ philosophy is on person-centered care that encompasses the well-being of residents, this should be addressed. Preconditions such as sufficient time and continuing training of nursing staff, for instance, in collaboration with educational health care institutions can contribute to this. A second important finding concerned the limited role differentiation between nursing staff, such as registered nurses and nursing assistants, despite differences in educational background. If nursing staff are deployed according to their scope of practice and specific knowledge and skills, this would improve the quality of care. Furthermore, to actually be able to make statements about the relationship between nursing staff and quality of care, quality outcomes should be sensitive to nursing interventions.