Practice Change and Culture Change in Implementing Geriatric Care Initiatives (original) (raw)
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Journal of Gerontological Nursing, 2008
The Omnibus Budget Reconciliation Act of 1987 required nursing facilities to complete a standardized comprehensive assessment known as the Resident Assessment Instrument (RAI) and to formulate a plan of care from the RAI to guide nursing care. The purpose of this retrospective case study was to examine the issues around the translation of nursing facility resident care plans to documents that guide daily care. Data were obtained by auditing 96 resident care plans in 10 nursing facilities in two states. Despite the importance of the resident plan of care, the audit revealed the provider approaches to resident problems varied appreciably in nursing facilities. The results of this study support the need for further research to assist in the development and implementation of strategies in nursing facilities that focus on standardized practices. Consistent systems can be promoted that translate the resident care plan into daily practice. Care planning is the foundation of the nursing process and is a federally mandated regulatory function in all American nursing facilities (Omnibus Budget Reconciliation Act, 1987 [OBRA '87]). Compared with residents served by nursing facilities in 1998, today's average resident is older, more frail, more acutely ill, and more impaired (Harrington, Carrillo, & Crawford, 2006). Comprehensive assessments and individualized, interdisciplinary care plans are essential in meeting the needs of these vulnerable older adults. Each resident's care plan is composed of a set of problems derived from the assessment and the associated interventions for each problem. Nursing facilities use a variety of strategies to move information from the care plan into daily operations. The study reported in this article was designed to examine the communication of the interventions from the care plan to staff who provide daily care to residents. Two research questions addressed gaps in the existing literature: • How are the interventions in the written care plan translated to documents used by nursing staff to guide resident care? • What are the issues surrounding the translation of the written care plan? This project was part of a larger study to explore the relationship between care planning integrity and nursing facility resident outcomes (Taunton et al., 2007).
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Journal of the American Geriatrics Society, 2000
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Gerontologist, 2020
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Innovation in Aging, 2021
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2011
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Journal of the American Geriatrics Society, 2007
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Nursing & Health Sciences, 2013
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