Implementation of a tool to improve quality of care in psychogeriatric units

The examples of change that occurred in the units show that in most instances the impetus came from the top and middle levels, but then became total staff projects. The most important tactic introduced to cause change was re-education and ensuing discovery, using the tool as a guide. In at least one unit, much thought and effort were devoted to developing trust and confidence, as proposed by Bennis et al. (1976). Acceptance by the peer group (Mauksch and Miller, 1981) was achieved through the group decision-making process in the units and the interagency meetings of the head nurses and supervisors. Termination of the relationship between the units and project will probably take place at a later date, to be replaced by a special interest group made up of practice, education, and research psychogeriatric nurses. Only a few of the experiences of the units in utilizing the instrument to improve quality of care have been presented. Some were very successful; others had little impact. The overall impression is that of awakened desire by staff and administration to improve care; increased valuing of patients, their families, and staff; readiness to utilize the help available in the instrument and the project team; and recognition of the professional challenge and status inherent in psychogeriatric nursing.