Quality Clinical Care in Nursing Facilities

Area of Science:

• Gerontology
• Healthcare Management
• Nursing Practice

Background:

• Nursing facility (NF) clinical care quality remains inconsistent despite quality improvement initiatives and regulatory efforts.
• Key challenges include workforce shortages, suboptimal interprofessional teamwork, and insufficient adoption of evidence-based practices and technology.

Purpose of the Study:

• To provide recommendations for overcoming barriers to consistent, high-quality clinical outcomes in long-term (LTC) and post-acute care settings.
• To outline strategies for improving workforce education, fostering a better care culture, and enhancing the use of evidence-based processes and technology.

Main Methods:

• The study synthesizes existing knowledge and expert recommendations to address critical issues in NF quality of care.
• Focuses on strategies for workforce development, interprofessional collaboration, evidence-based care processes, and technology integration.

Main Results:

• Recommendations include implementing robust training and simulation for staff, promoting leadership commitment to quality, optimizing nurse staffing ratios, and ensuring easy access to clinical decision support tools.
• Embedding evidence-based standards and algorithms into electronic health records workflows is highlighted as a key strategy.

Conclusions:

• Sustaining high clinical quality in NFs necessitates multipronged, integrated approaches.
• Developing practical, evidence-based national and international quality standards for LTC, utilizing implementation science principles, is essential for improving care for older adults.