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Ethical conflict in long-term care: is legislation the answer?
1Hahn School of Nursing, University of San Diego, CA 92110.
Summary
The Omnibus Budget Reconciliation Act of 1987 aimed to improve nursing home care but requires more than just regulation. True reform needs professional empowerment and organizational changes for a caring community.
Area of Science:
- Healthcare Administration
- Gerontology
- Bioethics
Background:
- The Omnibus Budget Reconciliation Act of 1987 significantly altered nursing facility operations and resident rights.
- This legislation aimed to enhance resident autonomy within skilled nursing facilities.
Purpose of the Study:
- To explore the impact of the 1987 legislation on nursing operations in skilled nursing facilities.
- To identify how the legislation affects the resolution of ethical conflicts faced by nurse administrators.
Main Methods:
- Two focus groups were conducted with nurse administrators from skilled nursing facilities.
- Qualitative data were gathered to understand their experiences with the legislation.
Main Results:
- Participants reported that the legislation both facilitated and inhibited the resolution of ethical conflicts.
- Nurse administrators found the legislation alone insufficient for comprehensive reform in long-term care.
Conclusions:
- Legislation requires complementary strategies for effective reform in long-term care.
- A multifaceted approach, including regulatory reform, professional empowerment, and organizational redesign, is recommended.
- A model for a 'community of caring' is proposed to drive change.