Abstract
ObjectiveTo explore the perspectives of key stakeholders on necessary factors to implement care quality improvement program.MethodsWe conducted qualitative descriptive research in eight nursing homes in four major prefecture-level cities of Changsha, Xiangtan, Zhuzhou, and Yueyang. Data of 50 clinical nurses and 64 nurse assistants were included and analyzed. Ethical approval was given by the medical ethics committee of Chinese Clinical Trial Registry (No. ChiCTR-IOC-17013109, https://www.chictr.org.cn/index.aspx). One-to-one interviews were used with the nursing managers, and separate focus group discussions were used with the clinical nurses and nurse assistants. All of the interviews were audio recorded and later transcribed verbatim. In addition, the first author documented the responses of every participant in the field notes during the interviews and focus groups.ResultsThe participants’ perspectives were characterized by two main themes: (1) enablers, with four subthemes of “organizational support”, “the evidence-based practice ability”, “proactivity”, “nursing supervision and feedback;” and (2) barriers, with five sub-themes of “low educational background”, “the limitations of self-role orientation”, “resistance to change”, “lack of job motivation”, and “organizational constraints”.ConclusionThese findings recognize factors at the organizational level, staff level and societal level that are necessary to implement effective mentoring. The results of this study can provide reference for nursing home in improving nursing management quality, formulating, implementing and revising training policies.
Highlights
The population of older people is increasing remarkably; the ageing population will increase by one million annually until the end of 2025 [1]
Using clinical mentors (CM) or champions as models of quality change has been widely reported in the evidence-based quality improvement literature, and this model has been recognized as a successful model in acute care Settings and geriatric care Settings worldwide [14, 15]
The Aged Care Clinical Mentoring (ACCM) defined as “a leader who facilitates improved quality of care for older people using best practice by providing and encouraging professional development in colleagues through communication, education and peer support” has been demonstrated an effective management practice model to promote the quality of care services [18], registered nurses served as clinical mentors for other nursing staff and were responsible for leading evidencebased quality improvement programmes in four aged care facilities and four community aged care settings in two Australian states [19]
Summary
The population of older people is increasing remarkably; the ageing population will increase by one million annually until the end of 2025 [1]. The Aged Care Clinical Mentoring (ACCM) defined as “a leader who facilitates improved quality of care for older people using best practice by providing and encouraging professional development in colleagues through communication, education and peer support” has been demonstrated an effective management practice model to promote the quality of care services [18], registered nurses served as clinical mentors for other nursing staff (mentees) and were responsible for leading evidencebased quality improvement programmes in four aged care facilities and four community aged care settings in two Australian states [19]. The ACCM model consists of six components that form five intervention strategies, including training geriatric care mentors, providing available training resources,promoting quality improvement process, establishing internal communication and feedback mechanism, providing expert support and external communication.(Fig. 1) The Aged Care Clinical Mentoring model (ACCM model) has been tested in four aged care facilities and four community aged care settings across two states in Australia [19, 21]. The results revealed that the ACCM model is an effective workforce model to improve aged care organizations’ capacity to create and sustain quality improvement [21]
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