Beyond 'doing': Supporting clinical leadership and nursing practice in aged care through innovative models of care
Lorraine Venturato
Research Centre for Clinical and Community Practice Innovation, Griffith University, Nathan QLD
Liz Drew
Strategy Advisor – Residential Aged Care, RSL Care, Brisbane QLD
PP: 157 - 170
Abstract
Contemporary health care environments are increasingly challenged by issues associated with the recruitment and retention of qualified nursing staff. This challenge is particularly felt by residential aged care providers, with registered nurse (RN) numbers already limited and resident acuity rapidly rising. As a result, aged care service providers are increasingly exploring creative and alternative models of care.
This article details exploratory research into a pre-existing, alternative model of care in a medium sized, regional residential aged care facility. Research findings suggest that the model of care is complex and multi-faceted and is an example of an integrated model of care. As a result of the implementation of this model of care a number of shifts have occurred in the practice experiences and clinical culture within this facility.
Results suggest that the main benefits of this model are: (1) increased opportunities for RNs to engage in clinical leadership and proactive care management; (2) improved management and communication in relation to work processes and practices; and (3) enhanced recruitment and retention of both RNs and care workers.
Keywords
aged care; nursing; staffing; retention; workforce; model of care
References
Australian Institute of Health and Welfare (2008) Australia's Health 2008. Canberra, Australia: Author.
Australian Institute of Health and Welfare (2009) Australia's Welfare 2009. Canberra, Australia: Author.
Castle NG and Engberg J (2007) The influence of staffing characteristics on quality of care in nursing homes. Health Services Research 42(5), 1822-1847.
Crisp J and Taylor C (2005) Potter and Perry's fundamentals of nursing (2nd edn). Marrickville: Elsevier Australia.
Department of Health and Ageing (2005) National aged care workforce strategy. Canberra: Commonwealth of Australia.
Harrington C (2004) Saving lives through quality of care: A blueprint for elder justice. Alzheimer's Care Quarterly 5(1), 24-38.
Harrington C (2005a) Nurse staffing in nursing homes in the United States: Part 1. Journal of Gerontological Nursing 31(2), 18-23.
Harrington C (2005b) Nurse staffing in nursing homes in the United States: Part 2. Journal of Gerontological Nursing 31(3), 9-15.
Harrington C, Kovner C, Meey M, Kayser-Jones J, Burger S, Mohler M, et al (2000) Experts recommend minimum nurse staffi ng standards for nursing facilities in the United States. The Gerontologist 40(1), 5-16.
Harrington C, O'Meara J, Collier E and Schnelle JF (2003) Nursing indicators of quality in nursing homes: A web-based approach. Journal of Gerontological Nursing 29(10), 5-11.
Harrington C, Zimmerman D, Karon S. L, Robinson J and Beutel P (2000) Nursing home staffing and its relationship to deficiencies. Journal of Gerontology 55B(5), S278-S287.
Hogan W (2004) Review of pricing arrangements in residential aged care: final report. Canberra: Commonwealth of Australia.
Kimball B, Joynt J, Cherner D and O'Neil E (2007) The quest for new innovative care delivery models. Journal of Nursing Administration 37(9), 392-398.
Lookinland S, Tiedeman ME and Crosson AE (2005) Non-traditional models of care delivery: Have they solved the problems? Journal of Nursing Administration 35(2), 74-80.
Martin B and King D (2008) Who cares for older Australians: A picture of the residential and community based aged care workforce 2007. Canberra: Department of Health and Ageing, Commonwealth of Australia.
McGillis-Hall L (2003) Nursing staff mix models and outcomes. Journal of Advanced Nursing 44(2), 217-226.
McGillis-Hall L and Doran D (2003) Nurse staffing, care delivery model, and patient care quality. Journal of Nursing Care Quality 19(1), 27-33.
Morris R, MacNeela P, Scott A, Treacy P and Hyde A (2007) Reconsidering the conceptualization of nursing workload: Literature review. Journal of Advanced Nursing 57(5), 463-471.
Mueller C (2002) Nurse staffing in long-term care facilities. Journal of Nursing Administration 32(12), 640-647.
Mueller C, Arling G, Kane R, Bershadsky J, Holland D and Joy A (2006) Nursing home staffing standards: Their relationship to nurse staffing levels. The Gerontologist 46(1), 74-80.
Mueller C and Karon SL (2004) ANA nurse sensitive quality indicators for long-term care facilities. Journal of Nursing Care Quality 19(1), 39-47.
Räikkönen O, Perälä M and Kahanpää A (2007) Staffing adequacy, supervisory support and quality of care in long-term care settings: Staff perceptions. Journal of Advanced Nursing 60(6), 615-626.
Schnelle JF, Simmons SF, Harrington C, Cadogan M, Garcia E and Bates-Jensen BM (2004) Relationship of nursing home staffing to quality of care. Health Services Research 39(2), 225-250.
Tiedeman M. E and Lookinland S (2004) Traditional models of care delivery: What have we learned. Journal of Nursing Administration 34(6), 291-297.
Venturato L, Kellett UM and Windsor C (2007) Nurses' experience of practice and political reform in long-term aged care in Australia: Implications for the retention of nursing personnel. Journal of Nursing Management 15, 4-11.
Wolf GA and Greenhouse PK (2007) Blueprint for design: Creating models that direct change. Journal of Nursing Administration 37(9), 381-387.
Zhang NJ, Unruh L, Liu R and Wan TTH (2006) Minimum nurse staffing ratios for nursing homes. Nurse Economics 24(2), 78-85.
eContent Home
