Implementing a nurse-led quality improvement project in nursing home during COVID 19 pandemic: A qualitative study

S. Gonella, P. Di Giulio, Marianna Angaramo, V. Dimonte, S. Campagna, K. Brazil, MySupport Study Group
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引用次数: 2

Abstract

Background: There is broad consensus that the quality of nursing home (NH) care is a research priority to advance NH practice. However, NHs often fail to implement quality improvement (QI) research projects and complex circumstances such as Coronavirus disease 19 (COVID-19) pandemic may further hinder compliance. This study aims to describe the challenges associated with implementing a nurse-led QI project in NH during COVID-19 pandemic and potential strategies for their overcoming. Methods: A descriptive qualitative study was performed, and three data collection strategies employed, including: 1. semi-structured, open-ended interviews with follow-up questions (one NH manager, three members of the NH staff, and two family caregivers of people with advanced dementia); 2. research diary; and 3. in-the-field-notes. A combined deductive and inductive content analysis was adopted to analyze data. Results: Challenges may be anticipated or unanticipated. QI projects should include preliminary assessments to identify the willingness to change and establish partnerships at multiple levels with all stakeholders, adjust the implementation plan to the organizational context, and be open to ongoing changes. Conclusions: Early and regular engagement of stakeholders strengthen relationships. Moreover, an ongoing reflective practice throughout the entire implementation process promotes openness to change, and finally learning and improvement.
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在COVID - 19大流行期间实施护士主导的养老院质量改进项目:一项定性研究
背景:广泛的共识是,养老院(NH)护理的质量是推进NH实践的研究重点。然而,NHs往往无法实施质量改进(QI)研究项目,而诸如冠状病毒病19 (COVID-19)大流行等复杂情况可能进一步阻碍合规性。本研究旨在描述在COVID-19大流行期间在NH实施护士主导的QI项目所面临的挑战以及克服这些挑战的潜在策略。方法:采用描述性定性研究,采用三种数据收集策略,包括:1。半结构化、开放式访谈和后续问题(一名NH经理、三名NH工作人员和两名晚期痴呆症患者的家庭照顾者);2. 研究日记;和3。in-the-field-notes。采用演绎与归纳相结合的内容分析方法对数据进行分析。结果:挑战可能是预料到的,也可能是预料不到的。QI项目应该包括初步评估,以确定变更的意愿,并在多个层次上与所有涉众建立伙伴关系,根据组织环境调整实施计划,并对正在进行的变更保持开放的态度。结论:利益相关者的早期和定期参与加强了关系。此外,贯穿整个实施过程的持续反思实践促进了对变化的开放,并最终促进了学习和改进。
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