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Empowering nursing assistants and family members of nursing home residents in decision-making results improved service, a new study finds.

Researchers, led by Darla J. Hamann, Ph.D., University of Texas at Arlington, analyzed managerial decisions of nursing home employees and how they are related to quality. Surveys were sent to 1,000 employees at 33 nursing homes and to the primary family member of each resident, answering questions around the ability to make decisions in areas such as menu plans, activities and the expansion of facilities.

When nursing staff had the autonomy to make decisions, there was a higher relationship to service quality. The empowerment of nursing assistants had an even greater effect than empowerment of nurses, the researchers concurred.

“Empowering the NAs, who spent more time with the residents and their families, was more effective for improving service quality than empowering other types of employees,” Harman wrote.

Results appeared in the Journal of Applied Gerontology.