The big gap in your nursing home

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Elizabeth Leis Newman
Elizabeth Leis Newman

Recently an academic geriatrician asked me, “What do you hear from those on the front lines?”

I was flattered to be asked, and I tried to find a nice way to say, “Yeah, no one trusts you.”

That's a blunt assessment, but I can practically smell the distrust of clincians when I attend long-term care conferences. It's a fear of surveyors, and of new administrators, but also of academics who are poking around their facility for research. There may be plenty of people who show up at sessions to hear the latest about antipsychotic reduction or breakthroughs in quality methods, but welcome a research project into their facility? Forget it.

That's why it was refreshing to be at the International Nursing Home Research Conference in St. Louis last week and hear about ways researchers can make their experience in a senior living community positive for everyone. If there's a single point I came away with from the conference, it's that there's a tremendous lack of evidence-based research practices in nursing homes — pressure ulcer guidelines, anyone? — and that much of what happens every day is based on belief rather than fact. We have to embrace finding out, in an objective process, how to help long-term care residents.

Plus, in an era when research grant money can be hard to come by, there are still tremendous opportunities for those working in nursing homes, even without an alphabet of letters after their names.

No matter which side you are on, be it academic or front-line staff, everyone should be clear what the benefit of a particular research project is for the facility, the residents and the administration. As a nurse practitioner, Barbara Resnick, Ph.D, CRNP, FAAN, FAANP, a professor of nursing at the University of Maryland School of Nursing, is able to see the point of view of researchers and clinicians.

“Don't assume that they would love to have you, and be prepared to start all over again with new administration,” she cautioned the attendees at the conference.

Researchers “need to be clear about what setting [they] want to be in, such as a SNF, NF, CCRC or AL,” and whether they want to focus on a rural or urban population. To researchers, these are questions she suggested asking: “What are the potential costs to the facility, what is the disruption in work routines and how will you highlight what you are going to give back?” That can include both sharing data as well as nominating staff for awards for participation, or even handing out tokens of appreciation such as mugs.

On the other side, surveyors can see research as a positive when they visit a nursing home, and administrators should be proud to mention their involvement. It shows both belief in your staff and a willingness to accept ideas for improvement. This is a time when there is increasing pressure to have facts and figures available, and administrators should embrace being able to have objective data.

By the time the second International Nursing Home Research conference occurs, in two years, I can only hope that SNF administrators will be co-presenting with researchers on what they found, and how research led them to increase quality and improve care for residents.

Elizabeth Newman is Senior Editor at McKnight's. Follow her @TigerELN.

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