Paper
Thursday, 20 July 2006
This presentation is part of : Models for Nurses' Work Environment
Medication Administration in Resident-Centered Nursing Homes
Melanie R. Krause and Barbara J. Bowers, RN, PhD, FAAN. School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
Learning Objective #1: The learner will be able to compare and contrast two nurse conceptualizations of resident-centered care.
Learning Objective #2: The learner will be able to describe two barriers nurses encounter when implementing resident-centered models of care during medication passes.
The negative effects of institutionalization on residents, including depression, decreased self-esteem and poor self-concept, have been well documented in the research literature.  In response, many nursing homes are participating in one of the resident-centered care initiatives.  Although many nursing homes claim to deliver resident-centered care, current definitions lack conceptual clarity and consistency.  Nurses are left confused about what resident-centered care is and how to implement the new model of care.  Currently, there is a lack of understanding of the impact of resident-centered models of care on the nursing workforce.

The purpose of this study is to describe how staff incorporate resident-centered models of care into medication passes.  Data were gathered at two nursing homes in the Midwestern United States with resident-centered models of care.  A total of twenty nurses and medication assistants have participated.  This study employs a field research design, wherein participants are observed during medication passes and later interviewed.  Field notes are recorded and interviews transcribed.  Data were analyzed using grounded dimensional analysis to develop theory about the way nurses and medication assistants conceptualize resident-centered care and they ways they incorporate the resident-centered care into their medication passes. 

There are several notable findings. First, while all staff strive to deliver resident-centered care, conceptualizations of resident-centered care vary across participants.  Secondly, participants report conflicts between resident-centered ideals and nursing care standards.  Finally, nurses and medication assistants report increased work loads and difficulty completing work within time constraints.  

The findings from this study will be useful for the future development of interventions to help nurses overcome barriers to implementation of resident-centered care.  Nurses are frequently blamed for difficulties nursing homes experience when implementing resident-centered models of care.  However, there is currently scare literature available that explores the barriers to implementation that nurses experience and how they overcome these obstacles. 

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See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)