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The COVID-19 pandemic highlighted long-standing gaps in the ability of nursing homes (NHs) to engage in quality improvement (QI) as evidenced by The National Academies of Sciences, Engineering and Medicine (NASEM) report "The National Imperative to Improve Nursing Home Quality" (2022). The report warns the current system is ineffective and unsustainable, and their resulting goals emphasize an urgent need to reinforce, expand, and otherwise remake QI in NHs (NASEM, 2022). Adult gerontology primary care nurse practitioners (AGPCNP) can bridge gaps in NH QI as their competencies promote safety and risk reduction for the adult gerontology population (American Association of Colleges of Nursing, 2016). Skills in leadership make nurse practitioners (NPs) key to collaborative efforts including multiple stakeholders, especially in systemic QI where communication and interprofessional relationships are key to success. A project to boost NH QI during the COVID-19 pandemic offered an opportunity to test a unique role for NPs. From Fall 2021 through Spring 2023, the project paired four NP QI advisors from a nearby academic medical center with more than 30 NHs to meet three objectives: 1) educate NH QI leaders, mostly through one-on-one mentorship in QI methodology; 2) engage facilities by coaching through QI methodologies, including plan, do, study, act (PDSA) cycles; and 3) empower facilities to embed evidence-based QI into standard workflows. QI topics varied and were self-selected by facilities. Topics included fall prevention, medication reduction, infection control, and COVID vaccination, among others. NP advisors provided real-time guidance in the application of QI methodologies as projects progressed. Over the 18-month project, seven NHs completed multiple PDSA cycles, 11 completed at least one, and 16 participated but did not complete a PDSA cycle. More than 200 nursing continuing education credit hours were awarded. In post-project interviews, facilities highly valued the educational component and credited the project with facilitating their engagement in QI. Empowerment to embed QI was more difficult to assess; facility QI leaders expressed a desire for more time with their NP advisor which could facilitate this. This project exemplifies how geriatric-focused NPs are uniquely positioned to lead future change by educating, engaging, and empowering NH QI leaders.
Learning Objective:
After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.