Registered Nurses' perspective of systemic factors affecting nursing home care quality decline: A qualitative descriptive study

Nurs Open. 2022 Nov 14. doi: 10.1002/nop2.1474. Online ahead of print.


Aim: A growing number of older people are living in nursing homes worldwide, but their safety and quality of care are not guaranteed. This study explores registered nurses' (RNs) perspectives on systemic factors affecting the quality of care and safety decline of nursing home.

Design: Qualitative descriptive study.

Methods: In this study, semi-structured interviews were conducted with 10 RNs working in six nursing homes, who were chosen through purposive sampling. Data were collected from 1 August-19 September 2019, and analysed using thematic analysis.

Results: The following five themes were derived: lack of sufficient number of RNs, poor work conditions, unclear job descriptions for RNs, no official position of nursing director and absence of transition care system.

Patient or public contribution: All reports of RNs affecting resident safety and quality of care decline were related to systemic factors. Therefore, improving quality of care in nursing homes should be supported by changes in systemic factors, such as maintaining an appropriate number of RNs and improving their working conditions.

Keywords: care quality; nursing homes; older adults; qualitative descriptive study; registered nurses.