STUDY: Empowering Nursing Home Employees Improves Care Quality

A recent study published in the Journal of Applied Gerontology found that empowering nursing assistants (NAs) in nursing home decision-making can positively influence care quality from the perspective of nursing home residents’ families.

The research team — headed by Darla J. Hamann of the University of Texas at Arlington — interviewed employees and family members in 33 nursing homes across Minnesota.

Respondents answered questions regarding their ability to participate in decision-making in the following areas:

• the hiring process
• the expansion of facilities
• changes in the services offered
• menu planning
• choosing activities for residents
• determining of standards of care for residents

Hamann writes, “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.” She points out this is due to the intimate contact NAs have with residents on a daily basis. Care quality improves with empowered skilled nursing staff as well, albeit to a lesser extent than with NAs.

Empowering residents’ family members also positively correlated with service quality. Family members who were disappointed with service quality were especially likely to want more empowerment.

While the study has limitations, it is the first of its kind to explore empowerment of nursing assistants — those nursing home staff who have the most customer contact — and not just RNs. Hamann suggests that further research be performed to test the generalizability of the study’s conclusions.

— by Stephen Campbell, PHI Policy Research Assistant