Chronicling resident and staff outcomes throughout the implementation of a professional nursing practice model in one Midwest continuing care retirement community: a longitudinal analysis

This research used a case study approach to chronicle the process of seeking the American Nurse Credentialing Center's Pathway to Excellence in Long-Term Care designation in one Midwest community. The PTE-LTC practice standards framework guided the implementation of professional nursing practice which focused on a positive practice environment, shared decision-making, accountability for resident care, and the leadership development of nursing staff. These practice standards are outlined in the study and incorporated the major components necessary to implement Professional Nursing Practice and Shared Governance in long-term care.

The components of the designation process over a five-year period were documented and compared with other models of shared governance and professional practice supported in the literature. The study included a rich description of the structures and processes in place prior to the designation process and those developed during the process to operationalize the model. The methods which were used to accomplish these organizational changes are identified as well. In addition, the study reports on the effects of the model implementation on organizational, nursing, and resident measures.

The implementation of, and support for, a professional nursing practice role and environment in a nursing home was expected to improve both the quality of care and quality of life for older adults who live in the nursing home, as well as staff job satisfaction and retention of nursing staff.