Guidelines to Support Nursing Home Staff

There is an urgency to respond to the ongoing challenges facing the long-term care home (LTCH) sector which have been uncovered by the COVID 19 pandemic. To address these challenges and contribute to mitigating the effects of any future outbreaks, members of our team along with their international colleagues have developed recommendations to support staff during COVID 19 (i.e., provide clear direction and guidance, keep staff healthy, promote effective human resource policies, implement new clinical practices) and improve infection control practices in nursing homes (McGilton et al., 2020, JAMDA). Preliminary findings from our ongoing work with Nurse Practitioners (NPs) have provided convincing evidence that NPs are well positioned to disseminate and implement these recommendations in LTCHs. This implementation study will determine the steps and resources that are necessary to adapt the guidelines to the context of and to effectively implement them in 2 LTCHs. The focus of the grant is to: 1) Adapt the recommendations to the context of the 2 LTCHs (Phase 1); and 2) Pilot test and evaluate the adaptation of the recommendations by focusing on feasibility, fidelity, cost and sustainability of implementing them per each LTCH context (Phase 2). The LTCHs in Ontario were selected as they have affiliated NPs and they expressed readiness to adopt the recommendations and to commit NP time and resources. We will combine the Consolidated Framework for Implementation Research (CFIR) for modifying and adapting the recommendations to LTCH settings; and the principles from Community-Based Participatory Research (CBPR) to guide our implementation approach. We anticipate that the uptake of the guidelines will have a significant impact on the staff job satisfaction in LTCH and retention rates, and will reduce mortality and admission rates to hospitals. We also believe that continued improvement of the guidelines and its eventual spread and scale up will make a profound contribution to ensuring residents in LTCHs receive the best care possible.