The important and complex role of nursing in culture change is examined in the newly released issue paper, Nurses' Involvement in Nursing Home Culture Change: Overcoming Barriers, Advancing Opportunities.  NCCNHR participated in the development of this paper, which was produced by The Hartford Institute for Geriatric Nursing at NYU College of Nursing, in collaboration with the Coalition for Geriatric Nursing Organizations (CGNO) and the Pioneer Network.  

"I encourage all advocates to review the paper's recommendations that address two important consumer issues - quality resident care and resident autonomy, respect and self-determination. This paper is an excellent summary of the culture change movement as well as a thorough examination of the many issues faced by nurses who work in culture change facilities," stated Sarah Wells, Executive Director of NCCNHR: The National Consumer Voice for Quality Long-Term Care.

The paper is based on an Expert Panel of leaders in culture change and in gerontological nursing that included Alice H. Hedt, former NCCNHR Executive Director.  Convened in October 2008, the panel was funded by The Commonwealth Fund and included long-time NCCNHR leader Sarah Greene Burger who is one of the paper's authors through her work with the Coalition of Geriatric Nursing Organizations.

The paper points out that "culture change, at this time, is a young, growing, value-driven movement for change, much like the movement for restraint-free care was when it started 20 years ago."  It cites NCCNHR's role in the movement by explaining that "in nursing homes, the movement away from institutional provider-driven models of care to more humane consumer-driven models of care that embrace flexibility and resident self-determination has come to be known as culture change. Culture change and resident-directed care has its origin in the work of the National Citizens' Coalition for Nursing Home Reform (NCCHNR) and represents a true operationalization of the Nursing Home Reform Act of 1987...each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care."

• Developing and distributing a statement of goals for practicing nurses in Culture Change Nursing Homes.  
• Developing competencies for nurses practicing in culture change.
• Conducting a comprehensive review of culture change content in pre-licensure (associate degree and bachelor of nursing) nursing programs.
• Disseminating existing tools/resources on culture change and nursing's role in culture change to academic nursing programs, including strategies for incorporating this content into the curriculum.  
• Creating new tools/resources based on the competencies for nurses in nursing homes; and
• Identifying research priorities for examining the role of nurses in nursing home culture change.

"This paper is incredibly important to quality long-term care because the culture change movement cannot move forward successfully without the increased involvement of nurses and quality of care cannot advance without the values of culture change," summarized Wells.

To access the Issue Paper visit the
Hartford Institute for Geriatric Nursing Web Site