Special Article| Volume 17, ISSUE 2, P99-103, February 01, 2016

Recommendations From the International Consortium on Professional Nursing Practice in Long-Term Care Homes

Published:December 17, 2015DOI:


      In response to the International Association of Gerontology and Geriatrics' global agenda for clinical research and quality of care in long-term care homes (LTCHs), the International Consortium on Professional Nursing Practice in Long Term Care Homes (the Consortium) was formed to develop nursing leadership capacity and address the concerns regarding the current state of professional nursing practice in LTCHs. At its invitational, 2-day inaugural meeting, the Consortium brought together international nurse experts to explore the potential of registered nurses (RNs) who work as supervisors or charge nurses within the LTCHs and the value of their contribution in nursing homes, consider what RN competencies might be needed, discuss effective educational (curriculum and practice) experiences, health care policy, and human resources planning requirements, and to identify what sustainable nurse leadership strategies and models might enhance the effectiveness of RNs in improving resident, family, and staff outcomes. The Consortium made recommendations about the following priority issues for action: (1) define the competencies of RNs required to care for older adults in LTCHs; (2) create an LTCH environment in which the RN role is differentiated from other team members and RNs can practice to their full scope; and (3) prepare RN leaders to operate effectively in person-centered care LTCH environments. In addition to clear recommendations for practice, the Consortium identified several areas in which further research is needed. The Consortium advocated for a research agenda that emphasizes an international coordination of research efforts to explore similar issues, the pursuit of examining the impact of nursing and organizational models, and the showcasing of excellence in nursing practice in care homes, so that others might learn from what works. Several studies already under way are also described.


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        • Tolson D.
        • Rolland Y.
        • Andrieu S.
        • et al.
        International Association of Gerontology and Geriatrics: A global agenda for clinical research and quality of care in nursing homes.
        J Am Med Dir Assoc. 2011; 12: 184-189
        • Howard-Brown C.
        • McKinley E.
        ARC NETP Program Evaluation Final Report.
        Sampere Research Group, Wellington, New Zealand2014
        • McGilton K.
        • Sorin-Peters R.
        • Sidani S.
        • et al.
        Focus on communication: Increasing the opportunity for successful staff-patient interactions.
        Int J Older People Nurs. 2011; 6: 13-24
        • Broad J.B.
        • Boyd M.
        • Kerse N.
        • et al.
        Residential aged care in Auckland, New Zealand 1988–2008: Do real trends over time match predictions?.
        Age Ageing. 2011; 40: 487-494
        • Hirdes J.P.
        • Mitchell L.
        • Maxwell C.J.
        • et al.
        Beyond the ‘iron lungs of gerontology’: Using evidence to shape the future of nursing homes in Canada.
        Can J Aging. 2011; 30: 371-390
        • Cardona P.
        • Tappen R.M.
        • Terrill M.
        • et al.
        Nursing staff time allocation in long-term care: A work sampling study.
        J Nurs Adm. 1997; 27: 28-36
        • Stone R
        • Wiener J
        Who Will Care For Us? Addressing the Long-Term Care Workforce Crisis.
        The Urban Institute, Washington, DC2001
        • Yu F.
        • Krichbaum K.
        • Wyman J.
        Predictors of nursing home admission for persons with dementia.
        Med Care. 2009; 47: 191-198
        • Bowers B.
        • Esmond S.
        • Jacobson N.
        The relationship between staffing and quality in long-term care facilities: Exploring the views of nurse aides.
        J Nurs Care Qual. 2000; 14: 55-64
        • Dellefield M.E.
        • Castle N.G.
        • McGilton K.S.
        • et al.
        The relationship between registered nurses and nursing home quality: An integrative review.
        Nurs Econ. 2015; 33: 95-116
        • Dorr D.A.
        • Horn S.D.
        • Smout R.J.
        Cost analysis of nursing home registered nurse staffing times.
        J Am Geriatr Soc. 2005; 53: 840-845
        • Decker F.H.
        The relationship of nursing staff to the hospitalization of nursing home residents.
        Res Nurs Health. 2008; 31: 238-251
        • McGilton K.S.
        • Hall L.M.
        • Wodchis W.P.
        • et al.
        Supervisory support, job stress, and job satisfaction among long-term care nursing staff.
        J Nurs Adm. 2007; 37: 366-372
        • Hussein S.
        • Manthorpe J.
        An international review of the long-term care workforce: Policies and shortages.
        J Aging Soc Policy. 2005; 17: 75-94
        • Katz P.R.
        An international perspective on long term care: Focus on nursing homes.
        J Am Med Dir Assoc. 2011; 12: 487-492.e1
        • Spilsbury S
        • Hanratty B
        • McCaughan D
        Supporting Nursing in Care Homes. Project Report for the RCN Foundation.
        University of York, York, United Kingdom2015
        • Siegel E.O.
        • Anderson R.A.
        • Calkin J.
        • et al.
        Supporting and promoting personhood in long term care settings: Contextual factors.
        Int J Older People Nurs. 2012; 7: 295-302
        • Warmington J.
        • Afridi A.
        • Foreman W.
        Is Excessive Paperwork in Care Homes Undermining Care For Older People?.
        Joseph Rowntree Foundation, York, UK2014
        • Bowers B.
        • Cohen L.W.
        • Elliot A.E.
        • et al.
        Creating and supporting a mixed methods health services research team.
        Health Serv Res. 2013; 48: 2157-2180
        • Corazzini K.N.
        • Anderson R.A.
        • Mueller C.
        • et al.
        Understanding RN and LPN patterns of practice in nursing homes.
        J Nurs Regul. 2013; 4: 14-18
        • McGilton K.S.
        • Bowers B.
        • McKenzie-Green B.
        • et al.
        How do charge nurses view their roles in long-term care?.
        J Appl Gerontol. 2009; 28: 723-742
        • Bowers B.
        • Nolet K.
        Developing Green House nursing care team: Variations on development and implementation.
        Gerontologist. 2014; 54: 553-564
        • Mueller C.
        • Anderson R.A.
        • McConnell E.S.
        • et al.
        Licensed nurse responsibilities in nursing homes: A scope-of-practice issue.
        J Nurs Regul. 2012; 3: 1-8
      1. College of Nurses of Ontario. Practice Guideline: RN and RPN practice: The Client, the Nurse and the Environment..
        The College of Nurses of Ontario, Toronto, ON, Canada2014
        • Chenoweth L.
        • Jeon Y.H.
        • Merlyn T.
        • et al.
        A systematic review of what factors attract and retain nurses in aged and dementia care.
        J Clin Nurs. 2010; 19: 156-167
        • Castle N.G.
        Nursing home caregiver staffing levels and quality of care: A literature review.
        J Appl Gerontol. 2008; 27: 375-405
        • Chu C.H.
        • Wodchis W.P.
        • McGilton K.S.
        Turnover of regulated nurses in long-term care facilities.
        J Nurs Manag. 2014; 22: 553-562
        • Neff D.F.
        • Cimiotti J.P.
        • Heusinger A.S.
        • et al.
        Nurse reports from the frontlines: Analysis of a statewide nurse survey.
        Nurs Forum. 2011; 46: 4-10
        • Stone R.
        • Harahan M.F.
        Improving the long-term care workforce serving older adults.
        Health Aff (Millwood). 2010; 29: 109-115
        • McGilton K.S.
        • Boscart V.M.
        • Brown M.
        • et al.
        Making tradeoffs between the reasons to leave and reasons to stay employed in long-term care homes: Perspectives of licensed nursing staff.
        Int J Nurs Stud. 2014; 51: 917-926
        • Lyons S.S.
        • Specht J.P.
        • Karlman S.E.
        • et al.
        Everyday excellence. A framework for professional nursing practice in long-term care.
        Res Gerontol Nurs. 2008; 1: 217-228
        • Herdrich B.
        • Aindrea L.
        Nurse residency programs: Redesigning the transition into practice.
        J Nurses Staff Dev. 2006; 22: 55-62
      2. Punch D. Prescribing change. Registered Nurse Journal. Registered Nurses' Association of Ontario 2015;21:11–15.

        • McCormack B.
        • Dewing J.
        • Breslin L.
        • et al.
        Developing person-centred practice: Nursing outcomes arising from changes to the care environment in residential settings for older people.
        Int J Older People Nurs. 2010; 5: 93-107
        • McGilton K.S.
        Editorial: The role of the nurse in long-term care.
        Int J Older People Nurs. 2012; 7: 282-283
        • Heath H.
        Outcomes from the work of registered nurses working with older people in UK care homes.
        Int J Older People Nurs. 2010; 5: 116-127
        • McGilton K.S.
        • Heath H.
        • Chu C.H.
        • et al.
        Moving the agenda forward: A person-centred framework in long-term care.
        Int J Older People Nurs. 2012; 7: 303-309
        • Nolan M.
        • Brown J.
        • Davies S.
        • et al.
        The Senses Framework: Improving care for older people through a relationship-centred approach.
        Getting Research into Practice. 2006; 2 (Project Report. University of Sheffield. Available at: Accessed December 10, 2015.): 1-152
        • Nolet K.
        • Roberts T.
        • Gilmore-Bykovskyi A.
        • et al.
        Preparing tomorrow's nursing home nurses: The Wisconsin Long Term Care Clinical Scholars Program.
        Gerontol Geriatr Educ. 2015; 36: 396-415