Changing An Unacceptable Reality: Enabling Nursing Knowledge for Quality Resident Outcomes in Ontario’s Long Term Care Homes

Purpose of the Study This study explores the enablers and barriers to the provision of optimal resident care in Ontario’s LTC homes, and the impacts of these factors on nurse and resident outcomes.  

Design and Sample This study was guided by an advisory panel of RPNs and RNs from LTC in direct practice and administrative roles, and a RN with direct experience in a LTC home as a family member. A non-experimental, descriptive research design was used for this study, specifically a survey among a targeted sample of RPNs and RNs employed in direct practice roles in LTC homes.

Results In total, 734 completed surveys were returned resulting in a 19% response rate. Use of the electronic version of the study was undertaken by 41%, and 59% of the respondents opted for the hard copy. There were no statistically significant differences identified in the item responses of those surveys received online versus those in the paper format following the reminder notice. Respondents who indicated they were in management and “other” roles (e.g., supervisor, coordinator, educator) were excluded, as the inclusion criterion was limited to only nurses indicating that their role was direct care. This resulted in a final response rate of 17% (n= 657) included for analysis.

Conclusions The issues of complex care needs, increased workload, and the resulting moral distress experienced by nurses is not unique to the LTC sector. Organizational support was a key factor that influenced both nursing and clinical outcomes. As such, both the survey and the findings from this study may be applicable to a wide range of practice settings and sectors. Future research is suggested to deepen the understanding of the interplay among these elements.

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