PURPOSE:Nursing homes face a growing demand for high-quality palliative wound care. Nursing home staff require not only knowledge but also clinical judgment to address the complex needs of residents at the end of life. This study aimed to develop and evaluate a web-based palliative wound care education program using a clinical judgment model. METHODS:An educational program was developed using the ADDIE model through needs analysis with 10 nursing home staff, program design and development, and pilot implementation and evaluation. Program effectiveness was evaluated in a quasi-experimental study with facility-level random allocation. Four nursing homes were randomly allocated to the experimental or control condition, and 52 nursing home staff were included in the final analysis (n=26 per group). The experimental group received clinical judgment model-based web education, whereas the control group received general web-based palliative wound care education without the clinical judgment model. Clinical judgment was assessed before and after the intervention using nonparametric tests. RESULTS:Both groups showed significant improvements in clinical judgment. However, the experimental group demonstrated greater improvements than the control group in noticing (Z=-3.91, p<.001), interpreting (Z=-3.39, p=.001), responding (Z=-3.64, p<.001), reflecting (Z=-2.30, p=.021), and the total clinical judgment score (Z=-4.62, p<.001). CONCLUSION:The findings support the effectiveness of clinical judgment model-based education in improving clinical judgment in palliative wound care. This web-based approach supports continuing education and improves care quality in nursing homes.

Purpose: End-of-life care is a multifaceted and holistic domain of nursing practice, and strengthening the competencies of nursing home nurses has become increasingly important in the context of a rapidly aging global population. This study aimed to apply the attention, relevance, confidence, and satisfaction (ARCS) model to a web-based end-of-life care education program and to evaluate its effects on learning motivation and end-of-life care competency among nursing home nurses.Methods: The education program was developed using the analysis, design, development, implementation, and evaluation (ADDIE) model. In Phase 1, needs and learner analyses were conducted through interviews with 20 nursing home nurses to inform the development of the educational content. In Phase 2, the effectiveness of the program was evaluated using a multisite, single-blind, quasi-experimental design. A total of 60 nursing home nurses were recruited and assigned to two groups. The experimental group received a web-based end-of-life care education program grounded in the ARCS model, whereas the control group received text-based online education.Results: The analysis demonstrated that all components of learning motivation and end-of-life care competency showed significantly greater improvement in the experimental group than in the control group.Conclusion: These findings support the effectiveness of ARCS-based instructional design in continuing education for nursing home nurses, particularly in addressing the growing demand for high-quality end-of-life care in aging societies.

Purpose: Infection control is a critical concern in nursing homes, especially in the post-COVID-19 era, due to the frailty and complex health conditions of older adults. This study aimed to develop an educational framework to improve infection control practices in nursing homes. Methods: We interviewed five infection specialists to gain practical insights. Subsequently, we administered three rounds of Delphi surveys to 20 nursing home practitioners to assess the validity and practicality of the selected items, thereby establishing a comprehensive framework. Results: The interview data revealed three key categories: recipient-centered, interaction-centered, and environment-centered. Following the Delphi surveys, we identified seven crucial factors for practicality in nursing homes: the characteristics of residents’ health, detection of subtle changes, identification of nonverbal signs, effective communication among professionals, feedback and assessment among professionals, following infection control principles, education based on problem-solving, and immunization and isolation strategies for creating a safe environment. Conclusion: By integrating expert insights and validating the framework through the Delphi technique, the proposed framework enhances infection control training and education programs in nursing homes, ultimately ensuring resident safety.

Continuing education in nursing homes (NHs) is facing a transition to distance learning, such as web-based education, as demonstrated during the COVID-19 pandemic. Since behavioral and psychological symptoms of dementia (BPSD) are managed through integrative direct care by nursing staff, including nurses, nursing assistants, and care workers with diverse educational backgrounds and needs, an effective and efficient web-based education program with a concrete pedagogical and theoretical basis is essential. Therefore, this study aimed to develop an adaptive learning web-based BPSD education system for NH nursing staff. The adaptive learning web-based BPSD education program, with an embedded artificial intelligence chatbot, was developed based on the frameworks of BPSD education and adaptive learning models. The educational program was evaluated using a multisite, single-blinded, quasi-experimental design. Fifty-eight nursing staff were recruited from five different NHs. The experimental group received an adaptive learning system that tailored content to prior knowledge, while the control group received a non-adaptive web-based system. The results from the analysis indicated that all components of learning effectiveness, including BPSD competence, BPSD knowledge, and self-efficacy, were significantly improved in the experimental group compared with the control group. System satisfaction was significantly higher in the experimental group than in the control group, and 75% of the participants in the experimental group actively adapted their individual educational content. These findings indicate that the adaptive learning system had positive outcomes on learning and system effectiveness, suggesting an innovative strategy toward a “new normal” education for NH nursing staff in the post-COVID-19 era.

Purpose: This study aimed to explore intensive care unit nurses' perceptions of end-of-life care and to identify strategies for improving patient comfort in the intensive care unit.Methods: This was a mixed-methods study comprising two phases. In Phase 1, we conducted focus group interviews to investigate how intensive care unit nurses perceived end-of-life care and its specific components within an intensive care unit setting. Phase 2 involved a descriptive questionnaire, utilizing items derived from the focus group interviews to assess how intensive care unit nurses evaluated the components of end-of-life care they provided in the intensive care unit.Results: The findings of the study’s two phases revealed that in end-of-life care, nurses aimed to provide comfort by connecting patients with their families, spiritual beliefs, social networks, and life experiences, while addressing challenges within the broader scope of nursing practice in the intensive care unit.Conclusion: This study examined intensive care unit nurses' perceptions of end-of-life care, the elements of end-of-life care, their practical implementation, and the associated priorities. These findings will help nurses in intensive care units determine and organize priorities in end-of-life care. For patients facing death in the intensive care unit and for the nurses who care for them, the obstacles involved in end-of-life care must be better overcome.

AIM:To explore how nursing home staff advocate for residents with dementia. DESIGN:Phenomenographic qualitative research. METHODS:Twenty nursing home staff from four disciplines (six nurses, four physical therapists, five social workers and five care workers) were purposively recruited from three different nursing homes. Data were collected through semi-structured interviews conducted from February 2023 to March 2023, and the analysis followed the sequential steps of phenomenographic analysis. RESULTS:The analysis identified five categories of description: focusing on what happened, finding the gaps in perspectives, how to bridge for finding a common perspective, how to tailor care such that each resident receives equitable care and how to establish interdisciplinary sharing for a consistent advocative pattern. Their structural relationship was also identified as an outcome space. CONCLUSION:The cyclical advocacy structure illustrated that nursing home staff engage in an ongoing process of advocacy during conflict situations as part of interdisciplinary care, emphasizing continuity of care rather than separate occurrences of care. IMPLICATIONS FOR THE PROFESSION:This study revealed that, in advocating for residents with dementia, nursing home staff adopted an approach that fosters consistent care and proactive prevention, achieved through the formation of shared knowledge applicable uniformly across similar situations. IMPACT:This study contributes significantly to the continuing education or training of interdisciplinary staff in nursing homes. The revelations of the study hold significance not only for the practical application but also for the theoretical advancement of concepts related to safeguarding the dignity, human rights and personhood of residents with dementia, with the ultimate goal of enhancing their quality of life within nursing homes. REPORTING METHOD:Reporting complied with the COREQ criteria for qualitative research. PATIENT OR PUBLIC CONTRIBUTION:Nursing home directors have contributed to the validation of data analysis and interpretation.

The behavioral and psychological symptoms of dementia (BPSD) present complex challenges for nursing home (NH) nurses, leading to confusion and difficulties in providing effective care. To address these issues, investigating how NH nurses perceive and manage the BPSD is crucial since it can lead to the development of tailored and effective care plans. This study therefore aimed to explore the ways in which NH nurses approach the management of the BPSD by using phenomenography. The study identified five categories of assessment and four categories of intervention in managing the BPSD, with their hierarchical structure represented as an outcome space. Each category's description provides a clear conceptualization of the complex and challenging nature of the BPSD care, offering insights into how NH nurses perceive the BPSD management. The study's findings can enhance NH nurse education and lead to effective care plans for residents with BPSD.

AimThis study aimed to assess perceptions of safety management, with a particular focus on interprofessional influences, to determine priorities for safety management training needs and to explore target areas for strengthening the capacity of nursing home practitioners.DesignA mixed methods design was used.MethodsA qualitative-driven mixed methods design was employed in two phases. In Phase 1, as a core component for integrating supplementary components, an inductive content analysis was performed to investigate perceptions of safety management and specific aspects of care related to it through semi-structured interviews with nursing home practitioners. In Phase 2, a descriptive survey was conducted using items derived from the interviews conducted in the initial stage. The aim was to explore the educational needs of practitioners concerning safety management elements practised in nursing homes.ResultsIn the study, through qualitative interviews, practitioners' perceptions of interprofessional safety management were derived into 5 themes and 22 subthemes. Based on this, the results of a descriptive survey derived priorities through a paired t-test, importance-performance analysis, Borich's needs assessment model and the Locus for Focus model for safety management items performed by nursing home practitioners. Results from both phases of the study showed that practitioners recognise the importance of sharing the causes of safety accidents and that there is a high need for training on falls, dehydration, and hypoglycaemia management.Patient or Public ContributionNurses, care workers, physical therapists, and social workers employed in nursing homes took part in this study by participating in interviews and surveys.

Purpose: The importance of wound care as a part of end-of-life care is rising due to aging populations and increased chronic disease prevalence. This study developed a comprehensive competency framework on palliative wound care for nursing staff within long-term care facilities (LTCFs). Methods: The study utilized a three-phased exploratory methods approach involving topic modeling, expert interviews, and a Delphi survey. Results: Four key competencies emerged regarding nursing competency for palliative wound care in LTCFs: (1) building partnerships with patients and caregivers, (2) an individual approach to wound treatment based on understanding the patient's situation, (3) a holistic approach through shared information and cooperative decision-making, and (4) integration of wound management knowledge within end-of-life care. Conclusion: This framework supports developing targeted training programs for nurses to improve the quality of life for terminally ill patients in LTCFs.

Abstract Background The importance of interprofessional education (IPE) programs is increasing due to the complexity and multidimensional aspects of discomfort in long-term care facilities (LTCFs). The social constructivist approach, which is helpful in IPE, has received considerable attention in education. This study aimed to develop and identify the effects of an interprofessional discomfort management online education program using a social constructivist approach. Methods Using the Network-Based Instructional System Design model, five steps were employed for online educational program development: analysis, design, production, implementation, and evaluation. We modified the framework of interprofessional discomfort care and a C3 (case-based, collaborative, and contextual learning) instructional model to construct the program. The study used a non-equivalent control group pre-post-test design with 54 interprofessional participants from four LTCFs. Results The pre-post outcomes were statistically significant for proactivity in problem-solving (t = − 2.244, p = 0.030), team outcomes (t = − 2.457, p = 0.017), and transactive memory system (t = − 3.229, p = 0.002). The results of the learners’ educational program-related satisfaction were as follows: overall degree of satisfaction, 3.67 ± 0.67; difficulty, 3.56 ± 0.82; suitability for practice, 3.83 ± 0.64, content, 3.69 ± 0.75; and educational method, 3.46 ± 0.86. Conclusions These findings support the effectiveness of the social constructivist approach education program for the awareness of discomfort care in LTCF healthcare professionals and can contribute to the improvement of IPE.

Background Intensive care unit (ICU) nurses working in South Korea report experiencing uncertainty about how to care for patients undergoing withdrawal of life-sustaining treatments (WLT). A lack of consensus on care guidelines for patients with WLT contributes to uncertainty, ambiguity, and confusion on how to act appropriately within current law and social and ethical norms. To date, little has been discussed or described about how ICU nurses construct meaning about their roles in caring for dying patients in the context of wider social issues about end-of-life care and how this meaning interacts with the ICU system structure and national law. We aimed to better understand how ICU nurses view themselves professionally and how their perceived roles are enabled and/or limited by the current healthcare system in South Korea and by social and ethical norms. Methods This qualitative descriptive study was conducted using in-depth, semi-structured interviews and discourse analysis using Gee’s Tools of Inquiry. Purposive sampling was used to recruit ICU nurses ( n = 20) who could provide the most insightful information on caring for patients undergoing WLT in the ICU. The interviews were conducted between December 2021 and February 2022 in three university hospitals in South Korea. Results We identified four categories of discourses: (1) both “left hanging" or feeling abandoned ICU nurses and patients undergoing WLT; (2) socially underdeveloped conversations about death and dying management; (3) attitudes of legal guardians and physicians toward the dying process of patients with WLT; and (4) provision of end-of-life care according to individual nurses’ beliefs in their nursing values. Conclusion ICU nurses reported having feelings of ambiguity and confusion about their professional roles and identities in caring for dying patients undergoing WLT. This uncertainty may limit their positive contributions to a dignified dying process. We suggest that one way to move forward is for ICU administrators and physicians to respond more sensitively to ICU nurses’ discourses. Additionally, social policy and healthcare system leaders should focus on issues that enable and limit the dignified end-of-life processes of patients undergoing WLT. Doing so may improve nurses’ understanding of their professional roles and identities as caretakers for dying patients.

BackgroundPerson-centered care (PCC), an approach to healthcare that focuses on the individual needs, preferences, and values of patients, is particularly important in the context of caring for residents of nursing homes (NHs) with the behavioral and psychological symptoms of dementia (BPSD). However, implementing PCC in NHs varies widely due to individual staff, NH environment, and country factors, leading to heterogeneity in person-centered approaches.PurposeThis study was designed to explore and gain insight into the shared subjective perspectives of nurses on providing PCC to manage BPSD in NHs in order to elicit a deeper understanding of how nurses interpret and approach the provision of PCC.MethodsQ methodology was applied to explore the subjective perspectives of nurses. Twenty-nine NH nurses with more than 3 years of experience in managing BPSD completed a Q-sorting task, categorizing 43 Q-samples into a normal distribution shape. Postsorting interviews were conducted after the participants had completed this task. The collected data were analyzed using centroid factor analysis and varimax rotation run within the PQMethod 2.35 program. Interpretation of the resulting factors was based on factor arrays, field notes, and interview data.ResultsFour factors from the shared subjective perspectives of nurses related to PCC were identified, including (a) sharing information focused on details to update care strategies, (b) monitoring until the true needs of residents are identified, (c) awareness of interactive cues in relationships, and (d) connecting an individual's life pattern to their current care.Conclusions/Implications for PracticeThe findings highlight that a one-size-fits-all approach may not be suitable for all nurses and interventions, indicating that nurses should consider the applicable subjective frames to ensure the effectiveness of planned interventions. A need for PCC education that specifically addresses BPSD management is suggested, with the findings implying that a strong organizational climate with respect to PCC in managing BPSD should promote higher job satisfaction and commitment and reduce turnover rates among nurses in NHs. Facilitating the development of PCC interventions appropriate for BPSD management that encompass the various categories and ranges of NH settings and nursing phenomena is thus recommended.

Introduction: Due to the global aging trend, the number of older people who will spend the last years of their lives in nursing homes is increasing. However, nursing homes have long confronted negative social and public discourses, including stigmas on dementia and life in such facilities. Nevertheless, the resident with dementia’s remaining time holds significance, for them and their families, as they seek respect and the ability to make meaningful end-of-life decisions.Objective: To explore how nursing home nurses advocate for the remaining lifetimes of residents with dementia.Design: A qualitative research design.Setting(s): Four nursing homes in Korea from January 2023 to February 2023Participants: Twenty nurses who provide direct caregiving for residents with dementia and have a minimum of two years' experience in nursing homes were recruited.Methods: This study employed a critical discourse analysis. Twenty interviews conducted with nursing home nurses were examined to explore the connections between the grammatical and lexical aspects of the language used by the nurses to construct their identities as advocates for residents with dementia and the broader sociocultural context.Findings: Four discourses regarding nursing home nurses advocating for the value of life of residents with dementia were identified: (1) Bridging perspectives: I am a negotiator between medical treatment and residents' families with differing views; (2) Embracing a shared humanity: Residents are no different from me; they just need professional help; (3) Affirming belongingness: Residents still belong to their families, even when care has been delegated; and (4) Empowering voices for change: We are struggling to provide better care in a challenging reality.Conclusions: This paper highlights the importance of nursing advocacy in safeguarding the remaining time and dignity of individuals with dementia, challenging the stigma surrounding dementia and nursing homes and calling for greater societal and political recognition of the efforts nurses make to preserve the personhood and well-being of these older adults.

Abstract Background Many issues when combined can make wound management complicated, including the types of wounds and symptoms most commonly affecting palliative care residents and the presence of concurrent comorbidities and their associated treatment in nursing homes. In those complex situations, a nursing staff's clinical judgment is essential for effective decision-making. This study aimed to (1) develop an e-learning program using the clinical judgment model to enhance clinical decision-making competencies and (2) examine the effectiveness of the developed education program. Methods In Step 1, developing the program, the characteristics of the learners and the necessary educational content were identified through qualitative interviews. Subsequently, the program was designed and created by considering the educational goals and content identified in the interviews. In Step 2, evaluating the program, its effectiveness was assessed using a quasi-experimental nonequivalent pretest-posttest design. The participants (n = 52) were randomly allocated into an experimental group (n = 26) and a control group (n = 26). Results The education program was developed based on the analysis of the educational needs suggested by 10 interviewees, who responded to 11 questions covering elements such as noticing, interpreting, responding, and reflecting, all based on the clinical judgment model. The results indicated that the e-learning program significantly improved clinical judgment in the experimental group compared to the control group (p < 0.01). Conclusions This study developed an e-learning program for palliative wound care and assessed its impact on the clinical judgment of nursing staff in nursing homes. The results are expected to enhance palliative wound care competency and contribute to more effective nursing care for residents in nursing homes.

Abstract Background Continuing education in long-term care facilities (LTCFs) is faced with a transition to distance learning, such as web-based education, as demonstrated during the COVID-19 pandemic. As behavioral and psychological symptoms of dementia (BPSD) are managed by integrative direct care of nursing staff that includes nurses, nursing assistants, and care workers whose educational background and needs are diverse, an effective and efficient web-based education with concrete pedagogical and theoretical basis is needed. In this context, adaptive learning could be considered an innovative educational strategy that enables individual approaches to focus on only the necessary elements by adapting time and content according to individual needs. Therefore, we aimed to develop an adaptive learning web-based BPSD education system for LTCFs nursing staff.Methods The adaptive learning web-based BPSD education was developed based on the frameworks of BPSD education and adaptive learning models. The system was developed as a Google Chrome-based website with an embedded artificial intelligence chatbot that promoted an interactive learning experience. The educational program was evaluated with a multisite single-blinded quasi-experimental design. The experimental group (N = 28) received an adaptive learning system that allowed learners to adapt the educational content according to their prior knowledge. The control group (N = 30) received a web-based learning system that could not be adapted.Results All components of learning effectiveness, including BPSD competence, BPSD knowledge, and self-efficacy, were significantly improved in the experimental group compared with the control group (p = .036; p = .003; and p = .002; respectively). System satisfaction was significantly higher in the experimental group than in the control group (p = .002), and 75% of the participants in the experimental group actively adapted their individual educational contents.Conclusions This study developed and evaluated an adaptive learning web-based BPSD education system for LTCF nursing staff. From a pedagogical theory and educational framework basis, it was identified that the adaptive learning system had positive outcomes on learning and system effectiveness, which suggest an innovative strategy toward a ‘new normal’ education for nursing staff of LTCFs in the post-COIVD-19 era.

Purpose: The aim of this study was to identify a clear definition of proactive nursing and to elucidate the essence of proactive nursing required in the current healthcare context. Methods: A concept analysis using Walker and Avant’s approach was conducted. Results: The defining attributes of proactive nursing included surveilling to surface problems, employing practices beyond the established protocols, tailoring a path toward the care goal, and arranging resources in advance. The antecedents were that nurses have their own theoretical and experiential knowledge, possess a professional identity, understand clients’ status, and have accessible resources. The consequences arising from proactive nursing were ensuring client safety, achieving the care goals efficiently, and improving nurses’ job satisfaction. Through this concept analysis, proactive nursing was defined as taking the initiative for practices during the care process that utilize creative methods and taking advantage of various resources to identify or solve implicit problems of clients. Conclusion: This concept analysis provided a clear meaning structure for proactive nursing, enabling a better understanding and communication of the concept within the nursing discipline. A clear definition of proactive nursing would lead nurses to practice in a more proactive way in the current healthcare system, resulting in improved quality of care and greater safety for clients.

Targeted protein degraders (TPDs) have expanded the breadth of therapeutic options through both their catalytic mechanism of action and ability to degrade previously “undruggable” target proteins. Prior reports of small-molecule GSPT1 degraders such as CC-90009 in AML demonstrate potent anti-tumor cytotoxicity, but with a potentially narrow therapeutic index. To increase the efficacy vs. tolerability window of TPDs and improve drug delivery, we introduce TPD-Squared (TPD2 TM), a dual-targeted protein degradation approach of combining the catalytic mechanism of targeted protein degradation with the precision of tumor-targeting therapeutic antibodies. We have previously shown in vitro and in vivo efficacy with a HER2-targeted TPD2 conjugate: ORM-5029. Following on that success, we generated conjugates using a CD33-targeting antibody (OR000283) produced by engineering the FAb (H&L) sequences from gemtuzumab onto an IgG1 Fc with N297A variant to inhibit Fc-γR binding. Medicinal chemistry optimization of linker-payloads led to the identification of ORM-6151, which is composed of SMol006, a highly potent GSPT1 degrader conjugated to OR000283 via a novel β-glucuronide releasable linker. ORM-6151 treatment in CD33-expressing cell lines showed picomolar activity with 10-1000-fold greater potency compared to several GSPT1 degrader molecules, including CC-90009 or Mylotarg, and had robust activity in Mylotarg-resistant lines (AML193 and Kasumi6). ORM-6151 also exhibited picomolar potency in in vitro cytotoxicity to primary relapsed/refractory AML patient blasts, with better potency than CC-90009 and Mylotarg. We evaluated ORM-6151 in several in vivo disseminated xenograft models and observed robust efficacy following a single treatment at doses as low as 0.1 mg/kg. Tumor growth inhibition correlated with the degree and duration of GSPT1 depletion and changes in the expression of previously described integrated stress response biomarker genes. In summary, ORM-6151 is a promising, potential therapy for AML and currently in preclinical development as a first-in-class targeted protein degrader therapy with CD33-targeted delivery. Citation Format: James Palacino, Pedro Lee, Hangyeol Jeong, Yeonjoon Kim, Yoojin Song, Uttapol Permpoon, Wesley Wong, Chen Bai, Nathan Fishkin, Khuloud Takouri, Eunjun Yu, Yong Yi, Anna Skaletskaya, Min-Soo Kim, Da-Yeong Kim, Dong-Ki Choi, Peter U. Park. ORM-6151: A first-in-class CD33-antibody enabled GSPT1 degrader for AML [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2700.

Educating interprofessional practitioners in long-term care facilities (LTCFs) is critical for managing discomfort of residents with dementia, which is often unnoticed and undertreated. A framework of education on discomfort management that is applicable in various environments in different facilities is necessary. We developed a preliminary framework to educate interprofessional practitioners on discomfort management of dementia residents in LTCFs. We conducted a three-step research process: a literature review using topic modeling, in-depth interviews, and Delphi surveys. We derived four categories for an interprofessional approach toward discomfort management education in LTCFs: identifying visual and nonvisual signs to communicate among professionals, close observation using comparison and contrast to share information for discomfort care, harmony in interprofessional roles, and applying common and specific professional knowledge for discomfort management. The findings provide the first outline for an educational framework for interprofessional discomfort management in LTCFs for residents with dementia. We recommend interventions across different cultures to verify the framework in future research.

Behavioral and psychological symptoms of dementia (BPSD) are common in residents of long-term care facilities (LTCFs). In LTCFs, nursing staff, including nurses and care workers, play a crucial role in managing BPSD as those most in contact with the residents. However, it is ambiguous where their focus should be for effective BPSD care. Thus, this paper aims to reveal BPSD care competencies for nursing staff in LTCFs and to outline an initial frame of education. A multiphase mixed-methods approach, which was conducted through topic modeling, qualitative interviews, and a Delphi survey, was used. From the results, a preliminary educational framework for nursing staff with categories of BPSD care competence was outlined with the four categories of BPSD care competence: using knowledge for assessment and monitoring the status of residents, individualizing approaches on how to understand residents and address BPSD, building relationships for shared decision-making, and securing a safe environment for residents and staff in LTCFs. This preliminary framework illuminates specific domains that need to be developed for competent BPSD care in LTCFs that are centered on nursing staff who directly assess and monitor the changing and deteriorating state of residents in LTCFs.

Infection is a significant factor adversely affecting the health of nursing home (NH) residents, potentially even leading to death. Therefore, educating NH staff to think critically is necessary to prevent and control infection. In this study, we developed an electronic problem-based learning (e-PBL) program using the Network-Based Instructional System Design model to enhance South Korean NH staff’s critical thinking competencies; subsequently, its effectiveness was evaluated. This study utilized a quasi-experimental nonequivalent pretest–post-test design. The participants (n = 54) were randomly allocated into an experimental group (n = 28) and a control group (n = 26). The results indicate that the e-PBL program significantly improved the critical thinking disposition in the experimental group compared with in the control group.