BackgroundInnovation in long-term care for older adults is essential to manage challenges such as a growing demand and workforce shortages. Organizations with higher innovation readiness are more likely to adopt and sustain innovations effectively. However, an approach indicating the innovation readiness of long-term care organizations for older adults is lacking. To address this, the Maastricht Innovation Readiness Approach (MIRA) was developed to (1) increase understanding about innovation readiness, (2) facilitate the organization's self-assessment of innovation readiness, and (3) inspire the organizational conversation on how to become better at innovating.ObjectiveThe aim of this work was to examine the feasibility of MIRA and explore whether it could be successfully applied in long-term care practice.MethodsMIRA consists of a questionnaire and a consensus meeting. To evaluate the MIRA approach, a mixed-method cross-sectional feasibility study was conducted in 10 Dutch long-term care organizations. The study evaluated scores on the MIRA Questionnaire, assessed its intrarater reliability, and examined the feasibility of both the MIRA Questionnaire and the MIRA Consensus meeting. Professionals (involved in innovation) were asked to (1) complete the MIRA Questionnaire and additional closed-ended questions about its feasibility twice online (1-month interval), (2) participate in the Consensus meeting and verbally answer open questions, and (3) complete a questionnaire directly following the consensus meeting on its feasibility.ResultsIn total, 173 participants completed the MIRA Questionnaire at t1 (#128 at t2); 127 participants attended the MIRA Consensus meeting (t1). The mean perceived innovation readiness score was 6.6 (scale 1–10). Intrarater reliability of the MIRA Questionnaire was good (intraclass correlation coefficient > 0.75). Participants evaluated MIRA as acceptable, suitable, and valuable: 88% indicated that MIRA provided insight into their organization's innovation readiness, and 84% would recommend it to other organizations. Interestingly, participants suggested annual use of MIRA.ConclusionMIRA is a feasible approach to assess innovation readiness in long-term care. It enhances internal awareness, supports group reflection across roles and disciplines, and may support structured progress in innovation readiness. However, it remains unclear whether conducting MIRA improves innovation readiness. Longitudinal studies are needed to follow organizations as they implement steps to improve innovation readiness and to explore how these contribute to succesful innovation outcomes.

Objectives To examine how organizations assess their innovation readiness (IR) maturity using the Maastricht Innovation Readiness Approach (MIRA) Questionnaire. Design Cross-sectional study in 21 Dutch long-term care organizations. Setting and Participants Health care professionals with insight into their organization's IR completed the questionnaire, including those in care, management, human resource management, communication, and client representation. Methods Data were collected using the MIRA Questionnaire, based on the IR framework, containing 4 domains: strategic direction, organization of innovation, leadership for innovation, and learning climate. The response options include 5 IR positions: “not,” “informal,” “occasionally,” “consistently,” and “optimally,” reflecting a progression in IR maturity and a “no insight” position. Results The MIRA Questionnaire was completed by 409 participants in 21 long-term care organizations. Across nearly all (n = 20) organizations, “consistently” was most frequently selected (mean [after which is M] = #21, 38%), particularly within the “strategic direction” domain (M = #21, 43%). In the “learning environment” domain, however, the “not” and “informal” positions were most frequently chosen (M = #21, 34%), suggesting that these factors were either not implemented or put in practice or only implemented without formalization. Questions about the active involvement of managers and intended end users (clients and family members) received more frequent responses in the “not and informal” positions (M = #21, 47%, 21%) and fewer responses in the “occasionally, consistently, and optimally” positions (M = #21, 25%, 59%). Conclusions and Implications The main findings indicate that most health care organizations' attention goes to strategy and organizing for innovation but less to leadership and the learning climate. This might indicate a temporal order in organizing the IR factors. Improving IR requires balanced attention to all factors of the IR framework. MIRA can support organizations by identifying specific steps to improve IR. Additional research is necessary to longitudinally track whether and how organizations translate MIRA use into actions that improve their IR. Policymakers can utilize these findings to develop sector-wide programs that promote learning for sustainable IR.

BackgroundIncreasing innovation readiness of long-term care organizations for older adults is vital to ensure future provision and affordability of care delivery. Research into innovation readiness of health care organizations is a rather new field. This study addresses following research question: What factors contribute to innovation readiness of long-term care organizations for older adults?MethodsSemi-structured interviews were conducted with 16 stakeholders connected to long-term care for older adults in the Netherlands: academics, (top) management, innovation managers and consultants. A thematic content analysis was used to analyze the data.ResultsFour main factors were identified that contribute to innovation readiness of long-term care organizations for older adults: 1) a clear strategic course for innovation, 2) a tailored innovation journey, 3) inspirational leading for innovation, and 4) hands-on-learning for innovation. Stakeholders highlighted that innovation readiness should not be developed as an ad-hoc initiative but should be embedded into corporate strategies and decision-making processes. All stakeholders mentioned the importance of ‘preparing’ the organization for innovation readiness via a strategic course and its deployment in an innovation journey. They also stressed the importance of professional ‘learning for innovation’ in becoming innovation ready. ConclusionsThis study provides a step toward evidence-based factors that contribute to innovation readiness of long-term care organizations for older adults. This study’s 4 main factors contributing to innovation readiness are substantiated by existing literature. Therefore, the findings of this study can support long-term care managers to structurally embed innovation. A better understanding of the contribution and interplay of factors enabling innovation readiness at all stages of the innovation process is needed. Future research could verify the findings of this study and develop a scan, based on this study’s innovation readiness factors, indicating the maturity of long-term organizations for older adults.

BACKGROUND:A skilled and diverse healthcare workforce is essential in nursing homes, yet recruitment and retention remain a major challenge. Gaining insight into the well-being of different care worker groups and how they perceive their work environment can highlight areas of concern and opportunities for improvement. AIMS:To compare the perceived work environment and well-being among different care worker groups in nursing homes. METHODS:This descriptive study used cross-sectional survey data from the Flanders Nursing Home (FLANH) project, collected from February-July 2023. A total of 1521 care workers from 25 Flemish nursing homes participated (64.4% response rate), including care assistants (43.7%), registered nurses (20.5%), support staff (15.4%), allied health professionals (14.8%), and team leaders (5.7%). Chi-squared tests were used to compare the percentages of the care worker groups reporting the work environment items and well-being outcomes (job satisfaction, intention to leave, burnout). Post hoc analyses were conducted to identify which groups contributed to the significant differences observed. RESULTS:Significant differences among care worker groups were found for almost all work environment items and well-being outcomes. Staffing adequacy was perceived least among care assistants and registered nurses. More registered nurses and team leaders perceived high workload and emotional burden compared to the other groups. Work-life interference and involvement were perceived most among team leaders. A person-centered vision, work autonomy, and salary satisfaction were reported most among allied health professionals and team leaders. Skill use and training opportunities were reported least among support staff. Work-related well-being appeared to be experienced most among allied health professionals and least among care assistants. LINKING EVIDENCE TO ACTION:These findings highlight key differences in work environment perceptions and well-being among care worker groups, offering valuable insights for tailored initiatives to foster a supportive workplace that benefits the well-being of all types of care workers in nursing homes.

BACKGROUND:Providing and improving relationship-centered care has gained increased importance in long-term care. However, quality improvement strategies are predominantly based on quantitative quality measures for care professionals. Therefore, the aim of this study was to explore how narrative data collected with Connecting Conversations is used in evaluation meetings to improve RCC. METHODS:A qualitative approach using structured observations was used. The participants were care professionals, residents and family members from two nursing home wards. The participating wards organized evaluation meetings to discuss the experienced quality of care based on narrative data collected with Connecting Conversations. To analyze the process of improving RCC, the organization of these meetings and the content were observed by independent researchers, and detailed notes were taken. The data were analyzed thematically by using conventional content analysis. RESULTS:In total, three evaluation meetings were organized. Primarily, care professionals were invited to discuss the results of the interviews. One ward organized a meeting for care professionals, residents and family members, and the other decided not to invite them. The discussion of themes related to experienced quality of care within the evaluation meetings was less profound than during the interviews. In total, 12 overarching themes concerning experienced quality of care were discussed in the Connecting Conversations' interviews. Nine themes were also mentioned in one or more evaluation meetings (i.e., activities for residents, personalized attention and preferences of residents, feeling at home and communication within the care triad). CONCLUSION:When using narrative data on quality of care to improve relationship-centered care, the full potential of narrative data is underutilized as discussions focussed on incidental problem solving rather than deeper reflections on the meaning of events in providing relationship-centered care. Establishing trust within the care triad of care professionals, family members, and residents is essential to improve relationship-centered care collaboratively.

INTRODUCTION:Green Care Farms are an alternative long-term care setting for people with dementia. Organizing daily life around a shared household and integrating nature and animals, they emphasize resident participation and activation. Such a radically different care environment not only affects residents, but also nursing staff who provide the care. OBJECTIVE:To explore nursing staff outcomes and work environment characteristics of Green Care Farms and compare them with traditional nursing homes for people with dementia. DESIGN:A comparative study based on a cross-sectional survey design1. SETTING(S):Green Care Farms for people with dementia, which provide care in an archetypical household, where nature and animals are an integrated part of daily life and where staff has integrated tasks (experimental group). Traditional psychogeriatric nursing homes for residents with dementia, where residents live in large wards, organizational routines determine daily life, and staff has differentiated tasks (comparison group). PARTICIPANTS:All staff working direct resident care. The total sample included 262 staff members from 10 Green Care Farms and 380 staff members from 21 traditional nursing homes in the Netherlands. METHODS:A questionnaire with eight measures was distributed online. Data were analyzed using regression analysis. RESULTS:Both groups reported similar work demands and expected a similar sustainable work performance in the future. However, staff in Green Care Farms experienced better work satisfaction (mean = 4.28; 95 % CI = 4.14-4.43) than those working in traditional nursing homes (mean = 3.67; 95 % CI = 3.54-3.8). Furthermore, they reported more work resources, more vitality, better recovery after work, and a better team climate than staff in traditional nursing homes. CONCLUSIONS:Knowing that work dissatisfaction, stress and burnout are predictors for staff turnover, the findings suggest that elements from the Green Care environment might provide a healthier work environment for staff compared to traditional nursing homes. More research is needed on these elements, to guide other nursing homes to improve their work environment.

AIM:This study examines the moderating role of specific job resources in the association between job demands, vigour, sustainable performance and fatigue in nursing home staff. DESIGN:A multi-location cross-sectional survey study in line with the STROBE guidelines. METHODS:Online self-completion questionnaires were distributed in the Summer of 2022. A total of 667 healthcare employees from 24 nursing home locations in the Netherlands participated in this study. Data were analysed using hierarchical multiple regression analysis. RESULTS:Job resources were able to moderate the relation between job demands on the one hand, and vigour, sustainable performance and fatigue on the other. Regression analyses revealed that high cognitive job resources moderated (i.e., strengthened) the positive association between cognitive job demands and successively cognitive liveliness, physical strength and sustainable performance. Furthermore, high emotional job resources moderated (i.e., buffered) the positive relation between emotional job demands and emotional and cognitive fatigue, respectively. CONCLUSIONS:It can be concluded that job resources are crucial for nursing home staff to deal with their high job demands. Maintaining a healthy balance between job demands and sufficient, matching, job resources to promote vigour and sustainable performance, as well as to prevent fatigue of staff, seems to be important. IMPLICATIONS FOR THE PROFESSION:There is an urgent need to train nursing home staff to cope better with increasing job demands. Because job demands cannot be reduced in many situations, this study revealed that the idea of boosting job resources instead is appealing to both staff and managers. PATIENT OR PUBLIC CONTRIBUTION:Dutch healthcare staff from 24 nursing home locations were involved in this study by responding to the online survey.

AIM:The aim of this study is to explore how students experience learning in a hybrid learning environment in a nursing home setting and their perceptions of relationship-centred care. BACKGROUND:Nursing homes are undergoing a culture shift from task-centred care to person- and relationship-centred care, requiring a different approach to how nursing home staff work and are educated. Hybrid learning environments aim to educate professionals who continuously work on their professional development by integrating and merging learning and working to facilitate the culture shift. DESIGN:An exploratory qualitative study design was used. The setting were nursing home wards organised according to a hybrid learning environment located in the Netherlands. Participants were students in two-year training for nurse assistants, three-year training for certified nurse assistants, or four-year training for vocationally trained registered nurses. Data were collected through semi-structured interviews and focus groups. Data were analysed using direct content analysis. RESULTS:Analysis revealed three themes regarding how students experienced learning in the hybrid learning environment: 1) design of the learning process, 2) disconnection between working and learning and 3) learning resources. Regarding how learning in the hybrid learning environment influences students' perceptions of relationship-centred care analyses revealed two themes: 1) recognising the essence of relationship-centred care and 2) overstaffing and student-resident interaction. CONCLUSIONS:The hybrid learning environment in a nursing home setting remains underdeveloped. By considering some improvement points (e.g., clarity of the role of work supervisor and students' awareness of learning while executing daily tasks), the hybrid learning environment can promote a shift from working task-centred to working relationship-centred. Additionally, students must grasp the essence of the concept of relationship-centred care and need support in developing reflection skills to provide it.

BackgroundMany long-term care facilities in the United States face significant problems with nurse retention and turnover. These challenges are attributed, at least in part, to moral distress and a negative nurse practice environment.ObjectiveThe purpose of the study was divided into two parts: first, to investigate the relationships among nurse practice environment, moral distress, and intent to stay; second, to explore the potential mediating effect of the nurse practice environment on the intent to stay among those with high levels of moral distress.DesignThis study was a descriptive, cross-sectional survey using targeted sampling.ParticipantsA total of 215 participants completed the surveys. Participants were nationally representative of long-term care nurses by age, years of experience, employment status, and type of health setting.MethodsThis study was an online national survey of long-term care nurses' perceptions of their intent to stay, moral distress level (Moral Distress Questionnaire), and nurse practice environment (Direct Care Staff Survey). Structural equation modeling analysis explored intent to stay, moral distress, and the nurse practice environment among long-term care nurses.ResultsThe mean moral distress score was low, while the mean nurse practice environment and intent to stay scores were high. Moral distress had a significant, moderately negative association with the nurse practice environment (beta = -0.41), while the nurse practice environment had a significant, moderately positive association with intent to stay (beta = 0.46). The moral distress had a significant, moderately negative association with intent to stay (beta = -0.20). The computed structural equation modeling suggested a partially mediated model (indirect effect = -0.19, p = 0.001).ConclusionSince the nurse practice environment partially mediates the relationship between moral distress and intent to stay, interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession.Clinical RelevanceOur study demonstrated that the nurse practice environment mediates moral distress and intent to stay.Interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession.

Abstract Background The scarcity of resources in long-term care demands more than ever that organizations in this sector are prepared for innovation to ensure affordable access to care for older adults. Organizations that are innovation ready are more capable of implementing innovations. Therefore, a better understanding of how stakeholders view innovation readiness in long-term care can provide actionable strategies to enhance their innovative capacities. ‘Innovation readiness’ indicates the level of maturity of an organization to succeed in any type of innovation. Our study explored perspectives among stakeholders on what they consider important for organizations in long-term care for older adults to be innovation ready. Methods Q-methodology, a mixed-methods approach, was used to investigate the perspectives of 30 stakeholders connected to long-term care for older adults in the Netherlands: academics, (top)management, innovation managers, client representatives, staff, and consultants. Stakeholders were asked to rank 36 statements on innovation readiness on importance. Statements were extracted from literature research and qualitative interviews. Thereafter in the post-interviews stakeholders explained their ranking and reflected on the statements. By-person factor analysis was used to identify clusters in the ranking data. Together with the qualitative data from follow-up interviews, these clusters were interpreted and described as perspectives of the stakeholders. Results Four distinct perspectives were identified on what they consider important for innovation readiness in long-term care: (1) ‘supportive role of management’ (2) ‘participation of the client (system) and employees’ (3) ‘setting the course and creating conditions’ and (4) ‘structuring decision-making, roles and responsibilities’. The 36 statements represented a complete overview of innovation readiness factors. No additional innovation factors to those previously identified in the literature emerged from the interviews. Conclusions Stakeholders agree that all factors contributing to innovation readiness of long-term care organizations for older adults are accounted for. The variety of perspectives on what is most important shows there is no agreement among stakeholders about a fixed route toward innovation readiness. However, stakeholders suggested a temporal order of the innovation readiness factors, preferably starting with formulating the innovation ambition. This study’s results could contribute to developing an assessment tool to deliver a structured approach for managers to assess the innovation readiness of their organization. Registration The study received ethical approval on April 13, 2022 from the Medical Ethics Board of Zuyderland Medical Center in the Netherlands with the number METCZ20220036.

Background Presenteeism, a phenomenon in which employees attend work despite physical or mental limitations, is prevalent among nurses and has negative implications for patients, healthcare organizations, and nurses themselves. Objective We aimed to present the current state of knowledge on presenteeism in nursing, focusing on prevalence rates, reasons, influencing factors, and consequences. Design We performed an integrative review. Methods We searched databases for studies on presenteeism in the nursing workforce published between 2018 and 2024. This review included 44 studies that met the inclusion criteria, specifically 38 quantitative studies, 4 qualitative studies, and 2 reviews. Results The results indicated that the prevalence of nurses exhibiting symptoms of presenteeism varies between 32 % and 94 %. The influencing factors include workload, team culture, age, childcare responsibilities, job insecurity, and leadership practices. Presenteeism can lead to significant individual and organizational consequences such as increased health issues among nurses, decreased quality of patient care, and higher healthcare costs. Most studies were focused on nurses who work in hospitals, with only one study addressing nurses who work in nursing homes. Conclusion This review highlights the high prevalence of presenteeism among nurses and its multifaceted causes and effects. This underscores the need for increased awareness and training of both nurses and management teams regarding the importance of addressing presenteeism. Further research is needed in settings such as nursing homes and outpatient care to understand the unique challenges and impacts in these environments. Efforts should focus on improving working conditions, fostering supportive organizational cultures, and implementing effective leadership practices to mitigate the negative effects of presenteeism.

Abstract Increasing innovation readiness of long-term care organizations is vital to ensure future provision and affordability of care delivery. Against this background, there is a need to obtain more insight into the factors that may lead to innovation readiness of long-term care organizations. Therefore, we conducted a scoping review and an interview study. The scoping review was based on the framework from Arksey and O’Malley and included 44 studies. The interview study was conducted with 16 stakeholders having a professional role in long-term care for older adults in the Netherlands: academics, (top)management, innovation managers and consultants. Based on the results of both studies, we propose a framework of factors contributing to innovation readiness. The framework consists of five main factors enabling innovation readiness of long-term care organizations for older adults: 1) strategic course for innovation 2) innovation journey 3) leadership for innovation 4) learning for innovation and 5) innovative organizational culture. The collective findings support the notion that for innovation readiness the interplay of main factors is vital and benefits from an approach at the individual, team, organizational and inter-organizational levels. Furthermore, our findings indicate that some factors might be more conditional and other factors might play a more supportive role. Research into innovation readiness of health care organizations is a rather new field. Further research directed toward a framework for innovation readiness might deliver a structured approach for managers of long-term care organizations to embed and assess innovation readiness.

Background Licensed nurses working in long-term care facilities experience ethical challenges if not resolved can lead to moral distress. There is a lack of an English-language validated tool to adequately measure moral distress in the long-term care setting. Aims To describe the modification and psychometric evaluation of the Moral Distress Questionnaire. Methods Instrument development and psychometric evaluation. Internal consistency using Cronbach’s α to establish reliability was conducted using SPSS version 27.0 while SPSS Amos version 27.0 was used to perform a confirmatory factor analysis of the Moral Distress Questionnaire Participants A national sample of US-licensed nurses who provided direct resident care in long-term care settings were recruited via a targeted sampling method using Facebook from 7 December 2020 to 7 March 2021. Ethical Consideration The study was approved by the university’s human research protection program. Informed consent was provided to all participants. Results A total of 215 participants completed the surveys. Confirmatory analysis indicated that the 21-item scale with a 4-factor structure for the Moral Distress Questionnaire model met the established criteria and demonstrates an acceptable model fit (CMIN/DF = 2.0, CFI = 0.82, TLI = 0.77, RMSEA = 0.07). Factor loadings for each item depict a moderate to a strong relationship (range 0.36–0.70) with the given underlying construct. Cronbach’s α coefficient was 0.87 for the overall scale and 0.60–0.74 for its subscales which demonstrate good reliabilities. Discussion This is the first English-language validated tool to adequately measure moral distress in the long-term care setting experienced by US long-term care nurses. This reliable and well-validated tool will help identify moral distress situations experienced by US long-term care nurses. Conclusion The modified 21-item English version of the Moral Distress Questionnaire is reliable tool that demonstrates good psychometric properties to validly measure sources of moral distress among direct resident care nurses.

BACKGROUND:Nursing homes were disproportionally affected by the COVID-19 pandemic. Vaccination was considered critical for the normalization of daily live of nursing home residents. The present study investigates the impact of the prolonged COVID-19 pandemic and the effect of vaccinations on the daily lives of residents and staff in Dutch nursing homes.SETTING AND PARTICIPANTS:The sample consisted of 78 nursing homes that participated in the Dutch national pilot on nursing home visits after the COVID-19 pandemic. One contact person per nursing home was approached for participation in this mixed-methods cross-sectional study.METHODS:Data was collected twice through questionnaires in April and December 2021. Quantitative questions focused on recent COVID-19 outbreaks, progress of vaccination, effects of vaccination on daily living in the nursing home and burden experienced by staff. Open-ended questions addressed the prolonged effect of the pandemic on residents, family members and staff.RESULTS:The overall vaccination rate of residents across nursing homes appeared to be high among both residents and staff. However, daily living in the nursing home had not returned to normal concerning personal interactions, visits, the use of facilities and work pressure. Nursing homes continued to report a negative impact of the pandemic on residents, family members and staff.CONCLUSIONS:Restrictions to the daily lives of residents in nursing homes were stricter than restrictions imposed on society as a whole. Returning to a normal daily living and working was found to be complex for nursing homes. With the emergence of new variants of the virus, policies strongly focusing on risk aversion were predominantly present in nursing homes.

Abstract Aims To gain insight into how direct care staff in Dutch nursing homes experienced work during the COVID‐19 pandemic. Design A qualitative study consisting of semi‐structured, face‐to‐face focus groups was conducted using “the active dialogue approach”. Methods Participants (n = 29) were care staff from four care teams at Dutch nursing homes. Teams were selected based on the number of COVID‐19 infections amongst residents. Data were analysed with conventional content analysis. Results Themes emerging from the data were the loss of (daily) working structure, interference between work and private life for direct care staff, the importance of social support by the team and a leader, and the effects on relationship‐centred care of the measures. Results offer concrete implications for similar situations in the future: psychological support on‐site; autonomy in daily work of care staff; an active role of a manger on the work floor and the importance of relationship‐centred care.

Background Increasing innovation readiness of healthcare organizations is necessary to meet upcoming challenges, including population aging, staff shortages and reduced funding. Health care organizations differ in the extent to which they are innovation ready. This review aims to clarify the concept of innovation readiness and identify which factors contribute to innovation readiness in health care organizations. Methods A scoping review was conducted based on the framework from Arksey and O’Malley. PubMed/MEDLINE, CINAHL and Web of Science were searched for studies that (a) aimed to contribute to scientific knowledge about innovation readiness of health care organizations, (b) were peer-reviewed, (c) reported empirical data and (d) were written in English, Dutch or German. Factors researched in the included studies were bundled into 4 overarching main factors and 10 sub-factors. Results Of the 6,208 studies identified, 44 were included. The majority ( n = 36) of the studies had been conducted since 2011 and almost half of the studies ( n = 19) were performed in hospitals. Of the 44 studies, 21 researched factors contributing to innovation readiness in the implementation stage of the innovation process. The authors used a variety of words and descriptions addressing innovation readiness, with hardly any theoretical frameworks for innovation readiness presented. Four main factors and 10 sub-factors contributing to the innovation readiness of health care organizations were summarized: strategic course for innovation, climate for innovation, leadership for innovation and commitment to innovation. Climate for innovation ( n = 16) was studied the most and individual commitment to innovation ( n = 6) was the least studied. Conclusion Our study identified four main factors contributing to the innovation readiness of health care organizations. Research into innovation readiness of health care organizations is a rather new field. Future research could be directed towards defining the concept of innovation readiness and the development of a framework for innovation readiness. More understanding of the interplay of factors contributing to innovation readiness in all stages of the innovation process and in diverse health care settings can support health care managers to structurally embed innovation. This review contributes to the first stage of theory building on factors contributing to innovation readiness of health care organizations.

Eine höhere Personalausstattung oder der Einsatz akademisch qualifizierter Pflegekräfte werden häufig als Allheilmittel für die Qualitätsverbesserung in der stationären Langzeitpflege gesehen. Mehrere internationale Studien deuten jedoch an, dass der Besetzungsgrad und das Ausbildungsniveau von Mitarbeitenden keine alleinigen Garanten für gute Qualität sind. Die Kompetenzen, Aufgaben und Tätigkeitsfelder sowie das Verhalten des Personals beeinflussen den Zusammenhang zwischen dem Personaleinsatz und der Pflegequalität. In diesem Kapitel werden vielversprechende Personaleinsatzmaßnahmen und Personalentwicklungskonzepte zur Qualitätsverbesserung in der stationären Langzeitpflege präsentiert.