Healthcare staff's experiences of implementing one to one contact in nursing homes

Abstract

Background: Person-centred care is often described as an ideal way of preserving vulnerable persons' wellbeing and dignity and an essential component of quality-care delivery. However, the staff find that making the care dignified is the most challenging issue, often because of effectivity, everyday stress and overload. In the interests of making the care more person-centred, systematic intervention involving 'one-to-one contact' (resident - carer) was trialled for 30 min twice a week over 12 months in two units in a nursing home in Eastern Norway.

Objectives: The aim of the study was to elicit healthcare staff's experiences of implementing 'one-to-one contact' between residents and carers in nursing homes.

Methods: The study has a grounded-theory inspired design. Two groups of health care staff were each interviewed three times. Data were collected over an 18-month period.

Ethical considerations: The study was approved by the Data Protection Official for Research under the auspices of the Norwegian Social Science Data Services.

Findings: The core category is 'One-to-one contact' at a nursing home is possible, but requires open-mindedness. The core category indicates that open-mindedness is required, since it does not take much for scepticism to take over and cause reversion to habitual practices. The category Expectant but Sceptical describes staff thoughts and experiences before the implementation phase got underway. The category Positive but Undecided describes staff experiences 6 months into the intervention and after 12 months.

Conclusions: This study has revealed that systematic 'one-to-one contact' between resident and carer in nursing home is achievable, and that such a simple action might be an important step towards achieving more person-centred care as the resident is seen more as a person. However, in order to make a more person-centred and dignified approach to care constant attentiveness and awareness is required, as there were ongoing factors counteracting it.

Keywords: Dignity; grounded theory; intervention; nursing homes; one-to-one contact; person-centred; staff.