A qualitative study explaining nurses' perceptions of quality care for older people in long-term care settings in Ireland.

AIM: The aim of this research was to explore nurses' perceptions of the attributes of quality care and the factors that facilitate or hinder high-quality nursing care in long-term care.

BACKGROUND: The quality of care for older people living in long-term care has been identified as an issue of concern in many nursing research studies. While many factors have been identified, it is difficult to determine key factors from current research.

METHOD: The study was a qualitative exploration of nurses' perceptions of quality care for older people and the factors that facilitate or hinder quality care. It involved 20 interviews with nurses. Respondents were asked to illustrate their accounts with examples from practice. This phase of the research was guided by the principles of hermeneutic phenomenology and the analysis process by Van Manen.

FINDINGS: The findings indicated that nurses perceived quality care for older people in Ireland as holistic, individualized and focused on promoting independence and choice. The research revealed, however, that care in many practice areas was not individualized, patient choice and involvement in decision making was limited and some areas engendered dependency. While staffing was identified as a factor which had an impact on the provision of patient choice, other issues, such as the motivation of staff, the role of the ward manager and the dominance of routine were also highlighted.

CONCLUSION: There is a need to review organizational approaches to care, develop patient centred approaches to care and provide educational support for managers.

RELEVANCE TO PRACTICE: This research focuses on care for older people; it helps practitioners identify key factors in the provision of quality care for older people living in long-term care.