Quality of care plans in long‐term care facilities for the older persons—How well is information from RAI assessments utilised in care planning?

Abstract

Background: In Finland, care plans at long-term care facilities (LTCF) for the older persons should be based on information from Resident Assessment Instrument (RAI) assessments and the principles of structured data. Hence, managers are responsible for ensuring that the RAI system is used to a satisfactory extent, the provided information is used in care planning, and that staff members are competent at composing high-quality care plans. Aim:To explore the congruence between first-line managers' assessments of the extent to which care plans include RAI information and separately observed RAI-related contents of care plans. Methods:The study was based on a descriptive, cross-sectional survey of first-line managers (n = 15) from three LTCF organisations and a randomly selected sample of care plans (n = 45) from two LTCF organisations in Finland. Manager responses and analysis of care plans were reviewed at a general level. The data were gathered in 2019 and analysed using statistical methods and content analysis.Results: First-line managers' assessments of the extent to which their units' care plans included RAI information did not match the observed care plan contents. The care plan analysis revealed that managers significantly overestimated the extent to which care plans included RAI-related content. Conclusion:Managers at LTCF organisations need more training to be able to sufficiently support their staff in using RAI information to draft high-quality care plans.Implication for practice: Care plans must include a higher level of information related to RAI assessments. To develop competencies in drafting high-quality care plans, training related to RAI information utilisation on all aspects of the care plan should be emphasised and training should be provided to first-line managers and more broadly across the nursing staff.

Implementation leadership of the Resident Assessment Instrument in healthcare services for older people: An interview study of specialists

“…Their crucial role in implementation has also been underscored in previous studies (Meza et al., 2021; Williams et al., 2020). However, other Finnish studies revealed some deficiencies in frontline leaders' RAI competencies (Kuha et al., 2022; Niemelä et al., 2018). As noted in both this study and Toye' (2016), these deficiencies may hinder the instrument's implementation.…”

“…Conversely, a lack of leader participation (de Stampa et al., 2018), knowledge, understanding and support has been found to hinder its implementation (Toye, 2016). However, deficiencies have been found in professionals' and leaders' RAI competencies in Finland (Kuha et al., 2022; Niemelä et al., 2018).…”