The quality of feeding assistance care practices for long-term care veterans: implications for quality improvement efforts.

The primary purpose of this study was to determine the quality of feeding assistance care and identify areas in need of improvement for a sample of long-term care veterans. A secondary purpose was to compare these findings with the results of previous studies in community facilities to determine ways in which the VA sample might differ. A repeated measures observational study was conducted in two VA facilities with 200 long-stay residents. Research staff conducted standardized observations during and between meals for 3 months. There was a trend for better feeding assistance care quality during meals in the VA sample, but there were still multiple aspects of care in need of improvement both during and between meals. Higher licensed nurse staffing levels in the VA should enable effective supervision and management, but observation-based measures of care quality are necessary for accurate information about daily feeding assistance care provision.

Whom do veteran nursing home residents prefer to talk to about satisfaction with care?: implications for nursing staff.

The purpose of this study was to determine whom residents in U.S. Department of Veterans Affairs (VA) nursing homes prefer to talk to about their quality of care. A total of 127 participants in three VA facilities completed a structured, in-person interview. Nearly half (47.6%) reported that they prefer talking with facility staff about their quality of care, with the most preferred staff being licensed nurses and physicians. However, 26% reported being hesitant to express complaints for fear of reprisal. Participants also reported being least comfortable talking to direct care staff (nurse aides) if they saw another resident being mistreated. These findings suggest that licensed nurses and primary care professionals, both of whom are in frequent contact with residents, should routinely ask residents questions about their quality of care so that nursing home residents have ample opportunity to express concerns. Finally, asking satisfaction questions routinely may also enable facilities to address problems as they occur.