The impact of an educational intervention on nursing staff ratings of quality of older people care: A prospective, controlled intervention study

Background: Low competence levels among nursing staff have been associated with lower quality of older people care. However, interventions to improve staff competence have not always been evaluated for their impact on the quality of older people care. An educational intervention in the form of a workplace "toolbox" was shown to have positive effects oil nursing staff competence and work satisfaction, but had no effects on care recipients' or their family members' ratings of quality of care. It was therefore of interest to investigate whether the intervention had any effect on nursing staff ratings of quality of care. Objectives: The aim of the Study was to evaluate the possible effects of an educational "toolbox" intervention on nursing staff ratings of quality of care. Design: A prospective, non-randomized, controlled intervention. Participants and settings: Nursing staff in two municipal older people care organizations in Sweden. Methods: Practical instruments and educational materials for improving staff competence and work practices were collated in a workplace "toolbox" and introduced in the intervention organization in February of 2003. Nursing staff ratings of quality of care were measured pre- and post-intervention by questionnaire and compared to nurses' quality ratings in a reference organization, where no toolbox was introduced. Results: Nursing staff ratings of quality of care improved significantly over time in the intervention organization. No improvements were found in the reference organization. Conclusions: Compared to a reference municipality, nursing staff ratings of quality of care improved in the organization where the toolbox was introduced. Competence development Measures may have a positive impact on nursing staff's ratings of quality, but not on the quality ratings of care recipients and their family members. Further research is needed to understand the differences in these stakeholders' perceptions. (C) 2008 Elsevier Ltd. All rights reserved.