The Services of A Gerontological Clinical Nurse Specialist Can Improve the Quality of Care in California Nursing Homes

Improving the quality of care in California nursing homes is one of the most pressing issues facing our state today. Yes, it’s even more important than our budget problems or who we elect to lead us in the political arena. Regardless of our social backgrounds or political opinions, none of us can escape the fact that as we age, all of us may be faced with the need to seek 24 hour skilled nursing care. This is a difficult reality facing many Californians today, as they grapple with not only selecting an appropriate nursing home for themselves or their loved ones, but also with ensuring that once there, the proper care and supervision is provided.
More, therefore, must be done to ensure significant improvements in the quality of care provided in California nursing homes, and particularly in nursing homes in Torrance, Long Beach and Santa Ana, given the significant rate of deficiencies issued to nursing homes in those areas in the last several years by the California Department of Public Health.
A recent study published in the August 2011 volume of the Journal of the American Medical Directors Association entitled “Randomized Clinical Trial of a Quality Improvement Intervention in Nursing Homes” (available for purchase online,) sheds further light on the various options at the disposal of nursing home owners and operators to improve the quality of care they deliver to our elderly, should they choose to avail themselves of such options. The authors designed a study to determine which of the following two options is more effective in improving clinical practices and resident outcomes: comparative quality performance information and education programs about quality improvement, or a quality improvement intervention that blends expert clinical consultation with existing nursing staff.
The results revealed that although there are no significant differences between the two groups, the outcomes of residents in nursing homes who made use of the clinical consultation showed improvements in Quality Indicators measuring falls, behavioral symptoms, little or no activity, and pressure ulcers.
The results suggest that simply giving comparative quality performance feedback and education are not enough to improve resident outcomes. Instead, nursing homes should seek out active clinical consultation by a gerontological clinical nurse specialist (GCNS) to improve clinical practice and care.
The findings of the study are consistent with California law regulating skilled nursing facilities, which mandates not only sufficient staffing in terms of numbers, but also in terms of the quality of the staff provided. It is insufficient to simply fill the nursing staff with certified nursing assistants (CNA) who do not have the training, education and expertise of licensed and registered nurses. It is clear that nursing homes can actually make an effort in improving clinical practices by putting these essential findings into practice.

Therefore, nursing home owners and operators should dedicate more resources to hiring a GCNS to provide consultation to the regular nursing staff delivering care to residents. A gerontological clinical nurse specialist can help improve the outcomes of pressure ulcer development, incontinence and aggressive behavior. Further, nursing homes should also have a well-developed comparative quality improvement system to improve resident outcomes. Nursing homes must hire more professional staff with leadership skills to implement the quality improvement programs effectively so as to provide better services to residents. With both clinical expertise and a strong quality improvement system in place, residents can receive better care and treatment from the nursing staff.


Unfortunately, many nursing home owners and operators in Torrance, Long Beach and Santa Ana do not utilize the wealth of knowledge and resources at their disposal to improve the quality and delivery of care to their residents. As a society, before placing our vulnerable loved ones in the custody of nursing homes, we must demand a higher standard of care and compassion for our elderly. If you or a loved one have suffered neglect and injury in a Torrance, Long Beach and Santa Ana nursing home, or in any nursing home in California, contact us today and we will not rest until we bring the responsible parties to justice.