DIRECTORS OF NURSING, ADAPTIVE LEADERSHIP, AND PERSON-DIRECTED ASSESSMENT AND CARE PLANNING

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DIRECTORS OF NURSING, ADAPTIVE LEADERSHIP, AND PERSON-DIRECTED ASSESSMENT AND CARE PLANNING

K. Corazzini ¹ , R. Anderson ² , E. McConnell ¹ , K. Scales ¹ , Y. Song ¹ , B. Kang ¹ , J. Meyer ⁴ , M. Lepore ³ , 1. Duke University, Durham, North Carolina, 2. University of North Carolina, Chapel Hill, North Carolina, 3. RTI International, Washington, District of Columbia, 4. City University London, London, United Kingdom

Directors of Nursing (DONs) are the administrative nurses in nursing homes and guide nursing and other clinical staff to implement person-directed assessment and care planning (PDAC). In this qualitative study, we examine DON strategies to implement PDAC and perceived progress in implementation. Interviews were conducted with DONs from homes diverse in profit status, size and region (N=10 homes). The adaptive leadership framework (Anderson et al 2015) informed template organizing analysis (Crabtree & Miller 1999), to identify technical and adaptive challenges and strategies to address these challenges. DONs describing primarily technical challenges to implementation focused on MDS modifications and compliance with new procedures; this approach co-occurred with a sense that implementation was largely complete. DONs describing primarily adaptive challenges to implementation focused on staff development to recognize resident personhood, and then to foster mutual respect and understanding. Findings are discussed in relation to how to support DONs for effective administrative leadership.