Implementing Quality Improvement in Nursing Homes: Nurse Practitioner Perspectives on Barriers, Facilitators, and Lessons Learned.

Authors

Anna H Gallion, Isaac Schlotterbeck, Carole Bartoo, Jacy Weems, Tara B Horr, Kristina M Niehoff, Sandra F Simmons, Sunil Kripalani

Published in

Journal of nursing care quality. Nov 12, 2025. Epub Nov 12, 2025.

Abstract

Nursing homes (NHs) face persistent challenges implementing evidence-based quality improvement (QI). Many barriers were intensified during the COVID-19 pandemic.
To identify barriers and facilitators to nurse practitioner (NP)-led QI implementation in NHs and share lessons learned.
Fifty-six NHs in middle Tennessee were each assigned an NP mentor to support QI efforts during the COVID-19 pandemic. Structured qualitative interviews with project NPs identified barriers and facilitators to QI implementation using the Consolidated Framework for Implementation Research.
Facilitators included leadership engagement, QI champions, a supportive culture, and evidence strength. Barriers included low prioritization, limited resources, low staff efficacy, and adaptability challenges.
NP-led QI is feasible in NHs but requires leadership support, adequate staffing, and an organizational culture that values improvement.

PMID:
41232092
Bibliographic data and abstract were imported from PubMed on 14 Nov 2025.

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