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Western Journal of Nursing Research
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An Exploration of Nursing Home Organizational Processes

Sarah Forbes-Thompson

Byron Gajewski

University of Kansas School of Nursing, Kansas City

Jill Scott-Cawiezell

University of Missouri Sinclair School of Nursing, Columbia

Nancy Dunton

University of Kansas School of Nursing, Kansas City

The purpose of this study is to explore the relationship between nursing home staffs' perceptions of organizational processes (communication, teamwork, and leadership) with characteristics (turnover, tenure, and educational preparation) of the nursing home administrator (NHA) and director of nursing (DON). NHAs and DONs rate communication, teamwork, and leadership significantly higher than direct care staff do (registered nurses, licensed practical nurses, certified nurse aides [CNAs]). CNAs have the lowest ratings of communication and teamwork. Turnover of the NHA and DON is significantly and negatively associated with communication and teamwork. Two thirds of DONs surveyed hold less than a baccalaureate degree; this does not influence staffs' ratings of communication, teamwork, and leadership. Findings from this study highlight the need to explore differences in perceptions between administrative and direct care staff and how these may or may not influence staff development and quality improvement activities in nursing homes.

Key Words: nursing homes • leadership • communication • teamwork • turnover

Western Journal of Nursing Research, Vol. 28, No. 8, 935-954 (2006)
DOI: 10.1177/0193945906287053
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