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A Need for Strong Partnerships for Successful Nursing Home Research.

In 2012, there were approximately 15,700 nursing homes (NHs) in the United States, with 1,383,700 residents (Harris-Kojetin, Sengupta, Park-Lee & Valverde, 2013). It is projected that by 2030 one in five Americans will be 65 or older (Colby & Ortman, 2015); thus, there is anticipation of an increased need for long-term care services, including NH care, to support these older adults. Due to limited research and evidence focusing on older adults residing in NHs, there continues to be a need for well-designed research studies and academic nurse researcher–NH facility partnerships (Kovach, 2015; Morrison, 2009). Research is essential for improving the quality of care delivered within NHs and positively affecting quality of life for residents. Some attention to the barriers to conducting research, particularly intervention studies, within NHs has been documented, such as staff support and cooperation, staff turnover, changes in ownership and leadership over the course of a study, retaining NH research sites through completion of a study, quality of data sources (e.g., MDS data), resident recruitment, and obtaining informed consent (Buckwalter et al., 2009; Hall, Longhurst, & Higginson, 2009; Maas, Kelley, Park, & Specht, 2002; Mentes & Tripp-Reimer, 2002; Tilden, Thompson, Gajewski, Buescher, & Bott, 2013). However, a significant barrier that has gained little attention is the challenge of gaining entrée into NHs to conduct research. Gaining entrée into NHs has been reported most successful through investigators’ prior contacts, a respectful approach toward NH administration, and a research design that avoids clinical staff burden (Hanson, Gilliam, & Lee, 2010). However, for some researchers, difficulty making initial connections with NH administrators and/or directors of nursing (DONs) to schedule time to discuss research proposals and lack of internal communication between administrators and DONs regarding initial contact from investigators continue to be problems with gaining entrée (Garcia, Kelley, & Dyck, 2013). Difficulty gaining entrée into NHs was the main barrier in commencing our observational, descriptive dissertation studies. Under the guidance and support of our mentors and through their connections, we easily obtained letters of support from corporate NH administrators supporting a partnership with us as research sites for our studies. Despite these approvals from the NH offices and research committees to move forward with our individual research proposals, we still faced challenges of gaining access to commence data collection from the onsite gatekeepers of the individual NH facilities. We both worked in NHs until matriculation into doctoral education, which influenced our research questions. Despite our previous connections to NHs as employees, having to relocate for our doctoral education created geographical barriers to contacting our previous places of employment to secure research partnerships. Based on our recent experiences, including challenges and successes to gaining NH entrée, and reflection on this topic, we have several recommendations on how gerontological nurses can work to improve partnerships between NH administration and nurse researchers.