title: Exploring nursing expertise in residential care for older people: a mixed method study.
abstract: OBJECTIVE
  To explore the expertise of Registered Nurses in residential care for older people.
  
  
  BACKGROUND
  As older people in residential care have many complex dependencies, nursing expertise is an essential component of care excellence. However, the work of these nurses can be invisible and, therefore, unrecognized. Thus, additional attention is required to illuminate such nursing expertise.
  
  
  METHODS
  A mixed method design was used in this study.
  
  
  METHODS
  The research took place in 2012 in the Republic of Ireland. Twenty-three case study nurses were recruited from nursing homes. Each case study nurse involved five data collection methods: shadowing, interview with a colleague, interview with a resident, a demographic profile and a director of nursing survey. The study was also informed by a modified focus group. Qualitative data were analysed using directed content analysis using a conceptual framework generated from the literature on nursing expertise. Quantitative data were analysed using SPSS and presented in descriptive statistics.
  
  
  RESULTS
  The findings from the case studies and the modified focus group are presented in seven themes, which represent nursing expertise in residential care of older people: transitions, context of the nursing home, saliency, holistic practice knowledge, knowing the resident, moral agency and skilled know how.
  
  
  CONCLUSIONS
  Nursing expertise in residential care of older people is a complex phenomenon which encompasses many aspects of care delivery in a person-centred framework. By rendering this expertise visible, the need for appropriate and adequate skill mix for a growing residential care population is presented.
authors.affiliation: School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland.
authors.forename: Amanda
authors.initials: A
authors.lastname: Phelan
authors.affiliation: Division of Nursing, School of Health Sciences Queen Margaret University Musselburgh East Lothian, UK.|Buskerud and Vestfold University College, Drammen, Norway.|University of Pretoria, South Africa.|Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Brendan
authors.initials: B
authors.lastname: McCormack
mesh_terms: D017144:Focus Groups; D006801:Humans; D007494:Ireland; D024802:Nurse's Role; D009735:Nursing Homes; D011795:Surveys and Questionnaires
keywords: art of nursing; case study research; long-term care; nursing home care; older people