Document Type


Date of Degree

Summer 2013

Degree Name

PhD (Doctor of Philosophy)

Degree In


First Advisor

Specht, Janet K

First Committee Member

Mobily, Paula

Second Committee Member

Herr, Keela

Third Committee Member

Ansley, Tim

Fourth Committee Member

Bern-Klug, Mercedes


This research used a case study approach to chronicle the process of seeking the American Nurse Credentialing Center's Pathway to Excellence in Long-Term Care designation in one Midwest community. The PTE-LTC practice standards framework guided the implementation of professional nursing practice which focused on a positive practice environment, shared decision-making, accountability for resident care, and the leadership development of nursing staff. These practice standards are outlined in the study and incorporated the major components necessary to implement Professional Nursing Practice and Shared Governance in long-term care.

The components of the designation process over a five-year period were documented and compared with other models of shared governance and professional practice supported in the literature. The study included a rich description of the structures and processes in place prior to the designation process and those developed during the process to operationalize the model. The methods which were used to accomplish these organizational changes are identified as well. In addition, the study reports on the effects of the model implementation on organizational, nursing, and resident measures.

The implementation of, and support for, a professional nursing practice role and environment in a nursing home was expected to improve both the quality of care and quality of life for older adults who live in the nursing home, as well as staff job satisfaction and retention of nursing staff.


designation, nursing, nursing homes, professional practice, quality


xi, 170 pages


Includes bibliographical references (pages 159-170).


Copyright 2013 Kimberly Michele Bergen-Jackson

Included in

Nursing Commons