Measurement of nursing home culture change: Systematic review

Diana L. Sturdevant, Christine A. Mueller, Kathleen C. Buckwalter

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations


Nursing home culture change (NHCC) aims to change the way care is provided in nursing homes. Valid and reliable measures are needed to evaluate the impact of NHCC on outcomes. The current systematic review provides an overview of instruments designed to measure NHCC and criteria for others to evaluate and choose instruments according to their own purpose. Ten instruments were identified that measure NHCC on an organizational level. Lack of development description hindered their assessment, and studies examining the relationship between NHCC and outcomes are rare. A common limitation of the instruments reviewed was the lack of psychometric testing; thus, their validity and reliability need further exploration.

Original languageEnglish (US)
Pages (from-to)103-115
Number of pages13
JournalResearch in Gerontological Nursing
Issue number2
StatePublished - Mar 1 2018

Bibliographical note

Funding Information:
Dr. Sturdevant was supported in the development of this manuscript by a Donald W. Reynolds Predoctoral Scholarship, Donald W. Reynolds Center of Geriatric Nursing Excellence, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. The remaining authors have disclosed no potential conflicts of interest,financial or otherwise. Address correspondence to Diana L. Sturdevant, PhD, GCNS-BC, APRN, Project Manager, Nursing Home Quality Improvement Projects, Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, 1192 Compelube Road, McAlester, OK 74501; e-mail: Received: August 27,2017; Accepted: November 13,2017 doi:10.3928/19404921-20171205-01

Funding Information:
Ten instruments were found to meet inclusion criteria for the current review: Artifacts of Culture Change (ACCT; Bowman & Schoeneman, 2006), Commonwealth Fund Survey (CFS; Doty, Koren, & Sturla, 2008), Components of NHCC Survey (CNHCCS; Mueller, 2007), Culture Change Assessment Tool (CCAT; Colorado Foundation for Medical Care, 2008), Culture Change Indicator Survey (CCIS; Institute for Caregiver Education, 2014), Culture Change Staging Tool (CCST; Grant, 2008), Culture Change Scale (CCS; Grant, 2008), Kansas Culture Change Instrument (KCCI; Bott et al., 2007), Long-Term Care Improvement Guide Self-Assessment Tool (LTCIGSAT; Frampton et al., 2010), and the Person Directed Care (PDC; White, Newton-Curtis, & Lyons, 2008).

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