Building and sustaining a positive organisational culture in aged care in rural and regional Australia: Registered nurses’ perspectives

Objective: This presentation reports on the emerging themes from a qualitative study privileging the voices of registered nurses (RNs) employed in residential and community aged care in rural and regional Australia. Positive organisational culture in the aged care sector will become increasingly important as increasing numbers of older Australians access residential and community-based services. Method: Fourteen RNs employed in diverse roles in the aged care sector in regional and rural Australia within the last 7 years were interviewed. Appreciative inquiry, which focusses on identifying strategies for positive change, informed the interview process. Results: The participants identified that to improve provision of complex care to older people across aged care environments, RNs should be supported to work to their full gerontological scope of practice, including in advance practice and in nurse practitioner roles. They identified a lack of congruence between the values of board and executive management and staff as a critical issue. They argued that staff must be engaged with developing organisational values and embodying them in their work so that the complexity and challenges of their contribution are recognised. The participants believed that this approach would facilitate staff feeling valued, teams working effectively and improving overall organisational culture. Conclusion: This study has highlighted that organisational cultures in aged care do not support nurses of all grades working to full scope of practice. Collaboration between nursing peak bodies and regulatory authorities must continue to refine structures that support quality care delivery and an organisational culture reflective of staff capacity and capability. Further research is required to review, develop, and integrate contemporary nurse-led models of care across aged care settings with a view to advancing policy and practice in the sector.