Creating In-Services Utilizing the 4Ms Framework: The Development of a Guide for Nursing Home Professionals

Age-Friendly Health Systems use the 4Ms Framework to improve care for older adults. The 4Ms Framework includes four evidence-based principles to provide high-quality care: What Matters, Medication, Mentation, and Mobility. While the 4Ms Framework has been successful, many healthcare professionals are unfamiliar with it. This project developed a guide that aids nursing home professionals in creating effective in-services that integrate the 4Ms Framework. The project used two conceptual frameworks during guide development and evaluation: Adult Learning Theory and the Plan-Do-Study-Act (PDSA) Cycle. The guide was developed using the Google Sites platform. Two rounds of feedback were collected from three professionals with experience in Age-Friendly Health Systems and/or nursing homes to evaluate the guide. Feedback was separated into four categories: Valuable features, missing features, readability, and suggestions. Reviewers identified valuable features, such as examples in the guide that related in-service topics to the 4Ms. One missing feature was the absence of specific nursing home departments in a section where nursing home departments were listed. Positive readability components were identified, such as the guide being "clear and engaging" and "visually appealing, but there were also negative readability components, like spacing and indentation errors. Suggestions included adding a short overview of Adult Learning Principles to improve guide content. The feedback provided was used to revise the guide. Ideas for disseminating the guide include emailing academic and long-term care professionals or presenting the guide to educational organizations. Sending academic and nursing home professionals a link to the guide or presenting the guide to an educational organization may expand the reach of the guide. While the guide was created for nursing homes, it has the potential to benefit other long-term care settings, such as assisted living facilities. Future testing may include gathering feedback from a larger group of nursing home professionals to ensure it benefits the nursing home setting.