Pervasive risk avoidance: Nursing staff perceptions of risk in person-centered care delivery

Honoring preferences is a significant facet of person-centered care (PCC). However, nursing home (NH) staff perceptions of the risks that residents’ preferences may have on resident safety and health can create a barrier to delivering PCC. This study utilized an innovative sequential focus group methodology to gain insight into staff perceptions of honoring risky preferences. Results indicated that pervasive, risk-avoiding attitudes are present throughout the organization, during care, and when attempting to honor resident preferences. “Risk-phobic” attitudes, apparent at all levels within NHs as well as written into organizational policies, may impede the delivery of PCC. The authors suggest that these attitudes can be mitigated by improving staff sense of agency while supporting appropriate risk-taking for residents, which can promote more PCC.