The prevalence of nursing home (NH) residents with obesity is rising. Perspectives of NH Directors of Nursing (DONs) who oversee care trajectories for residents with obesity is lacking. This study aimed to describe the experiences of NH DONs regarding care and safety for NH residents with obesity. An adapted version of Donabedian's structure-process-outcome model guided this qualitative descriptive study. Semi-structured interviews were conducted with 15 DONs. Data were analyzed using directed content analysis, and findings are presented under the model's constructs. We learned that admission decisions for NH referrals of patients with obesity are complex due to reimbursement issues, available space and resources, and resident characteristics. DONs described the need to coach and mentor Certified Nursing Assistants to provide safe quality care and that more staff education is needed. We identified novel findings regarding the challenges of short-term residents’ experience transitioning out of care due to limited resources.

养老院 (NH) 肥胖患者的患病率正在上升。缺乏监督肥胖居民护理轨迹的 NH 护理主任 (DON) 的观点。本研究旨在描述 NH DON 在 NH 肥胖居民的护理和安全方面的经验。Donabedian 的结构-过程-结果模型的改编版本指导了这项定性描述性研究。对 15 个 DON 进行了半结构化访谈。使用定向内容分析对数据进行分析，并在模型的结构下呈现调查结果。我们了解到，由于报销问题、可用空间和资源以及居民特征，肥胖患者的 NH 转诊入院决定很复杂。DON 描述了指导和指导认证护士助理以提供安全优质护理的必要性，并且需要更多的员工教育。我们确定了关于短期居民因资源有限而脱离护理的经历挑战的新发现。