题名

Nursing Staff Characteristics on Resident Outcomes in Nursing Homes

DOI

10.1097/jnr.0000000000000269

作者

Juh Hyun SHIN

关键词

nursing home ; quality of care ; administrator ; nursing management

期刊名称

The Journal of Nursing Research

卷期/出版年月

27卷1期(2019 / 02 / 01)

页次

1 - 9-008

内容语文

英文

中文摘要

Background: The outlook of administrative staff and registered nurses (RNs) plays a critical role in the management of nursing homes. No previous study has compared the outcomes of nursing homes with RNs on staff with those of nursing homes without RNs on staff in Korea. Purpose: The aim of this study was to investigate the association between nurse-led nursing homes, staff turnover, and resident outcomes in nursing homes in Korea. Methods: Using a cross-sectional design, 36 nursing homes with 30 or more beds participated. Primary data included 15 quality indicators. Results: Nursing homes with RNs had statistically significant better resident outcomes. RN turnover related positively to the prevalence of falls (β= 1.68, p < .05) and tube feeding (β= 1.71, p < .01) and negatively to incontinence (β= -1.53, p < .01). Nursing homes with RNs with tenures greater than 1 year had statistically significant lower prevalence of falls (β= -0.47, p < .05), incontinence (β= -0.45, p < .05), weight loss (β= -0.53 p < .05), and bed rest (β= -0.54, p < .01) and increased range of motion (β= -0.51, p G .05). Interestingly, having a nurse as a director for more than 1 year related negatively to the incidence of urinary tract infection (β= -0.56, p < .05) in residents. The rate of RN turnover was found to impact fall prevalence (β= 1.68, p < .05) and tube feeding (β= 1.71, p < .01) positively and to impact incontinence (β= -1.53, p < .01) negatively. Conclusions: Turnover of nursing home staff and length of tenure may contribute to the more effective management of nursing homes, higher-quality long-term care insurance, and RN-staffing-related laws. Assessing staff characteristics and the tenure of employees promotes the effective management of nursing homes.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. Adams, J. M.,Erickson, J. I.,Jones, D. A.,Paulo, L.(2009).An evidence-based structure for transformative nurse executive practice: The model of the interrelationship of leadership, environments, and outcomes for nurse executives (MILE ONE).Nursing Administration Quarterly,33(4),280-287.
  2. American Health Care Association. (2011). 2011 Staffing survey report. Retrieved from http://www.ahcancal.org/research_data/staffing/Documents/2011%20Staffing%20Survey%20Report.pdf
  3. American Nurses Association. (2017). Safe staffing literature review. Retrieved from http://nursingworld.org/SafeStaffingLiteratureReview
  4. Anderson, R. A.,Issel, L. M.,McDaniel, R. R., Jr.(2003).Nursing homes as complex adaptive systems: Relationship between management practice and resident outcomes.Nursing Research,52(2),12-21.
  5. André, B.,Sjøvold, E.,Rannestad, T.,Ringdal, G. I.(2014).The impact of work culture on quality of care in nursing homes-A review study.Scandinavian Journal of Caring Sciences,28(3),449-457.
  6. Blozik, E.,Born, A. M.,Stuck, A. E.,Benninger, U.,Gillmann, G.,Clough-Gorr, K. M.(2010).Reduction of inappropriate medications among older nursing-home residents: A nurse-led, pre/post-design, intervention study.Drugs & Aging,27(2),1009-1017.
  7. Brannon, S. D.,Kemper, P.,Heier-Leitzell, B.,Stott, A.(2010).Reinventing management practices in long-term care: How cultural evolution can affect workforce recruitment and retention.Generations,34(4),68-74.
  8. Castle, N. G.,Anderson, R. A.(2011).Caregiver staffing in nursing homes and their influence on quality of care: Using dynamic panel estimation methods.Medical Care,49(6),545-552.
  9. Castle, N. G.,Engberg, J.(2007).The influence of staffing characteristics on quality of care in nursing homes.Health Services Research,42(5),1822-1847.
  10. Castle, N. G.,Lin, M.(2010).Top management turnover and quality in nursing homes.Health Care Management Review,35(2),161-174.
  11. Decker, F. H.,Castle, N. G.(2009).The relationship of education level to the job tenure of nursing home administrators and directors of nursing.Health Care Management Review,34(2),152-160.
  12. Executive Search Solutions. (2011). Leadership turnover in long term care. Retrieved from http://www.essusa.net/pdf/NURSINGHOMELEADERSHIPTURNOVERESSWhitePaperFinal.pdf
  13. Harrington, C.(2005).Nurse staffing in nursing homes in the United States: Part II.Journal of Gerontological Nursing,31(3),9-15.
  14. Harvey, D.W.(2014).University of Phoenix.
  15. Kash, B. A.,Castle, N. G.,Phillips, C. D.(2007).Nursing home spending, staffing, and turnover.Health Care Management Review,32(3),253-262.
  16. Konetzka, R. T.,Stearns, S. C.,Park, J.(2008).The staffingoutcomes relationship in nursing homes.Health Services Research,43(3),1025-1042.
  17. Korean Ministry of Health and Welfare. (2013). Medical law. Retrieved from http://www.law.go.kr/DRF/lawService.do?OC=lrzh&target=law&MST=107499&type=HTML (Original work published in Korean)
  18. Korean National Health Insurance Corporation. (2013). Long term care insurance statistics (no. 11-B550928-000038-09). Retrieved from http://khiss.go.kr/board/bbs_seq=367&bbsid=B301&tname=MINBOARD358 (Original work published in Korean)
  19. Korean National Health Insurance Service. (2017). Judgment rating for long-term care insurance. Retrieved from http://www.nhis.or.kr/bbs7/boards/B0039/17025 (Original work published in Korean)
  20. Krause, M. R.(2012).Director of nursing current job tenure and past experience and quality of care in nursing homes.Health Care Management Review,37(1),98-108.
  21. Lee, G. H.,Lee, J. M.(2012).Impact of facility managers’ characteristics on their intention to introduce a unit care system.Health and Social Welfare Review,32(4),94-122.
  22. Lee, H. Y.,Shin, J. H.,Harrington, C.(2015).Comparing the nurse staffing in Korean and U.S. nursing homes.Nursing Outlook,63(2),137-143.
  23. Lerner, N. B.,Johantgen, M.,Trinkoff, A. M.,Storr, C. L.,Han, K.(2014).Are nursing home survey deficiencies higher in facilities with greater staff turnover.Journal of the American Medical Directors Association,15(2),102-107.
  24. Maenhout, B.,Vanhoucke, M.(2013).An integrated nurse staffing and scheduling analysis for longer-term nursing staff allocation problems.Omega,41(2),485-499.
  25. McGilton, K. S.,Bowers, B. J.,Heath, H.,Shannon, K.,Dellefield, M. E.,Prentice, D.,Mueller, C. A.(2016).Recommendations from the International consortium on professional nursing practice in long-term care homes.Journal of the American Medical Directors Association,17(2),99-103.
  26. National Law Information Center. (2015). Welfare of the Aged Act Article 22-1. Retrieved from http://www.law.go.kr/lsInfoP.do?lsiSeq=178901&efYd=20160101#AJAX (Original work published in Korean)
  27. Neylon, J.(2015).Nurse-led management of chronic disease in a residential care setting.Nursing Older People,27(9),22-26.
  28. Organisation for Economic Co-operation and Development(2011).Help wanted? Providing and paying for long-term care.
  29. Paek, S. C.,Zhang, N. J.,Wan, T. T.,Unruh, L. Y.,Meemon, N.(2016).The impact of state nursing home staffing standards on nurse staffing levels.Medical Care Research and Review,73(1),41-61.
  30. Rantz, M. J.,Hicks, L.,Grando, V.,Petroski, G. F.,Madsen, R. W.,Mehr, D. R.,Maas, M.(2004).Nursing home quality, cost, staffing, and staff mix.The Gerontologist,44(1),24-38.
  31. Rantz, M. J.,Vogelsmeier, A.,Manion, P.,Minner, D.,Markway, B.,Conn, V.,Mehr, D. R.(2003).Statewide strategy to improve quality of care in nursing facilities.The Gerontologist,43(2),248-258.
  32. Resnick, H. E.,Manard, B.,Stone, R. I.,Castle, N. G.(2009).Tenure, certification, and education of nursing home administrators, medical directors, and directors of nursing in for-profit and not-for-profit nursing homes: United States 2004.Journal of the American Medical Directors Association,10(6),423-430.
  33. Shin, J. H.,Hyun, T. K.(2015).Nurse staffing and quality of care of nursing home residents in Korea.Journal of Nursing Scholarship,47(6),555-564.
  34. Siegel, E. O.,Leo, M. C.,Young, H. M.,Castle, N. G.(2014).Nursing home administrator self-assessed preparedness.Health Care Management Review,39(3),210-222.
  35. Siegel, E. O.,Young, H. M.,Zysberg, L.,Santillan, V.(2015).Securing and managing nursing home resources: Director of nursing tactics.The Gerontologist,55(5),748-759.
  36. Statistics Korea. (2013). Estimated future population. Retrieved from http://meta.narastat.kr/metasvc/svc/SvcMetaDcDtaPopup.do?orgId=101&confmNo=10133&kosisYn=Y (Original work published in Korean)
  37. Trinkoff, A. M.,Han, K.,Storr, C. L.,Lerner, N.,Johantgen, M.,Gartrell, K.(2013).Turnover, staffing, skill mix, and resident outcomes in a national sample of US nursing homes.JONA: Journal of Nursing Administration,43(12),630-636.
被引用次数
  1. Young Rim CHOI,Sung Ok CHANG,Su Jung LEE,Min Sun PARK(2021).Exploring a Nursing Home-Specific, Interdisciplinary, Function-Focused, Communicative Framework Based on Situation, Background, Assessment, and Recommendation.The Journal of Nursing Research,29(3),1-10.