The Influence of Staff Turnover on Quality

员工流动对质量的影响

• 批准号: 7080218
• 负责人: NICHOLAS G CASTLE
• 金额: $ 16.91万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-01 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7080218
• 关键词: behavioral /social science research tag; caregivers; catheterization; chronic pain; clinical research; decubitus ulcer; employee; health care personnel; health care service evaluation; health science manpower; health services research tag; human data; job satisfaction; nurse performance; nursing care evaluation; nursing care quality; nursing homes; outcomes research; psychopharmacologic agent; restraint; urethra; work site

DESCRIPTION (provided by applicant): The belief that staff turnover influences quality is pervasive. Indeed, staff turnover in nursing homes is often used as a quality indicator. However, based on empirical studies in the literature this may be premature, as the association between turnover and quality is generally inconclusive. Some further research in this area is clearly warranted. Results from turnover studies set in other industries have also shown that some staff turnover is beneficial, and it is higher levels of turnover that negatively influence performance. Clearly, if turnover does influence quality in different directions depending on the level observed, then by using one linear measure of turnover the effects may be masked. Some further research in this area in nursing homes is also clearly warranted. In this initiative, we propose to use data previously collected from 2,127 nursing facilities and examine the association between staff turnover and quality. The caregiving labor force consists primarily of nurse aides (NAs) who provide 80 to 90% of resident care, but also includes licensed practical nurses (LPNs), and registered nurses (RNs). These are the staff we examine. The information on staff turnover was collected as part of an ongoing study investigating the accuracy of turnover reporting by nursing homes. We propose to use five well-accepted indicators of care quality in nursing homes. These are the rates of physical restraint use, urethral catheterization, pressure ulcers, psychoactive medication use, and persistent pain. We believe that by: (1) examining different levels of turnover; (2) using our precise measure of turnover; and (3) using the Minimum Data Set (MDS) resident-level data on quality and case mix - this proposed study represents a considerable improvement over prior works. Thus, using previously collected primary data matched to secondary data sources, such as the MDS, we propose to examine: (1) Association between caregiver turnover (RNs, LPNs, and NAs) and quality indicators in nursing homes; (2) Contribution of different caregivers (RNs, LPNs, and NAs) to the association between turnover and quality indicators; (3) Whether some level of turnover is positively associated with quality indicators and at what point turnover is negatively associated with quality indicators.

描述（由申请人提供）：认为员工流失会影响质量的信念无处不在。确实，疗养院的员工营业额通常被用作质量指标。但是，基于文献中的实证研究，这可能为时过早，因为营业额和质量之间的关联通常尚无定论。在这一领域进行了进一步的研究。在其他行业中设定的营业额研究的结果还表明，某些员工营业额是有益的，并且更高的营业额会对绩效产生负面影响。显然，如果营业额确实会根据观察到的水平影响不同方向的质量，则可以通过使用一种线性度量的离职量来掩盖效果。在这一领域的疗养院中，也有一些进一步的研究也可以清楚地保证。在此计划中，我们建议使用先前从2,127个护理设施收集的数据，并检查员工营业额与质量之间的关联。护理劳动力主要由提供80％至90％的居民护理的护士助手（NAS）组成，但还包括持牌实践护士（LPN）和注册护士（RNS）。这些是我们检查的员工。作为正在进行的研究的一部分，收集了有关员工营业额的信息，该研究调查了疗养院的营业额报告的准确性。我们建议在疗养院使用五个公认的护理质量指标。这些是物理约束使用，尿道导管插入术，压疮，精神活性药物的使用和持续疼痛的速度。我们相信：（1）检查不同级别的营业额； （2）使用我们的精确衡量营业额； （3）使用有关质量和案例组合的最小数据集（MDS）居民级数据 - 这项拟议的研究代表了对先前工作的可观改进。因此，使用先前收集的主要数据与二级数据源（例如MDS）相匹配，我们建议检查：（1）护理人员周转率（RNS，LPN和NAS）与疗养院中的质量指标之间的关联； （2）不同护理人员（RN，LPN和NAS）对营业额和质量指标之间的关联的贡献； （3）一定程度的营业额是否与质量指标呈正相关，而在什么时候营业额与质量指标负相关。