Staffing Characteristics of Nursing Homes and Quality

养老院人员配备特点及质量

• 批准号: 7241293
• 负责人: NICHOLAS G CASTLE
• 金额: $ 20.81万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-04-01 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7241293
• 关键词: Staffing; Characteristics; Nursing; Homes; Quality

DESCRIPTION (Provided by the Applicant): It is possible that much can be learned from examining the effect of workforce factors in nursing homes, given the almost intransigent low quality seen in many of these facilities. Although past research in this area as examined the effect of turnover and staffing levels on quality, there have been very few studies that have examined the impact of multiple workforce factors or that have looked at whether different characteristics of the workforce interact to produce either good or bad quality. Thus, prior underspecified models may have served to limit somewhat our understanding of which workforce factors influence most (least) quality of care. In addition, only weak evidence exists that staff ratios influence quality of care, again probably due to the underspecified nature of most investigations. In this research, we propose to examine the influence that multiple staffing characteristics, specifically turnover, staffing levels, worker stability, and agency staff, has on quality of care in a large sample of nursing homes. We believe that nursing home residents have increasingly more complex care needs, and facilities are using increasingly complex technology. Care is also dependent not only on how much is done, but upon what is done, how well it is done, when it is done, and by whom. Thus, simply adding more staff may be a necessary but not sufficient means of improving quality. Examining care processes more adequately is important, and may lead to broader policy debate over staffing issues rather than staffing levels in nursing homes. In preliminary analyses, we have identified staffing levels, turnover, stability, and use of agency staff as significant influences on quality. In this project, we propose to extend this prior research, by using a larger sample, more refined measures of quality, and better specified staffing characteristic variables. We will merge data collected from a unique survey on turnover from 2,946 nursing homes with data from: the Minimum Data Set (MDS), the On-line Survey Certification and Recording (OSCAR) system, and the Area Research File (ARF). Staffing characteristics will come from the primary data, resident characteristics and quality indicators will come from the MDS, facility characteristics will come from the OSCAR, and market characteristics will come from the ARF. We will examine the associations between staffing levels, turnover, stability, and use of agency staff and quality, not only for licensed practical nurses (LPNs), and registered nurses (RNs), but also for nurse aides (NAs).

描述（由申请人提供）：考虑到许多疗养院中几乎不妥协的低质量，通过检查疗养院劳动力因素的影响可能可以学到很多东西。尽管该领域过去的研究考察了人员流动和人员配置水平对质量的影响，但很少有研究考察多种劳动力因素的影响，或者考察劳动力的不同特征是否相互作用以产生良好或不良的结果。质量不好。因此，先前未明确说明的模型可能在一定程度上限制了我们对哪些劳动力因素影响最大（最小）护理质量的理解。此外，只有微弱的证据表明员工比例影响护理质量，这可能又是由于大多数调查的性质不明确。 在这项研究中，我们建议研究多种人员配置特征的影响，特别是 在大型疗养院样本中，流动率、人员配置水平、工人稳定性和机构人员对护理质量有影响。我们认为，疗养院居民的护理需求越来越复杂，设施正在使用越来越复杂的技术。护理不仅取决于做了多少，还取决于做了什么、做得如何、何时完成以及由谁完成。因此，简单地增加员工可能是提高质量的必要但不充分的手段。更充分地检查护理流程很重要，并且可能会引发关于人员配置问题而不是疗养院人员配置水平的更广泛的政策辩论。 在初步分析中，我们已确定机构人员的人员配置水平、流动率、稳定性和使用对质量有重大影响。在这个项目中，我们建议通过使用更大的样本、更精细的质量衡量标准以及更明确的人员配置特征变量来扩展先前的研究。我们将从一项关于 2,946 家疗养院营业额的独特调查中收集的数据与来自以下数据的数据合并：最小数据集 (MDS)、在线调查认证和记录 (OSCAR) 系统以及区域研究文件 (ARF)。人员特征将来自原始数据，居民特征和质量指标将来自MDS，设施特征将来自OSCAR，市场特征将来自ARF。我们将研究人员配置水平、流动率、稳定性以及机构人员的使用与质量之间的关联，不仅针对执业护士 (LPN) 和注册护士 (RN)，而且还针对护士助理 (NA)。