Agency Staffing and Nursing Home Quality

机构人员配置和疗养院质量

• 批准号: 7884669
• 负责人: NICHOLAS G CASTLE
• 金额: $ 15.77万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-01 至 2012-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7884669
• 关键词: Agency; Staffing; Nursing; Home; 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 has examined the effect of turnover and staffing levels on quality, there have been no studies that have examined the impact of agency staffing. In this research, we propose to examine the influence that agency staffing characteristics have 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 agency staffing may lead to broader policy debate over staffing issues rather than staffing levels in nursing homes. In preliminary analyses, we have identified use of agency staff as a significant influence 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 6,005 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 use of agency staff and quality, not only for licensed practical nurses (LPNs), and registered nurses (RNs), but also for nurse aides (NAs). PUBLIC HEALTH RELEVANCE: High turnover and absenteeism, combined with regulatory pressure to maintain minimum staff levels, has led to an increase in use of agency staff to cover staffing needs in nursing homes. Yet, little is known about this emerging practice and its impact on quality of care. This investigation examines use of agency staff and quality of care. Our results will have implications for policy makers, practitioners, and consumers.

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问题，通过检查疗养院劳动力因素的影响，我们可能会学到很多东西。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，但还没有研究考察机构人员配置的影响。在这项研究中，我们建议在大样本疗养院中研究机构人员配置特征对护理质量的影响。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。检查机构人员配置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，我们发现机构工作人员的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。我们将从对 6,005 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。我们将研究机构工作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），而且针对护士助理（NA）。 公共卫生相关性：高流动率和缺勤率，加上维持最低员工水平的监管压力，导致机构工作人员的使用增加，以满足疗养院的人员需求。然而，人们对这种新兴做法及其对护理质量的影响知之甚少。这项调查检查了机构工作人员的使用和护理质量。我们的结果将对政策制定者、从业者和消费者产生影响。