Improving the Well-being of Nursing Home Workers An Examination of Non-nurse Staff Turnover and Quality in Nursing Homes

改善疗养院工作人员的福祉 疗养院非护士人员流动率和质量的检查

• 批准号: 10739599
• 负责人: Hari Sharma
• 金额: $ 7.78万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2025-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10739599
• 关键词: Improving; Well; being; Nursing; Home

Project Summary: Nursing homes are considered one of the most dangerous workplaces in the United States, and the Occupational Safety and Health Administration (OSHA) has emphasized on both inspections and collaborative efforts to improve worker safety in nursing homes. Dangerous work environment can lead to high turnover of workers. In addition, high turnover of staff has potentially adverse consequences for more than a million residents who depend on nursing home workers for their daily needs including bathing, eating, and toileting. Despite the recognition by OSHA on high injury risk and the adverse implication of high turnover on resident quality of care, nursing home worker welfare and safety has not been given enough attention by policymakers and researchers. Although a few recent studies have highlighted the issue of high turnover of nurse staff in nursing homes, the turnover of other essential workers such as dietary and housekeeping staff that earn very low wages has not been examined. We do not yet have a national database of turnover rates for different staff types in nursing homes but some states such as Iowa require nursing homes to report turnover rates for different staff types. In 2015, turnover rates were 61% for dietary staff and 42% for housekeeping staff in Iowa nursing homes. There is limited evidence on the trends and organizational factors associated with high turnover of non-nurse staff in nursing homes. Moreover, the value of lowering staff turnover to improve resident welfare is not understood well. Despite the substantial role played by non-nurse staff on patient care in nursing homes, to our knowledge, no studies have examined non-nurse staff turnover or its impact on nursing home quality. To this end, we have three specific aims: 1) To examine trends in non-nurse staff turnover, overall, and stratified by staff types, 2) To identify risk factors for non-nurse staff turnover, and 3) To estimate the impact of turnover of different staff types on outcomes such as hospitalization rates, falls, pressure ulcers, citations for nutritional issues, and infections. Our findings have the potential to affect national and state policies on the collection of staff turnover data and efforts to lower staff turnover by providing rigorous estimates on the potential causes and consequences of staff turnover in nursing homes. This proposal fits within the Healthcare and Social Assistance sector area under NORA (NAICS code: 62) and focuses on the subsector of nursing and residential care facilities (NAICS code: 623). It addresses several priority goals for strategic goal 7 (7.12A- 7.12D; 7.2A-7.2C) within the NORA priorities. Our study examines how work organization affects both worker and patient safety. Our study also focuses on low-wage occupations such as dietary staff, therapists, housekeeping, and maintenance staff. The manuscripts and presentations from this innovative project will inform state and national policymakers about factors driving staff turnover in nursing homes and are critical to improve Research to Practice (r2p) efforts in the Healthy Work Design and Well-Being (HWD).

项目摘要： 疗养院被认为是美国最危险的工作场所之一， 职业安全与健康管理局（OSHA）强调了检查和协作 努力提高疗养院的工人安全。危险的工作环境可能导致高尚 工人。此外，员工的高营业额可能对超过一百万 依靠疗养院工作人员来满足日常需求的居民，包括洗澡，饮食和厕所。 尽管OSHA认识到高伤害风险和高营业额对居民的不利影响 政策制定者尚未给予护理质量，疗养院工人福利和安全性 和研究人员。尽管最近的一些研究强调了护士工作人员的高传递问题 疗养院，其他重要工人的营业额，例如饮食和家政人员 尚未检查低工资。我们还没有针对不同员工的国家离职率的国家数据库 养老院的类型，但爱荷华州等某些州要求疗养院报告营业额 不同的员工类型。 2015年，饮食人员的营业额为61％，爱荷华州的家政人员为42％ 疗养院。关于与高有关的趋势和组织因素的证据有限 非Nurse员工在疗养院的营业额。此外，降低员工流动率以改善居民的价值 福利不太了解。尽管非Nurse员工在护理中的患者护理中发挥了重要作用 据我们所知，尚无研究检查非Nurse员工流动或对疗养院的影响 质量。为此，我们有三个具体的目标：1）检查非Nurse员工营业额的趋势，总体上以及 由员工类型分层，2）确定非NURSE员工流动的风险因素，3）估计 不同人员类型的营业额，例如住院率，下降，压疮，引用 营养问题和感染。我们的发现有可能影响国家和国家政策 通过提供严格的估计，收集员工流动数据和降低员工流动的努力 疗养院员工流动的潜在原因和后果。该建议适合医疗保健 诺拉（NAICS CON：62）下的社会援助部门地区，重点关注护理的子部门 和住宅护理设施（NAICS代码：623）。它解决了战略目标的几个优先目标7（7.12a-- 7.12d; 7.2a-7.2c）在NORA优先级。我们的研究研究了工作组织如何影响两个工人 和患者安全。我们的研究还关注低薪职业，例如饮食人员，治疗师， 管家和维护人员。这个创新项目的手稿和演示将 告知州和国家决策者有关促进疗养院工作人员流动的因素，对 改善健康工作设计和福祉（HWD）的实践研究（R2P）。