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).

项目概要： 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）强调检查与协作并重 努力改善疗养院工人的安全。危险的工作环境可能导致人员流动率高 工人。此外，员工的高流动率可能会对超过一百万人造成不利后果。 依赖疗养院工作人员满足日常需求（包括洗澡、吃饭和上厕所）的居民。 尽管 OSHA 认识到高伤害风险以及高流动率对居民的不利影响 政策制定者没有对护理质量、疗养院工作人员的福利和安全给予足够的重视 和研究人员。尽管最近的一些研究强调了护士人员流动率高的问题 疗养院、其他重要工作人员的流动率，例如收入很高的膳食和家政人员 低工资尚未审查。我们还没有不同员工流失率的国家数据库 疗养院的类型，但爱荷华州等一些州要求疗养院报告以下人员的流动率： 不同的员工类型。 2015 年，爱荷华州餐饮人员的流失率为 61%，家政人员的流失率为 42% 疗养院。关于与高风险相关的趋势和组织因素的证据有限。 疗养院非护士人员的流动率。此外，降低员工流动率对于改善居民的价值 福利没有得到很好的理解。尽管非护士人员在护理中的患者护理中发挥着重要作用 据我们所知，没有研究调查非护士人员流动或其对疗养院的影响 质量。为此，我们有三个具体目标：1) 研究非护士人员流动率的总体趋势和 按员工类型分层，2) 确定非护士人员流动的风险因素，以及 3) 估计 不同类型员工的流动率对住院率、跌倒、压疮、引用率等结果的影响 营养问题和感染。我们的研究结果有可能影响国家和州的政策 收集员工流动率数据并通过对员工流动率进行严格估计来降低员工流动率 疗养院员工流动的潜在原因和后果。该提案适合医疗保健领域 NORA 下的社会援助部门领域（NAICS 代码：62），重点关注护理分部门 和住宿护理设施（NAICS 代码：623）。它解决了战略目标 7 (7.12A- 7.12D； 7.2A-7.2C) NORA 优先事项内。我们的研究探讨了工作组织如何影响员工 和患者安全。我们的研究还关注低工资职业，如膳食人员、治疗师、 家政和维修人员。这个创新项目的手稿和演示文稿将 向州和国家政策制定者通报导致疗养院员工流动的因素，这对于 改进健康工作设计和福祉 (HWD) 方面的研究到实践 (r2p) 工作。