Why Do We Require Registered Nurses in Nursing Homes? Using Longitudinal Hierarchical Linear Modeling
- 주제(키워드) Hierarchical linear model , nursing home , nursing staffing , quality of care
- 주제(기타) Nursing
- 설명문(일반) [Shin, Juh Hyun] Ewha Womans Univ, Coll Nursing, Seoul, South Korea
- 등재 SCIE, SSCI, SCOPUS
- 발행기관 WILEY
- 발행년도 2018
- URI http://www.dcollection.net/handler/ewha/000000160296
- 본문언어 영어
- Published As http://dx.doi.org/10.1111/jnu.12412
초록/요약
Aims: To examine the relationship between nurse staffing and quality of care of nursing home residents, longitudinally. Background: Mixed results abound on the relationship between nurse staffing and quality of care of residents in nursing homes. Cross-sectional designs may underpin bias because the relationship between staffing and quality emerges over time, with latent unobserved variables. To offset this limitation, I used a longitudinal design in this study. Design: I used repeated quarterly survey methods. Methods: I measured staffing information with a formula developed by the Centers for Medicare & Medicaid Services. Outcome variables were 15 quality indicators and the Korean National Health Insurance Service 2015 nursing home evaluation manual. Results and Findings: As registered nurse hours per resident day increased by 1, the percentage of residents with depression decreased by 3.88%, and the prevalence of residents with nasogastric tubes increased by 1.17% in 3 months. Prevalence of residents with bed rest decreased by 5.72%, and residents with restraints decreased by 1.092%. More registered nurses and fewer certified nursing assistants or qualified care workers yielded a statistically significant negative influence on aggressive behavior, depression, weight loss, and bed rest. The higher turnover of total nursing staff related to more use of antidepressants. Conclusions: Results supported registered nurses' exclusive impact on resident outcomes. More longitudinal research is required to confirm the influence of nurses on nursing home residents' outcomes.
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