Staffing and Service Availability in Assisted Living: The Importance of Nurse Delegation Policies
Staffing and Service Availability in Assisted Living: The Importance of Nurse Delegation Policies
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DOI：
10.1111/jgs.15580
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发表时间：
2018-11-01
影响因子：
6.3
通讯作者：
Reed, David
中科院分区：
文献类型：
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作者：
Beeber, Anna Song;Zimmerman, Sheryl;Reed, David
目的探讨在住宅护理和辅助生活（RC/AL）提供的卫生服务，提供这些服务的工作人员，以及在何种程度上涉及到国家级的护士代表团的政策和其他相关的服务providing.Design这一横断面研究resultatively检查RC/AL的特点，服务，人员配备，在美国8个州设置RC/AL设置（N=245）（加利福尼亚州，佛罗里达州，伊利诺伊州，堪萨斯州，北卡罗来纳州，新罕布什尔州，新泽西州，参与者管理员和医疗保健监督员（监督向居民提供的卫生保健和服务的个人）。测量使用电话调查，我们研究了授权政策如何与人员配备和26项卫生服务的可用性相关。允许授权的AL设置（授权状态）比不允许授权的状态（非授权状态）（19.7 vs 18.1，p <0.001）。代表州也有更多的药物技术人员管理，协助或观察处方和按需药物的自我管理（p < .001），而非代表州的工作人员具有较少的资格处理药物（p < .001）。在双向比较的护士人员配备（无，持牌实习护士（LPN）和持牌职业护士（LVNs），注册护士（RN）只有，LPN/LVNs和RN），RC/AL社区没有护士人员配备提供的服务显着少于所有其他类别。那些与RNs只也提供了显着较少的服务比那些与LPN/LVNs ONLY.CONCLUSION本研究是第一步，确定如何在RC/AL的人员配置和服务的可用性与全州范围内的护士代表团的做法，形成的基础上，进一步探索这些特点可能与护理质量。
Objectives To examine the health services provided in residential care and assisted living (RC/AL), the staff providing these services, and the degree to which the services relate to state-level nurse delegation policies and other correlates of service provision.Design This cross-sectional study descriptively examined the relationships among RC/AL characteristics, services, staffing, and nurse delegation regulations/policies.Setting RC/AL settings (N=245) in 8 U.S. states (CA, FL, IL, KS, NC, NH, NJ, OR).Participants Administrators and healthcare supervisors (individuals overseeing health care and services provided to residents).Measurements Using a telephone survey, we examined how delegation policies related to staffing and the availability of 26 health services.Results Significantly more services were available in RC/AL settings that permit delegation (delegation states) than states that do not permit delegation (nondelegation states) (19.7 vs 18.1, p < .001). Delegation states also had more medication technicians administering, assisting with, or observing self-administration of prescribed and as-needed medications (p < .001), whereas nondelegation states had staff with fewer qualifications handling medications (p < .001). In 2-way comparisons of categories of nurse staffing (none, licensed practical nurses (LPNs) and licensed vocational nurses (LVNs) only, registered nurses (RNs) only, LPN/LVNs and RNs), RC/AL communities with no nurse staffing offered significantly fewer services than all other categories. Those with RNs only also offered a significantly fewer services than those with LPN/LVNs only.Conclusion This study is a first step in identifying how staffing and availability of services in RC/AL are related to statewide nurse delegation practices, forming the basis for further exploration of how these characteristics may relate to quality of care.