The Influence of Nurse Staffing Levels on Quality of Care in Nursing Homes
The Influence of Nurse Staffing Levels on Quality of Care in Nursing Homes
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DOI：
10.1093/geront/gnr050
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发表时间：
2011-10-01
期刊：
影响因子：
5.7
通讯作者：
Weech-Maldonado, Robert
中科院分区：
文献类型：
--
作者：
Hyer, Kathryn;Thomas, Kali S.;Weech-Maldonado, Robert
目的：本研究探讨了在佛罗里达疗养院增加认证护理助理（CNAs）和持牌护士人员比例和不足之间的关系，在4年的时间。研究方法：来自佛罗里达人员配备报告和在线调查认证和报告数据库的数据研究了2002年至2005年期间佛罗里达663家养老院的人员配备水平和不足引用之间的关系。使用SAS Proc Genmod中的广义估计方程方法，我们估计了CNA和有执照的护理人员之间的关系，以及设施的总缺陷评分和护理质量缺陷评分-使用医疗保险和医疗补助服务中心的护理之家比较五星质量评级系统计算，该系统考虑了引用的范围和严重程度的复杂性。结果如下：我们的研究结果证实，较高的CNA人员配备水平是较低的总缺陷分数和护理质量缺陷分数的预测因子，在控制了设施的特点。结论：通过大样本量、重复测量设计和先进的方法，我们发现了CNA人员配置和养老院质量之间的关系。
Objective: This study examines the relationship between increasing certified nursing assistants (CNAs) and licensed nurse staffing ratios and deficiencies in Florida nursing homes over a 4-year period. Methods: Data from Florida staffing reports and the Online Survey Certification and Reporting database examine the relationship among staffing levels and deficiency citations for 663 Florida nursing homes between 2002 and 2005. Using a generalized estimating equation approach in SAS Proc Genmod, we estimate the relationship between CNA and licensed nursing staff, and facilities' total deficiency score and quality of care deficiency scores-calculated using the Centers for Medicare and Medicaid Services' Nursing Home Compare Five-Star Quality Rating System, which accounts for the complexity of the scope and severity of the cittions. Results: Our results confirmed that higher CNA staffing levels were predictors of lower total deficiency scores and quality of care deficiency scores after controlling for facility characteristics. Conclusion: With a large sample size, repeated measure design, and advanced methods, we have found a relationship between CNA staffing and nursing home quality.