The Need for Higher Minimum Staffing Standards in U.S. Nursing Homes
The Need for Higher Minimum Staffing Standards in U.S. Nursing Homes
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DOI：
10.4137/hsi.s38994
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发表时间：
2016-01-01
影响因子：
2.8
通讯作者：
Simmons, Sandra F.
中科院分区：
文献类型：
--
作者：
Harrington, Charlene;Schnelle, John F.;Simmons, Sandra F.
许多美国养老院存在严重的质量问题，部分原因是护士人手不足。本评论着重于两个问题。首先，美国养老院需要更高的最低护士配备标准，多项研究表明，养老院质量和人员配备之间存在积极关系，实施更高的最低人员配备标准也有好处。研究已经确定了提供符合联邦法规的护理所需的最低人员配备水平，但许多美国机构的人员配备水平低得危险。其次，讨论了人员编制改革的障碍。其中包括对成本的经济关注和对财政激励的关注。现有人员配备标准的执行力度一直很弱，养老院行业的强烈政治反对限制了建立更高标准的努力。研究人员应该研究如何提高人员配备标准和新的支付，监管和政治策略，以提高养老院的人员配备和质量。
Many U.S. nursing homes have serious quality problems, in part, because of inadequate levels of nurse staffing. This commentary focuses on two issues. First, there is a need for higher minimum nurse staffing standards for U.S. nursing homes based on multiple research studies showing a positive relationship between nursing home quality and staffing and the benefits of implementing higher minimum staffing standards. Studies have identified the minimum staffing levels necessary to provide care consistent with the federal regulations, but many U.S. facilities have dangerously low staffing. Second, the barriers to staffing reform are discussed. These include economic concerns about costs and a focus on financial incentives. The enforcement of existing staffing standards has been weak, and strong nursing home industry political opposition has limited efforts to establish higher standards. Researchers should study the ways to improve staffing standards and new payment, regulatory, and political strategies to improve nursing home staffing and quality.