Agency Staffing and Nursing Home Quality

机构人员配置和疗养院质量

• 批准号: 8050662
• 负责人: NICHOLAS G CASTLE
• 金额: $ 13.95万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-01 至 2013-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8050662
• 关键词: Agency; Staffing; Nursing; Home; Quality

DESCRIPTION (provided by the applicant): It is possible that much can be learned from examining the effect of workforce factors in nursing homes, given the almost intransigent low quality seen in many of these facilities. Although past research in this area has examined the effect of turnover and staffing levels on quality, there have been no studies that have examined the impact of agency staffing. In this research, we propose to examine the influence that agency staffing characteristics have on quality of care in a large sample of nursing homes. We believe that nursing home residents have increasingly more complex care needs, and facilities are using increasingly complex technology. Care is also dependent not only on how much is done, but upon what is done, how well it is done, when it is done, and by whom. Thus, simply adding more staff may be a necessary but not sufficient means of improving quality. Examining agency staffing may lead to broader policy debate over staffing issues rather than staffing levels in nursing homes. In preliminary analyses, we have identified use of agency staff as a significant influence on quality. In this project, we propose to extend this prior research, by using a larger sample, more refined measures of quality, and better specified staffing characteristic variables. We will merge data collected from a unique survey on turnover from 6,005 nursing homes with data from: the Minimum Data Set (MDS), the On-line Survey Certification and Recording (OSCAR) system, and the Area Research File (ARF). Staffing characteristics will come from the primary data, resident characteristics and quality indicators will come from the MDS, facility characteristics will come from the OSCAR, and market characteristics will come from the ARF. We will examine the associations between use of agency staff and quality, not only for licensed practical nurses (LPNs), and registered nurses (RNs), but also for nurse aides (NAs). PUBLIC HEALTH RELEVANCE: High turnover and absenteeism, combined with regulatory pressure to maintain minimum staff levels, has led to an increase in use of agency staff to cover staffing needs in nursing homes. Yet, little is known about this emerging practice and its impact on quality of care. This investigation examines use of agency staff and quality of care. Our results will have implications for policy makers, practitioners, and consumers.

描述（由申请人提供）：鉴于许多这些设施中几乎不固定的低质量，可以从检查劳动力因素的影响中学到很多东西。尽管过去在这一领域的研究检查了营业额和人员配备水平对质量的影响，但尚无研究检查机构人员的影响。在这项研究中，我们建议研究代理人员人员配备特征对大量疗养院样本中护理质量的影响。我们认为，疗养院居民的护理需求越来越复杂，设施正在使用越来越复杂的技术。护理还不仅取决于完成的工作，还取决于完成的工作，做得如何，完成的工作以及由谁。因此，仅仅添加更多的员工可能是提高质量的必要手段。检查机构人员配备可能会导致有关人员配备问题的更广泛的政策辩论，而不是疗养院的人员配备水平。在初步分析中，我们确定对代理人员的使用是对质量的重大影响。在这个项目中，我们建议通过使用更大的样本，更精致的质量度量以及更好的人员配备特征变量来扩展这项先前的研究。我们将合并从6,005家疗养院的营业额的独特调查中收集的数据与以下数据：最低数据集（MDS），在线调查认证和记录（OSCAR）系统以及区域研究文件（ARF）。人员配备特征将来自主要数据，居民特征和质量指标将来自MD，设施特征将来自奥斯卡，市场特征将来自ARF。我们将研究代理人员和质量的使用之间的关联，不仅适用于有执照的实践护士（LPN）和注册护士（RNS），还适用于护士助手（NAS）。 公共卫生相关性：高营业额和缺勤，再加上监管压力，以维持最低员工级别，这导致代理人员使用以满足疗养院的人员需求的增加。然而，对于这种新兴实践及其对护理质量的影响知之甚少。这项调查检查了代理人员的使用和护理质量。我们的结果将对政策制定者，从业者和消费者产生影响。