Nursing Home Employees:Community Ecology and Retention

关于养老院员工留职率的研究报告各不相同，然而，故事是一致的：流动率很高，特别是在护理服务领域。离职对连续性和护理质量产生负面影响，对于已经面临经济挑战的服务行业来说，离职成本高昂。迄今为止，许多评论和描述性研究的作者将注意力集中在与工作人员离职有关的因素上。这篇文献中尚未出现的是一个严格和有效的过程，以确定激励这种自然减员的原因，以指导成功的基于设施的干预策略的制定和实施。这项初步研究的总体目标是确定使用生态-社区容量模型的可行性，该模型是一种考虑个人、家庭和社区对长期护理工作场所留任的影响的方法，以确定影响养老院员工留任的多个变量之间的关键关系。这项初步研究的样本将是一家长期护理机构的大约125名员工。将使用多种方法收集数据，以支持拟议的评估模式，包括向护理、饮食和家政工作人员发放结构化的自我报告问卷，与主要管理人员进行半结构化访谈，以及审查书面人事文件。指导本研究的主要研究问题是：(1)哪些个人、家庭和社区变量最能描述养老院员工？(2)个人、家庭和社区因素与保留相关结果(如工作满意度和保留意向)之间有什么关系？(3)除了与保留相关结果(间接影响)的关系外，个人、家庭和社区因素与保留本身(直接影响)之间存在哪些关系？(4)保留相关结果与实际保留之间的关系是什么？利用从这项初步研究中获得的信息和见解，我们的长期目标是使用评估模型来制定在养老院环境中建设社区能力的干预策略。

Studies of retention among nursing home employees report varying rates, however, the story is consistent: turnover, particularly among nursing services, is high. Turnover negatively effects continuity and quality of care and is costly for a service industry already facing economic challenges To date, authors of numerous commentaries and descriptive studies have focused their attention on factors related to staff turnover. What has yet to emerge from this literature is a rigorous and valid process to determine the reasons motivating such attrition to guide the development and implementation of successful facility-based intervention strategies. The overall goal of this pilot study is to determine the feasibility of using an ecological-community capacity model, an approach that accounts for individual, family, and community influences on retention in the long term care workplace, to identify key relationships among and between multiple variables that influence retention of nursing home employees. The sample for this pilot study will be the approximately 125 employees of one longterm care facility. Multiple methods will be used to collect data in support of the proposed assessment model including structured, self-report questionnaires to the nursing, dietary, and housekeeping staff, semi-structured interviews with key administrators, and a review of written personnel documents. Primary research questions guiding the study are: (1) What individual, family, and community variables are most descriptive of nursing home employees? (2) What are the relationships between individual, family, and community factors and retention-related outcomes (such as job satisfaction and retention intentions)? (3) What relationships exist between individual, family, and community factors and retention itself (direct effects), aside from their relationships with the retention-related outcomes (indirect effects)? (4) What is the relationship between retention-related outcomes and actual retention? Using the information and insights garnered from this pilot study, our long-term goal is to use the assessment model in the development of intervention strategies for building community capacity within the nursing home environment.