Nursing Effort and Quality in Long-Term Care Facilities

描述（由申请人提供）：本研究的目的是探讨疗养院居民的护理努力与护理质量之间的关系。本研究使用三个州护理人员时间研究的现有数据和时间研究中由护士照顾的养老院居民的MDS数据来解决护理努力与护理质量之间的关系。护理工作是通过按护理人员类型（注册护士、护理护士、助理和其他直接护理人员）每天提供给每位住院医师的分钟数来衡量的。涵盖护理过程和结果的质量指标来自MDS，它们采用病例组合调整的质量指标，这些指标在以前的研究中广泛使用，但没有病例组合调整。多层次分析，HLM，将用于解决嵌套的影响，其中居民聚集在护理单位。这项研究比以前的工作取得了重大进展。以前几乎所有关于人员配备和护理质量的研究都依赖于设施层面的人员配备和质量指标。这项研究将允许对单位和居民水平的影响进行更细致的分析。该数据库包括来自62家机构的98个护理单位的3125名居民。研究结果应该有助于了解目前有关养老院人员配备标准的政策辩论。

DESCRIPTION (provided by applicant): The purpose of this study is to examine the relationship between nursing effort and quality of care for nursing home residents. This study uses extant data from time studies of nursing staff in three states and MDS data on the nursing home residents who were cared for by nurses in the time study to address the relationship between nursing effort and quality of care. Nursing effort is measured by the amount of minutes per day provided to each resident by nursing staff type (RN, LPN, aide, and other direct care staff'). The quality measures, which cover both care processes and outcomes, are derived from the MDS and they employ case-mix adjusted quality indicators that have been widely used in previous studies but without the case mix adjustment. Multi-level analysis, HLM, will be used to address the nesting of effects where residents are clustered within nursing units. This study represents a major advance over prior work. Nearly all previous research into staffing and care quality has relied on facility-level measures of staffing and quality. This study will allow for a much more fine-grained analysis of both unit and resident-level effects. The database consists of 3125 residents in 98 nursing units from 62 facilities. Results should shed light on the current policy debate over nursing home staffing standards.