Does Public Reporting of Staffing Ratios and Nursing Home Compare Ratings Matter?

Cordova, Pamela B. de; Johansen, Mary L.; Zha, Peijia; Prado, Joseph; Field, Victoria; Cadmus, Edna

doi:10.1016/j.jamda.2021.03.011

Cited by 4 publications

(5 citation statements)

References 15 publications

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“…The issue of heavy workload is especially troubling for those LPNs working at night. The number of residents assigned to LPNs is greater than that in acute care, with an average of 25 residents per LPN on the day shift and 50 residents per LPN at night 21…”

Section: Discussionmentioning

confidence: 98%

“…The number of residents assigned to LPNs is greater than that in acute care, with an average of 25 residents per LPN on the day shift and 50 residents per LPN at night. 21 Considering our study was conducted between the first and second waves of the COVID-19 pandemic, COVID-19 may have impacted the lower levels of PSC. The COVID-19 pandemic did bring new attention to inadequate staffing that existed in NJ nursing homes prior to the pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…One quality indicator consistently associated with better resident safety is the level of nurse staffing 20. Studies support that higher RN staffing levels are associated with higher safety culture scores and Nursing Home Compare Quality staffing ratings, a rating system that allows comparison of nursing homes 11,12,21. A recent study with Medicaid-certified long-term care (LTC) facilities found as the total numbers of licensed staff (RNs and LPNs) per resident per day increased, the fall rate decreased; yet, as the number of LPN hours per resident increased, the fall rate increased 17.…”

Section: Patient Safetymentioning

confidence: 99%

“…20 Studies support that higher RN staffing levels are associated with higher safety culture scores and Nursing Home Compare Quality staffing ratings, a rating system that allows comparison of nursing homes. 11,12,21 A recent study with Medicaid-certified long-term care (LTC) facilities found as the total numbers of licensed staff (RNs and LPNs) per resident per day increased, the fall rate decreased; yet, as the number of LPN hours per resident increased, the fall rate increased. 17 Considering there are more LPNs than RNs working in nursing homes, it is important to conduct additional research on LPN staffing and patient outcomes to better understand this finding.…”

mentioning

confidence: 99%

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Nursing Home Patient Safety Culture Perceptions Among Licensed Practical Nurses

Weaver

Cordova

Ravichandran

et al. 2022

Journal of Nursing Care Quality

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Background: Licensed practical nurses (LPNs) working in nursing homes are the primary licensed nurses providing care and ensuring patient safety in New Jersey. As such, it is important to understand LPNs' perception of patient safety culture (PSC) and job satisfaction, which may impact resident safety. Purpose: To describe the relationship between LPNs' perception of PSC in nursing homes and job satisfaction. Methods: A cross-sectional study design was used to survey LPNs in New Jersey. Results: LPNs working in nursing homes were less satisfied than LPNs working in other settings, and their perception of PSC was lower than that in 2019 national data report. Conclusion: LPNs in nursing homes indicated that PSC needs improvement. Now is an opportune time to implement initiatives to foster a culture of safety in nursing homes.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Patient Safetymentioning

confidence: 99%

mentioning

confidence: 99%

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Nursing Home Patient Safety Culture Perceptions Among Licensed Practical Nurses

Weaver

Cordova

Ravichandran

et al. 2022

Journal of Nursing Care Quality

Self Cite

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“…A staff-related barrier raised by participants was staffing levels on night shifts when fewer staff are working, as it is assumed that residents are sleeping so there is a lower need for staff, which may not always be true [ 41 ]. This was also mentioned in the previous qualitative study [ 32 ] when they conducted focus groups with family carers, but care home staff who were informally interviewed had mixed views on whether this was an issue.…”

Section: Discussionmentioning

confidence: 99%

How do care home staff use non-pharmacological strategies to manage sleep disturbances in residents with dementia: The SIESTA qualitative study

Webster

Costafreda

Powell³

et al. 2022

PLoS ONE

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Background Sleep disturbances affect 38% of care home residents living with dementia. They are often treated with medication, but non-pharmacological interventions may be safer and effective yet more difficult to implement. In the SIESTA study (Sleep problems In dEmentia: interviews with care home STAff) we explored care home staffs’ experience of managing sleep disturbances in their residents living with dementia. Methods We conducted one-to-one semi-structured interviews in four UK care homes, and purposively recruited a maximum variation sample of 18 nurses and care assistants, who were each interviewed once. We used a topic guide and audio-recorded the interviews. Two researchers independently analysed themes from transcribed interviews. Results Staff used a range of techniques that often worked in improving or preventing residents’ sleep disturbance. During the daytime, staff encouraged residents to eat well, and be physically active and stimulated to limit daytime sleep. In the evening, staff settled residents into dark, quiet, comfortable bedrooms often after a snack. When residents woke at night, they gave them caffeinated tea or food, considered possible pain and discomfort, and reassured residents they were safe. If residents remained unsettled, staff would engage them in activities. They used telecare to monitor night-time risk. Staff found minimising daytime napping difficult, described insufficient staffing at night to attend to reorient and guide awake residents and said residents frequently did not know it was night-time. Conclusions Some common techniques, such as caffeinated drinks, may be counterproductive. Future non-pharmacological interventions should consider practical difficulties staff face in managing sleep disturbances, including struggling to limit daytime napping, identifying residents’ night-time needs, day-night disorientation, and insufficient night-time staffing.

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