Nursing Activities and Job Satisfaction of the Licensed Practical Nurse Workforce in New Jersey

Weaver, Susan H.; Cordova, Pamela B. de; Ravichandran, Arun; Cadmus, Edna

doi:10.1016/s2155-8256(22)00029-1

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…High utilization of health services, especially if avoidable, and low use of RNs is costly to the healthcare system and can put residents at risk for poor outcomes as a result of care transitions (e.g., ED visits and hospitalizations) 17,20 . Additionally concerning, LPNs may not have the preparation and/or training for making clinical judgments and it is beyond their scope of practice 21–24 …”

Section: Discussionmentioning

confidence: 99%

“…17,20 Additionally concerning, LPNs may not have the preparation and/or training for making clinical judgments and it is beyond their scope of practice. [21][22][23][24] The structural characteristics associated with poor quality of care among NHs with greater proportions of Black residents may be an issue of funding and where funding is allocated as speculated by other researchers. 4,5 For-profit NHs prioritize their shareholders, with the goal of providing them with as much money as possible.…”

Section: Discussionmentioning

confidence: 99%

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Environmental and structural factors driving poor quality of care: An examination of nursing homes serving Black residents

Travers

Castle

Weaver³

et al. 2023

J American Geriatrics Society

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BackgroundPoor quality of care in nursing homes (NHs) with high proportions of Black residents has been a problem in the US and even more pronounced during the COVID‐19 pandemic. Federal and state agencies are devoting attention to identifying the best means of improving care in the neediest facilities. It is important to understand environmental and structural characteristics that may have led to poor healthcare outcomes in NHs serving high proportions of Black residents pre‐pandemic.MethodsWe conducted a cross‐sectional observational study using multiple 2019 national datasets. Our exposure was the proportion of Black residents in a NH (i.e., none, <5%, 5%–19.9%, 20–49.9%, ≥50%). Healthcare outcomes examined were hospitalizations and emergency department (ED) visits, both observed and risk‐adjusted. Structural factors included staffing, ownership status, bed count (0–49, 50–149, or ≥150), chain organization membership, occupancy, and percent Medicaid as a payment source. Environmental factors included region and urbanicity. Descriptive and multivariable linear regression models were estimated.ResultsIn the 14,121 NHs, compared to NHs with no Black residents, NHs with ≥50% Black residents tended to be urban, for‐profit, located in the South, have more Medicaid‐funded residents, and have lower ratios of registered‐nurse (RN) and aide hours per resident per day (HPRD) and greater ratios of licensed practical nurse HPRD. In general, as the proportion of Black residents in a NH increased, hospitalizations and ED visits also increased.Discussion/ImplicationsAs lower use of RNs has been associated with increased ED visits and hospitalizations in NHs generally, it is likely low RN use largely drove the differences in hospitalizations and ED visits in NHs with greater proportions of Black residents. Staffing is an area in which state and federal agencies should take action to improve the quality of care in NHs with larger proportions of Black residents.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Environmental and structural factors driving poor quality of care: An examination of nursing homes serving Black residents

Travers

Castle

Weaver³

et al. 2023

J American Geriatrics Society

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“…Instead, some nursing homes use LPNs in place of RNs; this is seen most frequently among nursing homes that serve greater proportions of Black residents or are in severely socioeconomically disadvantaged areas. 64,65 While LPNS do not meet the federal RN presence requirement, LPNs are cheaper and easier to recruit than RNs; therefore, some facilities use LPNs as a substitute for RNs in practice. 66 However, LPNs are not universally trained to take on independent roles and therefore may not be qualified to fulfill responsibilities specific to the RN role (e.g., performing assessments).…”

Section: Retention and Turnovermentioning

confidence: 99%

Addressing Racial and Ethnic Disparities in Nursing Homes

Travers,

Choula,

Hado

2024

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This Spotlight is part of the AARP Public Policy Institute's LTSS Choices initiative. This initiative includes a series of reports, blogs, videos, podcasts, and virtual convenings that seeks to spark ideas for immediate, intermediate, and long-term options for transforming long-term services and supports (LTSS). We will explore a growing list of innovative models and evidence-based solutions-at both the national and international levels-to achieve system-wide LTSS reform.We recognize the importance of collaborating and partnering with others across the array of sectors, disciplines, and diverse populations to truly transform and modernize the LTSS system. We invite new ideas and look forward to opportunities for collaboration.

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“…Furthermore, evidence indicates LPNs are functioning at higher levels because of the unavailability of RNs in the nursing home setting. 6,7 that hospital culture must change when errors occur from blaming to examining the incident and recommending areas for improvement. 9 The IOM identified the keys to patient safety culture (PSC) as (1) a shared belief that health care can be designed to prevent harm; (2) an organizational commitment to investigate patient injuries and near misses; and (3) an environment that balances the need for reporting of events and the need to take disciplinary action.…”

mentioning

confidence: 99%

“…This report recognized care in nursing homes is provided by registered nurses (RNs) and LPNs; however, RNs and LPNs have different scopes of practice and are used interchangeably. Furthermore, evidence indicates LPNs are functioning at higher levels because of the unavailability of RNs in the nursing home setting 6,7…”

mentioning

confidence: 99%

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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Nursing Activities and Job Satisfaction of the Licensed Practical Nurse Workforce in New Jersey

Cited by 4 publications

References 16 publications

Environmental and structural factors driving poor quality of care: An examination of nursing homes serving Black residents

Environmental and structural factors driving poor quality of care: An examination of nursing homes serving Black residents

Addressing Racial and Ethnic Disparities in Nursing Homes

Nursing Home Patient Safety Culture Perceptions Among Licensed Practical Nurses

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