Relationship of the Job Tenure of Nursing Home Top Management to the Prevalence of Pressure Ulcers, Pain, and Physical Restraint Use

Decker, Frederic H.; Castle, Nicholas G.

doi:10.1177/0733464810375801

Cited by 17 publications

(13 citation statements)

References 25 publications

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“…However, NHAs and DONs with the longest tenures (i.e., highest quartile) did have several significantly more favorable PSC domain scores than NHAs and DONs with shorter tenures. Some quality benefits have been identified for top managers with longer tenures (Decker & Castle, 2010), this finding may reflect a further benefit of longer top-management tenure and could be included in future research.…”

Section: Discussionmentioning

confidence: 92%

Safety culture of nursing homes

Castle

Wagner²,

Ferguson³

et al. 2011

Health Care Management Review

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Background Examining the perception of the patient safety culture (PSC) of top managers in healthcare settings is important because their orientation to PSC can have a large influence on the facility. Purposes In this research, the perception of the PSC of Nursing Home Administrators (NHAs) and Directors of Nursing (DONs) is examined. Methodology/Approach Primary data were collected to examine the opinions of the PSC from NHAs and DONs. Information was collected from a large nationally representative sample of 4,000 nursing homes. The Nursing Home Survey on Patient Safety Culture (NHSPSC) survey instrument was used as a measure of PSC. This has 12 domains and 38 items. Bias indexes, intraclass correlation coefficients, and Pearson’s product-moment correlation coefficients of the differences between NHA and DON item scores were examined. Findings Using a 0–100 scale, most scores fell into the 55–80 range. Higher scores represent a higher (more favorable) PSC. Agreement between the NHA and DON was excellent for 10 items, good in 15 items, moderate in 4 items, and poor in 8 items. Of the 4 largest differences in scores, the NHA scores were higher than the DON scores for one item and DON scores were higher than the NHA scores for 3 items. Implications The overall perception from both NHAs and DONs, would appear to represent a somewhat “positive” outlook from these top managers on their institution’s PSC. However, NHAs in general report higher scores than DONs. The areas of divergence between these top managers are further discussed, with a view towards directing future patient safety investigations and initiatives in nursing homes.

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Section: Discussionmentioning

confidence: 92%

Safety culture of nursing homes

Castle

Wagner²,

Ferguson³

et al. 2011

Health Care Management Review

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“…Data on selected organizational characteristics that research has suggested to be associated with quality of care—ownership, chain membership, facility size, occupancy, and Medicaid census—were included in this study (Castle & Engberg, 2008; Decker & Castle, in press; Dellefield, 2006). Organizational size was measured as the number of beds in the NH and was dichotomized into (0) less than 100 beds and (1) greater than or equal to 100 beds.…”

Section: Methodsmentioning

confidence: 99%

“…Two market characteristics that previous research has suggested to be associated with quality of care—market competition and unemployment rates—were included in this study (Carter & Porell, 2003; Castle, Liu, & Engberg, 2008; Decker & Castle, in press). Market competition, measured as the inverse of the number of nursing homes in the country, is believed to affect quality of care by creating greater market competition (Decker & Castle, in press).…”

Section: Methodsmentioning

confidence: 99%

“…Market competition, measured as the inverse of the number of nursing homes in the country, is believed to affect quality of care by creating greater market competition (Decker & Castle, in press). Unemployment rate, measured as the percentage of people in the county that were unemployed, may affect quality of care, since local economic conditions can influence the ability of NHs to provide high quality care (Castle & Engberg, 2008).…”

Section: Methodsmentioning

confidence: 99%

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Director of nursing current job tenure and past experience and quality of care in nursing homes

Krause

2012

Health Care Management Review

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Background Directors of nursing (DON) are central to quality of care in nursing homes (NH) because of their role in coordinating and overseeing nursing care. Research is needed to test the association between DON characteristics and quality using large, representative samples of NHs and global measures of quality. One such measure is the quality measure (QM) rating from the Centers for Medicare & Medicaid Services’ Five-Star Quality Rating, which aggregates 10 individual QMs into a single rating. Purpose This study examined whether DON current job tenure or past experience (1) differed across levels of the QM rating, (2) was associated with QM ratings, and (3) was associated with any of the individual 10 QM scores that comprise QM ratings. Methodology Data for a nationally representative sample of 1,174 NHs were obtained from the 2004 National Nursing Home Survey, publicly-reported QMs, and an Area Resource File. Wald tests were used to test differences in mean DON current job tenure and past experience across levels of the QM rating. Multinomial logistic and Poisson regression analyses were used to examine the association between DON current job tenure and past experience and QM ratings and QM scores, respectively, controlling for selected market and organizational characteristics. Findings NHs with longer DON current job tenure tended to have higher QM ratings. Longer DON current job tenure was associated with higher QM ratings and lower QM scores for several individual QMs, suggesting higher quality. DON past experience did not differ across levels of the QM rating and was neither associated with QM ratings or QM scores. Practice Implications This study highlights the need for owners and administrators to support DONs as they either transition into the role of the DON for the first time or learn to effectively fulfill their role in a new NH.

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“…A study conducted by Decker and Castle (2011) examined the 2004 National Nursing Home Survey and found that 32% of administrators had received a graduate degree, 50% had a bachelor's degree, and 17% had a high school or associate degree. However, the association between education and quality of care was not examined in this study.…”

Section: Educational Backgroundmentioning

confidence: 99%