The Relationship Between Nurse Staffing in Nursing Homes and Quality Indicators

Issues in Conducting Research in Nursing Homes

“…The model is reinforced by reimbursement that underestimates the cost of quality nursing care. Some research suggests that poor quality is due to inadequate numbers and types of nursing staff workers, yet the relationships of number and types of nursing staffers to quality resident outcomes are understudied (Aaronson, Zinn, & Rosko, 1994;Dellefield, 2000;Munroe, 1990). It is likely, however, that shortage and turnover of staff members and too few registered nurses with specific geriatric training are reasons for poor quality of care (Ouslander, Maloney, Grasela, Rogers, & Walawander, 2001).…”

“…This is especially true in nursing homes and other long-term care settings where there is an urgency to increase the quality of care (Dellefield, 2000).…”

Patient safety culture assessment in the nursing home

“…Adequate nurse staffing levels are important to ensure quality and reduce risks of healthcare problems. [23][24][25][26] When compared with doctors and advanced practitioners, nurses were more likely to perceive that there was enough staff to handle the workload, the staff were not working for more hours than is best for patient care, and the staff was not trying to do too much too quickly. This finding is in contrast with recent studies documenting insufficient nursing staff and difficulties in recruiting and retaining qualified staff.…”

The Institutional Practice

“…Nurse staffing patterns: The ways in which nursing home staff influence hospitalization has been covered extensively by the research literature (Anderson et al 1998, Anderson et al 2003, Carter 2003a, Carter 2003b, Decker 2006, Decker 2008, Dellefield 2000, Harrington et al 2000, Intrator et al 1999, Konetzka et al 2008, Weech-Maldonado et al 2004, Zimmerman et al 2002. The literature typically focuses on a) whether or not an isolated professional category influences hospitalization or b) the composition of the different professional categories and what composition is optimal.…”

“…International literature points to conflicting findings regarding the effect of advanced directives on the decision making process, arguing, for instance, that directives fail to properly guide nursing home staff in decisions (Lopez 2009, Terrell & Miller 2006, Carter 2003b, Dellefield 2000, Kayser-Jones et al 1989). Others show contradicting or modifying evidence (Intrator et al 1999, Konetzka et al 2008, O'Malley et al 2011.…”