RN staffing time and outcomes of long-stay nursing home residents

Pressure Ulcers and Direct Patient Care

Pressure ulcers and other undesirable outcomes of long-stay nursing home residents are less common as RNs spend more time on direct patient care. AJN 58-70 in the American Journal of Nursing, 105(11).

Research on Nursing Staffing Levels and Patient Outcomes

The majority of research on the impact of nursing staffing levels on patient outcomes has focused on hospitals. Researchers appear to have overlooked the importance of determining the nature of these connections in long-term care facilities like nursing homes. The study is an examination of data obtained from 1376 inhabitants of 82 long-term care facilities. The data was collected in the course of the National Pressure Ulcer Long-Term Study. The sample was made up of patients who had stayed within the facilities for at least two weeks. The data was retrieved from medical records between 1996 and 1997. Pressure ulcer, urinary tract infection, weight loss, deteriorating ability to perform urinary tract infection (UTIs) and the length of hospitalization were the dependent variables in this research. The independent variables included severity of illnesses, resident demographics, nurse staffing time and medications administered. The results show that an increase in the number of registered nurse direct care hours per resident are associated with fewer pressure ulcers, less urinary tract infections, less chances of weight loss, better ability to perform activities of daily living and a reduction in the length of hospitalization period. However, increased nursing assistant and licensed practical nurse time had no significant impact on the variables. Therefore, there is need to improve registered nurse staffing in order to realize positive patient outcomes.

Decker's Study on Nursing Home Stays and Discharge Status

Decker, F. H. (2006). Nursing staff and the outcomes of nursing home stays. Medical Care, 44(9), 812-821.

Decker’s study seeks to determine the relationship between the length of stay in nursing homes and discharge status of the patients. The study utilizes data collected in 1999 during the National Nursing Home Survey. The data was collected on 6386 nursing home residents. The sample was divided into short-stay and long-stay residents on the basis of models constructed applying multinational logistical regression. The results for this study show that individuals who stayed for longer than 60 days left the respective nursing homes in a stabilized condition. The positive results were enhanced where the facility had a higher ratio of registered nurses. According to Decker (2006), most studies concentrate on the effect of duration of stay and death as the major variables. However, there are other factors that can be studied to determine how staffing affects the quality of care provided to nursing homes’ residents. There also multiple ways of determining the quality of staffing that should be used by researchers as independent variables.

Nursing Staffing and Resident Outcomes in Nursing Homes

Dyck, M. J. (2007). Nursing staffing and resident outcomes in nursing homes: weight loss and dehydration. Journal of nursing care quality, 22(1), 59-65.

Dyck conducts a secondary analysis on databases used to determine how nurse staffing and outcomes of nursing home residents are related. The nursing home outcomes under study in this case are dehydration and weight loss. The patients in the facility from which data was collected were divided into two groups: that which received over 3 hours of nursing assistant time and that which received less than three hours. The data used in this study was collected from 363,895 residents residing in 2951 different homes spread across America. Prevalence of dehydration and weight loss were used as quality indicators in the nutrition domain. The results showed that there was a positive correlation between the number of hours of daily nursing care and positive indicators in the nutrition domain. The presence of the nurses in the dining room helps them ask key questions regarding the nutrition of a patient. The questions are then used to structure hydration and eating interventions. According to Dyck (2007), registered nurses assume leadership in most roles in the nursing home and are able to guide other staff members on how they can decrease cases of weight loss and dehydration among the residents.

References

Decker, F. H. (2006). Nursing staff and the outcomes of nursing home stays. Medical Care, 44(9), 812-821.

Dyck, M. J. (2007). Nursing staffing and resident outcomes in nursing homes: weight loss and dehydration. Journal of nursing care quality, 22(1), 59-65.

Horn, S. D., Buerhaus, P., Bergstrom, N., & Smout, R. J. (2005). RN staffing time and outcomes of long-stay nursing home residents: pressure ulcers and other adverse outcomes are less likely as RNs spend more time on direct patient care. AJN The American Journal of Nursing, 105(11), 58-70.