Staff Turnover and Quality of Care in Nursing Homes
Medical CarePublished 19 May 2005
Nicholas G. Castle, John Engberg
Citations409
SJR quartileQ1
SJR score1.57
SNIP1.38
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Multivariate analysis shows that decreases in quality are associated with decreases in RN turnover, and with increases in NA and LPN turnover, especially increases from moderate-to-high levels of turnover.
Abstract
These findings are significant because the belief that staff turnover influences quality is pervasive. The cross-sectional results are only able to show associations, nonetheless, few empirical studies in the literature have shown this relationship.
Keywords
Social SciencesHealth Professions
The Journals of Gerontology Series BNursing Home Staffing and Its Relationship to Deficiencies
506 Citations2000Charlene Harrington, David Zimmerman +3 more
Facility characteristics and states were stronger predictors of deficiencies than were staffing hours and resident characteristics, and much work remains to explore factors that influence deficiencies.
The consequences of turnover
476 Citations1980Barry M. Staw
Academy of Management ReviewOptimal and Dysfunctional Turnover: Toward an Organizational Level Model
348 Citations1984Michael A. Abelson, Barry D. Baysinger
The model presented posits that individual, organizational, and environmental attributes influence individual quit propensities of employees and, hence, expected turnover rates for the organization.
Journal of the American Geriatrics SocietyNursing Home Facility Risk Factors for Infection and Hospitalization: Importance of Registered Nurse Turnover, Administration, and Social Factors
262 Citations2002Sheryl Zimmerman, Ann L. Gruber‐Baldini +3 more
Determine the relationship between a broad array of structure and process elements of nursing home care and resident infection and hospitalization for infection and the consequences of infection.
Journal of Aging and HealthCharacteristics of Nursing Homes that Affect Resident Outcomes
248 Citations1991William D. Spector, Hitomi Adrianna Takada
Results suggest that higher staff levels and lower RN turnover were related to functional improvement, and facilities with high catheter use, low rates of skin care, and low participation in organized activities were associated with negative outcomes.
Journal of the American Geriatrics SocietyA Longitudinal Study of Risk Factors Associated with the Formation of Pressure Ulcers in Nursing Homes
222 Citations1994Gary H. Brandeis, Wee Lock Ooi +3 more
The objective of this study is to determine risk factors associated with the formation of stage II—IV pressure ulcers in nursing homes.
The GerontologistThe Quality of Quality Measurement in U.S. Nursing Homes
186 Citations2003Vincent Mor, Katherine Berg +4 more
Nursing home Quality Indicators now in use are multidimensional and quarterly estimates of incidence-based measures can be relatively unstable, suggesting the need for some averaging of measures over time.
Journal of Gerontological NursingDeterminants of Satisfaction and Turnover among Nursing Assistants: THE RESULTS OF A STATEWIDE SURVEY
179 Citations2003Sharon Parsons, William Paul Simmons +2 more
The multivariate analysis confirmed that professional growth and involvement in work-related decisions, supervision, and management keeping employees informed were significantly related to both turnover and overall satisfaction.
Medical Care Research and ReviewNursing Home Staffing, Turnover, and Case Mix
168 Citations2003Charlene Harrington, James H. Swan
This study examined the predictors of total nurse and registered nurse staffing hours per resident day separately in all free-standing California nursing homes using staffing data from state cost reports in 1999, taking into account nursing turnover rates, resident case mix levels, and other factors.
International Journal of Geriatric PsychiatryImproving nursing home quality of care through outcomes data: the MDS quality indicators
158 Citations2003David Zimmerman
The quality of care provided to nursing home residents is a continuing source of concern throughout the world and in the United States, the Health Care Financing Administration mandated the use of a standardised resident assessment instrument, called the Minimum Data Set (MDS), which facilitated the development of a set of nursing homequality of care indicators.
Research in Nursing & HealthThe influence of registered nurse staffing on the quality of nursing home care
154 Citations1990Donna J. Munroe
A positive, significant relationship existed between nursing home quality and the ratio of RN hours to licensed vocational nurse (LVN) hours per resident day.
The GerontologistAn Exploration of Job, Organizational, and Environmental Factors Associated With High and Low Nursing Assistant Turnover
152 Citations2002D. R. Brannon, J. S. Zinn +2 more
Factors that distinguish nursing facilities with very high and very low nursing assistant turnover rates from a middle referent group are examined, exploring the possibility that high and low turnover are discrete phenomena with different antecedents.
Medical CareInfluence of Facility Characteristics on Use of Antipsychotic Medications in Nursing Homes
150 Citations2000Carmel Hughes, Kate L. Lapane +1 more
Facility and resident characteristics are associated with use of antipsychotic medications, although the extent to which these factors explain variability in use of anti-psychotic medications may vary on the basis of the underlying financial incentives of the institution.
Nursing ManagementTurnover Among Nursing Home Staff
132 Citations1997Jiska Cohen‐Mansfield
Research demonstrates links between turnover and employment/employee characteristics and employment availability, and for the cognitively impaired nursing home resident, constant change of staff is bound to aggravate disorientation.
Medical CareThe Costs of Urinary Incontinence in Nursing Homes
122 Citations1984Joseph G. Ouslander, Robert L Kane
Management of UI with indwelling catheters results in the lowest firstorder costs, but the second-order costs probably outweigh any cost savings, and more active evaluation and treatment in nursing homes could result in considerable cost savings and improved well-being for both patients and caregivers.
Medical Care Research and ReviewPhysical Restraints in Nursing Homes: A Review of the Literature Since the Nursing Home Reform Act of 1987
122 Citations1998Nicholas G. Castle
The authors review the literature on the use and consequences of physical restraints in nursing homes since the passage of the NHRA and addresses demographic and clinical characteristics of residents that have been found to be associated with restraint use.
Medical CareRisk-Adjusted Outcome Measures and Quality of Care in Nursing Homes
117 Citations1997Dana B. Mukamel
This study demonstrates that valid risk-adjusted outcome measures of quality can be developed based on data collected for reimbursement purposes, and measures based on ADL decline, deterioration in decubiti, and physical restraints rates met all validity criteria.
The GerontologistQuality Report Cards and Nursing Home Quality
95 Citations2003Dana B. Mukamel, William D. Spector
Experience with report cards in other areas of the health care system suggests that nursing home quality reports may have a role to play in informing consumers' choices and providing incentives for quality improvement.
The GerontologistPsychotropic Drug Use in Long-term Care Facilities: A Review of the Literature
85 Citations1992Charlene Harrington, Connie A. Tompkins +2 more
It is found that a substantial proportion of nursing home residents are taking psychotropic drugs on a regular, long-term basis and this usage is accompanied by prescribing and monitoring problems and many potential adverse risks.
Medical CareFacility and Area Variation Affecting the Use of Physical Restraints in Nursing Homes
79 Citations1996Charles D. Phillips, Catherine Hawes +4 more
Controlling for residents' physical and cognitive function, facility characteristics and location had a significant impact on restraint practices, and those facilities with low nurse staffing were more likely to restrain residents.
Journal of Advanced NursingA descriptive study of pressure sores: the prevalence of pressure sores and the characteristics of patients
78 Citations1982Anna‐Christina Ek, G Boman
It was found that within the public health services area there was a pressure sore frequency of 4%; i.e. 71 patients of a total of 1776 had pressure sores; the total number of sores was 109 and the methods of prevention and treatment were numerous.
The GerontologistDesigning a Report Card for Nursing Facilities: What Information Is Needed and Why
77 Citations2003Charlene Harrington, Janis O’Meara +3 more
A rationale and conceptual framework for making comprehensive consumer information about nursing facilities available can meet the needs of various stakeholder groups, including consumers, family/friends, health professionals, providers, advocates, ombudsman, payers, and policy makers.
PubMedThe relationship between quality of care and financial performance in nursing homes.
59 Citations2003Robert Weech‐Maldonado, Gerald Neff +1 more
Findings indicate that nursing homes that produce high quality care are able to achieve lower resident costs and in the process, report better financial performance than those facilities producing lower quality care.
The GerontologistThe Minimum Data Set Prevalence of Restraint Quality Indicator: Does It Reflect Differences in Care?
52 Citations2004John F. Schnelle, Barbara M. Bates‐Jensen +5 more
There were differences in the use of in-bed restraining devices, and residents in high-restraint homes were in bed more often during the day, which reflect important differences in quality of care between homes, even though these differences are not what the restraint prevalence quality indicator purports to measure.
Evaluation & the Health ProfessionsUsing Outcomes to Make Inferences about Nursing Home Quality
45 Citations1998William D. Spector, Dana B. Mukamel
The authors discuss the difficulty in isolating the facility effect when studying nursing home outcomes and implications of using different estimation approaches and the need to integrate research with outcome-based quality assurance systems to allow ongoing evaluation and quality improvement.
Medical CareNursing Home Survey Deficiencies for Physical Restraint Use
43 Citations1995David R. Graber, Philip D. Sloane
These findings indicate that, despite implementation of these regulations, nearly one third of North Carolina nursing home residents remained physically restrained, and the characteristics associated with restraint use and with restraints violations can be used to identify facilities most likely to benefit from assistance and education in reducing physical restraints.
The GerontologistStaff Development and Morale Building In Nursing Homes
37 Citations1974A. N. Schwartz
Nursing ManagementCosting Nurse Turnover in Nursing Homes
26 Citations1991MARIAN E. CAUDILL, Maxine Patrick
The GerontologistProfile of the Nurse's Aide--Expanding Her Role as Psycho-Social Companion to the Nursing Home Resident
22 Citations1973S. S. Handschu
Social Science & MedicinePredicting turnover rates among the staff of English and Welsh old people's homes
22 Citations1983Martín Knapp, Spyros Missiakoulis
Using data on the personal characteristics of 8588 staff employed in old people's homes in England and Wales during 1976-1977, the individual propensities to change jobs and to leave social work-related employment altogether were found to be significantly associated with age, sex, length of service, basic education and professional qualifications.
Journal of Geriatric Psychiatry and NeurologyCorrelates of Behavioral Disturbances and Pattern of Psychotropic Medication Use in Five Skilled Nursing Facilities
6 Citations2003Fadi H. Ramadan, Bruce J. Naughton +1 more
The higher use of neuroleptics and benzodiazepines in the behavior group compared with the nonbehavior group indicates that BDs are being identified for treatment, but the medications used may not be efficacious.
