Nursing effort and quality of care for nursing home residents

Gregory Arling, Robert L. Kane, Christine Mueller, Julie Bershadsky, Howard B. Degenholtz

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Purpose: The purpose of this study was to determine the relationship between nursing home staffing level, care received by individual residents, and resident quality-related care processes and functional outcomes. Design and Methods: Nurses recorded resident care time for 5,314 residents on 156 units in 105 facilities in four states (Colorado, Indiana, Minnesota, and Mississippi). We linked residents' care times to their measures of health and functioning from Minimum Data Set assessments. Major variables were unit- and resident-specific minutes of care per day, process measures (physical restraints, range of motion, toileting program, and training in activities of daily living [ADLs]), outcome measures (ADL decline, mobility decline, and worsening behavior between the time study and 90-day follow-up), and covariates such as unit type and resident health status. We used multilevel analysis to examine staffing and quality relationships. Results: Residents with toileting programs, range of motion or ADL training, and restraints received significantly more care from unlicensed but not from licensed staff. However, functional outcomes were not significantly related to care received from licensed or unlicensed staff, except for ADL decline, which was greatest for residents receiving more unlicensed minutes of care. Unit staffing level (licensed and unlicensed) was unrelated to any of the care processes or outcome measures, although higher overall staffing was associated with more time devoted to direct resident care. Implications: Future research into nursing home quality should focus on organization and delivery rather than simply the amount of care available.

Original languageEnglish
Pages (from-to)671-682
Number of pages12
JournalGerontologist
Volume47
Issue number5
StatePublished - Oct 2007

Fingerprint

Quality of Health Care
Activities of Daily Living
Nursing Homes
Nursing
Process Assessment (Health Care)
Articular Range of Motion
Outcome Assessment (Health Care)
Physical Restraint
Mississippi
Multilevel Analysis
Time and Motion Studies
Health Status
Teaching
Nurses
Organizations
Health

Keywords

  • Multilevel model
  • Nurse staffing
  • Nursing home
  • Outcomes
  • Quality

ASJC Scopus subject areas

  • Aging

Cite this

Arling, G., Kane, R. L., Mueller, C., Bershadsky, J., & Degenholtz, H. B. (2007). Nursing effort and quality of care for nursing home residents. Gerontologist, 47(5), 671-682.

Nursing effort and quality of care for nursing home residents. / Arling, Gregory; Kane, Robert L.; Mueller, Christine; Bershadsky, Julie; Degenholtz, Howard B.

In: Gerontologist, Vol. 47, No. 5, 10.2007, p. 671-682.

Research output: Contribution to journalArticle

Arling, G, Kane, RL, Mueller, C, Bershadsky, J & Degenholtz, HB 2007, 'Nursing effort and quality of care for nursing home residents', Gerontologist, vol. 47, no. 5, pp. 671-682.
Arling G, Kane RL, Mueller C, Bershadsky J, Degenholtz HB. Nursing effort and quality of care for nursing home residents. Gerontologist. 2007 Oct;47(5):671-682.
Arling, Gregory ; Kane, Robert L. ; Mueller, Christine ; Bershadsky, Julie ; Degenholtz, Howard B. / Nursing effort and quality of care for nursing home residents. In: Gerontologist. 2007 ; Vol. 47, No. 5. pp. 671-682.
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