J Korean Acad Nurs.  2014 Feb;44(1):21-30. 10.4040/jkan.2014.44.1.21.

Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals

• Kim Y
• Lee JY
• Kang H

• KMID: 1730903
• DOI: http://doi.org/10.4040/jkan.2014.44.1.21

Abstract

PURPOSE
This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals.
METHODS
A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators.
RESULTS
Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable.
CONCLUSION
To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

Keyword

Nurse staffing; Registered nurse; Patient outcome; Turnover; Long term care

MeSH Terms

Activities of Daily Living
Dementia/physiopathology
Humans
Inpatients/*psychology
Long-Term Care
National Health Programs
Nursing Staff, Hospital/psychology/*statistics & numerical data
Personnel Turnover
Pressure Ulcer/etiology
*Quality Indicators, Health Care
Risk Factors