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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Charlene Harrington, PhD, Department of Social & Behavioral Sciences, University of California San Francisco, 3333 California St, Suite 455, San Francisco, CA 94143-0612, (415) 476-4030, chas@itsa.ucsf.edu and James H. Swan, PhD, Department of Public Health Sciences, Wichita State University, 1845 N. Fairmount, Box 152, Wichita, KS 67620-0152.
Many studies have documented the importance of nursing staff in both process and outcomes of nursing home care. This study examined nurse staffing levels to understand what factors influence facility decisions about nurse staffing, using nurse staffing data from California cost reports. The study examined: resident casemix; nursing staff turnover rates, facility characteristics, county demographic and economics variables, and county health industry factors to predict total nurse staffing in individual nursing facilities, in a sample of 1,155 California facilities. Analysis employed a two-stage least-square model (2SLS), treating total nurse staffing hours per resident day, resident dependency (ADLs), and nursing turnover rates as endogenous. Average total nurse staffing in California was 3.2 hours per resident day in 1999, somewhat lower than the national average. In the 2SLS analysis, resident dependency positively predicted and nurse turnover rates negatively predicted nurse staffing levels, both as hypothesized. Also as expected, staffing hours predicted higher dependency and lower turnover; and higher dependency predicted higher turnover. High turnover also predicted higher dependency, contrary to expectation. It appears that facilities do take resident need for care into account, but it is unclear whether they adequately do so. Considering the nurse shortages and high turnover rates, these findings suggest that facilities place greater emphasis on staff retention, to reduce effort devoted to recruitment. Facilities need examine the factors that encourage turnover and make efforts to address turnover problems.
Learning Objectives:
Keywords: Long-Term Care, Staff Retention
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.