title: Use of agency staff in nursing homes.
abstract: This article describes the extent and degree of use of agency staff by nursing homes and examines the relationship between agency staffing levels and quality of care in a large sample of nursing homes (N = 3,876). The quality indicators came from the Nursing Home Compare Web site. It was found that many nursing homes used agency staff (approximately 60% used at least some), and a strong association between better quality and lower agency use existed for both nurse aides and RNs. The influence on quality for the highest levels of agency use, compared with no agency use, was clinically significant. On the basis of these findings, facilities considering using high levels of agency staff should do so carefully.
authors.affiliation: Department of Health Policy and Management, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA 15261, USA. CASTLEN@Pitt.edu
authors.forename: Nicholas G
authors.initials: NG
authors.lastname: Castle
mesh_terms: D001509:Bed Occupancy / Q000706:statistics & numerical data; D006276:Health Facility Size / Q000706:statistics & numerical data; D006302:Health Services Research; D006801:Humans; D016294:Models, Nursing; D015999:Multivariate Analysis; D015401:Nursing Administration Research; D009728:Nursing Assistants / Q000600:supply & distribution*; D009735:Nursing Homes; D009740:Nursing Staff / Q000600:supply & distribution*; D009743:Nursing, Practical; D020416:Outsourced Services / Q000458:organization & administration*; D010067:Ownership / Q000706:statistics & numerical data; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D019984:Quality Indicators, Health Care / Q000458:organization & administration*; D012044:Regression Analysis; D014481:United States; D000078329:Workforce