Staffing characteristics, turnover rates, and quality of resident care in nursing facilities.
Despite substantial spending and considerable regulatory oversight, the quality of care provided to residents in the nation's nursing facilities is inadequate, and strategies to address this problem are needed. Staffing characteristics are important predictors of quality in nursing facilities, and the relationship between staffing and various quality measures fluctuates across studies and in analyses that account for the effects of market, resident, and organizational characteristics. However and even with such variations, it is has generally been concluded that higher staffing levels, less turnover, and higher retention rates are associated with an array of improved resident and facility outcomes. This article synthesizes literature, including published reports, expert opinion, and peer reviewed studies, on staffing levels, turnover, and quality of care in nursing homes. The findings were used to develop three staffing interventions that need to be further evaluated in an effort to improve the quality of care in nursing facilities.
Collier
Eric
E
Department of Social and Behavioral Sciences, School of Nursing, University of California-San Francisco, 3333 California Street, San Francisco, CA 94118, USA. Eric.Collier@ucsf.edu
Harrington
Charlene
C
D014487:Centers for Medicare and Medicaid Services, U.S.; D006287:Health Planning Guidelines; D006801:Humans; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D015401:Nursing Administration Research; D009735:Nursing Homes / Q000458:organization & administration*; D009740:Nursing Staff / Q000193:education / Q000600:supply & distribution*; D010043:Outcome and Process Assessment, Health Care; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D010563:Personnel Turnover / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000458:organization & administration*; D014481:United States