Measuring nursing care time and tasks in long-term services and supports:  one size does not fit all.
BACKGROUND
Although most staff in long-term care services and support (LTSS) are nursing care personnel, a method for measuring the provision of nursing care has not yet been developed.


OBJECTIVE
We sought to understand the challenges of measuring nursing care across different types of LTSS using a qualitative approach that included the triangulation of data from three unique sources.


RESULTS
Six primary challenges to measuring nursing care across LTSS emerged. These included (a) level of detail about time of day, amount of time, or type of tasks varied by type of nursing and organization; (b) time and tasks were documented across clinical records and administrative databases; (c) data existed in both paper and electronic formats; (d) several sources of information were needed to create the fullest picture of nursing care; (e) data were inconsistently available for contracted providers; and (f) documentation of informal caregiving was unavailable. Differences were observed between assisted living facilities and home- and community-based services compared with nursing homes. Differences were also observed across organizations within a setting. A commonality across settings and organizations was the availability of an electronically stored care plan specifying individual needs, but not necessarily how these would be met.


CONCLUSIONS
Findings demonstrate the variability of data availability and specificity across three distinct LTSS settings. This study is an initial step toward establishing a process for measuring the provision of nursing care across LTSS in order to explore the range of nursing care needs of LTSS recipients and how these needs are currently fulfilled.
School of Nursing, Duke University, Durham, NC 27710, USA. janet.bettger@duke.edu
Janet Prvu
JP
Bettger
Julie A
JA
Sochalski
Janice B
JB
Foust
Cynthia D
CD
Zubritsky
Karen B
KB
Hirschman
Katherine M
KM
Abbott
Mary D
MD
Naylor
D000368:Aged; D040561:Assisted Living Facilities / Q000592:standards; D014487:Centers for Medicare and Medicaid Services, U.S.; D057286:Electronic Health Records / Q000592:standards; D006699:Home Care Services / Q000592:standards; D006801:Humans; D008134:Long-Term Care / Q000379:methods*; D009515:New Jersey; D009518:New York; D009732:Nursing Care / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D009735:Nursing Homes / Q000592:standards; D009740:Nursing Staff / Q000523:psychology / Q000706:statistics & numerical data*; D010414:Pennsylvania; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000379:methods*; D012189:Retrospective Studies; D012944:Social Support; D013996:Time and Motion Studies; D014481:United States; D000078329:Workforce