title: [Impact of nurse, nurses' aid staffing and turnover rate on inpatient health outcomes in long term care hospitals].
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: College of Nursing, Eulji University, Sungnam, Korea.
authors.forename: Yunmi
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Nursing, Kangwon National University, Chuncheon, Korea. leejiyun@kangwon.ac.kr.
authors.forename: Ji Yun
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Informational Statistics, Hoseo University, Asan, Korea.
authors.forename: Hyuncheol
authors.initials: H
authors.lastname: Kang
mesh_terms: D000203:Activities of Daily Living; D003704:Dementia / Q000503:physiopathology; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008134:Long-Term Care; D009313:National Health Programs; D009741:Nursing Staff, Hospital / Q000523:psychology / Q000706:statistics & numerical data*; D010563:Personnel Turnover; D003668:Pressure Ulcer / Q000209:etiology; D019984:Quality Indicators, Health Care; D012307:Risk Factors
keywords: Long term care; Nurse staffing; Patient outcome; Registered nurse; Turnover