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Multicenter Study
. 2018 Oct 3;18(1):750.
doi: 10.1186/s12913-018-3552-5.

The associations between staffing hours and quality of care indicators in long-term care

Veronique M Boscart  1   2   3 , Souraya Sidani  4 , Jeffrey Poss  5 , Meaghan Davey  6   7   8 , Josie d'Avernas  9   10 , Paul Brown  10 , George Heckman  5   9 , Jenny Ploeg  8 , Andrew P Costa  9   8
Affiliations
Multicenter Study

The associations between staffing hours and quality of care indicators in long-term care

Veronique M Boscart et al. BMC Health Serv Res. .

Abstract

Background: Long-term care (LTC) staffing practices are poorly understood as is their influence on quality of care. We examined the relationship between staffing characteristics and residents' quality of care indicators at the unit level in LTC homes.

Methods: This cross-sectional study collected data from administrative records and resident assessments from July 2014 to June 2015 at 11 LTC homes in Ontario, Canada comprising of 55 units and 32 residents in each unit. The sample included 69 registered nurses, 183 licensed/registered practical nurses, 858 nursing assistants, and 2173 residents. Practice sensitive, risk-adjusted quality indicators were described individually, then combined to create a quality of care composite ranking per unit. A multilevel regression model was used to estimate the association between staffing characteristics and quality of care composite ranking scores.

Results: Nursing assistants provided the majority of direct care hours in LTC homes (76.5%). The delivery of nursing assistant care hours per resident per day was significantly associated with higher quality of resident care (p = < 0.01). There were small but significant associations with quality of care for nursing assistants with seven or more years of experience (p = 0.02), nursing assistants late to shift (p = < 0.01) and licensed/registered practical nurses late to shift (p = 0.02).

Conclusions: The number of care hours per resident per day delivered by NAs is an important contributor to residents' quality of care in LTC homes. These findings can inform hiring and retention strategies for NAs in LTC, as well as examine opportunities to optimize the NA role in these settings.

Keywords: Health care aides; Long-term care; Nursing assistants; Nursing homes; Quality of care.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Conestoga College Research Ethics Board (REB-118) Hamilton Integrated Research Ethics Board (0739D – McMaster University). Participant consent was not required given that the data used in this study were from existing anonymized records in compliance with the requirements for the secondary use of health information outlined in our provincial legislation (Province of Ontario Personal Health Information Protection Act, 2004, S.O. 2004, c. 3, Sched. A).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Nursing Home Care FastStats. Centers for disease control and prevention (online). https://www.cdc.gov/nchs/data/series/sr_03/sr03_038.pdf. Accessed 6 Mar 2017.
    1. Living arrangements of seniors. Statistics Canada (online). https://www12.statcan.gc.ca/census-recensement/2011/as-sa/98-312-x/98-31.... Accessed 6 Mar 2017.
    1. Moore KL, Boscardin WJ, Steinman MA, Schwartz JB. Age and sex variation in prevalence of chronic medical conditions in older residents of U.S. nursing homes. J Am Geriatr Soc. 2012;60:756–764. doi: 10.1111/j.1532-5415.2012.03909.x. - DOI - PMC - PubMed
    1. National Nursing Homes Survey. Centers for disease control and prevention (online). https://www.cdc.gov/nchs/nnhs/resident_tables_estimates.htm. Accessed March 6, 2017.
    1. When a nursing home is home: how do Canadian nursing homes measure up on quality? Canadian Institute for Health Information (online). https://secure.cihi.ca/free_products/CCRS_QualityinLongTermCare_EN.pdf. Accessed March 6, 2017.

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