Increasing Registered Nurse Hours Per Resident Day for Improved Nursing Home Residents’ Outcomes Using a Longitudinal Study
Abstract
:1. Introduction
2. Methods
2.1. Study Design
2.2. Sampling
2.3. Data Collection
2.4. Covariates
2.5. Analysis
3. Results
4. Discussion
5. Conclusions
Limitation
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Demographics | Frequency (%) | Mean(SD) | Min–Max | |
---|---|---|---|---|
Ownership | ||||
For profit | 14 (18.82) | |||
Not for profit | 60(81.08) | |||
Operation duration (years) | 11.27(5.35) | 3–36 | ||
Bed size | 72.06(52.53) | 7–296 | ||
Occupancy rate | 92.29(12.34) | 40.00–103.45 | ||
Location of organizations | ||||
Metropolitan (>1 million) | 32(43.24) | |||
Medium size (500 thousand–1 million) | 17(22.97) | |||
Small size (50–500 thousand) | 18(24.32) | |||
Rural area (<50 thousand) | 7(9.47) | |||
HHI | 0.0006348 (0.0018310) | 0.0000250–0.0324000 | ||
Facility evaluation by Korean National Insurance Corporation | ||||
A grade a | 27(36.49) | |||
B grade b | 13(17.57) | |||
C grade c | 11(14.86) | |||
D grade d | 9(12.16) | |||
E grade e | 0(0.00) | |||
Excluded from evaluation f | 14(18.92) | |||
Hours Per Resident Day (Hour) | ||||
RN | 0.179(0.205) | 0–1.030 | ||
CNA | 0.335(0.206) | 0–1.425 | ||
CW | 3.545(1.350) | 3.131–11.126 | ||
Director | 0.243(0.165) | 0–1.425 | ||
Secretary | 0.132(0.129) | 0–0.570 | ||
Social worker | 0.407(0.293) | 0–3.663 | ||
Administrative staff | 0.139(0.169) | 0–1.368 | ||
Dietician | 0.091(0.089) | 0–0.438 | ||
Cook | 0.367(0.224) | 0–1.425 | ||
Number of RN per facility | 1.567(3.034) | 0 | 0–17 | |
Skill mix | ||||
RN:CNA | 1:1.20 | |||
RN:CW | 1:17.08 | |||
Turnover rate | ||||
RN | 6.696(17.189) | 0 | 0–100 | |
CNA | 14.077(23.710) | 0 | 0–100 | |
CW | 16.187(15.807) | 0 | 0–86.179 | |
Quality of care (%) | ||||
Cognitive impairment | 67.76 | |||
Urinary Incontinence | 42.10 | |||
Antidepressant of sleeping pill | 27.83 | |||
Fecal Incontinence | 22.62 | |||
Bed rest | 21.91 | |||
Physically restrained | 6.40 | |||
Tube feeding | 6.36 | |||
Aggressive behavior | 5.62 | |||
Depression | 5.45 | |||
Fall prevalence | 4.63 | |||
Help for daily living | 4.24 | |||
Slip prevalence | 3.46 | |||
Hospital admission | 2.67 | |||
Range of motion | 2.51 | |||
10% Weight loss | 1.69 | |||
5% Weight loss | 1.35 | |||
Pressure sore prevalence | 1.27 | |||
Dehydration | 0.72 |
1 Time | 2 Times | 3 Times | 4 Times | 5 Times | 6 Times | 7 Times | |
---|---|---|---|---|---|---|---|
Hours Per Resident Day (Hour) | |||||||
RN | 0.168 | 0.180 | 0.199 | 0.185 | 0.179 | 0.180 | 0.162 |
Quality of care (%) | |||||||
Cognitive impairment | 70.83 | 67.88 | 65.58 | 66.53 | 64.51 | 63.58 | 75.41 |
Urinary Incontinence | 41.11 | 42.76 | 42.25 | 41.12 | 40.20 | 44.98 | 42.28 |
Antidepressant of sleeping pill | 28.88 | 27.34 | 25.56 | 28.87 | 26.60 | 28.12 | 29.44 |
Fecal Incontinence | 21.67 | 29.18 | 26.78 | 26.21 | 26.21 | 27.12 | 27.38 |
Bed rest | 21.89 | 22.32 | 20.91 | 19.98 | 20.11 | 23.56 | 24.60 |
Physically restrained | 6.36 | 6.99 | 6.40 | 5.98 | 6.15 | 6.22 | 6.70 |
Tube feeding | 6.75 | 6.34 | 6.48 | 6.12 | 5.99 | 6.23 | 6.61 |
Aggressive behavior | 5.66 | 5.12 | 5.45 | 5.78 | 5.81 | 5.34 | 6.18 |
Depression | 5.66 | 5.46 | 5.35 | 5.71 | 5.49 | 5.23 | 5.25 |
Fall prevalence | 4.88 | 4.78 | 4.59 | 4.39 | 4.78 | 4.56 | 4.43 |
Help for daily living | 4.24 | 4.34 | 4.28 | 4.29 | 4.21 | 4.54 | 3.78 |
Slip prevalence | 3.45 | 3.46 | 3.26 | 3.49 | 3.26 | 3.86 | 3.44 |
Hospital admission | 2.77 | 2.67 | 2.48 | 2.37 | 2.87 | 2.56 | 2.97 |
Range of motion | 2.53 | 2.56 | 2.43 | 2.76 | 2.66 | 2.32 | 2.31 |
10% Weight loss | 1.58 | 1.68 | 1.43 | 1.76 | 1.79 | 1.67 | 1.92 |
5% Weight loss | 1.87 | 1.79 | 1.25 | 1.54 | 1.55 | 1.82 | 2.01 |
Pressure sore prevalence | 1.34 | 1.32 | 1.15 | 1.24 | 1.35 | 1.22 | 1.27 |
Dehydration | 0.78 | 0.71 | 0.67 | 0.69 | 0.78 | 0.65 | 0.76 |
Outcome | Estimate | Standard Error | df | t-Value | p-Value | REML Criterion | Log Likelihood | Akaike Information Criterion | Bayesian Information Criterion |
---|---|---|---|---|---|---|---|---|---|
Aggregate z- | −10.59 | 4.37 | 187.07 | −2.43 | 0.02 | 1380.41 | −690.21 | 1392.41 | 1412.55 |
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Shin, J.H.; Renaut, R.A.; Reiser, M.; Lee, J.Y.; Tang, T.Y. Increasing Registered Nurse Hours Per Resident Day for Improved Nursing Home Residents’ Outcomes Using a Longitudinal Study. Int. J. Environ. Res. Public Health 2021, 18, 402. https://doi.org/10.3390/ijerph18020402
Shin JH, Renaut RA, Reiser M, Lee JY, Tang TY. Increasing Registered Nurse Hours Per Resident Day for Improved Nursing Home Residents’ Outcomes Using a Longitudinal Study. International Journal of Environmental Research and Public Health. 2021; 18(2):402. https://doi.org/10.3390/ijerph18020402
Chicago/Turabian StyleShin, Juh Hyun, Rosemary Anne Renaut, Mark Reiser, Ji Yeon Lee, and Ty Yi Tang. 2021. "Increasing Registered Nurse Hours Per Resident Day for Improved Nursing Home Residents’ Outcomes Using a Longitudinal Study" International Journal of Environmental Research and Public Health 18, no. 2: 402. https://doi.org/10.3390/ijerph18020402