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Measuring staff turnover in nursing homes.

Nicholas G Castle¹

¹University of Pittsburgh, Health Policy and Management, A649 Crabtree Hall, 130 DeSoto St., Pittsburgh, PA, USA. castleN@Pitt.edu

The Gerontologist

|April 4, 2006

Summary

Nursing home staff turnover rates vary significantly based on how turnover is defined, potentially misrepresenting findings in prior studies. This research highlights measurement errors and suggests improvements for future data collection.

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Area of Science:

Healthcare Management
Organizational Behavior
Nursing Home Administration

Background:

Staff turnover is a persistent challenge in the nursing home industry.
Previous literature reviews (1990-2003) have examined turnover rates but often used varied definitions.
Understanding the impact of definitional differences is crucial for accurate reporting.

Purpose of the Study:

To review nursing home staff turnover rates and definitions from existing literature.
To analyze the bias introduced by different turnover definitions using primary data.
To provide recommendations for more accurate future data collection on nursing home staff turnover.

Main Methods:

A survey was distributed to administrators of 526 nursing homes across four states in March 2003.
Data was collected from 354 facilities, yielding a response rate of 67%.
Analysis focused on comparing turnover rates across different staff roles and assessing the impact of definitional variations.

Main Results:

Reported 1-year turnover rates varied widely: nurse aides (119%), licensed practical nurses (89%), registered nurses (87%), administrators (57%), and directors of nursing (48%).
The definition of staff turnover influenced the reported rates, causing relative differences of up to 47%.
Measurement error due to inconsistent definitions can lead to misrepresented turnover rates in published studies.

Conclusions:

Inconsistent definitions of staff turnover contribute to significant measurement error.
Prior studies may have misrepresented actual nursing home staff turnover rates due to these definitional issues.
Recommendations are proposed to enhance future data collection, aiming to minimize measurement error and improve the accuracy of reported turnover rates.

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