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The influence of consistent assignment on nursing home deficiency citations
1Department of Health Policy & Management, Graduate School of Public Health, University of Pittsburgh, A610 Crabtree Hall, 130 DeSoto Street, Pittsburgh, PA 15261, USA. castlen@pitt.edu
The Gerontologist
|November 8, 2011
Summary
Consistent assignment of nurse aides (NAs) is linked to fewer quality of care and quality of life deficiencies in nursing homes. Higher levels of consistent NA assignment showed significant improvements, supporting this staffing practice.
Area of Science:
- Gerontology and Long-Term Care
- Healthcare Management and Policy
- Nursing and Allied Health
Background:
- Consistent assignment of nurse aides (NAs) is a proposed staffing practice in nursing homes.
- Empirical evidence supporting consistent assignment in peer-reviewed literature is limited.
- The impact of consistent NA assignment on resident care quality and life quality requires further investigation.
Purpose of the Study:
- To examine the association between consistent assignment of nurse aides (NAs) and nursing home quality of care and quality of life.
- To analyze the relationship using five groups of deficiency citations as indicators of care quality.
Main Methods:
- Data from 3,941 nursing facilities in 2007, including administrator surveys, Online Survey Certification and Reporting data, and Area Resource File.
- Variables measured: consistent assignment and staffing levels of registered nurses, licensed practical nurses, and NAs.
- Statistical analyses employed: negative binomial regression and multivariate logistic regression models.
Main Results:
- 68% of surveyed nursing homes reported using consistent assignment, but actual implementation levels varied.
- Only 28% of facilities achieved the recommended 85% or higher level of consistent NA assignment.
- Higher levels of consistent NA assignment were significantly associated (p < .01) with lower citations for resident quality of life, staffing quality of life, facility quality of life, and overall quality of care.
Conclusions:
- The study provides empirical justification for the use of consistent assignment for nurse aides (NAs) in nursing homes.
- Significant improvements in quality of care and life quality were observed in facilities with high levels of consistent NA assignment.
- Lower levels of consistent assignment showed fewer significant associations with improved care quality indicators.
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