Responding to long-term care staffing shortages: Addressing nurse aide turnover through perceived management support

Nursing homes (NHs), in general, have a significant shortage of nurse aides (NAs), often the result of high turnover rates. A study by the American Health Care Association reports that 84 percent of NHs face moderate to high staffing shortages, with shortages having a negative impact on the care provided to NH residents. Research has shown that one factor that can reduce NA turnover is NA perceptions of management support (MS).

to identify factors associated with NA perceptions of MS.

A self-administered questionnaire was completed by 285 NAs within 11 nursing homes in the north Texas region. Most of the independent variables were based on an index of three or more statements with Chronbach's alphas ranging from 0.716 to 0.889. Steps were taken to increase validity. Cluster-adjusted standard errors were used along with structure coefficients.

six of 10 characteristics were found to have a statistically significant association with NA perceptions of MS, with two additional characteristics close to significance (adjusted R2 = 0.628). The most highly associated characteristics included participation in decision-making, feedback on NA suggestions, adequate staffing, and recognition for good work.

Several theories that address employee perceptions of MS were supported including the Theory of Structural Empowerment and Transformational Leadership Theory.

The results suggest several strategies that could be used to provide positive management support including regular meetings between management and small groups of NAs and the establishment of empowered NA work teams.