Center for Gerontology and Healthcare Research, Brown University, Box G-S121 (6), Providence, RI 02912, USA.
Gerontologist. 2013 Apr;53(2):211-21. doi: 10.1093/geront/gns082. Epub 2012 Aug 30.
Individuals receiving postacute care in skilled nursing facilities often require complex, skilled care provided by licensed nurses. It is believed that a stable set of nursing personnel is more likely to deliver better care. The purpose of this study was to determine the relationships among licensed nurse retention, turnover, and a 30-day rehospitalization rate in nursing homes (NHs).
We combined two data sources: NH facility-level data (including characteristics of the facility, the market, and residents) and the Florida Nursing Home Staffing Reports (which provide staffing information for each NH) for 681 Florida NHs from 2002 to 2009. Using a two-way fixed effects model, we examined the relationships among licensed nurse turnover rates, retention rates, and 30-day rehospitalization rates.
Results indicate that an NH's licensed nurse retention rate is significantly associated with the 30-day rehospitalization rate (est. = -.02, p = .04) controlling for demographic characteristics of the patient population, residents' preferences for hospitalization, and the ownership characteristics of the NH. The NHs experiencing a 10% increase in their licensed nurse retention had a 0.2% lower rehospitalization rate, which equates to 2 fewer hospitalizations per NH annually. Licensed nurse turnover is not significantly related to the 30-day rehospitalization rate.
These findings highlight the need for NH administrators and policy makers to focus on licensed nurse retention, and future research should focus on the measures of staff retention for understanding the staffing/quality relationship.
在熟练护理机构中接受康复护理的个人通常需要由持照护士提供复杂、熟练的护理。人们认为稳定的护士队伍更有可能提供更好的护理。本研究的目的是确定养老院（NH）中持照护士留用率、离职率和 30 天再入院率之间的关系。
我们结合了两个数据源：NH 设施层面的数据（包括设施、市场和居民的特征）和佛罗里达州养老院员工报告（为每个 NH 提供员工信息），用于 2002 年至 2009 年的 681 家佛罗里达州 NH。使用双向固定效应模型，我们研究了持照护士离职率、留用率和 30 天再入院率之间的关系。
结果表明，NH 的持照护士留用率与 30 天再入院率显著相关（估计值=-.02，p=。04），控制了患者人群的人口统计学特征、居民对住院的偏好以及 NH 的所有权特征。持照护士留用率增加 10%的 NH 的再入院率降低了 0.2%，相当于每个 NH 每年减少 2 次住院。持照护士离职率与 30 天再入院率无显著关系。
这些发现强调了 NH 管理员和政策制定者需要关注持照护士的留用率，未来的研究应侧重于员工留用率的衡量标准，以了解人员配备/质量关系。
