School of Nursing, University of Maryland, Baltimore, MD, USA.
School of Nursing, University of Maryland, Baltimore, MD, USA.
Int J Nurs Stud. 2015 Jan;52(1):334-44. doi: 10.1016/j.ijnurstu.2014.10.002. Epub 2014 Oct 16.
Leadership is a key consideration in improving nursing home care quality. Previous research found nursing homes with more credentialed leaders had lower rates of care deficiencies than nursing homes with less credentialed leaders. Evidence that nursing home administrator (NHA) and director of nursing (DON) education and certification is related to resident outcomes is limited.
To examine associations of education and certification among NHAs and DONs with resident outcomes.
Cross-sectional secondary data analysis.
This study used National Nursing Home Survey data on leadership education and certification and Nursing Home Compare quality outcomes (e.g. pain, catheter use).
1142 nursing homes in the survey which represented 16628 nursing homes in the US.
Leadership education and certification were assessed separately for NHAs and DONs. Nursing home resident outcomes were measured using facility-level nursing home quality indicator rates selected from the Minimum Data Set. Facility-level quality indicators were regressed onto leadership variables in models that also held constant facility size and ownership status.
Nursing homes led by NHAs with both Master's degrees or higher and certification had significantly better outcomes for pain. Nursing homes led by DONs with Bachelor's degrees or higher plus certification also had significantly lower pain and catheter use. Whereas pressure ulcer rates were higher in facilities led by DONs with more education.
Selected outcomes for nursing home residents might be improved by increasing the education and certification requirements for NHAs and DONs. Additional research is needed to clarify these relationships.
领导力是提高养老院护理质量的关键考虑因素。先前的研究发现，拥有更多资质认证的领导的养老院比拥有较少资质认证的领导的养老院在护理缺陷方面的比例更低。有关养老院管理员（NHA）和注册护士主任（DON）教育和认证与居民结果相关的证据有限。
研究 NHA 和 DON 的教育和认证与居民结果之间的关联。
横断面二次数据分析。
本研究使用了国家养老院调查数据，涉及领导力教育和认证以及养老院比较质量结果（例如疼痛、导管使用）。
调查中共有 1142 家养老院，代表了美国的 16628 家养老院。
分别评估 NHA 和 DON 的领导力教育和认证情况。使用从最低数据集选择的设施级养老院质量指标比率来衡量养老院居民的结果。在模型中，将设施规模和所有权状况保持不变，将设施级质量指标回归到领导变量上。
由具有硕士及以上学位和认证的 NHA 领导的养老院，在疼痛方面的结果显著更好。由具有学士及以上学位和认证的 DON 领导的养老院，疼痛和导管使用的发生率也显著更低。而由教育程度更高的 DON 领导的设施中，压力性溃疡的发生率更高。
通过提高 NHA 和 DON 的教育和认证要求，可能会改善养老院居民的某些结果。需要进一步研究来阐明这些关系。
