Chung-Ang University Graduate School Department of Nursing, Seoul, Korea.
Chung-Ang University Red Cross College of Nursing, Seoul, Korea.
J Nurs Manag. 2018 Jul;26(5):518-524. doi: 10.1111/jonm.12576. Epub 2018 Jan 10.
To describe the characteristics of long-term care hospitals in 2010-2013 and to examine the longitudinal associations of nursing staff turnover with patient outcomes.
The number of long-term care hospitals has exploded in Korea since the national long-term care insurance was launched in 2008. The care quality deviation across long-term care hospitals is large.
This was a longitudinal secondary data analysis using the Health Insurance Review and Assessment Service's data.
From 2010 to 2013, the nursing staff turnover rate decreased. The number of patients per registered nurse increased while that per total nursing staff and skill mix decreased. All adverse patient outcomes decreased. Higher nursing staff turnover and lower RN proportions were associated with adverse patient outcomes.
Since the launch of the long-term care insurance, total nursing staffing, turnover rate and patient outcomes have improved, while the skill mix has decreased. Systematic efforts to decrease nursing staff turnover should be implemented for better long-term care patient outcomes.
In addition to maintaining high levels of nurse staffing and skill mix, supportive work environments and competitive wages and benefits could reduce turnover, and ultimately adverse patient outcomes. Health care policy should separate nursing staffing levels for registered nurses and certified nursing assistants.
描述 2010-2013 年长护医院的特征，并探讨护理人员离职率与患者结局的纵向关联。
自 2008 年韩国推出国家长期护理保险以来，长护医院的数量呈爆炸式增长。长护医院之间的护理质量差异较大。
这是一项使用健康保险审查和评估服务数据的纵向二次数据分析。
2010 年至 2013 年，护理人员离职率下降。每位注册护士照顾的患者人数增加，而每位护理人员和技能组合照顾的患者人数减少。所有不良患者结局均下降。较高的护理人员离职率和较低的注册护士比例与不良患者结局相关。
自长期护理保险推出以来，总体护理人员配置、离职率和患者结局得到改善，而技能组合却下降。为了获得更好的长期护理患者结局，应采取系统措施降低护理人员离职率。
除了保持高水平的护士人员配备和技能组合外，支持性工作环境以及有竞争力的工资和福利可以降低离职率，最终降低不良患者结局。医疗保健政策应将注册护士和认证护理助理的护理人员配备水平分开。
