Lee Hyang Yuol, Shin Juh Hyun
Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul, Korea.
College of Nursing, Ewha Womans University, Seoul, Korea.
J Korean Acad Nurs. 2019 Apr;49(2):161-170. doi: 10.4040/jkan.2019.49.2.161.
Quality ratings could provide vital information to help people in choosing a nursing home.
This study investigated factors aligned with quality ratings of nursing homes.
We employed a cross-sectional descriptive design to assess publicly available data on 1,354 nursing homes with 30 or more beds in the Republic of Korea. After excluding 289 nursing homes with no reported quality-evaluation ratings, we analyzed the 2015 data of 1,065 nursing homes. To prevent multicollinearity among independent variables, we carefully selected the final set of variables based on clinical and theoretical meaningfulness to direct nursing care. Quality, the ordinal outcome, was scored from 1 to 5 with a higher score indicating higher quality of the organization. We constructed a multivariate ordered logistic regression model.
Higher quality ratings of nursing homes was significantly related to the number of unoccupied beds (OR=0.99, =.024), registered nurses (RNs) (OR=1.30, =.003), qualified care workers (OR=1.03, =.011), cognitive-improvement programs (OR=1.05, =.024), and other programs for residents' activities (OR=1.09, <.001).
The number of RNs had the strongest influence on the publicly reported quality rating, while the rating of qualified care workers demonstrated little effect and that of nursing assistants had no effect. The number of RNs could be used as a crucial indicator for high-quality homes; more resident-engaging programs also demonstrated better quality of nursing home care.
质量评级可为人们选择疗养院提供重要信息。
本研究调查了与疗养院质量评级相关的因素。
我们采用横断面描述性设计,对韩国1354家拥有30张及以上床位的疗养院的公开数据进行评估。在排除289家未报告质量评估评级的疗养院后,我们分析了1065家疗养院的2015年数据。为防止自变量之间的多重共线性,我们根据临床和理论意义,精心挑选了一组最终变量,以指导护理工作。质量作为有序结果,评分从1到5,分数越高表明机构质量越高。我们构建了一个多元有序逻辑回归模型。
疗养院较高的质量评级与空床数量(OR = 0.99,P = 0.024)、注册护士(RNs)(OR = 1.30,P = 0.003)、合格护理人员(OR = 1.03,P = 0.011)、认知改善项目(OR = 1.05,P = 0.024)以及其他居民活动项目(OR = 1.09,P < 0.001)显著相关。
注册护士数量对公开报告的质量评级影响最大,而合格护理人员的评级影响较小,护理助理的评级则无影响。注册护士数量可作为高质量疗养院的关键指标;更多居民参与项目也表明疗养院护理质量更好。