Department of Health Policy, Management, and Leadership, School of Public Health, West Virginia University, Morgantown, USA.
Gerontologist. 2021 Jun 2;61(4):e118-e128. doi: 10.1093/geront/gnab012.
Retention of nursing home caregivers is examined. This represents the concept of continuously employing the same caregivers in the same facility for a defined period of time. In this research, several measures of caregiver retention are examined and the utility of these measures for practitioners and policy makers is discussed.
A survey of nursing home administrators conducted in 2016 was used to collect staffing data from 2,898 facilities. This was matched with Nursing Home Compare and the Certification and Survey Provider Enhanced Reporting data. The association of four measures of retention for each of three types of caregivers with six quality indicators was examined.
The descriptive statistics show rates of retention at 5 years for nurse aides (NAs), registered nurses (RNs), and licensed practical nurses to be low. The regression estimates show some support for the relationship that high caregiver retention is associated with better overall quality. The relationship was strongest for NAs and RNs. Support was also found for the notion that different measures of retention were more/less associated with quality. The 3- and 5-year retention measures had the strongest associations with the quality indicators.
The findings presented provide some evidence that caregiver retention may be an important metric that can be used as a means of improving quality of care in nursing homes. However, the findings also show practitioners and policy makers should be more nuanced in the use of caregiver retention metrics.
本研究旨在考察养老院护理员的留用情况。这一概念指的是在特定时间段内，同一护理员持续在同一机构工作。本研究探讨了几种护理员留用衡量指标，并讨论了这些指标对从业者和政策制定者的实用性。
本研究使用了 2016 年对养老院管理人员进行的一项调查，从 2898 家机构中收集了人员配备数据。这些数据与“养老院比较”和“认证和调查提供者增强报告”的数据相匹配。本研究考察了三种类型的护理员的四种留用衡量指标与六个质量指标之间的关联。
描述性统计数据显示，护理员助理（NAs）、注册护士（RNs）和执业护士的 5 年留用率较低。回归估计结果表明，高护理员留用率与整体质量较高之间存在一定的关联。这种关联在 NAs 和 RNs 中最为强烈。研究还发现，不同的留用衡量指标与质量的关联程度不同。3 年和 5 年留用衡量指标与质量指标的关联最强。
本研究结果提供了一些证据，表明护理员留用率可能是一个重要的衡量指标，可以作为提高养老院护理质量的手段。然而，研究结果也表明，从业者和政策制定者在使用护理员留用率衡量指标时应更加细致入微。
