Variation of Care Time Between Nursing Units in Classification-Based Nurse-to-Resident Ratios: A Multilevel Analysis
نویسندگان
چکیده
A validity test was conducted to determine how care level-based nurse-to-resident ratios compare with actual daily care times per resident in Germany. Stability across different long-term care facilities was tested. Care level-based nurse-to-resident ratios were compared with the standard minimum nurse-to-resident ratios. Levels of care are determined by classification authorities in long-term care insurance programs and are used to distribute resources. Care levels are a powerful tool for classifying authorities in long-term care insurance. We used observer-based measurement of assignable direct and indirect care time in 68 nursing units for 2028 residents across 2 working days. Organizational data were collected at the end of the quarter in which the observation was made. Data were collected from January to March, 2012. We used a null multilevel model with random intercepts and multilevel models with fixed and random slopes to analyze data at both the organization and resident levels. A total of 14% of the variance in total care time per day was explained by membership in nursing units. The impact of care levels on care time differed significantly between nursing units. Forty percent of residents at the lowest care level received less than the standard minimum registered nursing time per day. For facilities that have been significantly disadvantaged in the current staffing system, a higher minimum standard will function more effectively than a complex classification system without scientific controls.
منابع مشابه
Nurses-Nurses Professional Collaboration Status from the Nurses' Viewpoints in Critical Care Units of Ardabil Educational Hospitals, 2017
Background & Aim: Collaboration and teamwork are essential elements of nursing. Increased collaboration among nurses is critical for maintaining an effective and safe therapeutic environment. Therefore, checking the status of nurse-nurse collaboration is very important. The purpose of this study was to determine the status of nurse-nurse professional collaboration from nurses’ viewpoint in crit...
متن کاملEstimation of Working Hours of Nursing Staff in Neonatal Intensive Care Units: A Work Sampling
Background: Human resources are considered the most valuable capital of every healthcare system, and the quality of care is closely related to the quantity and skill of this group. Therefore, the proper estimation of the required nursing staff in different wards can help improve the quality of nursing care. The purpose of this study was to determine the hours of provided care by nursing staff i...
متن کاملAssociations among nurse and certified nursing assistant hours per resident per day and adherence to guidelines for treating nursing home-acquired pneumonia.
BACKGROUND Nursing home (NH)-acquired pneumonia (NHAP) causes excessive mortality, hospitalization, and functional decline, partly because many NH residents do not receive appropriate care. Care structures like nurse/resident staffing ratios can impede or abet quality care. This study examines the relationship between nurse/resident staffing ratios, turnover, and adherence to evidence-based gui...
متن کاملBenchmarking nurse staffing levels: the development of a nationwide feedback tool.
AIM This paper is a report of a study to develop a methodology that corrects nurse staffing for nursing care intensity in a way that allows nationwide benchmarking of nurse staffing data. BACKGROUND Although nurse workload measurement systems are recognized to be informative in nurse staffing decisions, they are rarely used. When these systems are used, however, it is only possible to compare...
متن کاملDevelopment and Psychometric Evaluation of Nursing Audit Tool
Background: Better healthcare outcomes in health services are obtainable from frequently observing ongoing healthcare activities, gathering data, and assessing outcomes. Objectives: This study aimed to establish the basic principles of nursing care standards and practices in wards, develop a nursing audit tool for periodically monitoring and controlling o...
متن کامل