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John Engberg - One of the best experts on this subject based on the ideXlab platform.
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organizational characteristics associated with staff turnover in nursing homes
Gerontologist, 2006Co-Authors: Nicholas G. Castle, John EngbergAbstract:Purpose: The association between certified Nurse aide, Licensed Practical Nurse, and registered Nurse turnover and the organizational characteristics of nursing homes are examined. Design and Methods: Hypotheses for eight organizational characteristics are examined (staffing levels, top management turnover, resident case mix, facility quality, ownership, chain membership, size, and Medicaid census), using Online Survey, Certification, and Reporting (known as OSCAR) data. Turnover information came from primary data collected from 854 facilities in six states (Missouri, Texas, Connecticut, New York, Pennsylvania, and New Jersey). Results: The 1-year turnover rates were 56.4%, 39.7%, and 35.8% for certified Nurse aides, Licensed Practical Nurses, and registered Nurses, respectively. The results consistently show that, for all caregivers, lower staffing levels, lower quality, for-profit ownership, and higher bed size are associated with higher turnover. Some differences also are found for different levels of turnover, but there are few differences among types of nursing staff. Implications: Given that turnover rates are problematic, this study gives us a better understanding of the phenomenon and at the same time helps us further understand the wide variation that is known to exist between nursing homes, based on their organizational characteristics.
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staff turnover and quality of care in nursing homes
Medical Care, 2005Co-Authors: Nicholas G. Castle, John EngbergAbstract:Purpose:In this work, the association between Nurse aide (NA) plus Licensed Practical Nurse (LPN) and registered Nurse (RN) turnover and quality indicators in nursing homes is examined.Design and Methods:Indicators of care quality used are the rates of physical restraint use, catheter use, contractu
Franziska Zuniga - One of the best experts on this subject based on the ideXlab platform.
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mobbing among care workers in nursing homes a cross sectional secondary analysis of the swiss nursing homes human resources project
International Journal of Nursing Studies, 2017Co-Authors: Myriam Tong, Rene Schwendimann, Franziska ZunigaAbstract:Abstract Background As a category of bullying, mobbing is a form of violence in the workplace that damages the employing organization as well as the targeted employee. In Europe, the overall prevalence of mobbing in healthcare is estimated at 4%. However, few studies have explored mobbing among long-term care workers. Objectives This study aims to examine the frequency of mobbing in Swiss nursing homes and its relationships with care workers' (i.e. registered Nurse, Licensed Practical Nurse, assistant Nurse, Nurse aide) health status, job satisfaction, and intention to leave, and to explore the work environment as a contributing factor to mobbing. Design A cross-sectional, multi-center sub-study of the Swiss Nursing Homes Human Resource Project (SHURP). Setting Nursing homes in Switzerland's three language regions. Participants A total of 162 randomly selected nursing homes with 20 or more beds, including 5311 care workers with various educational levels. Method Controlling for facility and care worker characteristics, generalized estimation equations were used to assess the relationships between mobbing and care workers' health status, job satisfaction, and intention to leave as well as the association of work environment factors with mobbing. Results In Swiss nursing homes, 4.6% of surveyed care workers (n=242) reported mobbing experiences in the last 6 months. Compared to untargeted persons, those directly affected by mobbing had higher odds of health complaints (Odds Ratios (OR): 7.81, 95% CI 5.56–10.96) and intention to leave (OR: 5.12, 95% CI 3.81–6.88), and lower odds of high job satisfaction (OR: 0.19, 95% CI 0.14–0.26). Odds of mobbing occurrences increased with declining teamwork and safety climate (OR: 0.41, 95% CI 0.30–0.58), less supportive leadership (OR: 0.42, 95% CI 0.30–0.58), and higher perceived inadequacy of staffing resources (OR: 0.66, 95% CI 0.48–0.92). Conclusions Mobbing experiences in Swiss nursing homes are relatively rare. Alongside teamwork and safety climate, risk factors are strongly associated with superiors' leadership skills. Targeted training is necessary to sensitize managers to mobbing's indicators, effects and potential influencing factors.
Nicholas G. Castle - One of the best experts on this subject based on the ideXlab platform.
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organizational characteristics associated with staff turnover in nursing homes
Gerontologist, 2006Co-Authors: Nicholas G. Castle, John EngbergAbstract:Purpose: The association between certified Nurse aide, Licensed Practical Nurse, and registered Nurse turnover and the organizational characteristics of nursing homes are examined. Design and Methods: Hypotheses for eight organizational characteristics are examined (staffing levels, top management turnover, resident case mix, facility quality, ownership, chain membership, size, and Medicaid census), using Online Survey, Certification, and Reporting (known as OSCAR) data. Turnover information came from primary data collected from 854 facilities in six states (Missouri, Texas, Connecticut, New York, Pennsylvania, and New Jersey). Results: The 1-year turnover rates were 56.4%, 39.7%, and 35.8% for certified Nurse aides, Licensed Practical Nurses, and registered Nurses, respectively. The results consistently show that, for all caregivers, lower staffing levels, lower quality, for-profit ownership, and higher bed size are associated with higher turnover. Some differences also are found for different levels of turnover, but there are few differences among types of nursing staff. Implications: Given that turnover rates are problematic, this study gives us a better understanding of the phenomenon and at the same time helps us further understand the wide variation that is known to exist between nursing homes, based on their organizational characteristics.
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staff turnover and quality of care in nursing homes
Medical Care, 2005Co-Authors: Nicholas G. Castle, John EngbergAbstract:Purpose:In this work, the association between Nurse aide (NA) plus Licensed Practical Nurse (LPN) and registered Nurse (RN) turnover and quality indicators in nursing homes is examined.Design and Methods:Indicators of care quality used are the rates of physical restraint use, catheter use, contractu
Rene Schwendimann - One of the best experts on this subject based on the ideXlab platform.
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mobbing among care workers in nursing homes a cross sectional secondary analysis of the swiss nursing homes human resources project
International Journal of Nursing Studies, 2017Co-Authors: Myriam Tong, Rene Schwendimann, Franziska ZunigaAbstract:Abstract Background As a category of bullying, mobbing is a form of violence in the workplace that damages the employing organization as well as the targeted employee. In Europe, the overall prevalence of mobbing in healthcare is estimated at 4%. However, few studies have explored mobbing among long-term care workers. Objectives This study aims to examine the frequency of mobbing in Swiss nursing homes and its relationships with care workers' (i.e. registered Nurse, Licensed Practical Nurse, assistant Nurse, Nurse aide) health status, job satisfaction, and intention to leave, and to explore the work environment as a contributing factor to mobbing. Design A cross-sectional, multi-center sub-study of the Swiss Nursing Homes Human Resource Project (SHURP). Setting Nursing homes in Switzerland's three language regions. Participants A total of 162 randomly selected nursing homes with 20 or more beds, including 5311 care workers with various educational levels. Method Controlling for facility and care worker characteristics, generalized estimation equations were used to assess the relationships between mobbing and care workers' health status, job satisfaction, and intention to leave as well as the association of work environment factors with mobbing. Results In Swiss nursing homes, 4.6% of surveyed care workers (n=242) reported mobbing experiences in the last 6 months. Compared to untargeted persons, those directly affected by mobbing had higher odds of health complaints (Odds Ratios (OR): 7.81, 95% CI 5.56–10.96) and intention to leave (OR: 5.12, 95% CI 3.81–6.88), and lower odds of high job satisfaction (OR: 0.19, 95% CI 0.14–0.26). Odds of mobbing occurrences increased with declining teamwork and safety climate (OR: 0.41, 95% CI 0.30–0.58), less supportive leadership (OR: 0.42, 95% CI 0.30–0.58), and higher perceived inadequacy of staffing resources (OR: 0.66, 95% CI 0.48–0.92). Conclusions Mobbing experiences in Swiss nursing homes are relatively rare. Alongside teamwork and safety climate, risk factors are strongly associated with superiors' leadership skills. Targeted training is necessary to sensitize managers to mobbing's indicators, effects and potential influencing factors.
Eleanor S Mcconnell - One of the best experts on this subject based on the ideXlab platform.
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Licensed Practical Nurse scope of practice and quality of nursing home care
Nursing Research, 2013Co-Authors: Kirsten Corazzini, Ruth A Anderson, Christine A Mueller, Joshua M Thorpe, Eleanor S McconnellAbstract:BACKGROUND Although higher levels of registered Nurse (RN) staffing in nursing homes are related to better care quality, Licensed Practical Nurses (LPNs) provide most Licensed-nursing care; prior research is mixed regarding how this influences quality. The nature of LPN practice, and RN direction of that practice, follows in part from state Nurse practice acts (NPAs). OBJECTIVE Among the 50 states and the District of Columbia, the aims of this study were to describe regulatory differences in how LPNs contribute to nursing assessment, care planning, delegation and supervision, and RN practice in these domains and to explore how these regulatory differences relate to quality of care in nursing homes. METHODS The study design was a sequential explanatory mixed-methods design of NPAs and Centers for Medicare and Medicaid quality measures of long-stay nursing home residents. In the qualitative strand, 51 NPAs and related administrative code were analyzed to classify guidance on RN and LPN practice; then, the coded data were transformed to quantitative indicators of specificity regarding LPN and RN scope of practice. In the quantitative strand, state NPA data were linked to facility-level Centers for Medicare and Medicaid staffing and quality measures (N = 12,698 facilities) for cross-sectional, quantitative analyses. RESULTS States varied considerably in how NPAs guided LPN and RN scope of practice. NPA differences were related to quality indicators of resident pain, catheter use, weight loss, and restraints, even when accounting for nursing home staff mix. DISCUSSION Care quality was better in states where the NPA clearly described LPN scope, but only when there was also greater RN availability (p < .05). Classifying scope of nursing practice regulations moves beyond traditional staffing measures to inform understanding of the effects of the RN-to-LPN staffing ratio on quality of care in nursing homes.
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regulation of lpn scope of practice in long term care
Journal of Nursing Regulation, 2011Co-Authors: Kirsten Corazzini, Ruth A Anderson, Christine A Mueller, Joshua M Thorpe, Eleanor S Mcconnell, Lawrence R Landerman, Nancy ShortAbstract:With changing staffing structures and persistent quality concerns in nursing homes, registered Nurses are challenged to ensure that appropriate care is delivered. We describe differences in the Nurse practice acts (NPAs) and related administrative code for all 50 states and the District of Columbia for Licensed Practical Nurse (LPN) delegation and supervision. Next, we explore relationships between these differences and quality measures from the Centers for Medicare & Medicaid Services for United States nursing homes, using 2007 data. Findings indicate that how boards of nursing (BONs) regulate LPN scope of practice is directly related to care quality. States with NPAs stating that LPN practice does not include delegation and supervision have better care quality outcomes. Further, the greater the extent to which BONs are either silent or permissive in these critical areas of LPN practice, the poorer the state performance on care quality.