N G Castle

..The relationship between job satisfaction of nurse aides and intent to leave and actual turnover after 1 year is examined...

..The association of consistent assignment of nurse aides (NAs) with quality of care and quality of life of nursing home residents is examined (using 5 groups of deficiency citations)...

..The conceptual model and empirical analyses show that agency staff likely influence other staff, facility operations, and residents. Administrators listed more disadvantages than advantages of using agency staff...

....

..In this analysis, we specified the nursing home labor composition by using staff stability, use of agency staff, and professional staff mix, in addition to staffing levels...

..I examined evacuation plans from 2134 nursing homes and analyzed national data to determine the types of nursing homes cited for deficiencies in their evacuation plans...

..One belief is that SCUs in nursing homes developed to provide better resident care. However, few studies have examined the impact of opening an SCU on the nursing home, rather than the impact on residents...

..We used data from a large sample of nursing homes to examine the association between staff turnover and quality...

..These gains occurred while the national trend was one of declining occupancy and private-pay census...

..In this study, we examine factors associated with the search, selection, and satisfaction of residents and family members in assisted living...

....

..5 for the workload subscale, and 5.3 for the rewards subscale. Mean score for the global ratings was 7.4. The findings indicate that in general, nurse aides enjoy working with residents and their coworkers but are less satisfied with pay...

....

..DISCUSSION: Proxy ratings do not necessarily substitute for resident ratings and are dependent on the nature of the question asked. Examining resident-proxy responses at different points in time may be useful...

..The findings show that consumers understand Nursing Home Compare information, and approximately 12% currently access the Web site...

..These questions, which are significant because the nursing home market presents several challenges to the effectiveness of report cards, were pursued in a study...

..The purpose of this study was to examine the association of Nursing Home Administrator (NHA) leadership style and Director of Nursing (DON) leadership style with quality of care...

..This study describes the creation and use of a web-based resource, designed to help nursing homes implement quality improvements through changes in staffing characteristics...

..In this research, the relationship of caregiver staffing levels, turnover, agency use, and professional staff mix with quality is further examined using a longitudinal analysis to overcome weaknesses of earlier research...

..This study examined the deficiency citation for infection control (ie, F-Tag 441). This information represents potential problems in infection control as identified in the yearly certification process of almost all US nursing homes...

..Examining the perception of patient safety culture (PSC) of top managers in health care settings is important because their orientation to PSC can have a large influence on the facility...

..Criterion validity was high (.77) as was the index of content validity (p > .05). We believe that we have produced a short psychometrically sound job satisfaction instrument for use in nursing homes...

..The text is provocative. It is also thought-provoking. In this commentary I provide a further opinion that we could do better within the current system using the current resources...

..Understanding the relationship between top management turnover and quality of care is important because turnover among top managers in nursing homes is generally high...

..The purpose of this research was to provide descriptive information on these SFFs and to examine the quality characteristics of these facilities...

..The influence on quality for the highest levels of agency use, compared with no agency use, was clinically significant. On the basis of these findings, facilities considering using high levels of agency staff should do so carefully...

..Using a national longitudinal sample of nursing homes residents (N = 264,068), we examine whether physical restraint use contributes to subsequent physical or psychological health decline...

..We determine the rate of nursing home closures for 7 years (1999-2005) and examine internal (e.g., quality), organizational (e.g., chain membership), and external (e.g., competition) factors associated with these closures...

..The aim of this work was to examine the association between organizational characteristics, market characteristics, and changes in antipsychotic medication use in US nursing homes over time...

..The psychometric properties of the nursing home administrator job satisfaction questionnaire (NHA-JSQ) are presented, and the steps used to develop this instrument...

..Second, how the safety culture of nursing homes varied according to facility characteristics and market characteristics was examined...

..A study was conducted to explore the agreement and association of nursing home residents' responses with family member proxy responses...

..To examine the agreement and association of elders' responses with family member proxy responses using the same, previously validated satisfaction instrument on both groups of respondents...

..The top managers examined were administrators and directors of nursing, and the caregivers examined were registered nurses, licensed practical nurses, and nurse aides...

..The association between certified nurse aide, licensed practical nurse, and registered nurse turnover and the organizational characteristics of nursing homes are examined...

....

..These results are discussed emphasizing their implications for efficient and effective resident care...

..On the one hand, the results show that nursing homes are sensitive to their operating environment; on the other hand, the likelihood of closure is very small, representing less than 1 percent of facilities per year...

..We found no association between mental health provider staffing levels and mental health outcomes...

..Multivariate analyses show work overload has a strong and robust association with both intent-to-turnover and turnover of NHAs, and may indicate that NHAs are leaving their positions because they are understaffed...

..We conclude that if facilities reduce restraint use then the prevalence of resident mental health problems will also likely decline...

..This study examines administrators' opinions of this initiative and whether it has fostered quality improvement...

..We find that 5% of facilities received a deficiency citation for administration, and lower facility quality is associated with these administration deficiency citations...

..Downsizing in the nursing home industry from 1992 to 2003 was examined. Most significantly, we show that downsizing is subsequently associated with improved quality...

..Second, the change score analyses show that nursing homes can increase their private-pay census by increasing quality...

..The incidence rate of closures was .7% of facilities per year. The multivariate analysis shows that facilities located in more competitive environments were significantly more likely to close...

..It is important to enable consumers to make a direct comparison between ALFs, and in order to do that there needs to be obvious standardization of presented information among the different states...

..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...

..Data from a large sample of nursing homes were used to examine the cross-sectional association between workplace injuries and organizational factors, caregiver staffing levels, and quality...

..The high degree of variation limits the usefulness of deficiency citations not only for CMS but also for consumers and providers...

..In this investigation, we examine changes in QM scores, and whether competition and/or excess demand have influenced these change scores over a period of 1 year...

..As policies to promote more competition in Long-term care proceed, further reducing occupancy rates, further, albeit small, quality gains will likely be made in the future...

..Few accounts of patient safety initiatives in nursing homes exist...

..In recent years, we have seen substantial interest in patient safety initiatives in health care. However, most studies in this area have examined hospital settings; few studies have examined nursing homes...

..With the use of primary data collected from 354 facilities, the study addresses the various degrees of bias that result, depending on how staff turnover is defined in nursing homes...

..In many cases, this likely influences the quality of life and quality of care of residents...

..In this commentary, we examine nursing home quality and indicators that have been used to measure nursing home quality...

..The purpose of this research was to examine whether nursing facilities included in the 2007 SFF initiative subsequently influenced the quality of other facilities in their market...

..However, we know little about factors associated with job satisfaction and dissatisfaction for nursing home workers...

..The study suggests that these facilities do not do better because they have more resources or because they care for less-challenging residents-they do better because they have a professional association as a resource...

..Deficiency citations for physical restraint use in two and three consecutive certification survey inspections are used as our measures of poor quality...

..To assess patient safety culture (PSC) in the nursing home setting, to determine whether nursing home professionals differ in their PSC ratings, and to compare PSC scores of nursing homes with those of hospitals...

..Yet few studies exist showing an association between restraint initiation and health decline. In this research, we examined whether physical restraint initiation is associated with subsequent lower physical or mental health...

..In general, the authors found a stronger association with job satisfaction and actual turnover than with intent to turnover...

..We examined the effects of facility and market-level characteristics on staffing levels and turnover rates for direct care staff, and we examined the effect of staff turnover on staffing levels...

..Recent work on nursing home staffing and turnover has stressed the importance of ownership and resources. However, few studies have examined spending behaviors, which might also influence staffing levels and staff turnover rates...

..The influence staffing levels, turnover, worker stability, and agency staff had on quality of care in nursing homes was examined...

....

....

..The objective of this research was to profile and compare state-level physical restraint use, urethral catheterization, contractures, pressure ulcers, and psychoactive medication use as indicators of quality of care in nursing facilities...

..Few studies have examined factors associated with antidepressant prescribing in older nursing home residents...

....

..To develop a consensus list of agreed-upon laboratory, pharmacy, and Minimum Data Set signals that a computer system can use in the nursing home to detect potential adverse drug reactions (ADRs)...

..These results are discussed along with several issues inherent to channeling low-care residents to other care setting...

..We conclude that it would be beneficial to use a standardized survey instrument, along with standardization of the sampling, administration protocol, and mode of administration...

..Fourth, prior knowledge of the chosen facility was limited. Finally, the authors also show that the time taken to choose a facility was in most cases extremely limited...

..These were the rates of physical restraint use, urethral catheterization, contractures, pressure ulcers, psychotropic medication use, and certification survey quality of care deficiencies...

..In this paper, we first examine elders' preferences between five response formats and then examine the response variability of these five commonly used formats...

....

..Their results further show that public reimbursement and asymmetric information are both important factors in explaining why low quality persists over time in certain facilities...

..However, overall, the author concludes that nursing facility closures are relatively rare events. And the likelihood of closure, even for poor-quality facilities, is low...

..There are few studies of voluntary and involuntary turnover in the nursing home literature. Previous research in this area has focused mainly on the linear effects of individual and organizational characteristics on total turnover...

..The author hypothesizes that prospector nursing facilities will have the highest quality outcomes, followed by defender, analyzer, and reactor facilities...

..abstract_text> ..

..abstract_text> ..

....

..We will examine the associations between staffing levels, turnover, stability, and use of agency staff and quality, not only for licensed practical nurses (LPNs), and registered nurses (RNs), but also for nurse aides (NAs). ..

..This information will further our development of a standardized incident reporting mechanism recommended by the Institute of Medicine and others. ..

..This investigation examines use of agency staff and quality of care. Our results will have implications for policy makers, practitioners, and consumers. ..