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Original Article
Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals
Yunmi Kim, Ji Yun Lee, Hyuncheol Kang
Journal of Korean Academy of Nursing 2014;44(1):21-30.
DOI: https://doi.org/10.4040/jkan.2014.44.1.21
Published online: February 28, 2014

1College of Nursing, Eulji University, Sungnam, Korea.

2Department of Nursing, Kangwon National University, Chuncheon, Korea.

3Department of Informational Statistics, Hoseo University, Asan, Korea.

Address reprint requests to: Lee, Ji Yun. Department of Nursing, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon 200-701, Korea. Tel: +82-33-250-8885, Fax: +82-33-242-8840, leejiyun@kangwon.ac.kr
• Received: September 30, 2013   • Revised: October 14, 2013   • Accepted: December 19, 2013

© 2014 Korean Society of Nursing Science

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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  • Purpose
    This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals.
  • Methods
    A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators.
  • Results
    Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable.
  • Conclusion
    To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.
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Table 1
Hospital Characteristics (N=610)
jkan-44-21-i001.jpg
Table 2
Patient Outcomes from Long Term Care Hospitals (N=610)
jkan-44-21-i002.jpg

ADL=Activities of daily living; PU=Pressure ulcer.

Table 3
Difference in Patient Outcome by Location and Nursing Staffing Level (N=610)
jkan-44-21-i003.jpg

ADL=Activities of daily living; PU=Pressure ulcer; RN=Registered nurse; NA=Nurses' aid.

Table 4
Impact of Nursing Staffing Level on Patient Outcomes in Long Term Care Hospitals (N=610)
jkan-44-21-i004.jpg

*1 unit=10 pts; 1 unit=10%; ADL=Activities of daily living, PU=Pressure ulcer, Pts=Patients, Dr.=Doctor, RN=Registered nurse, NA=Nurses' aid, OR=Odds ratio.

Figure & Data

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        Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals
        J Korean Acad Nurs. 2014;44(1):21-30.   Published online February 28, 2014
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      Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals
      Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals

      Hospital Characteristics (N=610)

      Patient Outcomes from Long Term Care Hospitals (N=610)

      ADL=Activities of daily living; PU=Pressure ulcer.

      Difference in Patient Outcome by Location and Nursing Staffing Level (N=610)

      ADL=Activities of daily living; PU=Pressure ulcer; RN=Registered nurse; NA=Nurses' aid.

      Impact of Nursing Staffing Level on Patient Outcomes in Long Term Care Hospitals (N=610)

      *1 unit=10 pts; 1 unit=10%; ADL=Activities of daily living, PU=Pressure ulcer, Pts=Patients, Dr.=Doctor, RN=Registered nurse, NA=Nurses' aid, OR=Odds ratio.

      Table 1 Hospital Characteristics (N=610)

      Table 2 Patient Outcomes from Long Term Care Hospitals (N=610)

      ADL=Activities of daily living; PU=Pressure ulcer.

      Table 3 Difference in Patient Outcome by Location and Nursing Staffing Level (N=610)

      ADL=Activities of daily living; PU=Pressure ulcer; RN=Registered nurse; NA=Nurses' aid.

      Table 4 Impact of Nursing Staffing Level on Patient Outcomes in Long Term Care Hospitals (N=610)

      *1 unit=10 pts; 1 unit=10%; ADL=Activities of daily living, PU=Pressure ulcer, Pts=Patients, Dr.=Doctor, RN=Registered nurse, NA=Nurses' aid, OR=Odds ratio.


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