Open Access, Peer-reviewed
eISSN 2093-758X
    J Korean Acad Nurs. 2014 Feb;44(1):21-30. Korean.
    Published online Feb 28, 2014.
    https://doi.org/10.4040/jkan.2014.44.1.21
    © 2014 Korean Society of Nursing Science
    Original Article

    Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals

    Yunmi Kim,1 Ji Yun Lee,2 and Hyuncheol Kang3
      • 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, Email: leejiyun@kangwon.ac.kr
    Received September 30, 2013; Revised October 14, 2013; Accepted December 19, 2013.

    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.

    Abstract

    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.

    Keywords
    Nurse staffing; Registered nurse; Patient outcome; Turnover; Long term care

    Tables

    Table 1
    Hospital Characteristics (N=610)

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

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

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

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    MeSH Terms
    Quality Indicators, Health Care*
    Activities of Daily Living
    Dementia/physiopathology
    Humans
    Inpatients/psychology*
    Long-Term Care
    National Health Programs
    Nursing Staff, Hospital/psychology
    Nursing Staff, Hospital/statistics & numerical data*
    Personnel Turnover
    Pressure Ulcer/etiology
    Risk Factors
    Metrics
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