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Variation of Care Time Between Nursing Units in Classification-Based Nurse-to-Resident Ratios: A Multilevel Analysis
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 nu...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815415/ https://www.ncbi.nlm.nih.gov/pubmed/29442533 http://dx.doi.org/10.1177/0046958018755242 |
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author | Brühl, Albert Planer, Katarina Hagel, Anja |
author_facet | Brühl, Albert Planer, Katarina Hagel, Anja |
author_sort | Brühl, Albert |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-5815415 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-58154152018-02-21 Variation of Care Time Between Nursing Units in Classification-Based Nurse-to-Resident Ratios: A Multilevel Analysis Brühl, Albert Planer, Katarina Hagel, Anja Inquiry Original Research 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. SAGE Publications 2018-02-14 /pmc/articles/PMC5815415/ /pubmed/29442533 http://dx.doi.org/10.1177/0046958018755242 Text en © The Author(s) 2018 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Brühl, Albert Planer, Katarina Hagel, Anja Variation of Care Time Between Nursing Units in Classification-Based Nurse-to-Resident Ratios: A Multilevel Analysis |
title | Variation of Care Time Between Nursing Units in Classification-Based Nurse-to-Resident Ratios: A Multilevel Analysis |
title_full | Variation of Care Time Between Nursing Units in Classification-Based Nurse-to-Resident Ratios: A Multilevel Analysis |
title_fullStr | Variation of Care Time Between Nursing Units in Classification-Based Nurse-to-Resident Ratios: A Multilevel Analysis |
title_full_unstemmed | Variation of Care Time Between Nursing Units in Classification-Based Nurse-to-Resident Ratios: A Multilevel Analysis |
title_short | Variation of Care Time Between Nursing Units in Classification-Based Nurse-to-Resident Ratios: A Multilevel Analysis |
title_sort | variation of care time between nursing units in classification-based nurse-to-resident ratios: a multilevel analysis |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815415/ https://www.ncbi.nlm.nih.gov/pubmed/29442533 http://dx.doi.org/10.1177/0046958018755242 |
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