Nursing Staff Characteristics on Resident Outcomes in Nursing Homes

BACKGROUND: The outlook of administrative staff and registered nurses (RNs) plays a critical role in the management of nursing homes. No previous study has compared the outcomes of nursing homes with RNs on staff with those of nursing homes without RNs on staff in Korea. PURPOSE: The aim of this study was to investigate the association between nurse-led nursing homes, staff turnover, and resident outcomes in nursing homes in Korea. METHODS: Using a cross-sectional design, 36 nursing homes with 30 or more beds participated. Primary data included 15 quality indicators. RESULTS: Nursing homes with RNs had statistically significant better resident outcomes. RN turnover related positively to the prevalence of falls ( β = 1.68, p < .05) and tube feeding (β = 1.71, p < .01) and negatively to incontinence (β = −1.53, p < .01). Nursing homes with RNs with tenures greater than 1 year had statistically significant lower prevalence of falls (β = −0.47, p < .05), incontinence (β = −0.45, p < .05), weight loss (β = −0.53 p < .05), and bed rest (β = −0.54, p < .01) and increased range of motion (β = 0.51, p < .05). Interestingly, having a nurse as a director for more than 1 year related negatively to the incidence of urinary tract infection (β = −0.56, p < .05) in residents. The rate of RN turnover was found to impact fall prevalence (β = 1.68, p < .05) and tube feeding (β = 1.71, p < .01) positively and to impact incontinence (β = −1.53, p < .01) negatively. CONCLUSIONS: Turnover of nursing home staff and length of tenure may contribute to the more effective management of nursing homes, higher-quality long-term care insurance, and RN-staffing-related laws. Assessing staff characteristics and the tenure of employees promotes the effective management of nursing homes.