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Appropriate Nursing Home Nurse Hours per Resident Day in Korea: A Secondary Analysis of Longitudinal Data

Title
Appropriate Nursing Home Nurse Hours per Resident Day in Korea: A Secondary Analysis of Longitudinal Data
Authors
Shin, Juh Hyun
Ewha Authors
신주현
SCOPUS Author ID
신주현scopus
Issue Date
2019
Journal Title
JOURNAL OF NURSING SCHOLARSHIP
ISSN
1527-6546JCR Link

1547-5069JCR Link
Citation
JOURNAL OF NURSING SCHOLARSHIP vol. 51, no. 5, pp. 569 - 579
Keywords
Nursing homenursing staffoptimizationquality of care
Publisher
WILEY
Indexed
SCIE; SSCI; SCOPUS WOS
Document Type
Article
Abstract
Purpose To encourage the enactment of laws about mandatory nurse staffing in nursing homes, researchers should provide evidence of concrete nurse hours per resident day (HPRD). This article estimates optimal nurse staffing HPRD to achieve increased quality-of-care outcomes for nursing home residents. Design Secondary analysis of longitudinal data. Methods This study used secondary analysis of longitudinal nursing home survey data. Nurse staffing HPRD and quality-of-care survey data accrued from nursing homes operating under long-term-care insurance in Korea. The collected data include a total of six quarterly base measurements on nurse staffing HPRD and 15 quality indicators from 2014 to 2017. The proposed optimization model emerged to most appropriately combine nurse staffing HPRD to increase quality-of-care outcomes for nursing home residents by 3% to 8%. Optimal outcome measures were fixed as best outcomes and compiled from 15 nursing-sensitive quality indicators. Findings Constrained nonlinear optimization was used for analysis. A 12% increase in registered nurse (RN) HPRD (from 0.168 HPRD [10 min 5 s] to 0.177 [10 min 38 s]) aligned with a 3% improvement in quality-of-care outcomes. A 20% RN HPRD increase aligned with a commensurate 5% to 8% increase in compiled quality-of-care outcomes (from 0.168 HPRD [10 min 5 s] to 0.202 HPRD [12 min 6 s]) without increasing certified nurse aide HPRD. About a 30% RN HPRD increase aligned with a commensurate 5% to 8% increase in compiled quality-of-care outcomes (from 0.168 HPRD [10 min 5 s] to 0.218 HPRD [13 min 6 s]) without increasing certified nurse aide HPRD. Conclusions It is urgent to institute mandatory nurse HPRD for nursing homes in Korea by law. This research provides evidence that increasing nursing HPRD improved residents' outcomes in nursing homes. Clinical Relevance Findings from the optimization model implied that stable care by RNs in nursing homes is a key factor in achieving acceptable quality of care for residents.
DOI
10.1111/jnu.12498
Appears in Collections:
간호대학 > 간호학전공 > Journal papers
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