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Kim, Lee, and Kang: Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals
Original Article

Journal of Korean Academy of Nursing 2014; 44(1): 21-30.

Published online: 28 February 2014

DOI: https://doi.org/10.4040/jkan.2014.44.1.21

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

Yunmi Kim1, Ji Yun Lee2, 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, leejiyun@kangwon.ac.kr

Received 30 September 2013       Revised 14 October 2013       Accepted 19 December 2013

© 2014 Korean Society of Nursing Science

(open-access):

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

Figures and Tables

Table 1
Hospital Characteristics (N=610)
jkan-44-21-i001
Table 2
Patient Outcomes from Long Term Care Hospitals (N=610)
jkan-44-21-i002

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

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

*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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