Impact of nurse staffing, skill mix and stability on resident health outcomes in korean nursing homes

Abstract

Purpose: The purpose of this study was to investigate the impact of nurse staffing, skill mix, and stability on resident health outcomes in nursing homes. Methods: This study used a cross-sectional design with proportionate stratified sampling. A total of 53 nursing homes of all 3,261 nursing homes in Korea participated in this study. The number of residents per nursing staff, hours per resident day (HPRD), skill mix, and turnover rate of each nursing staff were used as independent variables. Residents’ health-outcome indicators, and use of the emergency room and hospital were used as dependent variables. Multiple regression was used to investigate the impact of nurse staffing, skill mix, and turnover rate on resident health outcomes. Results: The impact of residents per director of nursing (DON) was supported in fall prevention, decreased aggressive behavior, decreased antipsychotic drug use, and increased hospital use (rate and frequency). The impact of registered nurse (RN) HPRD was supported in decreased weight loss, decreased deteriorated activities of daily living, and decreased deteriorated range of motion. High RN turnover related to higher antipsychotic drug use. Conclusion: Nursing homes should increase the staffing level of DONs and RNs to maintain and improve resident health outcomes. Further research is required to confirm the impact of nurse staffing on residents’ health outcomes in nursing homes.