Abstract
This study examined the effects of nurse staffing levels, work environment, and education levels on adverse events in nursing homes. A cross-sectional study was conducted involving 216 nurses working in 62 nursing homes in South Korea, using self-reported questionnaires and data from the National Health Insurance Service of South Korea. A logistic regression model was used to investigate the effects of nurse staffing levels, work environment, and nursing education levels on the adverse events experienced by residents. An increase of one resident per nurse was significantly associated with a higher incidence of medication error, pressure ulcers and urinary tract infections. A poor work environment increased the incidence of adverse events. Compared to nurses with a bachelor’s degree or higher, those with diplomas reported increased incidence rates of pressure ulcers. Improving the health outcomes of residents in nursing homes requires efforts that strengthen the nursing workforce in terms of numbers and educational level, and which improve their work environment at institutional and policy levels.
Highlights
This study examined the effects of nurse staffing levels, work environment, and education levels on adverse events in nursing homes
This study found that the prevalence of 5 adverse events, excluding medication errors, was 3.80 to 12.73 times higher when reported by registered nurse (RN) who perceived their work environment as poor rather than as better
This study showed that RN staffing levels were an important factor affecting the incidences of adverse events in nursing homes
Summary
This study examined the effects of nurse staffing levels, work environment, and education levels on adverse events in nursing homes. Improving the health outcomes of residents in nursing homes requires efforts that strengthen the nursing workforce in terms of numbers and educational level, and which improve their work environment at institutional and policy levels. Most residents of nursing homes have cognitive or functional restrictions caused by chronic progressive diseases and have more comorbid diseases compared to community-dwelling seniors who function w ell[4,5]. They may be at high-risk of being exposed to infectious disease outbreaks due to their grouped living conditions[6]. In seeking to provide empirical evidence concerning this matter, many researchers have examined the effects of nurse staffing on care quality or nursing home residents’ health-related outcomes, including safety-focused outcomes, in the United States and Europe[10,11,12]
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