Relationship between nursing staffing and quality of life in nursing homes

Abstract

Purpose: To investigate the relationship between nurse staffing and quality of life in nursing homes. Methods: This is a descriptive, correlational study. The independent variables were nursing staffing hours per resident day (HPRD), skill mix HPRD, and turnover rate of nursing staff. The data for the dependent variables were collected using the quality of life (QOL) section of minimum data set (MDS) version 3.0. Hierarchical linear models were used for data analysis. Results: Few staffing variables were statistically associated with residents’ QOL. More RN HPRD were associated with better comfort and enjoyment domains, more licensed practical nurses (LPN) HPRD were associated with better dignity, and more certified nurse assistant (CNA) HPRD were associated with better functional competence domains. In terms of skill mix, the unique contribution of more RNs (to less LPN or CNAs) was supported in the functional competence of residents. However, surprising results were that: (a) as the HPRD of RNs increased, the scores of meaningful activity and relationship decreased; and (b) the contribution of LPNs (more LPNs to less RNs) were supported in the autonomy and spiritual well-being domains. Interestingly, nursing staff turnover is positively correlated with some domains of QOL: (a) a higher score in the enjoyment domain with increased RN turnover; and (b) a higher score in privacy, relationship, and individuality domains with increased turnover of LPNs. Conclusion: This is a preliminary study to investigate the relationship between nursing staffing and QOL for nursing home residents. Further examination is needed to confirm the relationship and provide policy guidelines, including nurse staffing recommendations.