Abstract
BackgroundA training opportunity in which ongoing education is encouraged is one of the determinants in recruiting and retaining nurses in home-visit nursing care agencies. We investigated the association between ensuring training opportunities through scheduled training programs and the change in the number of nurses in home-visit nursing agencies using nationwide panel data at the agency level.MethodsWe used nationwide registry panel data of home-visit nursing agencies from 2012 to 2015 in Japan. To investigate the association between planning training programs and the change in the number of nurses in the following year, we conducted fixed-effect panel data regression analysis.ResultsWe identified 4760, 5160 and 5025 agencies in 2012, 2013, and 2014, respectively. Approximately 60–80% of the agencies planned training programs for all staff, both new and former, during the study period. The means and standard deviations of the percentage change in the number of full time equivalent (FTE) nurses in the following year were 4.2 (19.8), 5.7 (23.5), and 5.8 (25.1), respectively. Overall, we found no statistically significant association between scheduled training programs and the change in the number of FTE nurses in the following year. However, the associations varied by agency size. Results of analysis stratified by agency size suggested that the first and second quartile sized agencies (2.5–4.0 FTE nurses) with scheduled training programs for all employees were more likely to see a 9.0% (95% confidence interval [CI]: 4.5, 13.5) and 8.5% (95% CI: 2.4, 14.5) increase in the number of FTE nurses in the following year, respectively. Similarly, the first and second quartile sized agencies with scheduled training programs for new employees were more likely to see a 4.7% (95% CI: 2.1, 7.2) and 3.3% (95% CI: 0.4, 6.2) increase in the number of FTE nurses in the following year, respectively.ConclusionsEnsuring training opportunities through scheduled training programs for all staff, both new and former, in relatively small-sized home-visit nursing agencies might contribute to an increase in the number of nurses at each agency.
Highlights
A training opportunity in which ongoing education is encouraged is one of the determinants in recruiting and retaining nurses in home-visit nursing care agencies
To the best of our knowledge, this is the largest sample size study examining the association between training opportunities at home-visit nursing agencies and the change in the number of nurses in the following year, after adjusting for agency-specific confounding variables
We found that the associations varied by agency size
Summary
A training opportunity in which ongoing education is encouraged is one of the determinants in recruiting and retaining nurses in home-visit nursing care agencies. With the increase in the elderly population and the shifting of health policy to an integrated community care system that enables citizens to continue living in a familiar environment [7], the demand for home-visit nursing has been increasing [8, 9]. The majority of home-visit nursing agencies in Japan are small sized with fewer than five full-time equivalent (FTE) nurses [9]. Operations are likely to be inefficient, resulting in increased burden on staff [9] They tend to be unprofitable compared to large agencies [12]. They are unable to provide end-of-life care because of their inability to provide home-visit nursing 24 h a day owing to the shortage of manpower [13]. The Japanese Nursing Association has promoted polices that secure more home-visit nurses and expand the agency size [9]
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