Simply adding more staff is not sufficient to bridge the gap in quality of care and health outcomes among nursing home facilities with varying percentages of residents with dementia, according to a study published in the journal Health Services Research.
Despite estimates suggesting over 40% of nursing home residents have dementia or cognitive impairment, no research has compared health outcomes between facilities with high and low dementia resident populations.
For this study, researchers at the University of California, Irvine, led by Dr. Dana Mukamel, estimated and contrasted the relationships between nurse staffing and health outcomes in nursing homes with low and high dementia populations to understand the association of staffing hours with dementia care quality.
“We wanted to understand the association of staffing hours with care quality and compare the health outcomes in nursing homes with high- and low-dementia populations,” said first author Dr. Mukamel. “We found that registered nurses’ and certified nurse assistants’ staffing hours per resident-day were likely to improve outcomes for both high- and low-census dementia facilities but that simply increasing staff is not likely to be a solution.”
For this analysis, researchers employed data from a national sample of nursing homes between 2017 and 2019 (pre-pandemic period). The data sources included the Payroll-Based Journal, Medicare Claims, Nursing Home Care Compare, and Long-Term Care Focus.
The researchers found that nursing homes with registered nurses and certified nurse assistants who worked more hours per resident day (HPRD), regardless of the number of dementia patients, generally had better resident outcomes. However, the researchers observed that there were still differences in overall quality of care between facilities with high and low numbers of dementia residents, even at similar staffing levels.
“We wanted to understand the association of staffing hours with care quality and compare the health outcomes in nursing homes with high- and low-dementia populations,” said first author Dana Mukamel. “We found that registered nurses’ and certified nurse assistants’ staffing hours per resident-day were likely to improve outcomes for both high- and low-census dementia facilities but that simply increasing staff is not likely to be a solution.”
Beyond staffing levels, researchers identified specialized staff training, creating an easily navigable environment, and maintaining staff stability as key factors for improving dementia care in nursing homes:
“Our findings highlight the fact that high-quality care involves not only increased staffing but also specialized training in practices proven to be effective in managing the complexities of this condition, as well as providing a secure environment and maintaining staff consistency,” Dr. Mukamel said. “Further research is required to identify specific areas that can be targeted to pinpoint opportunities for improvement in both low- and high-dementia facilities.”
Source: UCI Edu News
Journal: Health Services Research
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