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Are Staffing, Work Environment, Work Stressors, and Rationing of Care Related to Care Workers' Perception of Quality of Care? A Cross-Sectional Study.
- Source :
-
Journal of the American Medical Directors Association [J Am Med Dir Assoc] 2015 Oct 01; Vol. 16 (10), pp. 860-6. Date of Electronic Publication: 2015 May 28. - Publication Year :
- 2015
-
Abstract
- Objectives: To describe care worker-reported quality of care and to examine its relationship with staffing variables, work environment, work stressors, and implicit rationing of nursing care.<br />Design: Cross-sectional study.<br />Setting: National, randomly selected sample of Swiss nursing homes, stratified according to language region and size.<br />Participants: A total of 4311 care workers of all educational backgrounds (registered nurses, licensed practical nurses, nurse aides) from 402 units in 155 nursing homes completed a survey between May 2012 and April 2013.<br />Measurements: Care worker-reported quality of care was measured with a single item; predictors were assessed with established instruments (eg, Practice Environment Scale-Nurse Working Index) adapted for nursing home use. A multilevel logistic regression model was applied to assess predictors for quality of care.<br />Results: Overall, 7% of care workers rated the quality of care provided as rather low or very low. Important factors related to better quality of care were higher teamwork and safety climate (odds ratio [OR] 6.19, 95% confidence interval [CI] 4.36-8.79); better staffing and resources adequacy (OR 2.94, 95% CI 2.08-4.15); less stress due to workload (OR 0.71, 95% CI 0.55-0.93); less implicit rationing of caring, rehabilitation, and monitoring (OR 0.34, 95% CI 0.24-0.49); and less rationing of social care (OR 0.80, 95% CI 0.69-0.92). Neither leadership nor staffing levels, staff mix, or turnover was significantly related to quality of care.<br />Conclusions: Work environment factors and organizational processes are vital to provide high quality of care. The improvement of work environment, support in handling work stressors, and reduction of rationing of nursing care might be intervention points to promote high quality of care in nursing homes.<br /> (Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Cross-Sectional Studies
Female
Humans
Logistic Models
Male
Organizational Culture
Patient Care Team
Patient Safety
Stress, Psychological etiology
Stress, Psychological prevention & control
Switzerland
Workforce
Health Care Rationing
Nursing Homes
Personnel Staffing and Scheduling
Quality of Health Care
Workload
Subjects
Details
- Language :
- English
- ISSN :
- 1538-9375
- Volume :
- 16
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of the American Medical Directors Association
- Publication Type :
- Academic Journal
- Accession number :
- 26027721
- Full Text :
- https://doi.org/10.1016/j.jamda.2015.04.012