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A systematic review of the association between nursing staff and nursing-sensitive outcomes in long-term institutional care.
- Source :
- Journal of Advanced Nursing (John Wiley & Sons, Inc.); Aug2021, Vol. 77 Issue 8, p3303-3316, 14p
- Publication Year :
- 2021
-
Abstract
- Aims: To examine the association between type of nursing staff and nursing-sensitive outcomes in long-term institutional care. Design: This systematic review included studies published in English, German, and Dutch between January 1997 and January 2020. Data sources: The databases Medline (PubMed), CINAHL, PsycINFO, Embase, and the Cochrane Library were searched. Original quantitative studies were included. Review methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was used to critically appraise the reporting of the studies. Results: Fifteen articles were included. Of 33 quality of care outcomes, 21 were identified as nursing-sensitive outcomes of which 13 showed a significant association with nursing staff, specifically: Activities of daily living, aggressive behavior, bladder/bowel incontinence, contractures, expressive language skills, falls, infection (including vaccination), range of motion, pain, pressure ulcers, and weight loss. However, studies reported inconsistent results regarding the association among RNs, LPNs, CNAs, and HCAs and these nursing-sensitive outcomes, evidence shows that more RNs have a positive impact on nursing-sensitive outcomes. As to the evidence regarding the other type of nursing staff, especially HCA, findings regularly showed a negative association. Conclusion: Future research should be expanded with structure and process variables of which the mediating and moderating effect on nursing-sensitive outcomes is known. These may explain variances in quality of care and guide quality improvement initiatives. Researchers should consider fully applying Donabedian's structure-process-outcomes framework as it is a coherent entirety for quality assessment. Impact: This review provides an overview of quality of care outcomes that are responsive to nursing interventions in long-term institutional care. As the effects can be monitored and documented, quality assessment should focus on these nursing-sensitive outcomes. The inconclusive results make it difficult to provide recommendations on who should best perform which care. [ABSTRACT FROM AUTHOR]
- Subjects :
- EVALUATION of medical care
ONLINE information services
CINAHL database
PSYCHOLOGY information storage & retrieval systems
MEDICAL quality control
NURSING
MEDICAL information storage & retrieval systems
INFORMATION storage & retrieval systems
MEDICAL databases
SYSTEMATIC reviews
MEDICAL personnel
NURSING care facilities
CONCEPTUAL structures
HOSPITAL nursing staff
RESEARCH funding
NURSES
QUALITY assurance
TERMS & phrases
MEDLINE
LONG-term health care
PERSONNEL management
Subjects
Details
- Language :
- English
- ISSN :
- 03092402
- Volume :
- 77
- Issue :
- 8
- Database :
- Complementary Index
- Journal :
- Journal of Advanced Nursing (John Wiley & Sons, Inc.)
- Publication Type :
- Academic Journal
- Accession number :
- 151849885
- Full Text :
- https://doi.org/10.1111/jan.14840