Finding Disparities in the Stars: Using the Nursing Home Five-Star Quality Rating System to Identify Disparities in Nursing Home Quality for Older Adults with Severe Mental Illness

Nurse Staffing and Veteran Outcomes in the Veterans Health Administration's Community Living Centers

BACKGROUND

The demand for nursing care is rising in the long-term care setting. Nurse staffing is a crucial measure linked to health care quality measure outcomes.

PURPOSE

To assess for associations between nursing hours per patient day (NHPPD) and outcome measures in the Veterans Health Administration Community Living Centers.

METHODS

A retrospective data review of NHPPD and quality measures for 134 community living centers was conducted. Linear regression was used to assess for linear associations between average total NHPPD and 6 quality measures.

RESULTS

A significant linear association was found between average total NHPPD and falls with major injury ( P = .02) and help with activities of daily living ( P = .01). No associations were found between nurse staffing and 4 other quality measures.

CONCLUSIONS

This study adds to the body of literature regarding the impact of nurse staffing on quality measures.

Evaluating the staffing methodology model in the veterans health administration's community living centers

PURPOSE

Program evaluation to describe nursing hours per patient day (NHPPD) within the Veterans Health Administration (VHA) and to evaluate Staffing Methodology in the VHA Community Living Centers (CLCs).

METHODS

Targeted and actual NHPPD were compiled retrospectively for each VHA CLC unit over a one-year timeframe for calendar year 2019. For descriptive analyses, actual NHPPD were averaged across months for each CLC unit.

RESULTS

The mean for actual hours as a percent of target was 121.6% (95% CI, 118.5 to 124.7%) indicating the units' average hours across 2019 were 21.6% significantly higher than target. The actual NHPPD significantly differed across months (p<0.001) with the 2019 months of January and October having the highest NHPPD.

CONCLUSIONS

Veteran safety is a VHA priority and appropriate nurse staffing is key to providing care that improves Veteran outcomes. Further exploration is needed on the impact of nurse staffing on Veteran outcomes, safety, and satisfaction.