Factors associated with retention intention of Registered Nurses in Korean nursing homes

Factors Influencing Hospitalization of Nursing Home Residents in Korea Using Regularized Negative Binomial Regression

The appropriateness of hospitalization for nursing home (NH) residents is still up for debate, with determining factors including timeliness, available treatment, healthcare staff, medication options in hospitals, and safety issues. Although the factors leading to hospitalization have been studied expansively, research on staffing is limited. Thus, this study aimed to investigate organizational predictors, nurse staffing, and government incentives and find important factors to hospitalization due to infection or disease among NH residents in Korea. A cross-sectional design was used, and data were collected via survey from a total of 51 NHs from August 27, 2021 to March 25, 2022. A total of 32 explanatory variables were included. The response variable was the count of hospitalized residents due to infection or disease. We analyzed data using least absolute shrinkage and negative binomial regression. We found that registered nurses' increased hours per resident day were related to decreased hospitalizations due to infection or disease. Appropriate retention and recruitment of nurse staffing with professional leadership should be performed to increase the quality of care for NH residents.

Registered nurses' experiences on job satisfaction in nursing home settings

AIM

To describe what registered nurses' experience to be important to job satisfaction in nursing home settings.

DESIGN

This is a qualitative study based on data from individual interviews.

METHODS

Sixteen registered nurses working in nursing homes were interviewed, and their responses were analysed with systematic text condensation.

RESULTS

A total of six categories were developed to describe various aspects of job satisfaction among registered nurses at nursing homes: meaningfulness is essential, to possess control and manageability is central, a possibility to balance daily challenges with professional development, supportive leadership is imperative, the nursing team's competence and companionship, and being confident in one's own profession.

CONCLUSION

In the present study, meaningfulness was essential to job satisfaction, and work was experienced to be meaningful and engaging when the demands were manageable, the workload controllable, and when the registered nurses felt supported by management and co-workers. Conversely, if the demands were too high, the workload was beyond their control and the nurses felt unsupported, then the work felt meaningless and thus unsatisfactory.

Use of physical restraints on older adults in South Korean nursing homes: a multicenter study

In this study, we aimed to examine the current status of physical restraint use and ascertain factors affecting the rate of usage of physical restraints on older adults in South Korean nursing homes. For this purpose, we conducted a secondary analysis of data from 190 registered nurses employed at 62 nursing homes. Logistic regression analysis was used to identify the factors affecting the use of restraints in nursing homes. The rate of using physical restraints was 79.5%. Nursing homes were found to use 90.7% and 91.3% less restraint when the work environment was better (odds ratio [OR]: 0.093, 95% confidence interval [CI]: 0.023-0.368) and mixed (OR: 0.087, 95% CI: 0.087-0.100), respectively. Nursing homes owned by corporations were 9.796 times more likely to use physical restraints than those owned by local governments (OR: 9.796, 95% CI: 1.473-65.158). Therefore, improving nurses' work environment and introducing regulations and education that enable the entrusted doctors or nurses to make decisions regarding restraint use, monitoring, and removal, regardless of nursing home ownership type, are necessary.

Long-term Care Facility Staff's Experience of Safety Activities: A Qualitative Study

BACKGROUND

Ensuring the safety and quality of care is paramount in long-term care facilities due to residents' vulnerability.

OBJECTIVE

We explored the experiences of long-term care facility staff (eg, registered nurses [RNs], certified nursing assistants [CNAs], care workers, social workers, and physical therapists) in safety activities, aiming to understand their meaning and nature.

METHODS

We conducted qualitative focus group interviews with 25 participants, specifically addressing safety issues in long-term care facilities through the use of open-ended questions. We transcribed the data and conducted thematic analysis.

RESULTS

Participants engaged in discussions about various challenges, including assisting residents in maintaining physical comfort, managing behavioral and psychological symptoms of dementia, ensuring medication safety, implementing infection control practices, and providing adequate training on fire prevention, evacuation, and response protocols. Themes identified were "physical comfort," "managing dementia symptoms," "drug administration," "infection control," and "fire prevention."

CONCLUSIONS

The staff emphasized the safety of residents as their highest priority. Considering the lack of registered nurses in long-term care facilities, ongoing training and supervision are necessary to ensure that other long-term care facility staff can perform safety activities.

Association between job satisfaction and current smoking and change in smoking behavior: a 16-year longitudinal study in South Korea

BACKGROUND AND AIMS

Previous studies have found that job satisfaction is closely associated with various health outcomes of workers. Our study measured the association between job satisfaction and current smoking and change in smoking behavior.

DESIGN

Data from the longitudinal Korea Labor and Income Panel Study (KLIPS) that consist of nationally representative samples were used. The repeated measures analysis was conducted.

SETTING

South Korea, 2005-2021.

PARTICIPANTS

In total, 21 154 workers in Korea followed from 2005 to 2021 (145 120 observations) were included as study participants.

MEASUREMENTS

The main predictor variable, job satisfaction, was assessed using a five-item general job satisfaction questionnaire. Job satisfaction was classified into 'dissatisfied', 'neutral' and 'satisfied', according to the tertiles of the sum of scores. The outcomes of interest were current smoking and initiation and cessation of smoking in the subsequent year.

FINDINGS

Compared with those with a neutral level of job satisfaction, those who reported dissatisfaction with their job had an increased risk of smoking initiation [odds ratio (OR) = 1.11, 95% confidence interval (CI) = 1.01-1.22)]. Workers satisfied with their jobs were associated with a decreased likelihood of current smoking (OR = 0.96, 95% CI = 0.94-0.98) and smoking initiation (OR = 0.90, 95% CI = 0.81-0.99). There was a positive relationship between cumulative years of job dissatisfaction and smoking risk: > 4 years of experiencing job dissatisfaction was positively related to current smoking (OR = 1.14, 95% CI = 1.06-1.24) and smoking initiation (OR = 1.22, 95% CI = 1.00-1.49) and negatively related to smoking cessation (OR = 0.84, 95% CI = 0.72-0.99).

CONCLUSIONS

In Korea, job dissatisfaction appears to be associated with an increased risk of smoking initiation.

Perceived Work Environment, Educational Status, Staffing Levels, and Work Outcomes in Long-Term Care Settings During COVID-19

OBJECTIVES

Coronavirus disease (COVID-19) has severely affected older residents in long-term care (LTC) settings. However, care workers' perceptions of their work environment and potential impact on their work outcomes during the pandemic is not well known. This study examined associations between care staff's perceived work environment, educational status, and facility staffing levels and work outcomes of care staff in LTC settings during the COVID-19 pandemic.

DESIGN

This study employed a cross-sectional, observational, correlational design.

SETTING AND PARTICIPANTS

A total of 207 care staff were conveniently recruited from 30 LTC settings in South Korea.

METHODS

The perceived work environment, educational status of care staff, and facility staffing levels (ie, beds-to-registered nurse [RN] and beds-to-nursing assistant [NA] or care worker ratios), as well as their work outcomes (ie, general and COVID-19 specific outcomes) were collected using questionnaires. Multivariable binary logistic regressions were conducted, controlling for the characteristics of care staff (ie, age, sex, occupation, and career length) and facilities (ie, location, bed size, ownership, and residents' disease and care profiles).

RESULTS

Approximately 45% of the participants were either NAs or care workers, and 38% were RNs. More than half (53.14%) perceived their work environment to be good. LTC staff who perceived their work environment to be poor were more likely to be dissatisfied with their work [odds ratio (OR) 20.88), experience high burnout (OR 8.63), intend to leave the facility within a year (OR 5.00), and experience increased overtime work (OR 3.58) and work-life imbalance (OR 1.93) due to COVID-19.

CONCLUSIONS AND IMPLICATIONS

LTC work environments should be improved and government-led initiatives for ensuring such improvements should be implemented to enable a better response to future public health crises and maintain the quality of care for and safety of residents in LTC settings.

Effects of registered nurses' staffing levels, work environment and education levels on nursing home residents' quality of life and nurse outcomes

AIMS AND OBJECTIVES

To examine the effects of registered nurse staffing levels, work environment and education levels on the residents' quality of life and nurses' job dissatisfaction, burnout and turnover intention.

BACKGROUND

Registered nurse staffing status and work environment are suboptimal in nursing homes worldwide. Nursing home care aims to maximise residents' quality of life. However, evidence on the impact of registered nurse staffing levels, work environment and education levels on the residents' quality of life and nurse outcomes in nursing homes is limited.

DESIGN

This is a cross-sectional observational study.

METHODS

A total of 513 residents and 117 registered nurses from 39 nursing homes in South Korea participated in surveys. The main measures included registered nurses' staffing levels, work environment, education levels, residents' quality of life, registered nurses' job dissatisfaction, burnout and turnover intention. We analysed data using the generalised estimating equations and reported the study using the STROBE checklist.

RESULTS

Overall, the residents' quality-of-life score was 13.7 ± 2.6 (out of 17). Residents in nursing homes with a higher number of registered nurses or with work environment evaluated as 'mixed' or 'better' (compared with 'poor') had a higher quality of life. Regarding nurse outcomes, 74.4% of the registered nurses were dissatisfied with their current jobs, 12.0% had burnout and 18.8% had a turnover intention. Registered nurses working in 'mixed' or 'better' work environment were less likely to have job dissatisfaction. Registered nurses' education levels did not have a statistically significant effect on the resident and nurse outcomes.

CONCLUSIONS

Registered nurse staffing levels and work environment should be considered important for improving residents' quality of life and nurses' job satisfaction.

RELEVANCE TO CLINICAL PRACTICE

Regulation and policy reforms are needed to increase the registered nurse staffing levels and to create a good work environment in nursing homes.

PATIENT OR PUBLIC CONTRIBUTION

Nursing home residents and registered nurses participated in the surveys of this study. Registered nurses facilitated resident recruitment by identifying and introducing the study to residents who were eligible for study participation.

TRIAL REGISTRATION

Not applicable.