The Relationship Between Registered Nurses and Nursing Home Quality: An Integrative Review (2008-2014)

Nursing home care is expensive; second only to acute hospital care for inpatient Medicare costs. The increased focus on costs of care accrued by Medicare beneficiaries in nursing homes presents a valuable opportunity for registered nurses (RNs) to further demonstrate quantitatively the value they add to the capacity of the nursing home nursing skill mix to provide cost-effective and efficient quality care. Most of the studies included in this review consistently reported that higher RN staffing and higher ratios of RNs in the nursing skill mix are related to better NH quality. Concerns about the costs of employing more highly skilled RNs and directors of nursing that have the potential to positively influence members of the nursing skill mix will continue to influence nursing home industry hiring practices. For both the advancement of nursing as an applied science and the benefit of society at large, nursing researchers are challenged to better demonstrate how the increased presence of a RN on each shift has the potential to enhance the cost effectiveness, efficiency, and quality of nursing homes

Thinking about the end of life: a common issue for patients with Huntington’s disease

Genetics of disease, diagnosis and treatmen

Alternative staffing structures in a clustered domestic model of residential aged care in Australia

Objective A clustered domestic model of residential aged care has been associated with better consumer‐rated quality of care. Our objective was to examine differences in staffing structures between clustered domestic and standard models. Methods A cross‐sectional study involving 541 individuals living in 17 Australian not‐for‐profit residential aged care homes. Results Four of the homes offered dementia‐specific clustered domestic models of care with higher personal care attendant (PCA) hours‐per‐resident‐per‐day (mean [SD] 2.43 [0.29] vs. 1.74 [0.46], P < 0.001), slightly higher direct care hours‐per‐resident‐per‐day (2.66 [0.35] vs. 2.58 [0.44], P = 0.006), higher staff training costs ($1492 [258] vs.$989 [928], P < 0.001) and lower registered/enrolled nurse hours‐per‐resident‐per‐day (0.23 [0.10] vs. 0.85 [0.17], P < 0.001) compared to standard models. Conclusions An Australian clustered domestic model of care had higher PCA hours, more staff training and more direct care time compared to standard models. Further research to determine optimal staffing structures within alternative models of care is warranted. Impact A dementia‐specific clustered domestic model of care within aged care facilities, which has previously been associated with better consumer‐rated quality of care has higher staff training costs and higher direct care hours. Further research on alternative staffing structures in alternative models of residential aged care should be undertaken