Consistent Assignment of Nursing Staff to Residents in Nursing Homes: A Critical Review of Conceptual and Methodological Issues
| Autor: | Tonya J. Roberts, Kimberly Nolet, Barbara J. Bowers |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
media_common.quotation_subject
Appeal Personnel Staffing and Scheduling Organizational culture Pay for performance Culture change Nursing Excellence Nursing Assistants Health care Homes for the Aged Humans Human services media_common Aged Quality of Health Care Aged 80 and over business.industry General Medicine Public relations Nursing Homes Workforce Nursing Staff Geriatrics and Gerontology business Psychology Nurse-Patient Relations Gerontology Research Article |
| Popis: | Many national organizations consider consistent assignment of nursing staff to residents in nursing homes an important strategy for improving quality of care and quality of life for residents (Advancing Excellence, 2012; American Health Care Association, 2012; Koren, 2010b; Leavitt, 2006; Pioneer Network, 2011; Quality Partners of Rhode Island, 2004), and some states have even included consistent assignment as target goals in their pay for performance programs (Colorado Department of Health Care Policy and Financing, 2011; Commonwealth of Massachusetts Office of Health and Human Services, 2012). Furthermore, consistent assignment is a central strategy in the culture change movement, a national effort to improve nursing home environments by transforming traditional, institutional culture to one that is home like, where residents are able to receive person-centered care according to their preferences and customary routines (Doty, Koren, & Sturla, 2008; Koren, 2010a; Pioneer Network, 2011). Culture change advocates believe consistent assignment fosters strong, trusting relationships between staff and residents and enhances ability of staff to better “know” residents, their needs and preferences, and to provide care in meaningful and person-centered ways (Advancing Excellence, 2012; Koren, 2010a; Pioneer Network, 2011). The practice of consistent assignment of nursing staff to residents has intuitive appeal, and anecdotal reports suggest that it leads to better quality of care outcomes, stronger relationships between staff and residents, and a more stable and committed workforce (Albright, 2009; Farrell & Frank, 2007; Farrell, Frank, Brady, McLaughlin, & Gray, 2006; Kaldy, 2011; Rahman, Straker, & Manning, 2009). However, research demonstrates an inconsistent link between consistent assignment and outcomes, with studies demonstrating improvements, as well as not changing, and even worsening outcomes. A recent review of consistent assignment outcomes noted methodological limitations may be influencing this inconsistency (Rahman et al., 2009). In order to explore reasons for varied results and advance the state of the science, it is necessary to have a thorough understanding of conceptual and methodological inconsistencies found in this research. The purpose of this review is to summarize and critique the conceptual and methodological inconsistencies in research on consistent assignment. This review will answer two questions: 1. How has consistent assignment been conceptualized and defined in research? 2. What are the methodological limitations in current research on consistent assignment that may contribute to inconsistencies in outcomes? |
| Databáze: | OpenAIRE |
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