U of M study: More RN hours Means Better Care in Nursing Homes

From the Minneapolis Star Tribune:

By Dan Browning

It took some sophisticated statistical methods to prove what might seem obvious to the untrained eye: If you pay more attention to nursing home residents, you improve their quality of life.

That sums up new research by the School of Public Health at the University of Minnesota, which examined five years’ worth of data on 369 Medicaid-certified nursing homes in the state. Specifically, the analysis found that higher ratios of registered nurses and activities staff produced measurable improvements in the residents’ quality of life. And scores measuring quality of care showed a direct correlation with quality of life scores.

Tetyana Shippee, an assistant professor in the U’s public health department, was the lead author of the study, which was published this month in the journal Research on Aging.

Even after adjusting for resident case types and facility characteristics, Shippee said, “staffing was a significant predictor of quality of life.”

But not just any staffing — and not staff retention, either.

“It was the number of hours by activity staff per resident, and the number of hours by RN — registered nurses — per resident,” she said.

Those findings are important at a time when many nursing homes are reducing RN hours in favor of cheaper licensed practical nurses (LPN), a lower-level certification. Shippee said the data did not show a similar improvement in quality of life scores with higher ratios of LPNs. She speculated that LPNs are so busy with direct care that they don’t make the same bond as registered nurses, who can spend more time with clients.

Shippee said that activity staffing is not taken as seriously as some other positions. Some providers try to get away with inexperienced staff or part-timers, and the result is lower quality-of-life scores over time, she said.

The study also found that nonprofit ownership of nursing homes are associated with higher quality of life scores than for-profit homes, and that larger facilities treating those with more profound health problems are associated with lower quality-of-life scores.



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