RNs in nursing homes—It is not always about the numbers

Author:

Mueller Christine A.1,Bowers Barbara J.2,Kolanowski Ann M.3

Affiliation:

1. School of Nursing University of Minnesota Minneapolis Minnesota USA

2. School of Nursing University of Wisconsin‐Madison Madison Wisconsin USA

3. Ross and Carol Nese College of Nursing Pennsylvania State University State College Pennsylvania USA

Abstract

AbstractThe compelling evidence that higher RN to resident ratios improve health outcomes in nursing homes underscores the necessity of implementing evidence‐based RN nursing home staffing standards. However, there are other dimensions to RN staffing in nursing homes beyond the numbers or hours per resident day (HPRD) that influence the quality of care. Without attending to a broader focus on nurse staffing, the benefits of increased RN staffing levels will not be achieved. This article outlines how RN HPRD can be maximized by magnifying the RN's scope of practice and attending to how nursing care is organized and delivered in nursing homes using a nursing practice model framework. This framework addresses the accountability of the RN and the RN's role in supporting and facilitating: (1) collective decision‐making among the nursing staff about the care of residents and the work environment, (2) continuity of information among care providers, and (3) ensuring residents have continuity with the care providers assigned to their care. Attention to the RN's expertise in gerontological nursing and leadership capacity further leverages the RN's ability to influence the quality of care for nursing homes residents.

Publisher

Wiley

Reference31 articles.

1. Improving the Quality of Care in Nursing Homes

2. Nursing Staff in Hospitals and Nursing Homes

3. Improving the Quality of Long-Term Care

4. Keeping Patients Safe

5. Medicare and Medicaid Programs: Minimum Staffing Standards for Long‐Term Care Facilities and Medicaid Institutional Payment Transparency Reporting.2023. Vol 42 CFR Parts 438 442 and 483.https://www.federalregister.gov/documents/2023/09/06/2023‐18781/medicare‐and‐medicaid‐programs‐minimum‐staffing‐standards‐for‐long‐term‐care‐facilities‐and‐medicaid

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