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In another study, the degree of nurse aide involvement in resident care planning was superseded only by the condition of the local economy as a factor affecting turnover.26 For example, in facilities where nursing staff were perceived to accept aides advice and suggestions or simply discussed care plans with aides, the turnover was lower than in those facilities where aides were not involved in care planning. High Nurse Aide Turnover May Lead to Higher Provider Costs and Quality of Care Problems Negative effectsrelated to both costs for the facility and quality of patient carehave been associated with high turnover. Direct provider costs of turnover include recruitment, selection, and training of new staff, overtime, and use of temporary agency staff to fill gaps. Indirect costs associated with turnover include an initial reduction in the efficiency of new staff and a decrease in nurse aide morale and group productivity. High turnover can disrupt the continuity of patient carethat is, aides may lack experience and knowledge of individual residents or clients. Furthermore, when turnover leads to staff shortages, nursing home residents may suffer harm because of the increased number of residents the remaining staff must care for, resulting in less time to care for each resident. The recent HCFA report to Congress that found a direct relationship between nurse staffing levels in nursing homes and quality also found a direct relationship between nurse aide staffing levels and the quality of resident care. HCFAs analysis of the three states data demonstrated that, after controlling for case mix, there is a minimum nurse aide staffing threshold below which quality of care may be seriously impaired. Moreover, 54 percent of the facilities in the three states were not staffing at that minimum threshold level. Go back to resources for nursing schools, resources, and jobs |
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