Suchergebnisse

This study examined the predictors of total nurse and registered nurse (RN) staffing hours per resident day separately in all free-standing California nursing homes (1,155), using staffing data from state cost reports in 1999. This study used a two-stage least squares model, taking into account nursing turnover rates, resident case mix levels, and other factors. As expected, total nurse and RN staffing hours were negatively associated with nurse staff turnover rates and positively associated with resident case mix. Facilities were resource dependent in that a high proportion of Medicare residents predicted higher staffing hours, and a higher proportion of Medicaid residents predicted lower staffing hours and higher turnover rates. Nursing assistant wages were positively associated with total nurse staffing hours. For-profit facilities and high-occupancy rate facilities had lower total nurse and RN staffing hours. Medicaid reimbursement rates and multifacility organizations were positively associated with RN staffing hours.

This article deals with chronically ill schoolage children and their parents' perceptions of their neighborhood. Three hundred and sixty-five chronically ill children (ages 10 through 12) were interviewed about their neighborhood. The children described aspects of their neighborhood that they liked and disliked, and their activity pattems alone and with peers. The parents also evaluated neighborhood safety. Regression analysis was used to identify parentand child-reported items that may have influenced images of neighborhood safety. The findings demonstrate that chronically ill children's activity patterns in their neighborhoods are influenced by child factors (perception of the neighborhood and its safety, gender, type of illness) and by parental factors (perception of neighborhood safety, income, home ownership). The findings also suggest that the patterns of interaction of chronically ill children with their neighborhood may be a source of developmental risk.

Trends in the average nurse staffing levels are reported for certified nursing facilities in the United States from 1991 through 1995. Data from the federal On-Line Survey Certification and Reporting system show a small overall increase in the staffing levels for registered nurses (RNs), licensed vocational and licensed practical nurses (LVNs/LPNs), and nursing assistants over the 5 years, but there are substantial variations across states and regions. A two-stage least squares panel analysis examined predictors of nurse staff levels in states. States with higher resident case mix levels had higher RN and LVN/LPN hours. States with higher percentages of large facilities had lower RN and LVN/LPN levels and states with higher percentages of for-profit facilities had lower RN staff levels. States with a higher percentage of Medicaid residents had higher LVN/LPN staff levels. These findings indicate the need for more studies of staff variations and public policies that affect staffing.