Staffing and service availability in assisted living: the importance of nurse delegation policies
- Autores: Anna Beeber, Sheryl Zimmerman, C. Madeline Mitchell, David Reed
- Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 66, Nº. 11, 2018, págs. 2158-2166
- Idioma: inglés
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Resumen
Objectives To examine the health services provided in residential care and assisted living (RC/AL), the staff providing these services, and the degree to which the services relate to state‐level nurse delegation policies and other correlates of service provision.
Design This cross‐sectional study descriptively examined the relationships among RC/AL characteristics, services, staffing, and nurse delegation regulations/policies.
Setting RC/AL settings (N=245) in 8 U.S. states (CA, FL, IL, KS, NC, NH, NJ, OR).
Participants Administrators and healthcare supervisors (individuals overseeing health care and services provided to residents).
Measurements Using a telephone survey, we examined how delegation policies related to staffing and the availability of 26 health services.
Results Significantly more services were available in RC/AL settings that permit delegation (delegation states) than states that do not permit delegation (nondelegation states) (19.7 vs 18.1, p < .001). Delegation states also had more medication technicians administering, assisting with, or observing self‐administration of prescribed and as‐needed medications (p < .001), whereas nondelegation states had staff with fewer qualifications handling medications (p < .001). In 2‐way comparisons of categories of nurse staffing (none, licensed practical nurses (LPNs) and licensed vocational nurses (LVNs) only, registered nurses (RNs) only, LPN/LVNs and RNs), RC/AL communities with no nurse staffing offered significantly fewer services than all other categories. Those with RNs only also offered a significantly fewer services than those with LPN/LVNs only.
Conclusion This study is a first step in identifying how staffing and availability of services in RC/AL are related to statewide nurse delegation practices, forming the basis for further exploration of how these characteristics may relate to quality of care. J Am Geriatr Soc 66:2158–2166, 2018.
