Absenteeism of nursing staff in a nursing home

Professional Care Team Burden (PCTB) scale - reliability, validity and factor analysis

Background

There is growing concern about how to provide care for persons with dementia in institutions such as nursing homes, day care centers, mobile services and hospitals. Care teams (formal caregivers) have to meet specific expectations from different sides: the Person with Dementia herself, the institution, and from different family members. Out of this situation, considerable burden can emerge hindering the professional development of care team members and counteracting quality of care of care recipients. So far there are very few specific reliable and valid scales measuring burden in care team members. Based on the theoretical concept of subjectively perceived burden, organizationally based factors of burden and structural factors of burden, we report on the construction of a care team burden scale and its scale quality criteria.

Methods

Based on the theoretical three assumed sources of burden, a structured interview guide was developed. Interviews were held with professional caregivers. Through qualitative data analysis, an item pool consisting of 40 Items was constructed. Experts selected 19 items found most appropriate to measure the three theoretically based domains of burden. The Perceived Stress Scale (PSS) was chosen as a criterion in order to test discriminant validity. An exploratory factor analysis was performed.

Results

The stepwise scale analysis revealed a 10 item solution. The Cronbach’s alpha was 0.785. The Pearson correlation between the PCTB 10 Item scale (mean score 10.2, SD = 5.0) and the PSS (mean score 13.0, SD = 5.9) was 0.46 (p < 0.001). All included items could clearly be assigned to one of three factors.

Conclusion

The 10 item PCTB scale provides a valid and reliable means of obtaining ratings of burden from formal care teams working in nursing homes in order to evaluate different interventions targeted at the reduction of burden in care teams.

Electronic supplementary material

The online version of this article (doi:10.1186/s12955-014-0199-8) contains supplementary material, which is available to authorized users.

Influence of Nurse Aide Absenteeism on Nursing Home Quality

PURPOSE

In this analysis, the association of nurse aide absenteeism with quality is examined. Absenteeism is the failure of nurse aides to report for work when they are scheduled to work.

DESIGN AND METHODS

Data used in this investigation came from survey responses from 3,941 nursing homes; Nursing Home Compare; the Online System for Survey, Certification and Administrative Reporting data; and the Area Resource File. Staffing characteristics, quality indicators, facility, and market information from these data sources were all measured in 2008. The specific quality indicators examined are physical restraint use, catheter use, pain management, and pressure sores using negative binomial regression.

RESULTS

An average rate of 9.2% for nurse aide absenteeism was reported in the prior week. We find that high levels of absenteeism are associated with poor performance on all four quality indicators examined.

IMPLICATIONS

The investigation presented, to our knowledge, is one of the first examining the implications of absenteeism in nursing homes. Absenteeism can be a costly staffing issue, one of the potential costs identified in this analysis is an impact on quality of care.

Comparing families and staff in nursing homes and assisted living: implications for social work practice

Nursing homes and residential care/assisted living settings provide care to 2.4 million individuals. Few studies compare the experience of, and relationships between, family and staff in these settings, despite ongoing family involvement and evidence that relationships are problematic. Data from 488 families and 397 staff members in 24 settings examined family involvement and family and staff burden, depressive symptoms, and perceptions; and staff absenteeism and turnover. There were few differences across setting types. Although conflict rarely occurred, there was room for improvement in family-staff relations; this area, and preparing family for their caregiving roles, are appropriate targets for social work intervention.

Improving nursing assistant turnover and stability rates in a long-term care facility

In this study, we developed formulas to calculate nursing assistant turnover and stability rates, identified reasons for termination and facility-specific strategies to reduce turnover, and evaluated the effectiveness of implemented strategies. Although turnover remained relatively unchanged (23% in year 1, 28% in year 2), the stability rate remained high (76% in year 1, 75% in year 2). Tracking turnover rates without tracking stability yields an incomplete picture of a facility's efforts to attract and retain qualified employees. Achieving high stability rates in addition to low turnover rates are important goals, and we have included some recommendations.

Is there a relationship between job satisfaction and absenteeism?

This study attempted to address the problem of stress and burnout in hospital nurses by exploring factors which affect job satisfaction and the relationship between these and absence rates. Fifty nurses working in the elderly care unit of a district general hospital were asked to complete a job satisfaction questionnaire, specifically developed to include factors appropriate to the study, together with Maslach's burnout inventory and Beck's hopelessness scale. The hypothesis that job satisfaction is related to absenteeism was not supported. However, significant correlations between some variables were isolated. These correlations were tested using Spearmans risk correlation co-efficient. It is hoped that the job satisfaction questionnaire will become a useful instrument in screening those at risk of burnout, and a diagnostic aid to help consider the factors which affect job satisfaction. The implications of the study point to the need for the prevention of stress from environmental factors by the adoption of organizational strategies to promote positive working conditions, and the development of coping strategies in the form of stress awareness seminars, regular staff support groups and counselling services.

Nurse absence--the causes and the consequences

This paper addresses nurse absence as it occurs in health care organizations and as a form of withdrawal behaviour from work. Absence represents a traditional domain of conflict between nursing management and their employees in day-to-day practice. The aim of the following discussion is to extend nursing management's understanding of the topic as a precondition for well-balanced schedules and effective human resource planning. A discussion of planned and unplanned absence thus arises and appropriate types of measurement, taking employee absence behaviour into account, are outlined. The implications of the arguments, developed in detail in the first part of the paper, are applied in the second part using a hypothetical account. In order to illustrate the importance of managing absence by nursing management, a method for calculating schedules is described which investigates the organizational control of planned and unplanned absence. This method proposes a seven stage calculation and highlights the processes that are essential for taking absence into account.

Primary nursing in long-term care: is it economically feasible?

1. The demand for nursing home beds exceeds supply, creating a sellers market. Administrators, therefore, do not see the need for making costly changes in the method of nursing care delivery. 2. ++Modified primary nursing, where permanent RN-nursing assistant teams are accountable to a permanent patient assignment, can be budget-neutral. Studies have suggested that primary nursing decreases supply costs, the use of sick leave, and the total number of staff. 3. For primary nursing in long-term care to be feasible, there must be an adequate number of budgeted full time employees, an adequate supply of RNs who are willing to work in long-term care, and adequate salaries to attract competent staff. 4. Although research addressing the costs of implementing primary nursing in long-term care exists, it is largely anecdotal. More controlled studies are needed.