Anna Song Beeber1,2, Sheryl Zimmerman2,3, C Madeline Mitchell2, David Reed2. 1. School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 2. Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 3. School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Abstract
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.
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.
Authors: Sheryl Zimmerman; Philip D Sloane; Paul R Katz; Margo Kunze; Kevin O'Neil; Barbara Resnick Journal: J Am Med Dir Assoc Date: 2020-05 Impact factor: 4.669
Authors: Anna Song Beeber; Sheryl Zimmerman; Christopher J Wretman; Stephanie Palmertree; Kush Patel; Philip D Sloane Journal: J Appl Gerontol Date: 2021-06-23