P-5: Associations Between staffing Hours and Quality of Care Indicators in Long-Term Care: Results From a Cross-Sectional Cohort Study
Meaghan Davey*, Andrew Costa, Jeffrey Poss, Veronique Boscart
Objective: Staff information and resident's quality of care indicators at the unit level in long-term care (LTC) facilities.
Methods: Data were collected from administrative records and resident assessments from July 2014 to June 2015 at 11 LTC facilities (villages) comprising 55 units (neighbourhoods) in Ontario, Canada. A total of 69 registered nurses, 183 registered nurses, 858 nursing assistants (NA), and 2173 residents were included in this cross-sectional study. Practice sensitive, risk-adjusted quality indicators were described individually, then combined to create a composite score for each neighbourhood. Multilevel regression models were used to estimate the impact of staffing characteristics on composite quality scores.
Results: NAs provided the majority of direct care hours in LTC facilities. NAs' years of experience and total care hours per resident day were significantly associated with higher quality of care.
Conclusions: The direct input of available care hours per resident day, especially that of NAs, was an important contributor to quality of care. The finding that shorter nursing assistant longevity also contributed to lower quality of care may have been related to less experienced staff contributing directly to poorer quality of care. This could have an indirect affect such that a poorly functioning neighbourhood contributed to nursing assistant's turnover. Overall, the most influential LTC staffing characteristics to resident's quality of care were total care hours and NA years of experience in LTC.