Browse > Article
http://dx.doi.org/10.11111/jkana.2015.21.2.174

Impact of Nurse Staffing Level and Oral Care on Hospital Acquired Pneumonia in Long-term Care Hospitals  

Chae, Jung Mi (Health Insurance Review & Assessment Research Department)
Song, Hyunjong (Department of Health Policy and Management, Sangji University)
Kang, Gunseog (Department of Statistics and Actuarial Science, Soongsil University)
Lee, Ji Yun (Department of Nursing, Kangwon National University)
Publication Information
Journal of Korean Academy of Nursing Administration / v.21, no.2, 2015 , pp. 174-183 More about this Journal
Abstract
Purpose: This study was conducted to explore the impact of nurse staffing level and oral care on pneumonia in elderly inpatients in long-term care hospitals (LTCHs). Methods: Data were obtained from the Health Insurance Review and Assessment Services (HIRA) including the profiles of LTCHs, monthly patient assessment reports and medical report survey data of pneumonia patients by HIRA in the fourth quarter of 2010. The sample consisted of 37 LTCHs and 6,593 patients. Results: Patient per nurse staff (OR=1.43, CI=1.22~1.68) and no oral care (OR=1.29, CI=1.01~1.64) were significantly related with hospital acquired pneumonia. The difference in percent of oral care by hospital was not significant between high and low group in nurse staffing level. Conclusion: In order to reduce the occurrence of pneumonia in eldery patients, effective nursing interventions are not only required but also nurse staffing levels that enable nurses to provide the intervention.
Keywords
Nurse staffing; Oral care; Patient outcome; Pneumonia; Long term care;
Citations & Related Records
Times Cited By KSCI : 3  (Citation Analysis)
연도 인용수 순위
1 Statistics Korea. Annual report on the causes of death statistics 2012. Daejeon: Statistics Korea; 2013.
2 Attridge RT. Healthcare-associated pneumonia: Refining the HCAP criteria [Internet]. Texas: The University of Texas at Austin College of Pharmacy. 2009 [cited 2014. May 21]. Available from: http://www.utexas.edu/pharmacy/divisions/pharmaco/rounds/11-20-09.pdf
3 Chae JM, Song HJ, Park CM, Kim YJ. Management of pneumonia and sepsis development of inpatients in long term care hospital. Health Insurance Review & Assessment Service, 2012, February. Report No:F8E-2012-19.
4 Jung KS. Pneumonia in the elderly patients. The Korean Journal of Medicine. 2008;75(2):129-140.
5 Fry AM, Shay DK, Holman RC, Cums AT, Anderson LJ. Trends in hospitalizations for pneumonia among persons aged 65 years or older in the United States, 1988-2002. JAMA. 2005;294 (21):2712-2719. http://dx.doi.org/10.1001/jama.294.21.2712   DOI
6 Shanley C, O'Loughlin G. Dysphagia among nursing home residents: An assessment and management protocol. Journal of Gerontological Nursing. 2000;26(8):35-48.   DOI
7 El-Solh AA. Nursing home acquired pneumonia: Approach to management. Current Opinion in Infection Diseases. 2011;24 (1):148-151. http://dx.doi.org/10.1097/QCO.0b013e328343b6cc   DOI
8 Abe S, Ishihara K, Adachib M, Okudaa K. Oral hygiene evaluation for effective oral care in preventing pneumonia in dentate elderly. Archives of Gerontology and Geriatrics. 2006;43 (1):53-64. http://dx.doi.org/10.1016/j.archger.2005.09.002   DOI
9 Yoneyama T, Yoshida M, Matsui T, Sasaki H. Oral care and pneumonia. The Lancet. 1999;354(9177):515. http://dx.doi.org/10.1016/S0140-6736(05)75550-1   DOI
10 Sjogren P, Nilsson E, Forsell M, Johansson O, Hoogstraate J. A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly people in hospitals and nursing homes: Effect estimates and methodological quality of randomized controlled trials. Journal of American Geriatric Society. 2008;56:2124-2130. http://dx.doi.org/10.1111/j.1532-5415.2008.01926.x   DOI
11 Unruh L. Licensed nurse staffing and adverse events in hospitals. Medical Care. 2003;41(1):142-152. http://dx.doi.org/10.1097/01.mlr.0000039835.19305.1d   DOI
12 Needleman J, Buerhaus S, Mattke M, Stewart M, Zelevinsky K. Nurse-staffing levels and the quality of care of hospitals. The New England Journal of Medicine.2002;346(22):1715-1722. http://dx.doi.org/10.1056/NEJMsa012247   DOI
13 Kovner C, Jones C, Zhan C, Gergen PJ, Basu J. Nurse staffing and postsurgical adverse events: An analysis of administrative data from a sample of U.S. hospitals, 1990-1996. Health Services Research;37(3):611-629. http://dx.doi.org/10.1111/1475-6773.00040   DOI
14 Zimmerman S, Gruber-Baldini AL, Hebel JR, Sloane PD, Magaziner J. Nursing home facility risk factors for infection and hospitalization: Importance of registered nurse turnover, administration and social factors. Journal of American Geriatric Society. 2002;50:1987-1995. http://dx.doi.org/10.1046/j.1532-5415.2002.50610.x   DOI
15 Kim YM, Cho SH, June KJ, Shin SA, Kim JY. Effect of hospital nurse staffing on in-hospital mortality, pneumonia, sepsis, and urinary tract infection in surgical patients. Journal of Korean Academy of Nursing. 2012;42(5):719-729. http://dx.doi.org/10.4040/jkan.2012.42.5.719   DOI
16 Donabedian A. The quality of care: How can it be assessed? The Journal of the American Medical Association. 1988;260 (12):1743-1748. http://dx.doi.org/10.1001/jama.1988.03410120089033   DOI
17 Arling G, Kane RL, Mueller C, Bershadsky J, Degenholtz HB. Nursing effort and quality of care for nursing home residents. The Gerontologist. 2007;47(5):672-682. http://dx.doi.org/10.1093/geront/47.5.672   DOI
18 Spilsbury K, Hewitt C, Stirk L, Bowman C. The relationship between nurse staffing and quality of care in nursing homes: A systematic review. International Journal of Nursing Studies. 2011;48:732-750. http://dx.doi.org/10.1016/j.ijnurstu.2011.02.014   DOI
19 Bostick JE, Rantz MJ, Flesner MK, Riggs CJ. Systematic review of studies of staffing and quality in nursing homes. Journal of American Medical Directors Association. 2006;7:366-376. http://dx.doi.org/10.1016/j-jamda.2006.01.024   DOI
20 Castle NG, Anderson RA. Caregiver staffing in nursing homes and their influence on quality of care using dynamic panel estimation methods. Medical Care. 2011;49(6):545-552. http://dx.doi.org/10.1097/MLR.0b013e31820fbca9   DOI
21 Zhang X, Grabowski DC. Nursing home staffing and quality under the nursing home reform act. The Gerontologist. 2004; 44(1):13-23. http://dx.doi.org/10.1093/geront/44.1.13   DOI
22 Lee JY, Kim EY, Cho E. Factors impacting the physical function of older adults in Korean long-tern care hospitals. Journal of Korean Academy of Nursing. 2011;41(6):780-787. http://dx.doi.org/10.4040/jkan.2011.41.6.780   DOI
23 Yoon JY, Lee JY, Bowers BJ, Zimmerman DR. The impact of organizational factors on the urinary incontinence care quality in long-term care hospitals: A longitudinal correlational study. International Journal of Nursing Studies. 2012;49:1544-1551. http://dx.doi.org/10.1016/j.ijnurstu.2012.07.011   DOI
24 Bates-Jensen BM, Schnelle JF, Alessi CA, Al-Samarrai NR, Levy-Storms L. The effect of staffing on in-bed times and nursing home residents. Journal of the American Geriatrics Society. 2004;52:931-938. http://dx.doi.org/10.1111/j.1532-5415.2004.52260.x   DOI
25 Kim YA, Lee JY, Kim HS, Hwang JH. A comparison of nursing problems identified through RAI-FC and by nurses caring for nursing home residents. Journal of Korean Gerontological Nursing. 2011;13(1):58-68.