Determining Nurse Aide Staffing Requirements to Provide Care Based on Resident Workload: A Discrete Event Simulation Model

Journal of the American Medical Directors Association

Volumn 17, Issue 11, 2016, Pages 970-977

  Schnelle, John F ^a,b   Schroyer, L Dale ^c   Saraf, Avantika A ^a,d   Simmons, Sandra F ^a,b  

^a VANDERBILT UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b Veteran's Affairs Tennessee Valley Healthcare System   (United States)

^c ProModel Corporation   (United States)

^d VANDERBILT UNIVERSITY MEDICAL CENTER   (United States)

Author keywords

activities of daily living; Discrete event simulation; nursing home; staffing models

Indexed keywords

DAILY LIFE ACTIVITY; HUMAN; HUMAN EXPERIMENT; MODEL; NURSE; NURSING HOME; PATIENT CARE; PRODUCTIVITY; RESIDENT; SAMPLE SIZE; STAFF; WORKLOAD; NONBIOLOGICAL MODEL; NURSING ASSISTANT; PERSONNEL MANAGEMENT;

ACTIVITIES OF DAILY LIVING; HUMANS; MODELS, ORGANIZATIONAL; NURSES' AIDES; NURSING HOMES; PERSONNEL STAFFING AND SCHEDULING; WORKLOAD;

EID: 84992598506     PISSN: 15258610     EISSN: 15389375     Source Type: Journal    
DOI: 10.1016/j.jamda.2016.08.006     Document Type: Article

References (40)

1. 1 The Official U.S. Government Site for Medicare. What Information Can I Get About Staffing? (online) Available at: https://www.medicare.gov/NursingHomeCompare/About/Staffing-Info.html. Accessed December 14, 2015.
2. 2 Page A, ed. Keeping Patients Safe. Institute of Medicine, The National Academies Press Committee on the Work Environment for Nurses and Patient Safety, Board of Healthcare Services. 2004. Available at: http://www.nap.edu/catalog/10851.html. Accessed December 14, 2015.
3. 3 The Coalition of Geriatric Nursing Organizations. Nursing staffing requirements to meet the demands of today's long term care consumer recommendations from the Coalition of Geriatric Nursing Organizations (CGNO). Available at: http://nadona.org/pdfs/CGNO%20Nurse%20Staffing%20Position%20Statement%201%20page%20summary.pdf. Accessed December 14, 2015.
4. 4 Department of Health and Human Services: Centers for Medicare and Medicaid Services; 42CFR Parts 405, 431, 447, et al. Reform of Requirements for Long-Term Care Facilities; Proposed Rule. Federal Register, 2015, Volume 80; No. 136.
5. 5 Levinson DR. A Review of Nursing Facility Resource Utilization Groups. Department of Health and Human Services: Office of Inspector General, 2006.
6. 6 Centers for Medicare and Medicaid Services. Expected and Adjusted Staff Time Values Data Set. Five-Star Quality Rating system, Downloads. Available at: https://www.cms.gov/Medicare/Provider-Enrollment-and Certification/CertificationandComplianc/FSQRS.html. Accessed December 16, 2015.
7. 7 Schnelle, J.F., Bates-Jensen, B.M., Chu, L., Simmons, S.F., Accuracy of nursing home medical record information about care-process delivery: Implications for staff management and improvement. J Am Geriatr Soc 52 (2004), 1378–1383.
8. 8 Schnelle, J.F., Osterweil, D., Simmons, S.F., Improving the quality of nursing home care and medical-record accuracy with direct observational technologies. Gerontologist 45 (2005), 576–582.
9. 9 Schnelle, J.F., Simmons, S.F., Harrington, C., et al. Relationship of nursing home staffing to quality of care. Health Serv Res 39 (2004), 225–250.
10. 10 Kalisch, B.J., Missed nursing care: A qualitative study. J Nurs Care Qual 21 (2006), 306–313 quiz 14–15.
11. 11 Bates-Jensen, B.M., Schnelle, J.F., Alessi, C.A., et al. The effects of staffing on in-bed times of nursing home residents. J Am Geriatr Soc 52 (2004), 931–938.
12. 12 Simmons, S.F., Durkin, D.W., Rahman, A.N., et al. Resident characteristics related to the lack of morning care provision in long-term care. Gerontologist 53 (2013), 151–161.
13. 13 Bostick, J.E., Rantz, M.J., Flesner, M.K., Riggs, C.J., Systematic review of studies of staffing and quality in nursing homes. J Am Med Dir Assoc 7 (2006), 366–376.
14. 14 Silbiger, S., Research Abstracts to be Presented at the 13th Annual International Meeting on Simulation in Healthcare, January 26-30, 2013 Orlando, Florida (vol. 7, pg 528, 2012). Simulation Healthcare, 8, 2013, 66.
15. 15 Günal, M.M., Pidd, M., Discrete event simulation for performance modelling in health care: A review of the literature. J Simulation 4 (2010), 42–51.
16. 16 Hall, R., Patient flow: Reducing delay in healthcare delivery. 2013, Springer Science and Business Media, New York (NY).
17. 17 Dittus, R.S., Klein, R.W., DeBrota, D.J., et al. Medical resident work schedules: Design and evaluation by stimulation modeling. Manage Sci 42 (1996), 891–906.
18. 18 Hashimoto, F., Bell, S., Improving outpatient clinic staffing and scheduling with computer simulation. J Gen Intern Med 11 (1996), 182–184.
19. 19 Dittus, R.S., Discrete-event simulation modeling of the content, processes, and structures of health care. Reid, P.P., Compton, W.D., Grossman, J.H., Fanjiang, G., (eds.) Building a Better Delivery System: A New Engineering/Health Care Partnership, 2005, National Academies Press, Washington (DC).
20. 20 US Centers for Medicare and Medicaid Services, Prepared by Abt Associates Inc. Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes. Report to Congress: Phase II Final. Volumes I-III. 2001, CMS, Baltimore, MD.
21. 21 Harrell, C., Ghosh, B.K., Bowdend, R.O. Jr., Simulation Using ProModel. 3rd ed., 2012, McGraw Hill Publisher, New York (NY).
22. 22 van Weert, J.C., van Dulmen, A.M., Spreeuwenberg, P.M., et al. Effects of snoezelen, integrated in 24h dementia care, on nurse–patient communication during morning care. Patient Educ Counseling 58 (2005), 312–326.
23. 23 Schnelle, J.F., Rahman, A., Durkin, D.W., et al. A controlled trial of an intervention to increase resident choice in long term care. J Am Med Dir Assoc 14 (2013), 345–351.
24. 24 Rogers, J.C., Holm, M.B., Burgio, L.D., et al. Improving morning care routines of nursing home residents with dementia. J Am Geriatr Soc 47 (1999), 1049–1057.
25. 25 Gozalo, P., Prakash, S., Qato, D.M., et al. Effect of the bathing without a battle training intervention on bathing-associated physical and verbal outcomes in nursing home residents with dementia: A randomized crossover diffusion study. J Am Geriatr Soc 62 (2014), 797–804.
26. 26 Schnelle, J.F., Alessi, C.A., Simmons, S.F., et al. Translating clinical research into practice: A randomized controlled trial of exercise and incontinence care with nursing home residents. J Am Geriatr Soc 50 (2002), 1476–1483.
27. 27 Schnelle, J.F., Sowell, V.A., Traughber, B., Hu, T.W., A Behavioral Analysis of the Labor Cost of Managing Continence and Incontinence in Nursing Home Patients. J Organ Behav Manage 9 (1988), 137–153.
28. 28 Ouslander, J., Schnelle, J., Simmons, S., et al. The dark side of incontinence: Nighttime incontinence in nursing home residents. J Am Geriatr Soc 41 (1993), 371–376.
29. 29 Schnelle, J.F., Cruise, P.A., Alessi, C.A., et al. Individualizing nighttime incontinence care in nursing home residents. Nurs Res 47 (1998), 197–204.
30. 30 Ouslander, J.G., Ai-Samarrai, N., Schnelle, J.F., Prompted voiding for nighttime incontinence in nursing homes: Is it effective?. J Am Geriatr Soc 49 (2001), 706–709.
31. 31 Schnelle, J.F., Leung, F.W., Rao, S.S., et al. A controlled trial of an intervention to improve urinary and fecal incontinence and constipation. J Am Geriatr Soc 58 (2010), 1504–1511.
32. 32 Schnelle, J.F., Simmons, S.F., Beuscher, L., et al. Prevalence of constipation symptoms in fecally incontinent nursing home residents. J Am Geriatr Soc 57 (2009), 647–652.
33. 33 Simmons, S.F., Osterweil, D., Schnelle, J.F., Improving food intake in nursing home residents with feeding assistance: A staffing analysis. J Gerontol A Biol Sci Med Sci 56 (2001), M790–M794.
34. 34 Simmons, S.F., Schnelle, J.F., Individualized feeding assistance care for nursing home residents: Staffing requirements to implement two interventions. J Gerontol A Biol Sci Med Sci 59 (2004), M966–M973.
35. 35 Simmons, S.F., Schnelle, J.F., Feeding assistance needs of long-stay nursing home residents and staff time to provide care. J Am Geriatr Soc 54 (2006), 919–924.
36. 36 Simmons, S.F., Levy-Storms, L., The effect of dining location on nutritional care quality in nursing homes. J Nutr Health Aging 9 (2005), 434–439.
37. 37 MacRae, P.G., Asplund, L.A., Schnelle, J.F., et al. A walking program for nursing home residents: Effects on walk endurance, physical activity, mobility, and quality of life. J Am Geriatr Soc 44 (1996), 175–180.
38. 38 Sorrentino, S.A., Mosby's Textbook for Long-term Care Nursing Assistants. 2013, Elsevier Health Sciences, St. Louis (MO).
39. 39 Schnelle, J.F., Bertrand, R., Hurd, D., et al. The importance of standardized observations to evaluate nutritional care quality in the survey process. J Am Med Dir Assoc 10 (2009), 568–574.
40. 40 Simmons, S.F., Babineau, S., Garcia, E., Schnelle, J.F., Quality assessment in nursing homes by systematic direct observation: Feeding assistance. J Gerontol A Biol Sci Med Sci 57 (2002), M665–M671.