Staffing at skilled nursing facilities across the U.S. continues to be a challenge. In fact, recent payroll data analyzed by Kaiser Health News shows that most nursing homes had fewer nurses and caretaking staff than they reported to the government. And while there are many different reasons for variations in staffing levels, the bottom line is that the nursing shortage contributes to neglect – and liability.
When numbers are low, the nearly 1.4 million residents in facilities must wait longer for nurses to answer their calls for pain medication and essential steps like repositioning residents to avoid bedsores may be skipped. Research shows a link between low staffing levels and other issues like falls and medically unexplained weight loss. Sometimes, even, overburdened staff can lead to avoidable readmissions.
In the current climate, recruitment and retention of qualified staff are more important than ever. While many facilities still rely on traditional methods like word of mouth in the community and ads, some are taking more creative approaches to bring on qualified workers, like offering the option for college students to complete required training through co-op or residency programs, providing mentoring, or extending other employment incentives. But bringing staff on isn’t the only issue.
Residents are most comfortable with staff they know. Likewise, employees are better able to assist residents when they’re more familiar with them, their health status and behavior. But, unfortunately, continuity of care isn’t guaranteed. In fact, the rate of turnover in skilled nursing is extremely high: 44 percent in 2012 according to AHCA, with even higher numbers for direct care staff. And it shows no signs of slowing down. That’s because acuity is high, the job can be both physically and emotionally demanding, and the pay is often not as high. To combat these and other stresses, retaining an effective workforce requires positioning the facility as a workplace where staff can be happy and productive.
While some of what skilled nursing facility employees want are benefits and perks, other less tangible aspects of the role are also important, namely satisfaction with their job and the work environment. Many factors impact a worker’s morale but one of the most critical is affording them the opportunity to provide meaningful care to residents by managing their work and assignments accordingly. There’s a direct link between increasing the nursing time per resident per day and more individualized care that results in fewer adverse outcomes.
One often overlooked aspect of care that holds opportunities to ease staff workloads so they can spend more time with residents is the discharge process. A facility can promote greater efficiency at this stage by cutting out unnecessary tasks. For example, instead of directing nursing staff to collect unused medications and process the returns to the pharmacy or, depending on the state, tasking them with disposal of the prescriptions, the discharge process could require that each resident leave with a supply of their medications. Not only would this step free up staff to dedicate more time to direct patient care, helping to improve facility performance, but it would also enable residents to avoid the often anxiety-producing stop at a pharmacy on the way home and ensure they have the drugs they need for continued adherence.
While staffing is important, what really matters is its impact on outcomes. Contact PharMerica at firstname.lastname@example.org or 800-564-1640 to discuss how DischargeRx can improve medication management efficiencies at discharge for the benefit of employees – and residents.Download PDF