A National View of Workplace Injuries in Nursing Homes

Published In: Health Care Management Review, v. 34, no. 1, Jan.-Mar. 2009, p. 92-103

Posted on RAND.org on December 31, 2008

by Nicholas G. Castle, John Engberg, John Mendeloff, Rachel M. Burns

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OBJECTIVES: Data from a large sample of nursing homes were used to examine the cross-sectional association between workplace injuries and organizational factors, caregiver staffing levels, and quality. METHODS: Three sources of data were used, the Occupational Safety and Health Administration data initiative for 2004, the Online Survey Certification and Recording system representing 2004, and the 2004 Area Resource File. RESULTS: For the organizational characteristics of interest, the results show that for-profit facilities were less likely to report high injury rates and that facilities with a higher average occupancy and belonging to a chain were more likely to report high injury rates. For the staffing characteristics of interest, facilities with high staffing levels of registered nurses were more likely to report high injury rates, whereas those with high staffing levels of nurse aides were less likely to report high injury rates. For the quality characteristic of interest, facilities of low quality (as measured by quality-of-care deficiency citations) were more likely to report high injury rates. CONCLUSIONS: Workplace injuries are associated with organizational, caregiver, and quality characteristics of nursing homes. This may present an opportunity to reduce high injury rates.

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