How Many Nurses Does It Take?
You’ve been told that your spouse or parent needs nursing home care. You know that the nursing staff is important but what do you do next? First, you start by realizing that not all nursing homes are created equal.
Always evaluate several nursing homes to determine which facility best meets the needs of your loved one.
Although no single criteria should be the deciding factor, staffing levels are an important consideration in choosing a facility.
In evaluating staffing levels at the various facilities, there are a series of steps one must take. It is not easy but with some effort you can minimize the risk that your loved one will be placed in a facility that is unable to properly care for them.
Patient Needs.
What are the patient’s needs? Has the patient suffered a stroke, and now requires assisted feeding and assistance with ambulation? Does the patient suffer from dementia with a tendency to wander requiring a secured facility?
Use the following rule of thumb: The greater the need, the greater the number of staff necessary to care for the patient.
Nurse and Nurse Aides Available to Care for Patient Needs.
Arizona has no minimum requirement for the number of nurses or nurse aides a facility must have on duty at any given time.
Based on Arizona’s failure to require a minimum staffing level, Arizona nursing homes rank low nationally in the number of nursing staff available to care for patients.
The average number of nurses and nurse aides reported for Arizona facilities is 3.5 nursing hours per patient day. As a means of comparison, 82% of the states have a higher average number of nursing staff available to care for patients. Harrington, Carrillo, and Blank, Department of Social and Behavioral Sciences, University of California, September, 2008.
How to Calculate Nursing Hours per Patient Day.
1. Add the total nursing hours for all nurses on duty on any given day.
2. Divide the total nursing hours by the patient census (number of patients at the facility) for the same period of time.
Example: 2 nurses each working 8 hours in a facility that has 10 patients.
2x8=16 divided by 10 patients = 1.6 nurse staffing hours per patient day
Where to get the Staffing Schedules.
Every nursing home is required to post its current staffing schedule in the facility for the public to view.
The staffing schedule will contain information such as how many nurses, nurses' aides, and patients there are in the facility on any given day.
If after calculating the number of combined nurses and nurses aide hours at the facility, and if you arrive at a number less than 3.5 nursing hours per patient day, then you know that your facility does not even meet the staffing level of the average Arizona nursing home.
Visit the Facility.
There is no substitute for personally visiting the nursing home. Try to visit on a Sunday afternoon, as that is when most families are there to see their loved ones. Speak with several families and ask them whether they believe there are enough nurses or nurse’s aides there to be attentive to the patients.
Other Factors to Evaluate.
There are two government websites that you should look at for each facility you are considering. Each will give you information based upon inspections made by the Arizona Department of Health Services:
Finding the right nursing home is not based on a scientific formula, but instead is dependent on research and common sense. Even under the best of circumstances, family members must be attentive to the condition of their loved ones as well as the condition of the facility.
Our Next Article.
Our next article will discuss how to be attentive to the condition of your loved one in a nursing home.
The “Guardian Blog” will provide information to help both families and professionals assess and improve the quality of nursing home care in Arizona and the Guardian Blog will encourage dialog with and among its readers.
