Table 3.
Study Outcomes and Staffing Levels for Years Prior to, of, and after Culture Change Introduction—By Nursing Homes with High versus Lower Culture Change Practice Implementation
| Bottom 3 Quartiles - Culture Change Composite Score |
Top Quartile - Culture Change Composite Score |
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|---|---|---|---|---|---|---|---|---|
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| Year Immediately Prior to Culture Change Introduction |
Year Culture Change Introduction Began |
Year Immediately Following Culture Change Introduction |
Year Immediately Prior to Culture Change Introduction |
Year Culture Change Introduction Began |
Year Immediately Following Culture Change Introduction |
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| N | mean (sd) | mean (sd) | mean (sd) | N | mean (sd) | mean (sd) | mean (sd) | |
| Processes | ||||||||
| on bladder training | 60 | 7.6 (14.7) | 7.5 (15.6) | 7.5 (14.9) | 217 | 4.9 (10.8) | 7.6 (15.1) | 8.7 (16.6) |
| program | 7 | |||||||
| 60 | 4.5 (12.5) | 4.1 (11.9) | 3.4 (9.8) | 217 | 2.5 (8.5) | 3.2 (9.6) | 4.0 (10.7) | |
| on bowel training program | 7 | |||||||
| % w/ preventive skin | 60 | 76.7 (28.0) | 78.1 (27.6) | 77.8 (28.0) | 217 | 78.9 (26.6) | 79.7 (26.3) | 78.9 (28.8) |
| care | 7 | |||||||
| 60 | 67.8 (24.7) | 68.2 (24.6) | 66.5 (26.0) | 217 | 70.6 (23.9) | 68.9 (24.8) | 71.4 (22.3) | |
| % w/ advanced directives | 7 | |||||||
| 60 | 5.0 (6.7) | 4.3 (6.1) | 3.5 (5.2) | 217 | 5.1 (6.6) | 3.8 (4.7) | 2.7 (3.9) | |
| % w/ restraints | 7 | |||||||
| 53 | 26.5 (12.2) | 26.3 (12.5) | 26.1 (12.7) | 207 | 25.2 (10.2) | 24.9 (10.0) | 24.7 (10.2) | |
| % w/ antipsychotic meds | 1 | |||||||
| 60 | 4.4 (4.8) | 4.3 (5.3) | 4.2 (4.6) | 217 | 4.1 (5.1) | 3.4 (3.4) | 3.4 (3.6) | |
| % w/ tube feeding | 7 | |||||||
| Outcomes | ||||||||
| 53 | 14.0 (6.3) | 14.3 (5.9) | 14.3 (6.0) | 207 | 14.7 (8.8) | 14.8 (6.6) | 14.7 (6.5) | |
| % w/ falls in last 30 days | 1 | |||||||
| 60 | 6.3 (4.6) | 6.4 (4.0) | 6.0 (4.0) | 217 | 6.0 (4.3) | 5.7 (3.6) | 5.4 (3.6) | |
| % w/ pressure ulcers | 7 | |||||||
| % residents w/ UTI | 53 | 8.4 (5.6) | 8.8 (5.6) | 8.9 (5.4) | 207 | 8.8 (4.9) | 9.1 (6.3) | 8.6 (5.1) |
| Survey Deficiencies | ||||||||
| 58 | 45.9 (62.7) | 43.9 (55.8) | 40.6 (46.4) | 211 | 41.2 (42.6) | 40.0 (46.0) | 41.5 (67.1) | |
| Health deficiencies | 7 | |||||||
| Quality of Life | 58 | 0.7 (1.0) | 0.7 (1.0) | 0.6 (1.0) | 211 | 0.6 (1.0) | 0.6 (0.9) | 0.5 (0.9) |
| deficiencies | 7 | |||||||
| Hospitalizations | ||||||||
| Hospitalizations per patient | 53 | 0.8 (0.4) | 0.9 (0.5) | 0.9 (0.4) | 208 | 0.8 (0.5) | 0.8 (0.5) | 0.8 (0.6) |
| year | 3 | |||||||
| 53 | 15.7 (7.1) | 16.0 (7.5) | 15.2 (8.5) | 207 | 15.0 (7.8) | 15.5 (8.5) | 16.0 (9.3) | |
| 30-day rehospitalizations | 2 | |||||||
| Staffng | ||||||||
| Registered Nurses per | 60 | 0.3 (0.4) | 0.3 (0.2) | 0.3 (0.2) | 217 | 0.4 (0.5) | 0.3 (0.4) | 0.4 (0.4) |
| resident day | 7 | |||||||
| Nursing Assistants per | 60 | 2.2 (0.9) | 2.2 (0.9) | 2.2 (1.1) | 216 | 2.4 (1.7) | 2.2 (0.8) | 2.2 (0.8) |
| resident day | 6 | |||||||
| Licensed Practical Nurses | 60 | 0.8 (0.3) | 0.8 (0.4) | 0.8 (0.4) | 217 | 0.8 (0.9) | 0.8 (0.5) | 0.8 (0.5) |
| per resident day | 6 | |||||||
UTI = urinary tract infection