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Staffing Injuries In Nursing Homes

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Team A reviewed the four papers that accounted for each team members' week one paper and unanimously chose Rachael's paper on injuries that occur on the job in Nursing Homes. In the original article that Rachael's paper was written about, it clearly states research has been done supporting the fact that injuries are occurring more often as a direct link to reductions in nursing staff hours. According to the Bureau of Labor Statistics, there is a significant increase in numerous reported categories of injuries between the 2003 report and 2004 report. Columns of new data were added to the 2004 report and instead of reporting injuries per thousand (as they did in the 2003 report) the 2004 report shows the data as per 10,000 full time workers.

The primary sources of data can be defined as "sources that contain raw, original, uninterpreted and unevaluated information"(Diablo Valley College, 2006). When using this definition for primary data, team A would interpret that the Bureau of Labor statistics is an excellent first data source for primary data. Another site that team A will use for primary data is the Occupational Safety and Hazard Administration (OSHA) which is another government agency that reports raw data in terms of on the job injuries. When considering what secondary data to use, team A considered the following definition of secondary data: "Sources that digest, analyze, evaluate and interpret the information contained within the primary sources. They tend to be argumentative and often come in scholarly periodicals or books" (Diablo Valley College, 2006). The article that the original paper was based upon has interpretations of raw data from the bureau of labor statistics in it, so this bolstered our theory about primary and secondary data. Team A will utilize that article as well as other books listed throughout the paper as our secondary data, such as "The Epidemic of Heath Care Worker Injury" by William Charnay and Guy Fragala, written in 1998. This paper states that a decade ago, nursing home injuries ranked third in industry related injuries.

According to a chart posted on OSHA, in the year 2000, the Nursing Home related injuries still ranked third in the total number of injuries reported in terms of total cases reported. Only eating establishments and hospitals had more cases reported. The incident rate for nursing homes was 13.9 (per 100 full time workers), and it ranked behind motor vehicles and equipment and air transportation, scheduled respectively. This data is defined to mean:

1. The incidence rates represent the number of injuries and illnesses per

100 full-time workers and were calculated as: (N/EH) x 200,000, where

N = number of injuries and illnesses

EH = total hours worked by all employees during the

calendar year

200,000 = base for 100 equivalent full-time workers

(working 40 hours per week, 50 weeks per year)

2. Industries with 100,000 or more cases were determined by analysis of

the number of cases at the 3-digit SIC code level.

3. Standard Industrial Classification Manual, 1987 Edition.

4. A statistical significance test indicates that the difference between

the 2000 count and the 1999 count is statistically significant at the 95

percent confidence level.

5. A statistical significance test indicates that the difference between

the 2000 incidence rate and the 1999 rate is statistically significant at

the 95 percent confidence level.

6. Excludes farms with fewer than 11 employees.

As this information indicates, the health care industry has a very visible problem given the number of employees and the number of incidents reported. Low nurse staffing levels contribute to high rates of nurse injury, according to research involving 445 nursing homes in Maryland, Ohio, and West Virginia. Fewer nurse-staffing hours correlated to more claims of worker injuries, especially musculoskeletal injuries related to lifting or transferring patients. After obtaining First Reports of Injury and workers' compensation data from each state for the year 2000, researchers evaluated nurse-staffing hours per resident day for RNs, LPNs, and Nursing Assistants. They found that each additional hour of nursing care decreased the injury rate by 16%. Lead study author Alison M. Trinkoff, RN, SCD, FAAN, says she'd expect similar results in hospital settings. A previous study had found that when RN positions decreased by 9%, work-related illness and injuries increased by 65%.

Staff and worker injury in the health care field drains insurance companies and the labor pool each year. Felletto and Graze (2000) describes health care worker injuries are about 3.5% over the average of the private industry. The costs to insurance companies are billions of dollars a year in rehabilitation and lost staffing hours (p.7). Analysis of the research process and statistical approach that researchers took in this study is of interest. Lind et al (2004) describe statistics as "the science of collecting, organizing, presenting, analyzing, and interpreting data to assist in making more effective decisions"(p. 5). The statistical results of this study could result in a push for a higher degree of prevention, education and an increase in staffing levels in order to decrease the chance of injury to health care workers.

The Dependent and Independent Variables

The dependent variable is the variable whose value is the result (or consequence) that varies with the change in the independent variable. In this article, the dependent variable is worker injury rates. Trinkoff, Johantgen, Muntaner and Le examine the relationship between nursing home staffing levels and worker injury rates. The independent variable is the number of staffing hours of nurses in nursing homes. The dependent and independent variables are clearly specified. In this non experimental study, the independent variable is not manipulated and is assumed to have occurred naturally before the study (Lobiondo-Wood and Haber, 1994, p. 168). The dependent variable is the variable whose value

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