| Hospital-based research has sought to improve patient and staff outcomes through improving nurse system characteristics, such as the support for the professional practice of nursing as experienced by registered nurses (RNs). There has been a lack of research conducted in nursing homes, however, seeking to explore the relationships between organizational system characteristics and resident and nurse outcomes. The majority of nursing homes in the U.S. are operated on a for-profit basis and, of these, many are entities managed by multi-facility chains. Research has consistently suggested that less favorable quality of care exists in for-profit nursing homes. The purpose of this study was to describe the current professional practice environment of RNs in a large, for-profit, multi-facility nursing home chain and to examine the effect of organizational system characteristics (nursing characteristics and nursing home characteristics) on resident and nurse outcomes. The Quality Health Outcomes Model provided the theoretical framework for this research. This cross-sectional study of 121 nursing homes used previously collected survey results and a range of data elements extracted from corporate-owned, administrative and clinical datasets. Results showed that nursing homes with more positive RN practice environments and a greater percentage of experienced RNs had increased nurse and family satisfaction and decreased turnover. Additionally, the Practice Environment Scale of the Nursing Work Index (PES-NWI) revealed mean RN scores in sample nursing homes to be higher than RN scores reported in the hospital-based literature. |
