ORGANIZATIONAL FACTORS OF RESIDENT WEIGHT LOSS IN GERMAN NURSING HOMES

摘要

Background: Nursing care in Germany is faced with a radical change in quality report standards. Until now nursing home quality has been measured mostly on the basis of structural and care process criteria. By the year 2018, new quality indicators will be implemented by law that include measures of resident outcomes. The results of this doctoral project should contribute to scientific discourse on quality reporting standards for German nursing homes. Theoretical Orientation: Using Donabedian’s structure-process-outcome framework (1988), we assumed that structural indicators of quality are associated with outcome indicators. Methods: The data for this study came from the internal quality management of the Caritas Association and form the “EQisA”-project, within which the indicators of nursing home outcomes were developed and validated. The sample consisted of 221 German nursing homes which included data of over 22 thousand residents. For the investigation of relationship between organizational characteristics and weight loss a logistic regression analysis was used. Findings: The analysis showed that resident-to-staff ratios and mortality rate were associated with weight loss of residents with low cognitive impairment. Conclusion: The findings indicated that resident weight loss is more probably to occur in facilities with lower staffing levels of registered nurses and additional care staff and in facilities with higher mortality rates. However, there are only a few studies in Germany that examine this kind of relationships. More research using a broader national sample of nursing facilities would be needed in this field.