Problems Associated with Staffing in Long Term Care

Problems Associated with Staffing in Long Term Care
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Problems Associated with Staffing in Long Term Care
The demand for long-term care (LTC) has been on the rise due to an increase in an aging population and a high prevalence of chronic diseases. According to Harris-Kojetin et al. (2019), a majority of people using LTC services are adults aged 65 years and above. Further, most LTC users have chronic diseases such as Alzheimer's, heart disease, diabetes, asthma, and chronic kidney disease, among others. With the rising demand and the need to provide quality patient care, LTC facilities need to utilize effective staffing practices. Yet, there are several problems associated with staffing in LTC. This paper discusses these staffing issues and how they affect patient care. It also provides possible solutions to these issues.
Rising numbers of people in need of LTC will require more LTC workers such as registered nurses, nurse’s aides, and hospice aides, among others, to provide direct care. One of the key issues experienced in LTC facilities concerning staffing is understaffing. According to Koopmans et al. (2018), there has been a decline in the number of healthcare workers, including nurses, which has affected the supply of healthcare workers in LTC facilities. Another issue is inadequate training of LTC facilities’ staff. As revealed by Koopmans et al. (2018), most healthcare workers in the LCT facilities are not sufficiently trained to deal with the complex nature of healthcare needs for an aging population or the increasing burden of chronic conditions. Further, there is a high turnover rate in the LTC industry. Gilster et al. (2018) reveal that the inability of LTC facilities to retain staff is associated with a lack of a supportive environment. Also, compensation is an issue that affects staffing in LTC facilities. Gilster et al. (2018) indicate that compensation not only affects job satisfaction but also retention rates in the LTC industry.
Adequate staffing significantly influences the provision of adequate patient care in LTC facilities. Understaffing can affect the quality of care received by residents because as Harrington et al. (2020) reveal, low staffing levels contribute to insufficient patient care. Residents receiving insufficient care are more likely to develop pressure ulcers and healthcare-acquired infections. It also contributes to higher rates of patient falls and injuries, malnutrition, and even death. Yet, the specific regulatory requirements for staffing are quite ambiguous. At the federal level, the law requires LTC facilities to have ‘sufficient staff’ to meet the needs of residents (Boscart et al., 2018). However, state requirements, although they vary, have higher staffing standards. The nursing hours per resident per day vary per state. California requires at least 3.5 hours per resident per day (Harrington et al., 2020). Also, inadequate training makes it challenging for LTC workers to provide care that actually meets the needs of patients. As Koopmans et al. (2018) reveal, training increases the staff’s knowledge about diseases and communication skills which allows them to better deal with the complexities of healthcare, especially in relation to LTC.
Nursing homes have a responsibility for the residents receiving care at the facilities. As such, nursing homes are liable for any incident that occurs with a resident (Anderson et al., 2018). Residents depend on the nursing home staff who provide care and when the workers are understaffed, cases of neglect and abuse may occur. Nursing homes are required to comply with the existing laws and ensure that there is adequate staffing at their facilities (Harrington et al., 2020). Nursing home administrators are responsible for the outcomes of all departments in a nursing home. This implies that they are responsible for staffing and addressing staffing issues at the nursing home. However, this does not imply that they have a strict liability if there is understaffing and an incident occurs with a resident. According to the American College of Health Care Administrators (2017), federal regulations do not require nursing home administrators to be held strictly liable for the actions/inactions of others. Thus, administrators would not be held liable for actions of the staff that resulted in an incident with a resident, even if the staff was understaffed.
As pointed out earlier, states have established laws that govern staffing practices in nursing homes. Such laws are important in helping states ensure that nursing homes in their localities are adequately staffed. In California, the law mandates that all nursing homes should provide a minimum of 3.5 hours of direct care services per resident per day (Harrington et al., 2020). This means that each resident should receive 3.5 hours every day from a qualified direct caregiver such as a registered nurse or certified nurse assistant. The provisions of this la...