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RN Staffing Linked to COVID-19 Incidence in Nursing Homes

Increase in registered nurse staffing linked to reduction in confirmed cases, fewer COVID-19 deaths

TUESDAY, June 23, 2020 (HealthDay News) -- Higher registered nurse (RN) staffing is associated with a reduced number of COVID-19 cases and deaths in nursing homes, according to a study published online June 18 in the Journal of the American Geriatrics Society.

Yu Li, Ph.D., from the University of Rochester Medical Center in New York, and colleagues conducted a cross-sectional analysis of 215 Connecticut nursing homes to examine the associations between key nursing home characteristics and the likelihood of at least one confirmed COVID-19 case (or death) in the facility.

The researchers found that the average number of confirmed COVID-19 cases was eight per nursing home (107 facilities had zero cases) and the average number of confirmed deaths was 1.7 per nursing home (131 facilities had zero deaths). Among facilities with at least one confirmed case, an increase of 20 minutes in RN staffing per resident day was associated with a significant decrease in confirmed cases (incidence rate ratio, 0.78; 95 percent confidence interval [CI], 0.68 to 0.89; P < 0.001); 4- or 5-star facilities had fewer confirmed cases compared with 1- to 3-star facilities (incidence rate ratio, 0.87; 95 percent CI, 0.78 to 0.97; P < 0.015); and more confirmed cases were seen for facilities with high concentrations of Medicaid residents or racial/ethnic-minority residents (incidence rate ratios, 1.16 [95 percent CI, 1.02 to 1.32; P = 0.025] and 1.15 [95 percent CI, 1.03 to 1.29; P = 0.026], respectively). Among facilities with at least one death, fewer COVID-19 deaths were seen with every 20-minute increase in RN staffing per resident day (incidence rate ratio, 0.74; 95 percent CI, 0.55 to 1.00; P = 0.047). No significant associations with deaths were seen for other characteristics.

"Nursing homes with higher RN staffing and quality ratings have the potential to better control the spread of the novel coronavirus and reduce deaths," the authors write.

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