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long-term care, nurse aides, nursing homes, quality of care, residents, staffing



  1. Bowers, Barbara J. PhD, MSN, BSN
  2. Esmond, Sarah BA
  3. Jacobson, Nora PhD, MA


Research on staffing and quality of care in long-term care facilities confirms that adequate staffing levels are important to ensuring quality but few studies have examined how the two are linked. The research reported in this article used participant observation and indepth interviewing to explore how nurse aides (NAs) understand the link between staffing and quality. The findings show that NAs deem their relationships with residents to be the central determinant of quality of care as well as an important outcome in itself. Adequate staffing is essential to allowing NAs to nurture these relationships.