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nursing home quality, nursing home staffing, nurse-staffing construct, nurse-staffing taxonomy



  1. Reilly, Karen E. ScD
  2. Mueller, Christine PhD, RN
  3. Zimmerman, David R. PhD


A nurse-staffing taxonomy is proposed to facilitate informed staffing decisions in long-term care nursing facilities and to set forth construct components for empirically related research. Recommendations from an expert workgroup were synthesized with current staffing research to define a staffing taxonomy. Refinements were made, incorporating on-site nursing home quality assessments and concepts founded on psychometric theory and Donabedian's model. A quality monitoring protocol, based on the staffing taxonomy, was used to assess quality improvement systems. Results from 48 US nursing facilities indicate that most long-term care facilities struggle with staffing allocation and the integration of staffing into a quality monitoring process.