The federal Nursing Home Reform Law requires every nursing
facility to have a registered nurse on duty eight hours a day, seven days a
week. Despite the existence of this minimal floor for registered nurse hours,
some nursing homes still fail to meet this requirement. Data from the newly
implemented payroll-based journal (PBJ) system shows that, for at least one day
in the last quarter of 2017, 25 percent of facilities “reported no registered
nurses at work.” As many reports have indicated, quality of care and quality of
life among nursing home residents suffer when inadequate staffing exists. A
recently published report in the Journal of Psychiatric and Mental Health
Nursing (JPMHN) now lends further evidence that registered nurse hours and
antipsychotic drug use are linked.
According to “An observational study of antipsychotic
medication use among long-stay nursing home residents without qualifying
diagnoses,” increasing registered nurse hours could reduce antipsychotic drug
use among residents. The study found that just “[o]ne additional registered
nurse hour per resident day could reduce the odds of antipsychotic use by 52%
and 56% for residents with and without a dementia diagnosis respectively.”
Looking at nursing homes in the state of Missouri, the study found that meeting
the national average in registered nurse hours (.8) would reduce the odds of
inappropriate antipsychotic drug use among residents with and without dementia
by 22 percent and 25 percent, respectively.
The authors of the study concluded by stating that nursing
homes “must work to reduce APM [antipsychotic medication] use, primarily for
residents’ health, but also for certification and survey outcomes.” The authors
also encourage the use of evidence-based nonpharmacological interventions to
reduce the use of antipsychotic drugs and comply with federal regulations.
•For more information about the registered nurse hours of
any given nursing home, please see LTCCC’s nursing home staffing data for the
first quarter of 2018, available at https://nursinghome411.org/nursing-home-staffing-2018-q1/.
•To learn about resident rights in relation to
antipsychotics, please see LTCCC’s Issue Alert on antipsychotic drugs,
available at https://nursinghome411.org/issue-alert-antipsychotic-drugs/.
•To learn about the federal nursing home staffing
requirements, please see LTCCC’s Issue Alert on staffing, available at https://nursinghome411.org/ltccc-issue-alert-nursing-home-staffing-requirements/.
