Performance Improvement 2007. Why Do Individuals Choose and Remain in Nursing Assistant Careers and Work in Nursing Homes?



This survey was the first national survey of certified nursing assistants working in nursing homes. It represents a major advance in the data available about certified nursing assistants and has the potential for numerous studies to improve our understanding of the direct care workforce. This survey provided a basis for future evidence-based policy, practice, and applied research to address the shortage of long-term direct care works. The survey involved a stratified, multistage probability design sampling nursing facilities and nursing assistants within these facilities. A sub-sample of 790 facilities was selected. Of those eligible, 187 did not participate in all or a portion of the survey. This resulted in a facility response rate of 76%. A total of 582 facilities agreed to participate, and from these facilities, 4,542 nursing assistants were selected to participate. Among these, 4,274 were eligible and 3,017 completed an interview, yielding a response rate of 71%.

The total number of Americans in need of long-term care is projected to more than double from 13 million in 2000 to 27 million in 2050. Long-term care providers face tremendous challenges each day trying to provide high-quality care to clients. One of the greatest challenges is staff retention among direct care workers -- nursing assistants, personal care attendants and home health aides -- who provide hands-on services to clients. Annual turnover among direct care workers is high and can reach rates of over 100% in some organizations. If left unaddressed, this emerging care gap could severely restrict the ability of providers to deliver adequate long-term care. This introductory study examined the relevant research that led to federal interest in sponsoring the survey, provided a comprehensive overview of the procedures undertaken, addressed the advantages of combining nursing home facility and nursing home worker surveys, and highlighted the potential uses of the data. Subsequent papers will report on survey findings to inform improved planning, decision-making and policy development.

Report Title: An Introduction to the National Nursing Assistant Survey
Agency Sponsor: ASPE, Office of the Assistant Secretary for Planning and Evaluation
Federal Contact: Squillace, Marie, 202-690-6250
Performer: Department of Health and Human Services (HHS); Washington, DC
PIC ID: 8317

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"PerformanceImprovement2007.pdf" (pdf, 717.63Kb)

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