Overworked Nursing Home Employees Rush Or Miss Essential Care Duties: Study

A new report suggests that more than half of nursing home employees rush or fail to complete essential duties for the proper care and treatment of residents, often due to a lack of adequate resources and support provided by the nursing home facility.

The study was published this week in The Journal of the American Medical Association (JAMA), highlighting serious risks that nursing home residents may face due to unfavorable work environments, which often cause staff to rush through important care duties, or fail to perform the activities altogether due to their workload.

Researchers from the Canadian based University of Alberta surveyed 4,016 care aides from 93 Canadian nursing homes between May and December 2017, to determine whether their daily workloads realistically allowed them to provide the necessary care for each patient assigned, and if essential care duties were missed or rushed in their most recent shifts.

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According to participant responses, 2,306 care aides (57.4%) reported missing at least one essential care task and 2,628 care aides (65.4%) reported rushing at least one essential care task. Researchers were able to determine that care aides with favorable workloads were 59% less likely to miss care tasks and 66% less likely to rush care tasks.

Specifically, care aides reported the two most commonly missed and rushed tasks were talking with residents and taking them for walks, both of which are important for preserving mobility and combating loneliness and decreased morale.

At least 14% of respondents reported missing, and 39% reported rushing, mouth care aide to residents, such as assisting them in brushing their teeth, flossing or assisting in the use of mouth wash. Essential care duties such as helping residents use the restroom, get ready for bed, bathe, eat or dress were missed 10% of the time and rushed by more than 30% of aides.

The study highlights the importance for nursing home facilities to evaluate the work environment of each care aide and assign realistic workloads that allow them to tend to each patient appropriately. Research has shown that residents are more likely to receive poor care when facilities are understaffed, causing them to be prone to suffering from nursing home neglect, as well as falls and fractures and other injuries when staff at a facility are stretched thin.

Previous studies have raised concerns indicating nursing homes may not be ready for a coming influx of residents as Baby Boomers age, highlighting the risks that nursing home neglect could significantly increase as the quality of care steadily declines due to understaffing.

In August 2019, Pennsylvania Auditor General Eugene DePasquale issued a special report (PDF), outlining the condition of the state’s nursing homes, indicating they are not nearly ready for the population growth to come that will require assisted living.

The report was a follow-up to a 2016 audit, which found that the state’s Department of Health had failed to adequately review nurse staffing levels, complaints and sanctions against facilities.

Nursing home facilities that are understaffed not only face challenges when it comes to routine daily aide for participants, but also put them at an increased risk of an infection outbreak that cannot be controlled properly.

In September 2019, an outbreak of Candida auris was reported to have sickened at least 800 residents across U.S. nursing homes. Reports indicated the drug-resistant infection appears to be spreading rapidly due to poorly-run long-term care facilities who were unable to stop the spread of infection because they lacked adequate sanitary control measures and staffing.


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