Determining the CNA Training-Hour Requirement for Quality Care in U.S. Nursing Homes

초록

Introduction: Critical gaps in knowledge exist regarding the training hours needed for optimal quality of care in U.S. nursing homes (NHs). Aims: This study provides empirically derived estimates of the numbers of CNA training hours that yield the best nursing NH resident care outcomes. Methods: CNA training regulatory information was linked to 2014 quality indicator data from 13,608 U.S. NHs. Training hour requirements that yielded the best outcomes were estimated using multivariate regression models with generalized estimating equations. Results: Lower proportions of residents with quality indicators (activities of daily living, falls with injuries, and pain) were found in states requiring more than the federal minimum of 75 CNA training hours compared with states requiring only 75 hours (all p < .001). The findings suggest that 151.6 total training hours and a ratio of twice as many clinical hours to didactic hours are needed to promote quality care in NHs. Conclusion: Given the increasing complexity of clinical settings in NHs, regulatory changes in U.S. CNA training requirements may be indicated.

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