Study: Consistency a key for nursing aides

Certified Nursing Assistants, or nursing aides, provide the majority of the care for elderly patients at long-term care facilities. But turnover rates of the aides remain around 50%.

Those facilities may be able to significantly reduce turnover by making a few small scheduling changes.

New research from Washington State University, in collaboration with the University of Cincinnati and Indiana University, showed that when CNAs consistently were scheduled with more of the same coworkers, facilities reduced turnover by around 24%.

Researchers conducted the study using real scheduling data from a long-term care company with 6,221 part-time CNAs at 157 facilities in the United States, over a 26-month period.

Kevin Mayo is an associate professor at WSU and lead author of the study. His research doesn’t show direct evidence for why coworker consistency is important, he said, but other research has indicated that stability for employees in their reporting structure and understanding job expectations are important.

Social stability is also important from an employee standpoint, Mayo said, especially for positions such as CNA jobs, where staff typically have little organizational power and low pay.

“There is research that shows that when you are lower on the power dynamic or lower on the income scale, which these workers definitely are, those become even more important to you,” he said.

The researchers also found that employers could somewhat improve retention by scheduling part-time workers a few more hours per week over their baseline of 23.3.

Too many hours, Mayo said, and retention decreases because part-time workers can’t manage their other life responsibilities. Too few hours, and staff struggle to make enough money.

“The hourly rate for a CNA is quite low, many of them are at or below the poverty line,” Mayo said. “At, if you’re considering one individual. Below, if you’re considering a family of two or more.”

In addition, the ideal number of working hours for CNA retention varied slightly depending on whether staff members were able to work with a consistent group of coworkers.

When coworker variability was average, roughly 62%, the ideal number of working hours per week to increase retention was 29.4 — roughly six hours more than baseline.

When CNAs worked with more of the same coworkers, the ideal number of hours increased to 33.2, and turnover reduced by 12.4%.

Conversely, when CNAs worked with a less consistent rotation of coworkers, their ideal working hours were only 26.6, and the reduction in turnover was less significant at only 2%.

The big takeaway for managers, Mayo said, is to prioritize providing staff with a consistent environment they can rely on.

“Attack the environment that makes it uncomfortable to the extent that you can, and everything else will actually just get a much greater lift from it,” he said.

Further research, Mayo said, might look at how wages affect turnover.

Another important piece of information to research, Mayo said, is how long it takes to replace staffers. Knowing both the turnover rate and length of time it takes to replace aides when they leave is important to determine adequate staffing levels

“At that point, you could then actually start asking the question, ‘What is the right staffing level, period?’” he said.

Sun may be contacted at rsun@lmtribune.com or on Twitter at @Rachel_M_Sun. This report is made in partnership with Northwest Public Broadcasting, the Lewiston Tribune and the Moscow-Pullman Daily News.