High turnover among CNAs has been linked to quality of care and resident behavior deficiencies, as well as poor end-of-life quality indicators ( Castle & Anderson, 2011 Lerner, Johantgen, Trinkoff, Storr, & Han, 2014 Tilden, Thompson, Gajewski, Buescher, & Bott, 2013). The long-standing interest in retention and turnover among certified nursing assistants (CNAs) in long-term care stems from projections for a dramatic increase in demand for workers ( Institute of Medicine, 2008) and the widely held belief that staff stability has positive impacts on quality of care in nursing homes ( Bowers & Nolet, 2011 Castle & Engberg, 2005). This research suggests that staffing empowerment practices on the whole are worthwhile from the CNA staffing stability perspective. Greater opportunities for CNA empowerment are associated with longer CNA retention. 001) and those with high empowerment scores had a 64% greater likelihood of having higher CNA retention (OR = 1.64 95% CI =, p < 001). Compared with the low empowerment category, nursing homes with scores in the medium category had a 44% greater likelihood of having higher CNA retention (odds ratio = 1.44 95% confidence interval =, p =. ![]() After adjustment for covariates, a greater staff empowerment practice score was positively associated with greater retention. ![]() ![]() Data from 2,034 nursing home administrators from a 2009/2010 national nursing home survey and ordered logistic regression were used. This article examines whether staff empowerment practices common to nursing home culture change are associated with certified nursing assistant (CNA) retention.
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