ResearchRecherche N nursing homes provide long-term housing, support and direct care to members of the community who are unable to function independently because of medical, physical and cognitive disabilities. Although only a small proportion of older Canadians reside in nursing homes (18% of those ≥ 80 years), the majority (81%) of long-term care residents are frail elderly people over the age of 65.1 Government-funded long-term care in Canada has been provided for many years by a mix of not-for-profit (nonproprietary) and for-profit (proprietary) facilities. The ratio of this mix varies greatly by province. For example, in Ontario 52% of publicly funded nursing homes are for-profit, as compared with 15% in Manitoba. 2Previous studies from the United States have shown that having more direct-care personnel is associated with better care in nursing homes.3-7 Specifically, higher numbers of registered-nurse hours per resident-day have been associated with fewer violations of care standards 4 and improved functional ability of residents.7 Schnelle and colleagues examined 21 nursing homes in California and found that the homes with the highest number of nurse aides performed significantly better in 13 of 16 quality-of-care measures than the homes with fewer nurse aides. 6 Although there has been little research on staffing levels and nursing home care in other countries, health policy-makers in the United Kingdom 8 and Australia 9 have begun to call for greater accountability for public resources spent in this area.The American literature has also shown that, compared with for-profit nursing homes, not-for-profit facilities have higher direct-care staffing levels 4 and lower staff turnover rates.10,11 However, the majority of nursing home care in the United States is delivered by the for-profit sector, whereas in Canada the not-for-profit sector constitutes the majority. This may result in a difference in the informal benchmarks for staffing levels between the 2 countries. There also may be a wider variation in wages and working conditions among nursing homes in the United States, which potentially confounds the comparison between for-profit and not-for-profit facilities.We compared staffing levels of nursing and support staff in publicly funded long-term care facilities by ownership type (not-for-profit v. for-profit) in British Columbia at a time when the majority of publicly funded not-for-profit and for-profit facilities employed a unionized labour force with standardized wages and benefits set by a master collective agreement.In British Columbia, approximately 70% of publicly funded nursing homes are nonproprietary (not-for-profit) Currently there is a lot of debate about the advantages and disadvantages of for-profit health care delivery. We examined staffing ratios for direct-care and support staff in publicly funded not-for-profit and for-profit nursing homes in British Columbia. Methods: We obtained staffing data for 167 long-term care facilities and linked these to the type of facility and ownership of t...

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Objectives: To examine how injury rates and injury types differ across direct care occupations in relation to the healthcare settings in British Columbia, Canada. Methods: Data were derived from a standardised operational database in three BC health regions. Injury rates were defined as the number of injuries per 100 full-time equivalent (FTE) positions. Poisson regression, with Generalised Estimating Equations, was used to determine injury risks associated with direct care occupations (registered nurses [RNs], licensed practical nurses [LPNs) and care aides [CAs]) by healthcare setting (acute care, nursing homes and community care). Results: CAs had higher injury rates in every setting, with the highest rate in nursing homes (37.0 injuries per 100 FTE). LPNs had higher injury rates (30.0) within acute care than within nursing homes. Few LPNs worked in community care. For RNs, the highest injury rates (21.9) occurred in acute care, but their highest (13.0) musculoskeletal injury (MSI) rate occurred in nursing homes. MSIs comprised the largest proportion of total injuries in all occupations. In both acute care and nursing homes, CAs had twice the MSI risk of RNs. Across all settings, puncture injuries were more predominant for RNs (21.3% of their total injuries) compared with LPNs (14.4%) and CAs (3.7%). Skin, eye and respiratory irritation injuries comprised a larger proportion of total injuries for RNs (11.1%) than for LPNs (7.2%) and CAs (5.1%). Conclusions: Direct care occupations have different risks of occupational injuries based on the particular tasks and roles they fulfil within each healthcare setting. CAs are the most vulnerable for sustaining MSIs since their job mostly entails transferring and repositioning tasks during patient/resident/client care. Strategies should focus on prevention of MSIs for all occupations as well as target puncture and irritation injuries for RNs and LPNs.

This study examines the influence of transportation dependence and fulfillment of transportation needs on well-being based on a community sample ( N = 174). The majority (54.4%) of transportation-dependent participants had unfulfilled transportation needs, whereas this was the case for very few (7.1%) of those independent of transportation support. Regression analyses revealed that the transportation needs variable was statistically significant, whereas the transportation dependence factor was not. In terms of the prioritization of environmental components, elderly dependent on transportation support placed higher importance on housing than on neighborhood or community elements compared to more mobile seniors. Participants with unmet transportation needs were more likely to depend solely on family to provide transportation, whereas participants with fulfilled transportation needs were more likely to include friends or neighbors for providing transportation support. Results suggest that prioritization of needs enables seniors to maintain positive wellbeing despite experiencing functional limitations or being dependent on transportation services.

Background: Analysis of workers' compensation data and occupational health and safety trends in healthcare across Canada was conducted to provide insight concerning workplace injuries and prevention measures undertaken in the healthcare sector.