J Gerontol Nurs
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Comparative Study
Nurse staffing in nursing homes in the United States: Part II.
This study compared state minimum staffing standards with actual nurse staffing levels in nursing homes in each state. The actual nurse staffing levels in nursing homes were compared to the nurse staffing levels recommended by experts in 2000 and 2001. ⋯ When actual nurse staffing levels were compared with the minimum standards recommended in a federal report, 97% of all nursing homes had staffing levels below those considered safe. Considerable new federal and state resources are needed to bring the state staffing standards and the actual nursing home staffing levels up to the levels recommended by experts.
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Review
Assessing pain as a fifth vital sign in long-term care facilities: Recommendations from the field.
In long-term care facilities, pain management is complex because dementia, delirium, and other reasons for residents' altered communication ability are a significant barrier to pain assessment. The purpose of this study was to explore the status of implementation of pain as a fifth vital sign in a sample of long-term care facilities. ⋯ The results of this study highlight many important considerations in the treatment of pain as a fifth vital sign in long-term care facilities. Evidence-based practice will be facilitated by further research related to underexplored aspects of pain assessment and management, and further attention to care delivery systems that support continued knowledge acquisition and the implementation of best practices.