Quality Care Outcomes in Nursing Homes: The Effects of a Nurse's Country of Origin and Education

The purpose of this article is to describe differences in nursing home quality outcomes among nurses who are foreign born and foreign educated, nurses who are foreign born and U.S. educated, and nurses who are U.S. born and U.S. educated. This cross-sectional study took place in 91 nursing homes across the United States. Full- and part-time licensed practical and registered nurses were asked to complete a survey, and data on their personal characteristics were linked to facility-level quality indicators. A total of 1,476 nurses were included. The findings indicate that facilities with more responding foreign-born, foreign-educated Filipino nurses exhibit lower quality of care in pain management, prevention of pressure ulcers, and catheter use, but higher quality of care regarding physical restraint use when compared with U.S.-born, U.S-educated and non-Filipino foreign-born and foreign-educated nurses. In facilities with more responding non-Filipino foreign-born, foreign-educated nurses, care quality was better than that of other groups in pain management and physical restraint use.