The Impact of Labor Unions in Nursing Homes: A Scoping Review Protocol

Abstract

Objective: The objective of this scoping review is to map evidence on the impact of unions in nursing homes on employee, resident, and facility outcomes.

Introduction: Fifty-two percent of nursing home staff turnover annually; however, turnover rates decrease by 9% in counties with predominately unionized nursing homes. Labor unions may provide structural, organizational, and policy-related solutions to foster a sustainable healthcare workforce. Healthcare labor unions are associated with improved financial and employment outcomes for workers, and improved health-related outcomes for both workers and patients. Previous reviews have examined labor unions across healthcare settings representing specific job types (i.e., nurses and direct-care workers), the current state of evidence regarding the impact of labor unions representing any job type in nursing homes remains unclear.

Inclusion criteria: This review will include studies on labor unions in United States nursing homes that represent any job type. We will focus on studies that report outcomes for employees, residents, and/or facilities.

Methods: Relevant sources will be identified using PubMed.gov, Embase.com and CINAHL complete (EBSCO), Business Source Complete (EBSCO), Health Policy Reference Center (EBSCO), ABI/INFORM Collection (ProQuest), Scopus.com, and Web of Science. The search will be limited to peer-reviewed empirical studies published in English and focused on labor unions in nursing home settings; grey literature will not be included. Covidence will be used to screen studies for inclusion criteria. Study characteristics will be extracted from each article based on prespecified domains. Two authors will independently screen and review selected articles, with any disagreements resolved by an additional reviewer. The review will follow the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) checklist for reporting scoping reviews.