Frank Lori, Schmier Jordana, Kleinman Leah, Siddique Reshmi, Beck Cornelia, Schnelle John, Rothman Margaret
MEDTAP International, Inc., Bethesda, Maryland 20814, USA.
J Am Med Dir Assoc. 2002 Jul-Aug;3(4):215-23. doi: 10.1097/01.JAM.0000019536.75245.86.
Chronic constipation is a common disorder among residents in long-term care; yet the cost to the nursing home of constipation-related care is not known. The objective of this study was to quantify the nursing staff and supply-related cost of constipation care to nursing homes from the perspective of the nursing home.
Prospective, observational time-and-motion design.
Two United States nursing homes.
A total of 59 nursing home residents with chronic constipation and nursing staff providing constipation care to them.
Actual time to complete constipation care-related tasks was measured via stopwatch by trained observers, and the number and professional level (eg, staff nurse, CNA) of staff performing each task was recorded. Frequency of constipation care task data was obtained through 60-day retrospective medical chart review for each subject. Nurse wage rate data was obtained from the Nursing Home Salary and Benefits Report, a US-based national source. Resident and nursing home descriptive information was also collected.
The average cost per task occurrence ranged from 0.72 US dollars for enema administration to 1.74 US dollars for oral medication administration. Average nursing staff costs per subject per year were 1577 US dollars for oral medication administration, 215 US dollars for dietary supplement administration, 39 US dollars for constipation assessment, 17 US dollars for suppository administration, and 6 US dollars for enema administration. Based on estimates of frequency of occurrence, the total annual labor and supply cost per long-term care resident with constipation was 2253 US dollars.
Nursing staff performance of constipation care-related tasks is time consuming and costly in the long-term care setting.
慢性便秘是长期护理机构居民中的常见病症；然而，与便秘护理相关的养老院成本尚不清楚。本研究的目的是从养老院的角度量化养老院便秘护理的护理人员和供应相关成本。
前瞻性、观察性时间与动作设计。
两家美国养老院。
共有59名患有慢性便秘的养老院居民以及为他们提供便秘护理的护理人员。
由训练有素的观察员通过秒表测量完成与便秘护理相关任务的实际时间，并记录执行每项任务的工作人员数量和专业水平（如，注册护士、护理助理）。通过对每个受试者进行60天的回顾性病历审查，获取便秘护理任务数据的频率。护士工资率数据来自《养老院薪资与福利报告》，这是一个美国的全国性数据源。还收集了居民和养老院的描述性信息。
每项任务发生的平均成本从灌肠给药的0.72美元到口服药物给药的1.74美元不等。每位受试者每年的平均护理人员成本为口服药物给药1577美元、膳食补充剂给药215美元、便秘评估39美元、栓剂给药17美元、灌肠给药6美元。根据发生频率估计，每位患有便秘的长期护理居民每年的劳动力和供应总成本为2253美元。
在长期护理环境中，护理人员执行与便秘护理相关的任务既耗时又成本高昂。
