Arain Mubashir A, Deutschlander Siegrid, Charland Paola
Workforce Research & Evaluation, Alberta Health Services, Calgary, Alberta, Canada.
BMJ Open. 2017 May 17;7(5):e015521. doi: 10.1136/bmjopen-2016-015521.
Over the last 10 years, appropriate workforce utilisation has been an important discussion among healthcare practitioners and policy-makers. The role of healthcare aides (HCAs) has also expanded to improve their utilisation. This evolving role of HCAs in Canada has prompted calls for standardised training, education and scope of practice for HCAs. The purpose of this research was to examine the differences in HCAs training and utilisation in continuing care facilities.
From June 2014 to July 2015, we conducted a mixed-method study on HCA utilisation in continuing care. This paper presents findings gathered solely from the prospective cross-sectional survey of continuing care facilities (long-term care (LTC) and supportive living (SL)) on HCA utilisation.
We conducted this study in a Western Canadian province. The managers of the continuing care facilities (SL and LTC) were eligible to participate in the survey.
The pattern of HCAs involvement in medication assistance and other care activities in SL and LTC facilities.
We received 130 completed surveys (LTC=64 and SL=52). Our findings showed that approximately 81% of HCAs were fully certified. We found variations in how HCAs were used in SL and LTC facilities. Overall, HCAs in SL were more likely to be involved in medication management such as assisting with inhaled medication and oral medication delivery. A significantly larger proportion of survey respondents from SL facilities reported that medication assistance training was mandatory for their HCAs (86%) compared with the LTC facilities (50%) (p value <0.01).
The utilisation of HCAs varies widely between SL and LTC facilities. HCAs in SL facilities may be considered better used according to their required educational training and competencies. Expanding the role of HCAs in LTC facilities may lead to a cost-effective and more efficient utilisation of workforce in continuing care facilities.
在过去十年中，医疗保健从业人员和政策制定者一直在热烈讨论劳动力的合理利用问题。医疗保健助理（HCA）的作用也得到了扩展，以提高其利用率。HCA在加拿大的这一角色演变促使人们呼吁为HCA制定标准化的培训、教育和执业范围。本研究的目的是调查持续护理机构中HCA培训和利用情况的差异。
2014年6月至2015年7月，我们对持续护理中HCA的利用情况进行了一项混合方法研究。本文仅展示了从持续护理机构（长期护理（LTC）和支持性生活（SL））关于HCA利用情况的前瞻性横断面调查中收集到的结果。
我们在加拿大西部的一个省份进行了这项研究。持续护理机构（SL和LTC）的管理人员有资格参与调查。
HCA参与SL和LTC设施中药物协助及其他护理活动的模式。
我们共收到130份完整的调查问卷（LTC = 64份，SL = 52份）。我们的研究结果表明，约81%的HCA获得了全面认证。我们发现SL和LTC设施中HCA的使用方式存在差异。总体而言，SL中的HCA更有可能参与药物管理，如协助吸入药物和口服药物给药。与LTC设施（50%）相比，SL设施中显著更高比例的调查受访者表示其HCA必须接受药物协助培训（86%）（p值<0.01）。
SL和LTC设施中HCA的利用情况差异很大。根据所需的教育培训和能力来看，SL设施中的HCA可能得到了更好的利用。扩大HCA在LTC设施中的作用可能会使持续护理机构的劳动力利用更具成本效益且效率更高。
