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管理安养院的以患者为中心的痴呆症护理:人员配置和时间考虑因素。

Managing Person-Centered Dementia Care in an Assisted Living Facility: Staffing and Time Considerations.

机构信息

Center for Quality Aging, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.

Division of Geriatrics, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.

出版信息

Gerontologist. 2018 Jul 13;58(4):e251-e259. doi: 10.1093/geront/gnx089.

Abstract

BACKGROUND AND OBJECTIVES

To describe (a) the unlicensed staff time necessary to provide quality activities of daily living (ADL) care to residents receiving dementia care within an assisted living facility and (b) a staff management approach to maintain quality ADL care.

RESEARCH DESIGN AND METHODS

Supervisory staff used a standardized observational method to measure ADL care quality and the staff time to provide care during the morning and evening across 12 consecutive months. Staff were given individual feedback about the quality of their care provision following each observation.

RESULTS

The average staff time to provide ADL care averaged 35 (± 11) minutes per resident per care episode with bathing and 18 (± 6) minutes/resident/care episode without bathing. Morning ADL care required significantly more staff time than evening care. There was not a significant relationship between residents' levels of cognitive impairment or ADL dependency and the staff time to provide ADL care. Quality ADL care was maintained for 12 months.

DISCUSSION AND IMPLICATIONS

This study provides novel data related to the amount of staff time necessary to provide quality ADL care for persons with dementia in an assisted living care setting. This study also describes a standardized approach to staff management that was effective in maintaining quality ADL care provision. Assisted living facilities should consider these data when determining the necessary unlicensed staffing level to provide person-centered ADL care and how to effectively manage direct care providers.

摘要

背景与目的

描述(a)在辅助生活设施中为接受痴呆症护理的居民提供高质量日常生活活动(ADL)护理所需的无执照员工时间,以及(b)维持高质量 ADL 护理的员工管理方法。

研究设计与方法

监督人员使用标准化观察方法,在 12 个月的连续时间内,在早上和晚上测量 ADL 护理质量和提供护理所需的员工时间。每次观察后,都会向员工提供有关其护理提供质量的个人反馈。

结果

提供 ADL 护理的平均员工时间平均为每位居民每次护理事件的 35(±11)分钟,洗澡时间为 18(±6)分钟/居民/护理事件,不洗澡时间为 18(±6)分钟/居民/护理事件。ADL 护理的早晨需要明显更多的员工时间。居民的认知障碍或 ADL 依赖程度与提供 ADL 护理所需的员工时间之间没有显著关系。12 个月内维持了高质量的 ADL 护理。

讨论与意义

本研究提供了有关在辅助生活护理环境中为痴呆症患者提供高质量 ADL 护理所需的员工时间的新数据。本研究还描述了一种标准化的员工管理方法,该方法在维持高质量 ADL 护理提供方面非常有效。辅助生活设施在确定提供以人为本的 ADL 护理所需的无执照人员配置水平以及如何有效管理直接护理提供者时,应考虑这些数据。

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