Nursing staff and care needs in hospitalized elders, are there enough resources?
Alfonso Jesús Cruz Lendínez, Rafael Villar Dávila, Pedro Antonio García Ramiro, Isabel Mª López Medina, Mª Carmen Jiménez Díaz, Pedro Luis Pancorbo Hidalgo

SUMMARY

   Introduction: The increase in the elders' population makes more and more frequent its admittance in hospitals. The hospital stay of the elder patients is usually longer than the rest of patients.

   Aim: To analyze the care delivery capacity in 3 units of the hospital and to compare it with the needs for care of the elders.

   Methods: Observational and prospective study in 3 Internal medicine units in an university hospital belonging to the Andalusian Health Service (Spain). A sample of 190 hospitalized elders has been included. Variables reported were: demographics, hospitalization- related, needs for care and care delivery capacity of the nursing staff. Data were extracted by the Hospital information system, the minimum basic set of data and by direct observation applying the method of level of care.

   Results: The median age of the elders was 77.4 years, a 21.1% of the patients were older than 85 years. The hospital stay was 15.68 days as average. The nursing staf has a care delivery capacity of 2.8 hours/patient/day (with a skill-mix of RN 60%). According to the dependence level, the need for care of the elders was 4.9 hours/patient/day, as average. This gap means a lack of 51 nurses each year, among the 3 units. Factors influencing the needs for care of elders were: age, hospital stay, medical diagnosis and discharge destination. There is a relation also with the presence of a relative accompanying to the patient (family caregiver). The proportion of basic care was a 65.7% of the total amount of care.

   Conclusions: The rate of frail elders in the hospitals is increasing. The needs for care of the elders are higher than capacity for care delivery of nursing staff, so a shortage is created that can be taken up by family caregivers.

KEY WORDS

   Elders, hospitalization, needs for care, nursing staff.

Vol. 18 nº4-2007