Nursing workload predictors in Catalonia (Spain): a home care cohort study

作者：Gene Badia Joan; Borras Santos Alicia; Contel Segura Joan Caries; Camprubi Casellas Ma Dolors; Cegri Lombardo Francisco; Heras Tebar Antonio; Noguera Rodriguez Ramon; Gonzalez Martinez Susana; Oliver Olius Anna; Pineiro Gonzalez Martino; Montanuy Baro Teresa; Limon Ramirez Esther; Aranzana Martinez Antonio; Pedret Llaberia Roser; Borrell Munoz Manuel; Hidalgo Garcia Antonio

来源：Gaceta Sanitaria, 2011, 25(4): 308-313.

DOI：10.1016/j.gaceta.2010.12.011

• Nursing workload
• Home care
• Elderly
• Primary care

Objective: To identify the characteristics of chronic patients and their environment in order to predict the nursing workload required 1 year after their inclusion in a home care program.
Methods: A longitudinal study was carried out in 72 primary health care teams in Catalonia (Spain) with a 1-year follow-up of 1,068 home care patients over 64 years old. The variables collected from each patient included data on health and social status (Charlson and Barthel indexes and the Pfeiffer, Braden and Gijon scales), carer overburden (Zarit scale), hospital admissions, use of emergency services, self-perceived health (SF-12) and the number of health worker visits.
Results: Patients received 7.2 (SD 10.4) visits per year from their nurse-in-charge, out of a total of 8.7 (SD 13.1) nursing visits per year. Risk factors for receiving more nursing visits at home were male gender (IRR= 1.42, 95%CI: 1.20-1.67), dependency for daily activities (IRR = 1.65, 95%CI: 1.29-2.13), decubitus ulcers (IRR= 4.03, 95%CI: 2.27-7.14) and receiving emergency medical care at home (IRR= 1.65, 95%CI: 1.31-2.07). In contrast, patients with major cognitive impairment (IRR = 0.78, 95%CI: 0.63-0.98) had a lower probability of receiving nursing visits at home.
Conclusion's: Workload can be predicted by patients' clinical characteristics. The positive correlation of workload with variables related to disease severity and the negative correlation with variables related to cognitive impairment show that home care nursing in Catalonia is basically demand-oriented.

• 出版日期2011-8