Plantilla de enfermería y demanda de cuidados de ancianos hospitalizados, ¿son suficientes los recursos? / Nursing staff and care needs in hospitalized elders, are there enough resources?

ABSTRACT

Introduction: The increase in the elders’ population makesmore and more frequent its admittance in hospitals. Thehospital stay of the elder patients is usually longer than therest of patients. Aim: To analyze the care delivery capacityin 3 units of the hospital and to compare it with the needsfor care of the elders. Methods: Observational and prospectivestudy in 3 Internal medicine units in an universityhospital 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 thenursing staff. Data were extracted by the Hospital informationsystem, the minimum basic set of data and by directobservation applying the method of level of care. Results:The median age of the elders was 77.4 years, a21.1% of the patients were older than 85 years. The hospitalstay was 15.68 days as average. The nursing staf has acare delivery capacity of 2.8 hours/patient/day (with askill-mix of RN 60%). According to the dependence level,the need for care of the elders was 4.9 hours/patient/day, asaverage. This gap means a lack of 51 nurses each year, among the 3 units. Factors influencing the needs for care ofelders were: age, hospital stay, medical diagnosis and dischargedestination. There is a relation also with the presenceof a relative accompanying to the patient (family caregiver).The proportion of basic care was a 65.7% of the totalamount of care. Conclusions: The rate of frail elders inthe hospitals is increasing. The needs for care of the eldersare higher than capacity for care delivery of nursing staff,so a shortage is created that can be taken up by family caregivers (AU)