Training Nonnursing Staff to Assist with Nutritional Care Delivery in Nursing Homes: A Cost-Effectiveness Analysis.
Training Nonnursing Staff to Assist with Nutritional Care Delivery in Nursing Homes: A Cost-Effectiveness Analysis.
复制标题
DOI：
10.1111/jgs.14488
复制
发表时间：
2017-02
影响因子：
6.3
通讯作者：
Silver HJ
中科院分区：
文献类型：
--
作者：
Simmons SF;Hollingsworth EK;Long EA;Liu X;Shotwell MS;Keeler E;An R;Silver HJ
医疗保险和医疗补助服务中心 (CMS) 的规定允许疗养院 (NH) 培训非护理人员提供喂养协助。这项随机对照试验的目的是确定培训非护理人员为营养风险居民提供喂养帮助的影响和成本效益。随机对照试验。从 5 个社区 NH 中招募了 122 名长期居住的 NH 居民，他们被要求补充热量。研究人员为非护理人员提供了 8 小时的培训课程。训练有素的工作人员被分配为干预组提供餐间补充品或零食；而对照组则接受常规护理。研究人员使用标准化观察和加权摄入方法来测量两餐之间的输送频率、工作人员协助时间和居民的热量摄入量。共有 50 名员工（平均每个地点 10 名）完成了培训。干预对两餐之间的热量摄入有显着影响 (F = 56.29, P<.001)，干预组每人每天比常规护理对照组平均多消耗 163.33 (95% CI = [120.19, 206.47]) 卡路里。干预费用比常规护理高 1.27 美元/人/天 (P < .001)。干预措施的增量成本效益比为 134 大卡/每美元。成本增加的原因是每人每天提供零食的频率和数量增加，以及相关工作人员提供帮助的时间增加。培训非护理人员提供热量补充是具有成本效益的，这种做法对居民的两餐之间的摄入量有积极的影响。
A Centers for Medicare and Medicaid Services (CMS) regulation allows nursing homes (NHs) to train non-nursing staff to provide feeding assistance. The purpose of this randomized, controlled trial was to determine the impact and cost-effectiveness of training non-nursing staff to provide feeding assistance for nutritionally at risk residents. Randomized, controlled trial. One-hundred-twenty-two long-stay NH residents with an order for caloric supplementation were recruited from five community NHs. Research staff provided an 8-hour training curriculum to non-nursing staff. Trained staff were assigned to between-meal supplement or snack delivery for the intervention group; while, the control group received usual care. Research staff used standardized observations and weighed intake methods to measure frequency of between-meal delivery, staff assistance time and residents’ caloric intake. A total of 50 staff (mean = 10 per site) completed training. The intervention had a significant effect on between-meal caloric intake (F = 56.29, P<.001) with the intervention group consuming, on average, 163.33 (95% CI = [120.19, 206.47]) calories per person/day more than the usual care control group. The intervention costs were $1.27/person/day higher than usual care (P < .001). The incremental cost-effectiveness ratio for the intervention was 134 kcals/per dollar. The increase in cost was due to the higher frequency and number of snack items given per person/day and the associated staff time to provide assistance. It is cost-effective to train non-nursing staff to provide caloric supplementation and this practice has a positive impact on residents’ between-meal intake.
影响因子：
5.8
作者：
Simmons, S. F.;Peterson, E. N.;You, C.
通讯作者：
You, C.