A preliminary evaluation of the paid feeding assistant regulation: Impact on feeding assistance care process quality in nursing homes
A preliminary evaluation of the paid feeding assistant regulation: Impact on feeding assistance care process quality in nursing homes
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DOI：
10.1093/geront/47.2.184
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发表时间：
2007-04-01
期刊：
影响因子：
5.7
通讯作者：
Schnelle, John F.
中科院分区：
文献类型：
--
作者：
Simmons, Sandra F.;Bertrand, Rosanna;Schnelle, John F.
目的：医疗保险和医疗补助服务中心和医疗保健研究与质量机构发起了一项全国性的研究，以评估联邦有偿喂养助理（PFA）法规，该法规允许养老院雇用单任务工人为养老院居民提供喂养援助。组织者设计了PFA条例，以增加工作人员的数量，以提供援助的饮食和提高营养护理过程的质量。设计和方法：训练有素的研究人员使用标准化协议在用餐期间进行直接观察，并在七个具有PFA项目的便利样本中进行面对面的工作人员访谈，以评估护理过程质量。结果：在7家实地考察机构中，大多数（84%）培训的PFAs是机构内的非护理人员；这些工作人员提供的喂养辅助护理的质量与土著护理人员提供的质量相当。在实施PFA计划后，现有的人员配备水平（护士助理或持证护士）没有变化，大多数（约90%）的各级土著工作人员报告说，PFA计划对工作人员和住院医生都有积极的好处。含义：本初步研究的结果表明，PFA规定可能有助于提高现有非护理人员的利用率，以改善用餐期间的喂养辅助护理，而不会对现有护士助理和持牌护士的人员配备水平产生负面影响。
Purpose: The Centers for Medicare and Medicaid Services and the Agency for Healthcare Research and Quality sponsored a nationwide study to evaluate the federal paid feeding assistant (PFA) regulation that allows nursing homes to hire singletask workers to provide feeding assistance to nursing home residents. Organizers designed the PFA regulation to increase the number of staff available to provide assistance with eating and improve nutritional care process quality. Design and Methods: Trained research staff used standardized protocols to conduct direct observations during meals and faceto-face staff interviews in a convenience sample of seven facilities with PFA programs to evaluate care process quality. Results: Most (84%) of the trained PFAs in the seven site visit facilities were non-nursing staff within the facility; the quality of feeding assistance care provided by these workers was comparable to that provided by indigenous nurse aides. There were no reported changes in existing staffing levels (nurse aide or licensed nurses) follow- ing PFA program implementation, and the majority (> 90%) of indigenous staff at all levels reported positive benefits of the PFA program for both staff and residents. Implications: Findings from this preliminary study indicate that the PFA regulation may serve to increase the utilization of existing non-nursing staff to improve feeding assistance care during meals without having a negative impact on existing nurse aide and licensed nurse staffing levels.