TAMI: Technology Assisted Management of Incontinence

描述（由申请人提供）：虚弱、老龄化人口的规模与为老年人提供护理的护理人员之间的差距正在扩大，并将继续以惊人的速度扩大。虽然政府和公众可能会要求养老院为老年居民提供高质量的护理，但目前的预期支付系统并不足以偿还设施的费用，以雇用和保留适当的员工水平。居民的生活质量和护理人员花费的直接护理时间之间的相关性是有据可查的，但是，如果没有重大变化的报销制度，居民应该期待更少的时间投入到直接护理在未来。许多老年人因无法自理而被收容。提供失禁护理所需的工作人员时间很长。这项拟议的研究将调查技术辅助失禁管理（TAMI）系统的有效性，该系统解决了用于衡量所有养老院提供的护理质量的三个关键质量指标。研究人员假设，使用TAMI系统将减少提供失禁护理所需的总时间，同时改善个性化护理。疗养院的居民、工作人员和管理人员的总体潜在利益包括提高居民的生活质量、提高工作人员的生产力、减少与在潮湿条件下度过的时间相关的皮肤破裂所造成的成本和痛苦。最终，预计养老院可以利用劳动力的净储蓄，进一步关注其他基本和预防性护理过程。拟定的临床研究将在3家疗养院进行，采用重复测量设计，以确定使用拟定的技术是否1）在提供失禁护理方面节省时间，2）在更换内裤时减少皮肤潮湿，3）减少可漂白红斑的发生率，4）在研究人员不在场时持续有效地使用，5）从设施的角度来看具有成本效益，以及6）导致家庭愿意支付的护理的明显改善。讨论了该过程质量控制系统的商业潜力。以前试图将类似的技术引入养老院设施，但主要由于成本、操作笨拙和无效而遇到阻力。此外，这些系统的设计并没有满足养老院护理过程中最关键的元素的需求：护士助手。失禁是一个条件，许多老年人制度化，劳动密集型，以防止和treat.We假设，使用技术辅助管理的失禁：TAMi将减少总时间需要提供失禁护理通过有针对性的干预和护理院可以利用劳动力的净储蓄出席其他基本和预防性护理过程。这种节省时间的总体潜在好处包括改善生活质量、提高工作人员的生产力以及避免不利结果而可能节省的成本。

DESCRIPTION (provided by applicant): The disparity between the size of the frail, aging population and the nursing workforce that provides care for the elderly is growing, and will continue to expand at an alarming rate. Though the government and the public may demand that nursing homes provide high quality of care to elder residents, the current prospective payment system does not sufficiently reimburse facilities to hire and retain appropriate staffing levels. The correlation between a resident's quality of life and the amount of direct care time spent with nursing staff is well documented; however, without significant changes to the reimbursement system, residents should expect even less time devoted to direct care in the future. Incontinence is a condition for which many older adults are institutionalized. Staff time required to provide incontinence care is substantial. The proposed study will investigate the efficacy of a technology-assisted management of incontinence (TAMI) system that addresses three of the key quality indicators used to measure the quality of care provided by all nursing homes. Investigators hypothesize that use of the TAMI system will reduce the total time required to deliver incontinence care, while simultaneously improving individualized care. The overall potential benefits for residents, staff and management of nursing homes include improved quality of life for residents, higher staff productivity, and reduction in cost and suffering caused by skin breakdown related to time spent in wet conditions. Ultimately it is expected that nursing homes can utilize net savings in labor to further focus attention on other basic and preventive care processes. The proposed clinical study will be conducted in 3 nursing home facilities using a repeated measures design to determine if use of the proposed technology 1) incurs time savings in the provision of incontinence care, 2) reduces skin wetness upon change of briefs, 3) reduces incidence of blanchable erythema, 4) is consistently and effectively utilized when research staff are not present, 5) is cost effective from the perspective of facilities, and 6) results in perceived improvements in care for which families are willing to pay. The commercial potential for this process quality control system is discussed. Previous attempts to introduce similar technology into the nursing home facility have met resistance primarily due to the cost, unwieldy operation, and ineffectiveness. Moreover, the systems were not designed to meet the needs of the most critical element within the nursing home care process: the nurse aide. Incontinence is a condition for which many older adults are institutionalized and are labor intensive to prevent and to treat. We hypothesize that use of Technology Assisted Management of Incontinence: TAMi will reduce the total time required to deliver incontinence care through targeted intervention and that nursing homes can utilize the net savings in labor to attend to other basic and preventive care processes. The overall potential benefits of this time savings include improved quality of life, higher staff productivity, and potential cost savings resulting from avoidance of adverse outcomes.