Research On Nursing Service And Working Hour Measuring Of Nursing Staff For The Elderly With Dementia In Nursing Homes

Background:With the deepening of the aging society,the matter of caring for the elderly with dementia has an unprecedented impact on the traditional mode of aged-care at home in China.Compared with the traditional mode,professional care in nursing homes is beneficial to their physical and mental health.The most important work content in nursing homes is nursing service provided by registered nurses and nursing assistants.However,the development of nursing homes in China started relatively late.There is no authoritative definition of nursing service and the scientific allocation standard of nursing human resource in nursing homes,which affected the quality of care.Therefore,this study aims to explore the work content and workload of nursing staff and provide references for rational allocation of nursing human resources in dementia care area.Objective:(1)To construct a nursing service framework for the elderly with dementia in nursing homes.(2)Based on this framework,to calculate the rational number of nursing staff in dementia care area by using working hour measuring method.Methods:Delphi Method was used to determine the nursing service framework of the nursing staff for the elderly with dementia through two rounds of letter consultation with fifteen experts.From November 2020 to February 2021,six nursing assistants and four nurses in dementia care area of a nursing home in Beijing were recruited by convenience sampling method.Working hour measuring method was used to record their nursing workload and preliminarily estimate the rational number of nursing staff in dementia care area.Results:The effective response rate of two rounds’ questionnaires were 100%.The experts’ authority coefficient in two rounds were 0.900 and 0.913.The Kendall’s coordination coefficient in two rounds were statistically significant(P<0.01).The content framework of nursing work included 4 first-level indicators:basic life care,rehabilitation and safety management,professional care and coping with behavioral and psychological symptoms in dementia(BPSD).There were 17 second-level indicators and 81 third-level indicators.It comprehensively covered the care needs of the elderly with dementia and discussed the coping strategies of BPSD.According to working hour measuring method,the actual ratio of the elderly to nursing assistants was 1:0.2353,and the rational ratio was 1:0.4532.The actual ratio of the elderly to nurses was 1:0.0167,and the rational ratio was 1:0.1527.Conclusions:(1)This study scientifically and objectively measured the work content and workload of nursing staff in dementia care area of nursing homes,which can provide references for the division of labor of nursing staff for the elderly with dementia.(2)At present,there is an obvious gap between the actual ratio of nursing assistants and registered nurses in private nursing homes and the rational state.Nursing homes should timely adjust the ratio of the elderly with dementia to nursing staff according to the actual situation and give full play to nurses’ potential ability.