| [Objective]1.To obj ectively and comprehensively assess the care needs of the elderly in geriatric nursing facilities with international common and standardized assessment tools-interRAI2.To assess the nursing service supply received everyday by the elderly in geriatric nursing facilities.3.To explore the relationgship between care needs and service supply of the elderly,and revealing the supply of various needs of the elderly in geriatric nursing facilities4.To construct the nursing service content of the geriatric nursing facilities based on the results of the comprehensive evaluation of interRAI and the standardized nursing language.[Methods]This study is a cross-sectional survey.725 elderly people from three geriatric nursing facilities in Jiangsu Province were selected by convenient sampling method to conduct a questionnaire survey.According to the questionnaire issued by the Ministry of Civil Affairs,the elderly in geriatric nursing facilities are divided into different competency levels.According to the InterRAI-LTCF,the elderly care needs are objectively assessed.A self-made questionnaire on the status of implementation of nursing service projects in geriatric nursing facilities is used to investigate the nursing service items accepted by the elderly for 24 hours.The primary and secondary factors are used to analyze the relationship between the demand and supply of care services for the elderly is analyzed.Based on the investigation of all nursing problems triggered by interRAI-LTCF and the actuality of service implementation in institutions,review the relevant literature at home and abroad,defines and classifies nursing measures and nursing activities corresponding to nursing problems by reference to the Classification of Nursing Measures(NIC),formulates a delphi inquiry form,and finally determines the content framework of nursing service in geriatric nursing facilities[Results]1.Care needs of the elderly:The main problems in the elderly with good ability,mild disability,moderate disability,and severe disability are 4,7,8,and 10.Depressive mood.malnutrition,cardiovascular and respiratory problems,and inadequate preventive immunization are four types of care needs that are common to all abilities.Compared with the elderly with good ability,the disabled elderly people have different levels of physical function,which leads to corresponding daily care problems and social participation problems2.Service delivery for the elderly:The number of nursing services for the elderly with good ability,mild disability,moderate disability,and severe disability is 3,11,18,and 24 respectively.The care services offered by the elderly at all competency levels are diet and cleaning services.Disabled elderly people have increased their basic specialist care services and communication to meet their needs compared to the elderly with good ability3.Comparison of elderly care needs and service provision:The geriatric nursing facilities have excellent ability to provide services such as"diet"and"clean"services,but the existing nursing problems are mainly"clinical health problems"and"depressive emotions".The organization has not paid attention to and adopted these issues,these indicate the existence of supply and demand dislocation in the care of the institution;With the increase of disability,the disabled elderly people gradually change the types of daily life care services from basic clean catering services to complex daily care,indicating that the geriatric nursing facilities can respond to the elderly in daily life care services.In response to the clinical health problems of the elderly,the institution provides mainly basic nursing monitoring and drug delivery services,and the service supply form is single;In the elderly cognitive and mental health services.only by chatting with the elderly to alleviate their bad mood,the service supply lacks specialization;In view of the lack of social participation of the elderly,it is rare to meet the social participation needs of disabled people4.Based on the NIC standardized nursing language and the results of inter-RAI evaluation,22 experts were asked two rounds of questionnaires by Delphi method.The effective recovery rates of the questionnaires were 100%and 86.4%respectively.The authoritative coefficients of experts were 0.87 and 0.88 respectively.Finally,the framework of nursing service for the geriatric nursing facilities was preliminarily established,including 61 nursing measures for 23 types of nursing problems[Conclusions]1.The care of the elderly in the geriatric nursing facilities is diversified.The elderly have problems that require attention and intervention in various dimensions such as physical function status,cognitive and mental health,social function status.And there are different priorities for the care of older people with different ability levels2.Although the service provision for the elderly in the geriatric nursing facilities includes the contents of"medical"and"care",it still focuses on daily life care,and other care service supply items are too singular and grouped.3.The supply of care services for the geriatric nursing facilities does not match the care needs and abilities of the elderly.It is necessary to expand the content of the aged care services based on objective assessment to meet the diversified and personalized care needs of the elderly.4.After Delphi inquiry,combined with NIC standardized nursing language,the nursing service content of geriatric nursing facilities was initially formed,including 61 nursing measures for 23 types of nursing problems.The service content has the characteristics of pertinence,standardization and standardization,which is conducive to clinical promotion and application. |
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