Characteristics of geriatric patients as related to nursing needs.

Abstract

A series of studies have been conducted at the Health Services Research Centre at the University of Birmingham, England, of nursing needs, nursing workload and staffing levels on geriatric wards in hospitals. The method used to calculate the workload at different levels of skill required takes into account the nursing care needs of individual patients at a defined standard of care, and uses measured event times for necessary items of care, taking account of the patients’ individual characteristics. It also includes an indirect care factor for nursing work which is not directly attributable to the needs of individual patients. A survey of all the geriatric wards in one Region and selected wards in another yielded information on some characteristics of geriatric patients in general, as well as providing data for using a computer package to estimate workload. This paper describes the 7561 patients included in the survey and the rate of occurrence of the recorded dependency characteristics. Previous work has shown that the workload generated by the patients on geriatric wards is strongly dependent upon the care plans in effect for the patients, and hence upon the standard of care upheld (Rhys Hearn, 19794. An earlier study in this series examined the nursing workload generated when care was prescribed at some rather idealised standards of care determined by the ward sisters (Rhys Hearn, 1979b). The present study calculates workload at a less idealistic standard of care based on a Base Line Care Policy (Young and Rhys Hearn, in press) formulated by a Panel including ward sisters, nursing administrators and staff in nursing education. The policy prescribes the frequency with which the main items of nursing care, which account for the bulk of workload, should be carried out. It also provides for the special technical treatments required for individual patients. A survey was conducted in all geriatric wards in the West Midlands Region (Young and Rhys Hearn, 1980) and in one ward in each district of the North West Thames Region. A ‘Patient State Form’ was completed for each patient upon which were recorded characteristics of the patient influencing the method and associated activities (and hence