Nursing Home Care Services Research Articles

The impact of hospital restructuring on home care nursing.

Health reform in many industrialized countries has prompted the shift from institutional to community care. In Ontario, this approach was instigated through the Health Services Restructuring Commission. The purpose of this study was to determine whether changes in the hospital sector between 1996 and 2000 resulted in changes in the provision of home-care services by nurses and practical nurses. This study was a retrospective trend analysis of linked hospitalization and home-care utilization data for Kingston for 1996 to 2000. The measures include the rate of home care and the volume and intensity of home-care services. Between 1996 and 2000 there was a net 4% increase in the age-gender standardized rate of admission to home-care nursing services, with a 10% rate rise between 1996 and 1997. The total volume of home-care services increased during the study, as did the average intensity of home-care service delivery over the first month post-hospitalization during the first four years. This article will give readers their first look at the changes in home-care nursing following hospital restructuring in Kingston.

Mexican American elders' use of skilled home care nursing services.

Hispanic elders use skilled home care nursing (SHCN) services less often than Anglo elders. The purpose of this study was to identify factors that influence whether disabled Mexican American elders decide to use SHCN services. The research process included reviewing the historical context in one Mexican American community, interviewing key and primary informants, presenting a report to the community and getting feedback, and assessing whether the community perceived a need for increased use of SHCN services by their disabled elders. Seven barriers to the use of SHCN services were identified: expectations of discrimination, lack of knowledge about services, expectations embedded in familism, lack of sense of prevention, lack of health insurance, preference for traditional remedies, and neglect/abuse. A community advisory committee validated the barriers identified during interviews and the need for increased use of SHCN services. Results provide new insight into the sociopolitical and cultural complexities that influence health care utilization decisions by Mexican American elders and their families and uncover traditional, oversimplified beliefs and practices by mainstream professionals and policymakers. Interventions that decrease inequities in a southern Arizona community may be transferable to other vulnerable populations in the United States and globally.

Mini Nutritional Assessment in elderly subjects receiving home nursing care

Summary Background: Old age and disease are risk factors for malnutrition. We assessed the nutritional status in elderly receiving home nursing care. Methods: Eighty people (86% women) over the ages of 70 years (mean±SD 84±6) were investigated. One‐third had lung and/or cardiovascular disease, 10% had diabetes mellitus and the remainder had miscellaneous disorders. The Mini Nutritional Assessment (MNA) scale (0–30 points), consisting of 18 point‐weighted questions, including anthropometry, e.g. body mass index (BMI, kg m−2), was used. Results: Fifty patients (62%) were assessed as having suspected malnutrition (MNA 17–23.5 points), while two were assessed as being malnourished (MNA < 17 points). The mean BMI was 22.7±5. One third of the subjects had BMI values <20 and 64% had BMI ≤ 23. Patients with cardiac failure and/or lung disease had the lowest MNA values (20.9±3.3 points) and 85% of these patients were assessed as being at risk for malnourishment. More than half drank ≤1 L of fluid per day. Over half of those who were malnourished or were suspected to be malnourished did not have meal support, whereas almost half of the well‐nourished patients had meal support. Conclusion: Two‐thirds of the patients receiving home nursing care were assessed as having suspected or confirmed malnutrition, or were underweight. Nutritional routines may need more focus within home nursing care services.

Home Care Nursing Services

Home Care Nursing Services