A needs assessment for nursing care in state community homes

Abstract

Older people who live in community homes are likely to be vulnerable, have complex physical and mental health problems and therefore some level of nursing intervention will be needed. Assessment is considered to be the first step in the process of individualized nursing care. It provides information that is critical to the development of a plan of action that enhances personal health status. Provision of long-term care should reflect the preferences of consumers. This suggests that data are needed about the users' perspectives on the excellence of their care, and that consumers should be included as a source of data on that care. The objective of the study is to evaluate the dependency level and mental capabilities of the resident population within a state community home, to determine the nursing input needed, define the level of nursing intervention and to identify the hours of nursing care required for each resident through a scoring data. A qualitative approach was utilized which employed a validated questionnaire, consisting of the RCN assessment tool for older persons. The total population of the study group was one hundred and fourteen older persons residing in Mosta and Floriana homes. No exclusion criterion was employed. Results showed that in Mosta Home, 6 (9%) of residents did not need any nursing care, 15 (22%) residents needed 1 hour of nursing care per day, 10 (14%) residents needed 1.2 hours of nursing care per day, 16 (25%) residents needed 2.5 hours of nursing care per day and 21 (30%) residents needed 4.1 hours of nursing care per day. In Floriana Home, 10 (22%) of residents did not need any nursing care, 12 (26%) residents needed 1 hour of nursing care per day, 2 (4%) residents needed 1.2 hours of nursing care per day, 7 (15%) residents needed 2.5 hours of nursing care per day and 15 (33%) residents needed 4.1 hours of nursing care per day. This study was able to identify that findings show that the state community homes are not consistent with the Social Security Act, Legal Notice no.259 of 2004, were article 93 of the same act, specifies that the institutions at Cospicua, Floriana, Gzira, Mosta, Msida, Mtarfa and Zejtun as 'Hostels' for the Elderly and provide care at level one (Appendix 8). A Hostel provides shared accommodation in a house run by a housekeeper with the provision of meals (Tinker, 1997). Such housing is aimed for independent persons who require board and lodging accommodation. This study was able to identify the dependency needs of the service users in long-term settings. Similar studies should be repeated on a regular basis to ensure that desired policies, procedures and standards are reached and maintained over time in all state community homes. This would give a holistic picture of the dependency needs in statutory long-term care and ensuring that services provided remain appropriate to those needs.