Measuring Relative Work Values for Home Care Nursing Services in Japan

Atuação do enfermeiro na atenção domiciliar: uma revisão integrativa da literatura

RESUMO Objetivo: analisar a produção científica acerca da atuação do enfermeiro na atenção domiciliar em saúde. Método: realizou-se uma revisão integrativa da literatura por meio de consulta às bases de dados LILACS, BDENF, IBECS e MEDLINE. Foram incluídos estudos em espanhol, inglês e português, não delimitando data de publicação. Resultados: analisados 48 artigos, identificou-se que a atuação do enfermeiro na atenção domiciliar possui complexidade e diversidade de ações com uso de tecnologias leves, leve-duras especialmente, e duras. Destaca-se que desafios relacionados ao processo formativo para a atenção domiciliar estão relatados na literatura. O enfermeiro utiliza conhecimento experiencial e recomendações científicas aliados à reflexão na prática. Conclusão: a atuação do enfermeiro no espaço domiciliar é fundamental e ampla. As ações relacionais e educacionais se destacam, sendo necessárias inclusive nos cuidados técnicos, predominando a necessidade de formação para a atenção domiciliar.

Measuring the efficiencies of visiting nurse service agencies using data envelopment analysis

This study develops a measure of the efficiency of visiting nurse (VN) agencies in Japan, examining the issues related to the measurement of efficiency, and identifying the characteristics that influence efficiency. We have employed a data envelopment analysis to measure the efficiency of 108 VN agencies, using the numbers of 5 types of staff as the input variables and the numbers of 3 types of visits as the output variables. The median efficiency scores of the VN agencies were found to be 0.80 and 1.00 according to the constant returns to scale (CRS) and variable returns to scale (VRS) models, respectively, and the median scale efficiency score was 0.95. This study supports using both the CRS and VRS models to measure the scale efficiency of VN service agencies. We also found that relatively efficient VN agencies filled at least 30 % of staff positions with experienced workers, and so concluded that this characteristic has a direct influence on the length of visits.

Assessment of dependency levels of older people in the community and measurement of nursing workload

AIM

This paper is a report of a study to explore the relationship between the dependency levels of older people who are part of the community nurse's caseload and the volume and nature of nursing input required.

BACKGROUND

International healthcare policy has consistently emphasized the reorientation of health services from hospital to community care. It is necessary to determine ways to use nursing resources appropriately to meet service needs of an increasing older population.

METHOD

This quantitative study was conducted in one region of Ireland, which included a city and sparsely populated rural areas. Over a 4-week period in 2004, a volunteer sample of 44 nurses assessed all older people (1482) on their community caseload using the Community Client Need Classification System. In addition, participants recorded the amount of care time spent with each individual client by all members of the community nursing team.

FINDINGS

The vast majority of clients were seen in their own homes (85%, n = 1259). On the 5-point Community Client Need Classification System, the majority (39%, n = 571) were assessed at level 2 (low level of need) and 4% (n = 61) at level 5 (high level of need). As client need level increased, the consumption of community nursing time also increased.

CONCLUSION

The tool was successful in discriminating between care needs levels of older people and may be useful in predicting the type and amount of human resources required by individuals who need community nursing services. Lack of information on demographic variables may limit the transferability of these findings.