Care needs of residents in community-based long-term care facilities in Taiwan.
OBJECTIVE
The purpose of this study is to gain an understanding both of the characteristics of residents who receive the services of nursing assistants and the service intensity (service tasks, service time and cost) of nursing assistants as a means of developing a patient classification based upon resource consumption.


BACKGROUND
Most people in Taiwan send their disabled older family members to community-based long-term care facilities instead of nursing homes because they are much cheaper, and because they are generally closer to their homes, making visits more convenient. Nursing assistants make up the largest group of personnel in long-term care facilities. To determine resource use, both the service time and the actual activities performed for a resident by nursing assistants need to be assessed and this will help to develop a patient classification system to predict resource use and patient outcomes.


METHODS
A descriptive survey method was used to identify the tasks performed by nursing assistants in community-based long-term care facilities in Taiwan. Nursing assistants were recruited from 10 long-term care facilities in the Shihlin and Peitou Districts of Taipei City. Thirty-four nursing assistants and 112 residents participated in this study.


RESULTS
Findings showed that each nursing assistant spent 5.05 hours per day doing direct service care, which is much higher than the 2.08 hours for nursing assistants in the United States. Among service tasks provided by nursing assistants, personal care consumed 35.1% of their time. Non-complex treatments were second (33.3%). Skilled nursing and medical services were third (31.6%). The service intensity required of nursing assistants was strongly related to the residents' activities of daily living and their needs.


CONCLUSIONS
Complex nursing procedures are normally provided by Registered Nurses in nursing homes and consumed almost as much of the nursing assistants' time as did personal care activities in this study.


CONCLUSIONS
It is suggested that a training program for nursing assistants, especially for foreigners in community-based long-term care facilities, should be mandated to assure the quality of service.
Li
I-Chuan
IC
Institute of Community Health Nursing, National Yang-Ming University, Taipei, Taiwan. icli@ym.edu.tw
Yin
Teresa Jeo-Chen
TJ
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004180:Direct Service Costs / Q000706:statistics & numerical data; D006233:Persons with Disabilities / Q000145:classification; D004509:Education, Nursing, Continuing / Q000458:organization & administration; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D020380:Needs Assessment / Q000458:organization & administration*; D024802:Nurse's Role; D015401:Nursing Administration Research; D009728:Nursing Assistants / Q000193:education / Q000458:organization & administration*; D015403:Nursing Evaluation Research; D009735:Nursing Homes / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D013624:Taiwan; D013996:Time and Motion Studies; D016526:Workload / Q000145:classification / Q000191:economics