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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Byrne
Gobnait
G
School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland. gobnait.byrne@tcd.ie
Brady
Anne-Marie
AM
Horan
Paul
P
Macgregor
Catriona
C
Begley
Cecily
C
D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003858:Dependency, Psychological; D005851:Geriatric Nursing; D006301:Health Services Needs and Demand; D006801:Humans; D007494:Ireland; D015401:Nursing Administration Research; D009740:Nursing Staff / Q000458:organization & administration / Q000523:psychology*; D011637:Public Health Nursing / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D016526:Workload