2021 Volume 86 Issue 780 Pages 391-401
Background
“Unit care”, in which a small number of residents live together, has been one of the effective methods to the practice of individual care in elderly facilities. The unit care type facilities were adopted not only in the nursing home but also in other elderly facilities and welfare facilities. However, the unit type is said to have the following problems. The first is that the staff spends a lot of time alone assisting in the unit, and the second is that it is difficult to educate staff.
So, in this survey, from the viewpoint of planning of scale in care group, we are considered improvement of working environment of staff.
Objective
The purpose of this study is to clarify the effects of the differences in the scale of nursing care units on the work system and nursing care contents. The subjects of the survey were: 7-8 person unit, 10-person units (2 facilities A, B), 12-person unit and 13-person unit.
Research Method
The survey methods were interview survey, behavior observation survey and activity amount survey of staffs. The period of behavior observation survey was 24 hours × 3 days, and the target unit were 2 units of each facility.
Conclusions
(1) Shift of care staffs during the daytime: The 7-8 person unit and 10-person unit B had a two-person system for early and late shift. The 10-person unit A had a three-person system for early, day, and late shift. The 12-person unit and the 13-person unit had a four-person system for early, day shift, and two late shift staffs.
(2) Percentage of the number of staffs stayed in the unit: In the 7-8 person unit, the ratio of no staff in the unit was 8.4% (75.6 minutes). On the other hand, in the 12-person unit, the ratio of two or more staffs in the Unit was 64.2% and that in the 13-person unit was 73.3%.
(3) Percentage of time when there was no staff in LDK: 7-8 person unit is 51% (464.6 minutes), 10-person unit A was 37% (333 minutes) and 10-person unit B was 36% (324 minutes). 12-person unit 37% (333 minutes) and 13-person unit was 28% (243 minutes). The difference between the 7-8 person unit and the 13-person unit was as large as 23%.
(4) Characteristics of individual assistance: Regarding bathing assistance, the 13-person unit also provided assistance at night, but the 10-person unit A and the 10-person unit B provided assistance in the morning.
As for dietary assistance, breakfast was provided at all facilities in accordance with the life rhythm of individual residents. For lunch and dinner, the 7-8 person unit, 10 person unit A, 10 person unit B and 12 person unit had a uniform meal time, but the 13 person unit had a long meal time and individual care was possible.
Regarding excretion assistance, in the 12-person unit and the 13-person unit, the difference between the regular excretion assistance time and that in other time zones was small, and excretion assistance was frequently provided.
(5) Information transmission such as records and business conversation: In the 7-8 person unit, there were few conversations during work, and information was communicated by meeting and recording. In the 12-person unit, in addition to records, there were long meeting time and business conversations during work, and information was shared among staffs.
