Introduction. We report the results of a one-day survey of nursing care loa d in University Hospitals (UH), General Hospitals (GH) and Stroke Units (SU) reg arding the acute stage of stroke. Methods. The type of care ...Introduction. We report the results of a one-day survey of nursing care loa d in University Hospitals (UH), General Hospitals (GH) and Stroke Units (SU) reg arding the acute stage of stroke. Methods. The type of care and the time devoted to care were compared by type of stroke (transient ischemic attack, ischemic st roke, hemorrhagic stroke, cerebral thrombophlebitis, sub-arachnoid hemorrhage) , and degree of handicap (Barthel score). Results. Twenty-two hospitals (13 UH and 9 GH) participated in the study and provided care for 328 stroke victims (3 0 transient ischemic attacks, 247 ischemic strokes, 36 hemorrhagic strokes, 3 ce rebral thrombophlebitis events and 11 strokes of unknown mechanism). Care was gi ven in UHs for 63 percent of the patients and in GHs for 37 percent; in SUs for 40 percent (132 patients) and general neurology units for 60 percent (196 patien ts). Care involved physiotherapy for 70 percent, speech therapy for 42 percent, and care for cognitive decline for 36 percent. Mean time spent by nurses and nur sing assistants peaked in the morning with a significant time not devoted to car e. More than 3 hours of nurse care per day of care was significantly more freque nt in SUs (p < 0.001) and in GHs (p = 0.02) for patients with Barthel score < 40 or hemorrhagic stroke, irrespective of age. Patients older than 80 years, with a Barthel score < 40, with hemorrhagic stroke, and who were admitted more than 1 5 days before the survey required more than two hours per day of nursing assista nt care significantly more often. The probability of more than three hours per d ay of nurse care for stroke increased 2.8-fold for hemorrhagic stroke, 6.0-f old for Barthel Score < 40, and 2.0-fold for care in a GH. The probability of more than two hours per day of nurse assistant care for stroke increased 3.0- fold for hemorrhagic stroke, 6.1-fold for Barthel score < 40, 2.0-fold for patient s older than 70 years, and 1.5-fold for stroke onset more than 14 days before the survey. Conclusion. This survey enabled calculating the number of care giver s required for 10 patients: 6 nurses and 5 nursing assistants, a level in line w ith recommended practices. These results emphasize the important role of nursing care for stroke victims, and points out that the type of hospital, the type of stroke, and the patient’s age and degree of handicap have an effect on nursing load. This one-day survey enabled calculation of the number of nurses and nur sing assistants needed for a 10-patient unit.展开更多
文摘Introduction. We report the results of a one-day survey of nursing care loa d in University Hospitals (UH), General Hospitals (GH) and Stroke Units (SU) reg arding the acute stage of stroke. Methods. The type of care and the time devoted to care were compared by type of stroke (transient ischemic attack, ischemic st roke, hemorrhagic stroke, cerebral thrombophlebitis, sub-arachnoid hemorrhage) , and degree of handicap (Barthel score). Results. Twenty-two hospitals (13 UH and 9 GH) participated in the study and provided care for 328 stroke victims (3 0 transient ischemic attacks, 247 ischemic strokes, 36 hemorrhagic strokes, 3 ce rebral thrombophlebitis events and 11 strokes of unknown mechanism). Care was gi ven in UHs for 63 percent of the patients and in GHs for 37 percent; in SUs for 40 percent (132 patients) and general neurology units for 60 percent (196 patien ts). Care involved physiotherapy for 70 percent, speech therapy for 42 percent, and care for cognitive decline for 36 percent. Mean time spent by nurses and nur sing assistants peaked in the morning with a significant time not devoted to car e. More than 3 hours of nurse care per day of care was significantly more freque nt in SUs (p < 0.001) and in GHs (p = 0.02) for patients with Barthel score < 40 or hemorrhagic stroke, irrespective of age. Patients older than 80 years, with a Barthel score < 40, with hemorrhagic stroke, and who were admitted more than 1 5 days before the survey required more than two hours per day of nursing assista nt care significantly more often. The probability of more than three hours per d ay of nurse care for stroke increased 2.8-fold for hemorrhagic stroke, 6.0-f old for Barthel Score < 40, and 2.0-fold for care in a GH. The probability of more than two hours per day of nurse assistant care for stroke increased 3.0- fold for hemorrhagic stroke, 6.1-fold for Barthel score < 40, 2.0-fold for patient s older than 70 years, and 1.5-fold for stroke onset more than 14 days before the survey. Conclusion. This survey enabled calculating the number of care giver s required for 10 patients: 6 nurses and 5 nursing assistants, a level in line w ith recommended practices. These results emphasize the important role of nursing care for stroke victims, and points out that the type of hospital, the type of stroke, and the patient’s age and degree of handicap have an effect on nursing load. This one-day survey enabled calculation of the number of nurses and nur sing assistants needed for a 10-patient unit.
