Objectives
To determine the effect and cost-effectiveness of training nonnursing staff to provide feeding assistance for nutritionally at-risk nursing home (NH) residents.
Design
Randomized, controlled trial.
Setting
Five community NHs.
Participants
Long-stay NH residents with an order for caloric supplementation (N = 122).
Intervention
Research staff provided an 8-hour training curriculum to nonnursing staff. Trained staff were assigned to between-meal supplement or snack delivery for the intervention group; the control group received usual care.
Measurements
Research staff used standardized observations and weighed-intake methods to measure frequency of between-meal delivery, staff assistance time, and resident caloric intake.
Results
Fifty staff (mean 10 per site) completed training. The intervention had a significant effect on between-meal caloric intake (F = 56.29, P < .001), with the intervention group consuming, on average, 163.33 (95% CI = 120.19–206.47) calories per person per day more than the usual care control group. The intervention costs were $1.27 per person per day higher than usual care (P < .001). The incremental cost-effectiveness ratio for the intervention was 134 kcal per dollar. The increase in cost was due to the higher frequency and number of snack items given per person per day and the associated staff time to provide assistance.
Conclusion
It is cost effective to train nonnursing staff to provide caloric supplementation, and this practice has a positive effect on residents’ between-meal intake.
from Journal of the American Geriatrics Society http://ift.tt/2fg3hZ5
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