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Open Access Choosing a Model of Care for Patients in Alternate Level Care: Caregiver Perspectives with Respect to Staff Injury

Le choix d'un modèle de soins pour les patients exigeant un autre niveau de soins: le point de vue des soignants sur les accidents du travail

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The population of alternate level care (ALC) patients utilizing acute-care hospital resources inappropriate to their needs is growing.The purpose of this study was to explore how the care of ALC patients was managed at 4 acute-care facilities in the Canadian province of British Columbia and to examine how this care impacts on outcomes of staff injury.Interviews were conducted to identify and characterize the different models of ALC. Injury outcomes for all caregivers were obtained ( = 2,854) and logistic regression conducted to compare staff injuries across ALC models. Injured workers were surveyed regarding their perceptions of injury risk and ALC. Five ALC models were identified: low-mix, high-mix, dedicated ALC units, extended care units, and geriatric assessment units.The risk for caregiver injuries was lowest on dedicated ALC units.These findings suggest that acute-care facilities faced with a growing ALC population should consider creating dedicated ALC units.

French
On constate une augmentation de la population des patients exigeant un autre niveau de soins (ANS), lesquels accaparent des ressources hospitalières en soins actifs inadaptés à leurs besoins. Ce projet de recherche porte sur quatre établissements de soins actifs dans la province canadienne de la Colombie-Britannique, dans le but d'étudier la gestion des soins destinés aux patients ANS et d'analyser son incidence sur les accidents du travail. On a mené des entrevues pour définir différents modèles ANS et obtenu des données relatives aux accidents pour tous les soignants (n = 2 854). On a ensuite effectué une analyse de régression logistique pour classer les accidents en fonction des modèles ANS. On a également sondé les travailleurs accidentés sur leurs perceptions à l'égard du risque de blessure en relation avec l'ANS. Cinq modèles ANS ressortent de l'analyse: légèrement hétérogène, très hétérogène, services ANS spécialisés, services de soins actifs et services d'évaluation gériatrique. C'est dans les services spécialisés que le risque d'accident s'est révélé le moins élevé. Ces résultats suggèrent que les établissements de soins actifs qui connaissent une augmentation de la population ANS devraient envisager de créer des services ANS spécialisés.

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Keywords: ACUTE-CARE; ALTERNATE LEVEL CARE; GERIATRIC PATIENTS; HOSPITALS; NURSING STAFF; STAFF INJURY; WORK ORGANIZATION

Document Type: Research Article

Publication date: 2004-03-01

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