The WeanCare nutritional intervention in institutionalized dysphagic older people and its impact on nursing workload and costs: A quasi-experimental study

J Nurs Manag. 2021 Nov;29(8):2620-2629. doi: 10.1111/jonm.13435. Epub 2021 Aug 17.

Abstract

Aim: The aim of this study is to explore how a nutritional intervention that improves the biochemical and functional profile of dysphagic older people impacts on nursing workload and costs for nursing homes.

Background: Dysphagic institutionalized older people particularly at risk of malnutrition require more intensive support from nursing staff and higher costs for nursing homes.

Method: This is an open pre-post longitudinal multicentre quasi-experimental study without a control group.

Results: There is a significant reduction in the number of enemas (from 3.51 to 1.11 enemas), with an average nursing workload reduction from 52 to 16 min per patient every month. Each nurse also spent 20 h less per patient every month spoon-feeding. This resulted in nursing staff cost savings.

Conclusions: The nutritional intervention led to a significantly better quality of life for the patients manifested through increased independence and social engagement. This reduced workload for nursing staff and costs for nursing home administrators.

Implications for nursing management: Sensitive, targeted nutritional interventions have the potential to improve nursing home residents' quality of life and enable a more efficient use of resources. This study revealed reduced workload and cost savings due to less time spent administering enemas and spoon-feeding, in addition to reduced malnutritional consequences.

Keywords: dysphagia; eating behaviours; elder nutritional physiology; food technology; institutionalized persons; staff workload.

MeSH terms

  • Aged
  • Costs and Cost Analysis
  • Humans
  • Malnutrition*
  • Nursing Homes
  • Quality of Life*
  • Workload