TY - JOUR
T1 - Training Nonnursing Staff to Assist with Nutritional Care Delivery in Nursing Homes
T2 - A Cost-Effectiveness Analysis
AU - Simmons, Sandra F.
AU - Hollingsworth, Emily K.
AU - Long, Emily A.
AU - Liu, Xulei
AU - Shotwell, Matthew S.
AU - Keeler, Emmett
AU - An, Ruopeng
AU - Silver, Heidi J.
N1 - Funding Information:
This research was supported by National Institute of Aging (NIA) Grant 1R01AG033828–01A2 awarded to Dr. Sandra F. Simmons (Principal Investigator). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agency. The authors thank the nursing home facilities, residents, and their families for allowing us to work closely with them as part of this project. Conflict of Interest: Dr. Sandra Simmons has served as a professional consultant for Nestle, which is a company that makes nutritional supplement products, but no portion of this study was funded or otherwise supported by Nestle. Dr. Heidi Silver has grant funding support from Nestle and other nutrition-based companies, but none of these grant funds supported her work on this study. Author Contributions: Simmons: study from concept and design, oversight of data collection, analyses, preparation of manuscript. Silver: analysis of nutrient intake data. Shotwell, Liu: analyses and corresponding write-up of analysis section and results tables. Keeler, An: cost-effectiveness analysis and preparation of corresponding section of manuscript and related figures. Hollingsworth: data collection, oversight on data entry, data cleaning procedures. Long: preparation of study databases for biostatistics and cost-effectiveness analyses, creation of results tables. Sponsor's Role: There was no role of the sponsor in any aspect of this study beyond funding.
Publisher Copyright:
© 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society
PY - 2017/2/1
Y1 - 2017/2/1
N2 - 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.
AB - 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.
KW - feeding assistant regulation
KW - long-term care
KW - staff training
KW - unintentional weight loss
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U2 - 10.1111/jgs.14488
DO - 10.1111/jgs.14488
M3 - Article
C2 - 28198565
AN - SCOPUS:84999700074
SN - 0002-8614
VL - 65
SP - 313
EP - 322
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 2
ER -