Evaluating the psychosocial component of nursing care in a geriatric program

Today, most health care programs must operate within a framework of: 1) competing demands for resources, 2) pressure to reduce staffing levels, and 3) consumer demands for high quality service. Competing demands for resources means that there is a need to continuously justify a program by providing critical evaluations of program components and identifying effective outcome measures. Within a geriatric psychiatry program that provides assessment and short term treatment, various evaluation measures were tried. While none of the measurement techniques was completely satisfactory, it became very apparent that the psychosocial nursing skills that were critical in the care of this population were not accounted for by any of the current tools. Given the need to justify the high ratio of RN staffing to other categories, eg. CCA or LPN, two measures specific to nursing were tried on a pilot basis. This paper reports on the initial measurement techniques used and the results from the trial of new measures.