A study of the dependency of elderly patients in wards using different methods of nursing care.

Geriatric wards using individualized care (nursing process) were compared with task allocation wards in three hospitals. Patient dependency was measured using the CAPE scales. Patients admitted to the wards were similar in dependency but patients who had been in hospital for more than a month were significantly less dependent if they had been cared for in individualized care wards. Patient turnover was slower in task allocation wards, and the ratio of discharges to deaths was lower. Several nursing practices were seen to be pushing patients into dependency. The findings indicate that a considerable proportion of the dependency of elderly patients can be iatrogenic, and the formulae for calculating the number of nurses needed on the basis of patient's dependency are inadequate.