Kusaka Kazuyo, Kanoya Yuka, Sato Chifumi
Department of Mental Health and Psychiatric Nursing, Graduate School of Health Sciences, Tokyo Medical and Dental University, Japan.
J Nurs Manag. 2006 Jan;14(1):69-80. doi: 10.1111/j.1365-2934.2005.00552.x.
This research aimed to examine whether early discharge can be performed by nurses of a ward participating in the process of critical path method supporting with offer and evaluation of standard and efficient medical treatments and nursing cares. In order to enrich the system that performs hospitable medical treatment and nursing cares standardized at the psychiatry acute term and to prevent chronic, critical path method was introduced into the acute term ward, then the investigation for nursing job satisfaction that was important to establish critical path method was conducted. By introducing critical path method, it became possible to assess the patients in standard, and the subject of business or a system became clear towards early discharge. It became possible to tie up this subject to a future improvement. Consequently, as for comparison of the patient who applied the schedule table of critical path method at the first and second term, the latter decreased the average length of hospitalization period significantly. The satisfaction of the task requirement, which was important to maintain systems, was decreased by the introduction of critical path method but the score of autonomy in satisfaction increased significantly by the improvement of usage of critical path method. From these, it was suggested that the introduction of critical path method in the acute-care unit psychiatry had possibility to aim at standardization of treatment and nursing and patients' early discharge from hospitals.
本研究旨在探讨参与关键路径法流程的病房护士，在提供和评估标准且高效的医疗与护理服务时，能否实现早期出院。为丰富在精神科急性期实施规范化热情医疗和护理的体系，并预防慢性病，将关键路径法引入急性期病房，随后针对对建立关键路径法至关重要的护理工作满意度进行了调查。通过引入关键路径法，可以对患者进行标准化评估，并且业务或系统的主题对于早期出院变得清晰明了。可以将该主题与未来的改进联系起来。因此，对于在第一期和第二期应用关键路径法时间表的患者进行比较，后者的平均住院时间显著缩短。引入关键路径法降低了对维持系统很重要的任务要求满意度，但通过改进关键路径法的使用，满意度中的自主性得分显著提高。由此表明，在精神科急症病房引入关键路径法有可能实现治疗和护理的标准化以及患者的早期出院。
