Hadjistavropoulos Heather D, Dunn-Pierce Tanya, Biem H Jay
Department of Psychology, 3737 Wascana Parkway, University of Regina, Regina, SK S45 0A2.
Can J Cardiovasc Nurs. 2008;18(4):20-6.
Integrated care pathways (ICPs) for atrial fibrillation and congestive heart failure have been examined in the literature. Systematic study, however, of provider experiences with implementation of pathways for these conditions is lacking. Given the pivotal role of nurses in the care of these chronic heart conditions, this information may be valuable for cardiovascular nurses who use pathways for these chronic heart conditions. In this study, qualitative methods were used to systematically examine providers' experiences with the implementation of integrated care pathways for these conditions. Nurses, physicians, and pharmacists provided feedback on their experiences. Analyses revealed that pathways were perceived by providers to have strengths (e.g., improved communication, knowledge, transition, patient involvement and review), but also multiple challenges (e.g., education, timelines, complexity, interest, ownership, coordination, and documentation) when implemented for these complex chronic medical conditions. Provider recommendations for pathway implementation with these conditions are shared in this study. This information may facilitate cardiovascular nurses in implementing ICPs in other centres.
心房颤动和充血性心力衰竭的综合护理路径已在文献中得到研究。然而,缺乏对医疗服务提供者实施这些病症护理路径经验的系统性研究。鉴于护士在这些慢性心脏病护理中发挥的关键作用,这些信息对于使用这些慢性心脏病护理路径的心血管护士而言可能很有价值。在本研究中,采用定性方法系统地考察了医疗服务提供者实施这些病症综合护理路径的经验。护士、医生和药剂师就他们的经验提供了反馈。分析表明,医疗服务提供者认为护理路径有优势(例如,改善沟通、知识、过渡、患者参与和审查),但在针对这些复杂的慢性病症实施时也面临多重挑战(例如,教育、时间安排、复杂性、兴趣、自主权、协调和文档记录)。本研究分享了医疗服务提供者针对这些病症实施护理路径的建议。这些信息可能有助于心血管护士在其他中心实施综合护理路径。