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心脏手术后从医院到家庭:一种社区护理管理模式的评估

From hospital to home after cardiac surgery: evaluation of a community nursing care management model.

作者信息

Morin Diane, Aubin Michele, Vezina Lucie, Gagnon Johanne, Racine Sandra, Reinharz Daniel, Paradis Michele, Dallaire Clemence, Aubin Karine

机构信息

Faculty of Nursing Sciences, Université Laval, Québec, Québec, Canada.

出版信息

Prof Case Manag. 2009 Jul-Aug;14(4):167-75; quiz 176-7. doi: 10.1097/NCM.0b013e318198d4be.

DOI:10.1097/NCM.0b013e318198d4be
PMID:19625933
Abstract

PURPOSE/OBJECTIVES: This quasi-experimental research aims to (1) evaluate the implementation process of a community nursing care management model and (2) assess the effects of this model on patients followed at home.

PRIMARY PRACTICE SETTING

Two community healthcare centers had introduced a community nursing care management model in their practice (experimental groups), whereas another health community care center with no experience with such a model served as a control group. The community nursing care management model included clinical pathways designed for a clientele who had been hospitalized for cardiac surgery.

FINDINGS/CONCLUSIONS: Even though the implementation process was challenging, the community nursing care management model was found useful enough to be integrated into routine nursing home care practice after cardiac surgery. Although the effects produced by this systematic home care program on the clientele did not differ significantly from those produced by usual nursing care, there was a positive effect for the clientele recorded on all measurement indicators used.

IMPLICATIONS FOR CASE MANAGEMENT PRACTICE

The introduction of the nursing care management model enabled nurses to structure the care provided and reduced interindividual variation. The application of this program also proved to be an opportunity to initiate and assimilate new professional roles. Additional studies should be conducted to assess its effectiveness in home care for other health problems.

摘要

目的/目标:本准实验研究旨在(1)评估社区护理管理模式的实施过程,以及(2)评估该模式对居家随访患者的影响。

主要实践场所

两家社区医疗中心在其实践中引入了社区护理管理模式(实验组),而另一家没有此类模式经验的社区医疗中心作为对照组。社区护理管理模式包括为心脏手术住院患者设计的临床路径。

研究结果/结论:尽管实施过程具有挑战性,但社区护理管理模式被发现足够有用,可纳入心脏手术后常规的疗养院护理实践。虽然该系统性居家护理计划对患者产生的效果与常规护理产生的效果没有显著差异,但在所使用的所有测量指标上,患者均有积极效果记录。

对病例管理实践的启示

护理管理模式的引入使护士能够构建所提供的护理,并减少个体差异。该计划的应用也被证明是一个启动和融入新专业角色的机会。应进行更多研究以评估其在其他健康问题居家护理中的有效性。

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