Small Deborah C, Small Robert M
Cleveland Clinic health system (CChs), Fairview and Lakewood Hospitals, USA.
Online J Issues Nurs. 2011 May 31;16(2):2.
Like every healthcare system today, the Cleveland Clinic health system is a combination of medical hospitals, institutes, and services in which the implementation of uniform care methodologies faces significant barriers. The guiding principle of the Cleveland Clinic, 'Patients First,' focuses on the principle of patient- and family-centered care (PFCC) but deliberately lacks details due to the wide scope of care delivered by the organization. The Stanley Shalom Zielony Institute of Nursing Excellence (the Nursing Institute) at the Cleveland Clinic was charged with standardizing nursing practice across a system with 11,000 registered nurses and 800 advanced practice nurses. The challenge involved providing firm direction on delivering PFCC that was appropriate for all clinical disciplines and could be implemented quickly across existing practices and technologies. Successful implementation required full engagement in the concept of PFCC by what the Institute for Healthcare Improvement has termed the 'hearts and minds' of nurses. To achieve these ends, development of a systemwide nursing practice model was initiated. In this article the authors identify the essence of PFCC, consider barriers to PFCC, review their process of developing PFCC, and describe how the Cleveland Clinic health system has implemented a PFCC nursing practice model. In doing so the authors explore how the concept of 'Passion for Nursing' was used to stimulate nurse engagement in PFCC.
与如今的每个医疗保健系统一样，克利夫兰诊所医疗系统是由医疗医院、研究所和服务组成的联合体，在其中实施统一的护理方法面临重大障碍。克利夫兰诊所的指导原则“患者至上”侧重于以患者和家庭为中心的护理（PFCC）原则，但由于该组织提供的护理范围广泛，故意缺乏细节。克利夫兰诊所的斯坦利·沙洛姆·齐洛尼卓越护理研究所（护理研究所）负责在一个拥有11000名注册护士和800名高级实践护士的系统中规范护理实践。这项挑战涉及为提供适用于所有临床学科且能在现有实践和技术中快速实施的PFCC提供明确指导。成功实施需要护士的“全心投入”，即医疗改进研究所所说的护士在思想和情感上完全接受PFCC理念。为实现这些目标，启动了全系统护理实践模式的开发。在本文中，作者确定了PFCC的本质，考虑了PFCC面临的障碍，回顾了他们开发PFCC的过程，并描述了克利夫兰诊所医疗系统如何实施PFCC护理实践模式。在此过程中，作者探讨了如何利用“对护理的热情”这一概念来激发护士参与PFCC。
