Bliss Donna Z, Westra Bonnie L, Savik Kay, Hou Yuefeng
Donna Z. Bliss, PhD, RN, FAAN, FGSA, Professor, School of Nursing, University of Minnesota, Minneapolis. Bonnie L. Westra, PhD, RN, FAAN, FACMI, Associate Professor, School of Nursing, University of Minnesota, Minneapolis. Kay Savik, MS, Biostatistician, School of Nursing, University of Minnesota, Minneapolis. Yuefeng Hou, MS, Research Assistant, School of Nursing, University of Minnesota, Minneapolis.
Home Healthc Nurse. 2014 Jan;32(1):31-8. doi: 10.1097/NHH.0000000000000012.
To assess whether there was a significant improvement and stabilization (not worse at discharge) in pressure ulcers, lower extremity venous ulcers, surgical wounds, urinary incontinence, bowel incontinence, and urinary tract infections in home health care (HHC) patients cared for by a certified WOC nurse.
There were 449,170 episodes of care from a national convenience sample of 785 HHC agencies with 447,309 nonmaternity, adult patients between October 1, 2008, and December 31, 2009.
Descriptive and comparative.
Data from the Outcome and Assessment Information Set documented by HHC clinicians were analyzed using mixed-effects logistic regression, propensity score analysis, and appropriate parametric and nonparametric tests. An Internet survey identified whether WOC nurses provided care to patients in an HHC agency. Home health care agencies identified records of patients receiving WOC nurse visits/consults.
An HHC patient assigned to a WOC nurse had surgical wounds, pressure ulcers, and incontinence problems that were significantly worse than HHC patients not assigned to a WOC nurse. Patients cared for by a WOC nurse showed significant improvement and stabilization of the number of pressure ulcers and surgical wounds and the frequency of urinary and bowel incontinence, despite having problems that were more severe than other patients. Home health care patients not cared for by WOC nurses, with less-severe wound and incontinence problems, also got better.
WOC nurses are effective in achieving positive health outcomes for pressure ulcers, surgical wounds, and incontinence in HHC patients with severe health problems.
评估在接受认证造口治疗师（WOC）护理的家庭医疗保健（HHC）患者中，压疮、下肢静脉溃疡、手术伤口、尿失禁、大便失禁和尿路感染是否有显著改善和稳定（出院时情况不恶化）。
2008年10月1日至2009年12月31日期间，来自785家HHC机构的全国便利样本中有449,170次护理事件，涉及447,309名非产妇成年患者。
描述性和比较性。
使用混合效应逻辑回归、倾向得分分析以及适当的参数和非参数检验，对HHC临床医生记录的结果与评估信息集中的数据进行分析。通过互联网调查确定WOC护士是否在HHC机构为患者提供护理。家庭医疗保健机构确定接受WOC护士访视/咨询的患者记录。
分配到WOC护士护理的HHC患者的手术伤口、压疮和失禁问题比未分配到WOC护士护理的HHC患者严重得多。尽管存在比其他患者更严重的问题，但由WOC护士护理的患者在压疮数量、手术伤口以及尿失禁和大便失禁频率方面显示出显著改善和稳定。伤口和失禁问题较轻、未接受WOC护士护理的家庭医疗保健患者情况也有所改善。
对于存在严重健康问题的HHC患者，WOC护士在实现压疮、手术伤口和失禁的积极健康结果方面是有效的。
