发展绿色病房护理团队：发展和实施的变化。
Developing the green house nursing care team: variations on development and implementation.
机构信息
*Address correspondence to Barbara J. Bowers, RN, School of Nursing, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792-2455. E-mail:
出版信息
Gerontologist. 2014 Feb;54 Suppl 1(Suppl 1):S53-64. doi: 10.1093/geront/gnt109.
PURPOSE OF THE STUDY
A core component of the Green House nursing home model is an altered supervisory relationship between the nurse and direct care workers. Some have expressed concern that the Green House model might weaken professional nursing oversight, threatening the quality of clinical care. This qualitative research study explores the role of the nurse as implemented in the Green House model, focusing on how variations in the nursing team influence clinical care practices.
DESIGN AND METHODS
Dimensional analysis, a "second generation" grounded theory methodology, was used to conduct this study. Data were collected through observations and interviews with 37 nurses, 68 CNAs, and 11 Guides working at 11 Green House sites.
RESULTS
Implementation of the nursing role within the Green House model varied both within and across sites. Four nursing model types were identified: Traditional, Visitor, Parallel, and Integrated. Care processes, CNA/Shahbaz skill development, and worker stress varied with each nursing model.
IMPLICATIONS
Government policies have been enacted to support culture change. However, there is currently little guidance for regulators, providers, or consumers regarding variability in how culture change practices are implemented and consequences of these variations. This article outlines the importance of understanding these practices at a level of detail that distinguishes and supports those that are most promising.
研究目的
绿房子养老院模式的一个核心组成部分是护士与直接护理人员之间改变了的监督关系。有人表示担心，绿房子模式可能会削弱专业护理监督，从而威胁到临床护理的质量。这项定性研究探讨了绿房子模式中护士的角色，重点关注护理团队的变化如何影响临床护理实践。
设计与方法
维度分析，一种“第二代”扎根理论方法，用于进行这项研究。通过对在 11 个绿房子地点工作的 37 名护士、68 名 CNA 和 11 名导游进行观察和访谈，收集了数据。
结果
绿房子模式中护理角色的实施在不同的地点和不同的地点之间存在差异。确定了四种护理模式类型：传统型、访客型、并行型和综合型。护理过程、CNA/Shahbaz 技能发展和工人压力因每种护理模式而异。
意义
政府已经制定了支持文化变革的政策。然而，目前对于监管机构、提供者或消费者来说，关于文化变革实践的实施方式的变化以及这些变化的后果，几乎没有指导。本文概述了在细节层面上理解这些实践的重要性，这些实践可以区分和支持最有前途的实践。
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