Kane R L, Garrard J, Skay C L, Radosevich D M, Buchanan J L, McDermott S M, Arnold S B, Kepferle L
School of Public Health, University of Minnesota, Minneapolis 55455.
Am J Public Health. 1989 Sep;79(9):1271-7. doi: 10.2105/ajph.79.9.1271.
We compared measures of quality of care and health services utilization in 30 nursing homes employing geriatric nurse practitioners with those in 30 matched control homes. Information for this analysis came from reviews of samples of patient records drawn at comparable periods before and after the geriatric NPs were employed. The measures of geriatric nurse practitioner impact were based on comparisons of changes from pre-NP to post-NP periods. Separate analyses were done for newly admitted and long-stay residents; a subgroup of homes judged to be best case examples was analyzed separately as well as the whole sample. Favorable changes were seen in two out of eight activity of daily living (ADL) measures: five of 18 nursing therapies; two of six drug therapies; six of eight tracers. There was some reduction in hospital admissions and total days in geriatric NP homes. Overall measures of medical attention showed a mixed pattern with some evidence of geriatric NP care substituted for physician care. These findings suggest that the geriatric NP has a useful role in nursing home care.
我们比较了30家聘用老年护理执业医师的疗养院与30家匹配的对照疗养院在护理质量和医疗服务利用方面的指标。该分析的信息来自于在聘用老年护理执业医师前后的可比时期抽取的患者记录样本的审查。老年护理执业医师影响的指标基于从聘用前到聘用后时期变化的比较。对新入院居民和长期居住居民进行了单独分析；一组被判定为最佳案例的疗养院以及整个样本也分别进行了分析。在八项日常生活活动（ADL）指标中的两项出现了有利变化：18项护理疗法中的五项；六项药物疗法中的两项；八项追踪指标中的六项。老年护理执业医师所在疗养院的住院次数和总住院天数有所减少。总体医疗护理指标呈现出混合模式，有一些证据表明老年护理执业医师的护理替代了医生的护理。这些发现表明老年护理执业医师在疗养院护理中发挥着有益作用。
