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为急性冠状动脉综合征原住民患者实施合作模式:一名原住民医院联络官和一名心脏专科护士共同努力改善医院护理。

Implementing a working together model for Aboriginal patients with acute coronary syndrome: an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse working together to improve hospital care.

作者信息

Daws Karen, Punch Amanda, Winters Michelle, Posenelli Sonia, Willis John, MacIsaac Andrew, Rahman Muhammad Aziz, Worrall-Carter Linda

机构信息

St Vincent's Hospital, Melbourne, Vic., Australia. Email: ; ; ; ;

St Vincent's Centre for Nursing Research (SVCNR), Australian Catholic University, Melbourne, Vic., Australia. Email: ;

出版信息

Aust Health Rev. 2014 Nov;38(5):552-6. doi: 10.1071/AH13211.

Abstract

Acute coronary syndrome (ACS) contributes to the disparity in life expectancy between Aboriginal and non-Aboriginal Australians. Improving hospital care for Aboriginal patients has been identified as a means of addressing this disparity. This project developed and implemented a working together model of care, comprising an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse, providing care coordination specifically directed at improving attendance at cardiac rehabilitation services for Aboriginal Australians in a large metropolitan hospital in Melbourne. A quality improvement framework using a retrospective case notes audit evaluated Aboriginal patients' admissions to hospital and identified low attendance rates at cardiac rehabilitation services. A working together model of care coordination by an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse was implemented to improve cardiac rehabilitation attendance in Aboriginal patients admitted with ACS to the cardiac wards of the hospital. A retrospective medical records audit showed that there were 68 Aboriginal patients admitted to the cardiac wards with ACS from 1 July 2008 to 30 June 2011. A referral to cardiac rehabilitation was recorded for 42% of these. During the implementation of the model of care, 13 of 15 patients (86%) received a referral to cardiac rehabilitation and eight of the 13 (62%) attended. Implementation of the working together model demonstrated improved referral to and attendance at cardiac rehabilitation services, thereby, has potential to prevent complications and mortality. WHAT IS KNOWN ABOUT THE TOPIC?: Aboriginal Australians experience disparities in access to recommended care for acute coronary syndrome. This may contribute to the life expectancy gap between Aboriginal and non-Aboriginal Australians. WHAT DOES THIS PAPER ADD?: This paper describes a model of care involving an Aboriginal Hospital Liaisons Officer and a specialist cardiac nurse working together to improve hospital care and attendance at cardiac rehabilitation services for Aboriginal Australians with acute coronary syndrome. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS?: The working together model of care could be implemented across mainstream health services where Aboriginal people attend for specialist care.

摘要

急性冠状动脉综合征(ACS)导致了澳大利亚原住民与非原住民预期寿命的差异。改善对原住民患者的医院护理已被视为解决这一差异的一种方式。本项目开发并实施了一种协同护理模式,该模式由一名原住民医院联络官和一名专科心脏护士组成,专门提供护理协调,旨在提高墨尔本一家大型都市医院中澳大利亚原住民参加心脏康复服务的比例。一个使用回顾性病例记录审核的质量改进框架评估了原住民患者的住院情况,并发现心脏康复服务的出勤率较低。实施了由一名原住民医院联络官和一名专科心脏护士组成的协同护理协调模式,以提高入住该医院心脏科病房的急性冠状动脉综合征原住民患者的心脏康复出勤率。一项回顾性病历审核显示,2008年7月1日至2011年6月30日期间,有68名原住民患者因急性冠状动脉综合征入住心脏科病房。其中42%的患者有心脏康复转诊记录。在护理模式实施期间,15名患者中有13名(86%)接受了心脏康复转诊,13名患者中有8名(6%)参加了心脏康复。协同护理模式的实施表明,心脏康复服务的转诊率和出勤率有所提高,因此有可能预防并发症和降低死亡率。关于该主题已知的信息:澳大利亚原住民在获得急性冠状动脉综合征推荐护理方面存在差异。这可能导致澳大利亚原住民与非原住民之间的预期寿命差距。本文补充了什么内容:本文描述了一种护理模式,即一名原住民医院联络官和一名专科心脏护士共同努力,改善对患有急性冠状动脉综合征的澳大利亚原住民的医院护理和心脏康复服务出勤率。对从业者有何启示:协同护理模式可在原住民前往接受专科护理的主流卫生服务机构中实施。

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