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[西西里岛卫生局“心脏病事件入院后出院及与患者沟通的区域建议”法令]

[The Health Department of Sicily "Regional recommendations for hospital discharge and communication with patients after admission due to a cardiologic event" decree].

作者信息

Abrignani Maurizio Giuseppe, De Luca Giovanni, Gabriele Michele, Tourkmani Nidal

出版信息

Monaldi Arch Chest Dis. 2014 Jun;82(2):93-104. doi: 10.4081/monaldi.2014.50.

Abstract

Mortality and rehospitalizations still remain high after discharge for an acute cardiologic event. In this context, hospital discharge represents a potential pitfall for heart disease patients. In the setting of care transitions, the discharge letter is the main instrument of communication between hospital and primary care. Communication, besides, is an integral part of high-quality, patient-centered interventions aimed at improving the discharge process. Inadequate information at discharge significantly affects the quality of treatment compliance and the adoption of lifestyle modifications for an effective secondary prevention. The Health Department of Sicily, in 2013, established a task force with the aim to elaborate "Regional recommendations for hospital discharge and communication with patients after admission due to a cardiologic event", inviting to participate GICR-IACPR and many other scientific societies of cardiology and primary care, as discharge letter and communication are fundamental junctions of care transitions in cardiology. These recommendations have been published as a specific decree and contain: a structured model of discharge letter, which includes all of the parameters characterizing patients at high clinical risk, high thrombotic risk and low risk according to the Consensus document ANMCO/GICR-IACPR/GISE; is thus possible to identify these patients, choosing consequently the most appropriate follow-up pathways. A particular attention has been given to the "Medication Reconciliation" and to the identification of therapeutic targets; an educational Kit, with different forms on cardiac diseases, risk factors, drugs and lifestyle; a check-list about information given to the patient and caregivers. The "Recommendations" represent, in conclusion, the practical realization of the fruitful cooperation between scientific societies and political-administrative institutions that has been realized in Sicily in the last years.

摘要

急性心脏事件出院后的死亡率和再住院率仍然很高。在这种情况下,医院出院对心脏病患者来说是一个潜在的陷阱。在护理过渡的背景下,出院小结是医院与基层医疗之间沟通的主要工具。此外,沟通是旨在改善出院流程的高质量、以患者为中心的干预措施的一个组成部分。出院时信息不足会显著影响治疗依从性以及为有效二级预防而采取生活方式改变的情况。西西里岛卫生部在2013年成立了一个特别工作组,旨在制定“因心脏事件入院后医院出院及与患者沟通的地区建议”,邀请GICR - IACPR和许多其他心脏病学及基层医疗科学协会参与,因为出院小结和沟通是心脏病护理过渡的基本环节。这些建议已作为一项特定法令发布,内容包括:一个结构化的出院小结模型,根据ANMCO/GICR - IACPR/GISE共识文件,该模型涵盖了所有表征高临床风险、高血栓形成风险和低风险患者的参数;因此能够识别这些患者,进而选择最合适的随访途径。对“用药核对”和治疗目标的识别给予了特别关注;一个包含关于心脏病、危险因素、药物和生活方式等不同形式内容的教育工具包;一份关于向患者和护理人员提供信息的核对清单。总之,这些“建议”体现了西西里岛近年来科学协会与政治行政机构之间卓有成效合作的实际成果。

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