Kreitzer Mary Jo
Director, Center for Spirituality & Healing; Professor, School of Nursing, University of Minnesota, Minneapolis, MN, USA.
Rambam Maimonides Med J. 2015 Apr 29;6(2):e0016. doi: 10.5041/RMMJ.10200. eCollection 2015 Apr.
While the essence of nursing has long been whole person (body, mind, and spirit) and whole system-focused, in reality the contemporary practice of nursing in many settings around the globe has become increasingly fragmented and de-stabilized. Nursing shortages in many parts of the world are significant, and hierarchies and bureaucracies often remove nurses from the point of care, be that the bedside, home, or clinic, replacing them with less skilled workers and filling their time with documentation and other administrative tasks. Integrative nursing is a framework for providing whole person/whole system care that is relationship-based and person-centered and focuses on improving the health and wellbeing of caregivers as well as those they serve. It is aligned with what is being called the "triple aim" in the United States-an effort focused on improving the patient experience (quality and satisfaction), improving the health of populations, and reducing the cost of care. The principles of integrative nursing offer clear and specific guidance that can shape and impact patient care in all clinical settings.
虽然护理的本质长期以来一直是以整个人（身体、心理和精神）以及整个系统为重点，但实际上，全球许多地方的当代护理实践变得越来越碎片化和不稳定。世界许多地区存在严重的护理短缺问题，层级制度和官僚作风常常使护士远离护理现场，无论是床边、家中还是诊所，取而代之的是技能较低的工作人员，还让护士把时间花在文件记录和其他行政任务上。综合护理是一种提供整个人/整个系统护理的框架，它以关系为基础、以患者为中心，专注于改善护理人员及其服务对象的健康和福祉。它与美国所谓的“三重目标”相一致，即致力于改善患者体验（质量和满意度）、改善人群健康以及降低护理成本。综合护理的原则提供了清晰而具体的指导，能够在所有临床环境中塑造并影响患者护理。
