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增加接受精神评估的门诊患者数量:一项疼痛与姑息治疗服务质量改进项目。

Increasing the Number of Outpatients Receiving Spiritual Assessment: A Pain and Palliative Care Service Quality Improvement Project.

作者信息

Gomez-Castillo Blanca J, Hirsch Rosemarie, Groninger Hunter, Baker Karen, Cheng M Jennifer, Phillips Jayne, Pollack John, Berger Ann M

机构信息

Georgetown University Medical Center, Washington, DC; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland, USA.

Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland, USA.

出版信息

J Pain Symptom Manage. 2015 Nov;50(5):724-9. doi: 10.1016/j.jpainsymman.2015.05.012. Epub 2015 Jul 10.

Abstract

BACKGROUND

Spirituality is a patient need that requires special attention from the Pain and Palliative Care Service team. This quality improvement project aimed to provide spiritual assessment for all new outpatients with serious life-altering illnesses.

MEASURES

Percentage of new outpatients receiving spiritual assessment (Faith, Importance/Influence, Community, Address/Action in care, psychosocial evaluation, chaplain consults) at baseline and postinterventions.

INTERVENTION

Interventions included encouraging clinicians to incorporate adequate spiritual assessment into patient care and implementing chaplain covisits for all initial outpatient visits.

OUTCOMES

The quality improvement interventions increased spiritual assessment (baseline vs. postinterventions): chaplain covisits (25.5% vs. 50%), Faith, Importance/Influence, Community, Address/Action in care completion (49% vs. 72%), and psychosocial evaluation (89% vs. 94%).

CONCLUSIONS/LESSONS LEARNED: Improved spiritual assessment in an outpatient palliative care clinic setting can occur with a multidisciplinary approach. This project also identifies data collection and documentation processes that can be targeted for improvement.

摘要

背景

精神需求是患者的一种需求,需要疼痛与姑息治疗服务团队给予特别关注。这个质量改进项目旨在为所有患有严重改变生活疾病的新门诊患者提供精神评估。

措施

新门诊患者在基线期和干预后接受精神评估(信仰、重要性/影响、社区、护理中的应对/行动、心理社会评估、牧师会诊)的百分比。

干预措施

干预措施包括鼓励临床医生将充分的精神评估纳入患者护理,并为所有初次门诊就诊安排牧师共同问诊。

结果

质量改进干预措施提高了精神评估水平(基线期与干预后对比):牧师共同问诊(25.5% 对 50%)、信仰、重要性/影响、社区、护理中的应对/行动完成情况(49% 对 72%)以及心理社会评估(89% 对 94%)。

结论/经验教训:在门诊姑息治疗诊所环境中,采用多学科方法可以改善精神评估。该项目还确定了可针对改进的数据收集和记录流程。

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