Briggs Marion C E, McElhaney Janet E
Northern Ontario School of Medicine, Sudbury, Canada.
Interdiscip Top Gerontol Geriatr. 2015;41:121-36. doi: 10.1159/000381204. Epub 2015 Jul 17.
This chapter underscores the importance of interprofessional collaboration in the care of frail older patients. Hospital-based care is emphasized because interprofessionalism is difficult in that setting since the setting is constantly changing and since multiple healthcare professionals care for many complex, very ill patients, only some of whom are frail older people. Interprofessionalism is particularly important and challenging in teaching units in the acute care setting, where many health professionals practice and learn together and team membership changes frequently. Learning is enhanced and interprofessionalism can enhance learning by viewing the patient as a key part of the teaching team. While 'best practice' interventions have been identified for frail older adults who are hospitalized, these interventions are not easily implemented in routine hospital care. Three interdependent processes in clinical practice--representation, sense-making, and improvisation--are described, which contribute to an understanding of how practices change when implemented in a way that takes the local context into account and keeps person-centered care as the central consideration.
本章强调了跨专业协作在体弱老年患者护理中的重要性。重点关注基于医院的护理，因为在这种环境中跨专业协作存在困难，原因在于环境不断变化，且有多名医疗保健专业人员护理许多复杂的重病患者，其中只有一部分是体弱老年人。在急性护理环境中的教学单元，跨专业协作尤为重要且具有挑战性，许多卫生专业人员在那里共同实践和学习，团队成员也经常变动。通过将患者视为教学团队的关键部分，学习效果得以增强，跨专业协作也能促进学习。虽然已确定针对住院体弱老年人的“最佳实践”干预措施，但这些干预措施在常规医院护理中并不容易实施。文中描述了临床实践中的三个相互依存的过程——呈现、意义建构和即兴发挥，这有助于理解在考虑当地情况并将以患者为中心的护理作为核心考量的情况下实施实践时，实践是如何发生变化的。
