Lannering Christina, Ernsth Bravell Marie, Johansson Linda
School of Health and Welfare, Institute of Gerontology, Jönköping University, Jönköping, Sweden.
Region Jönköping County, Futurum, Länssjukhuset Ryhov, Jönköping, Sweden.
Health Soc Care Community. 2017 May;25(3):1011-1020. doi: 10.1111/hsc.12400. Epub 2016 Oct 12.
A structured and systematic care process for preventive work, aimed to reduce falls, pressure ulcers and malnutrition among older people, has been developed in Sweden. The process involves risk assessment, team-based interventions and evaluation of results. Since development, this structured work process has become web-based and has been implemented in a national quality registry called 'Senior Alert' and used countrywide. The aim of this study was to describe nursing staff's experience of preventive work by using the structured preventive care process as outlined by Senior Alert. Eight focus group interviews were conducted during 2015 including staff from nursing homes and home-based nursing care in three municipalities. The interview material was subjected to qualitative content analysis. In this study, both positive and negative opinions were expressed about the process. The systematic and structured work flow seemed to only partly facilitate care providers to improve care quality by making better clinical assessments, performing team-based planned interventions and learning from results. Participants described lack of reliability in the assessments and varying opinions about the structure. Furthermore, organisational structures limited the preventive work.
瑞典已制定了一个用于预防工作的结构化、系统化护理流程，旨在减少老年人跌倒、压疮和营养不良的情况。该流程包括风险评估、基于团队的干预措施以及结果评估。自开发以来，这个结构化工作流程已实现网络化，并已在一个名为“老年警报”的国家质量登记处实施，并在全国范围内使用。本研究的目的是描述护理人员运用“老年警报”概述的结构化预防护理流程开展预防工作的经验。2015年期间进行了八次焦点小组访谈，参与人员包括来自三个市镇养老院和居家护理机构的工作人员。访谈材料进行了定性内容分析。在本研究中，对该流程既有正面评价也有负面评价。系统且结构化的工作流程似乎仅在一定程度上有助于护理人员通过进行更好的临床评估、实施基于团队的计划干预措施以及从结果中学习来提高护理质量。参与者描述了评估缺乏可靠性以及对结构存在不同意见。此外，组织结构也限制了预防工作。
