养老院居民转至急诊科的情况：高转院率与低转院率养老院之间的组织差异
Transfer of nursing home residents to emergency departments: organizational differences between nursing homes with high vs. low transfer rates.
作者信息
Kirsebom Marie, Hedström Mariann, Pöder Ulrika, Wadensten Barbro
机构信息
Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden.
出版信息
Nurs Open. 2016 Oct 25;4(1):41-48. doi: 10.1002/nop2.68. eCollection 2017 Jan.
Abstract
AIM
To explore possible factors in the organization of nursing homes that could be related to differences in the rate of transfer of residents from nursing homes to emergency department.
DESIGN
Explorative.
METHOD
In a single municipality, qualitative and quantitative data were collected from documents and through semi-structured interviews with 11 RNs from five nursing homes identified as having the highest vs. six identified as having the lowest transfer rates to emergency department. Data were analysed by non-parametric tests and basic content analysis.
RESULTS
All nursing homes in the highest transfer rate group and one in the lowest transfer rate group were run by private for-profit providers. Compared with the group, the group had fewer updated advance care plans and the RNs interviewed had less work experience in care of older people and less training in care of persons with dementia. There was no difference in nursing home size or staff/resident ratio. The RNs described similar possibilities to provide palliative care, medical equipment and perceived medical support from GPs.
摘要
目的
探讨养老院组织中可能与居民从养老院转至急诊科的比率差异相关的因素。
设计
探索性研究。
方法
在一个单一的市政辖区内，从文件中收集定性和定量数据，并通过对来自五家被确定为转至急诊科比率最高的养老院和六家被确定为转至急诊科比率最低的养老院的11名注册护士进行半结构化访谈来收集数据。数据通过非参数检验和基本内容分析进行分析。
结果
转至急诊科比率最高组的所有养老院以及转至急诊科比率最低组的一家养老院由私营营利性机构运营。与低比率组相比，高比率组更新的预先护理计划较少，接受访谈的注册护士在照顾老年人方面的工作经验较少，在照顾痴呆症患者方面接受的培训也较少。养老院规模或工作人员/居民比率没有差异。注册护士描述了提供姑息治疗、医疗设备以及从全科医生那里获得医疗支持的类似可能性。
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本文引用的文献
1
General practitioners' experiences as nursing home medical consultants.全科医生作为养老院医疗顾问的经历。
Scand J Caring Sci. 2017 Mar;31(1):37-44. doi: 10.1111/scs.12310. Epub 2016 Apr 4.
2
Is the competence of Swedish Registered Nurses working in municipal care of older people merely a question of age and postgraduate education?在市政老年护理机构工作的瑞典注册护士的能力仅仅取决于年龄和研究生学历吗？
Scand J Caring Sci. 2015 Jun;29(2):307-16. doi: 10.1111/scs.12164. Epub 2014 Sep 12.
3
Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study.九个欧洲国家的护士配备和教育与医院死亡率：回顾性观察研究。
Lancet. 2014 May 24;383(9931):1824-30. doi: 10.1016/S0140-6736(13)62631-8. Epub 2014 Feb 26.
4
The frequency of and reasons for acute hospital transfers of older nursing home residents.老年疗养院居民急性住院转移的频率和原因。
Arch Gerontol Geriatr. 2014 Jan-Feb;58(1):115-20. doi: 10.1016/j.archger.2013.08.002. Epub 2013 Aug 19.
5
Hospice for nursing home residents: does ownership type matter?养老院临终关怀：所有权类型重要吗？
J Palliat Med. 2013 Oct;16(10):1221-6. doi: 10.1089/jpm.2012.0544. Epub 2013 Jul 30.
6
Older patients referred by community nurses to emergency departments--a descriptive cross-sectional follow-up study in a Swedish context.
Scand J Caring Sci. 2014 Mar;28(1):97-103. doi: 10.1111/scs.12044. Epub 2013 Apr 15.
7
Communication and coordination during transition of older persons between nursing homes and hospital still in need of improvement.老年人在养老院和仍有需求的医院之间的过渡期间的沟通和协调仍有待改善。
J Adv Nurs. 2013 Apr;69(4):886-95. doi: 10.1111/j.1365-2648.2012.06077.x. Epub 2012 Jun 29.
8
Transitions in care for older adults with and without dementia.老年人（有和无痴呆症）的护理过渡。
J Am Geriatr Soc. 2012 May;60(5):813-20. doi: 10.1111/j.1532-5415.2012.03905.x.
9
Hospital transfers of nursing home residents with advanced dementia.养老院中患有晚期痴呆症的居民的医院转院。
J Am Geriatr Soc. 2012 May;60(5):905-9. doi: 10.1111/j.1532-5415.2012.03919.x. Epub 2012 Mar 16.
10
Geriatrician input into nursing homes reduces emergency hospital admissions.老年病医生对养老院的投入可减少急诊住院人数。
Arch Gerontol Geriatr. 2012 Sep-Oct;55(2):331-7. doi: 10.1016/j.archger.2011.10.014. Epub 2011 Nov 21.
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