Attfield J, Brown S, Carter T, Callaghan P
Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK.
Institute of Mental Health, Nottingham, UK.
J Psychiatr Ment Health Nurs. 2017 Aug;24(6):348-357. doi: 10.1111/jpm.12386.
WHAT IS KNOWN ON THE SUBJECT?: There is some evidence reporting the value of diagnostic-driven Integrated Care Pathways (ICPs) in reducing service users' length of inpatient stay, readmission rates and follow-up within seven days of discharge, but this evidence is untested in studies comparing care using ICP with other forms of care planning. WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE?: This study present findings from research comparing care in a Trust that uses an ICP with a Trust using another form of care planning to direct the care of people diagnosed with schizophrenia. We were interested particularly in whether using an ICP was linked to length of inpatient stay, readmission rates and follow-up care within seven days of discharge. The results compare ICP driven care with another form of care. This study adds to the international evidence by being among the first to compare empirically, outcomes in a mental health Trust using an ICP with a Trust not using an ICP to direct care. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses are central to the delivery of the psychosocial aspects of ICPs in particular and judging by the link between psychosocial interventions and quality of mental health care, it is possible that nurse-led psychosocial interventions contributed to the reduced length of stay.
Background Integrated Care Pathways (ICPs) are used to deliver mental health services, yet evidence relating to outcomes is mixed. Aim To compare service users' length of stay, readmission rates and follow-up within 7 days of discharge in a mental health Trust using an ICP to direct the care of people diagnosed with schizophrenia with a Trust using a nonICP method of care planning in England.
A cohort study with a random sample of 400 service users with outcomes analysed retrospectively. Results The ICP Trust had a 13.5 day shorter average length of stay, this difference was statistically significant. No statistically significant differences were observed in rates of readmission or follow-up within 7 days of discharge. Discussion and implications Mental health nurses are central to the delivery of the psychosocial aspects of ICPs in particular and judging by the link between psychosocial interventions and quality of mental health care, it is possible that nurse-led psychosocial interventions contributed to the reduced length of stay.
关于该主题已知的信息有哪些？：有一些证据报告了诊断驱动的综合护理路径（ICP）在缩短服务使用者住院时间、再入院率以及出院后七天内的随访方面的价值，但在比较使用ICP的护理与其他形式护理计划的研究中，这一证据尚未得到验证。本研究对现有知识的补充是什么？：本研究展示了一项对比研究的结果，该研究对比了一家使用ICP的信托机构与一家使用另一种护理计划形式来指导精神分裂症患者护理的信托机构。我们特别关注使用ICP是否与住院时间、再入院率以及出院后七天内的后续护理有关。结果将基于ICP的护理与另一种护理形式进行了比较。本研究作为首批通过实证比较使用ICP的心理健康信托机构与不使用ICP指导护理的信托机构的结果，为国际证据增添了内容。对实践有何启示？：心理健康护士对于特别是ICP心理社会方面的提供至关重要，并且从心理社会干预与心理健康护理质量之间的联系来看，由护士主导的心理社会干预有可能促成了住院时间的缩短。
背景综合护理路径（ICP）用于提供心理健康服务，但关于结果的证据参差不齐。目的比较在英格兰一家使用ICP指导精神分裂症患者护理的心理健康信托机构与一家使用非ICP护理计划方法的信托机构中，服务使用者的住院时间、再入院率以及出院后7天内的随访情况。
一项队列研究，随机抽取400名服务使用者作为样本，对结果进行回顾性分析。结果使用ICP的信托机构平均住院时间短13.5天，这一差异具有统计学意义。在出院后7天内的再入院率或随访方面未观察到统计学上的显著差异。讨论与启示心理健康护士对于特别是ICP心理社会方面的提供至关重要，并且从心理社会干预与心理健康护理质量之间的联系来看，由护士主导的心理社会干预有可能促成了住院时间的缩短。
