Kada Olivia, Janig Herbert, Likar Rudolf, Cernic Karl, Pinter Georg
Carinthia University of Applied Sciences, Feldkirchen, Austria.
Alps Adria University of Klagenfurt, Austria.
Gerontol Geriatr Med. 2017 Mar 21;3:2333721417696671. doi: 10.1177/2333721417696671. eCollection 2017 Jan-Dec.
Hospital transfers from nursing homes (NHs) are frequent, burdensome for residents, and often avoidable. The evidence regarding the effectiveness of interventions to reduce avoidable transfers is limited, and most projects focus on nurses' knowledge and skills. In the present project, interventions focusing on nurses and physicians are integrated, elaborated, and implemented in 17 NHs. Results of the 6 months preintervention period are reported. Hospital transfer rates ( = 1,520) and basic data on all residents ( = 1,238) were collected prospectively. Nurses' preintervention knowledge and self-efficacy were assessed using standardized questionnaires ( = 330). Many hospital transfers were initiated by nurses without physician involvement, polypharmacy was common, and a high potential for reducing transfers by increasing physician presence was observed. Nurses showed rather low knowledge but high self-efficacy. The results are discussed against the background of the interventions including enhancement of physician presence and geriatric quality circles.
从养老院（NHs）转至医院的情况很常见，这给居民带来负担，且往往是可避免的。关于减少可避免转院的干预措施有效性的证据有限，并且大多数项目侧重于护士的知识和技能。在本项目中，针对护士和医生的干预措施在17家养老院进行了整合、细化并实施。报告了干预前6个月的结果。前瞻性收集了医院转院率（n = 1520）以及所有居民的基本数据（n = 1238）。使用标准化问卷评估了护士干预前的知识和自我效能感（n = 330）。许多医院转院是由护士发起的，医生并未参与，多重用药情况常见，并且观察到通过增加医生在场来减少转院的潜力很大。护士的知识水平较低，但自我效能感较高。结合包括增加医生在场和老年病质量改进小组在内的干预措施背景对结果进行了讨论。
