Northway Ruth, Rees Stacey, Davies Michelle, Williams Sharon
School of Care Sciences, University of South Wales, Pontypridd, UK.
Llanfrechfa Grange, Aneurin Bevan University Health Board, Llanfrechfa, Cwmbran, UK.
J Clin Nurs. 2017 Dec;26(23-24):5160-5168. doi: 10.1111/jocn.14065. Epub 2017 Oct 4.
To review hospital passports currently in use for people with intellectual disabilities in the UK and to make recommendations for practice.
Hospital passports have been introduced internationally to address communication barriers that may limit access to appropriate health care for people with intellectual disabilities. They are viewed as promoting patient safety and person-centred care but their format may vary, they are not always used appropriately, and hence, their effectiveness may be limited.
Qualitative content analysis.
Sixty hospital passports in use in the UK were reviewed against a coding frame by two members of the research team. Areas of interest included key patient and primary care information, support network details, consent and capacity, support required in relation to activities of daily living, length of the document and completion details. Results were entered into Excel.
Considerable variation was found between documents in terms of terminology, length and format. Most included information regarding communication and support needs although some omitted important information such as allergies, risk assessment and need for reasonable adjustments.
Considerable variation exists between current hospital passports, which may limit their effectiveness: key information required may not be included and/or it may not be easy to locate. Greater standardisation of documents is required, but this process should include input from all key stakeholders.
Internationally nurses provide care for people with intellectual disabilities and others with communication difficulties. Hospital passports are one way of enhancing safety and person-centred care, need to be accessed and used as a basis for care planning. However, variation in format may limit this effectiveness and nurses should work with others to develop a more standardised approach, which better meets the needs of all stakeholders.
回顾英国目前用于智障人士的医院护照,并提出实践建议。
医院护照已在国际上推行,以解决可能限制智障人士获得适当医疗保健的沟通障碍。它们被视为促进患者安全和以患者为中心的护理,但格式可能各不相同,使用也并不总是恰当,因此其有效性可能有限。
定性内容分析。
研究团队的两名成员根据编码框架对英国正在使用的60份医院护照进行了审查。关注领域包括关键患者和初级护理信息、支持网络细节、同意与能力、日常生活活动所需支持、文件长度和填写细节。结果录入Excel。
文件在术语、长度和格式方面存在很大差异。大多数文件包含了有关沟通和支持需求的信息,尽管有些遗漏了重要信息,如过敏、风险评估和合理调整的需求。
当前的医院护照存在很大差异,这可能会限制其有效性:所需的关键信息可能未被包含,和/或可能不容易找到。文件需要更大程度的标准化,但这一过程应包括所有关键利益相关者的参与。
在国际上,护士为智障人士和其他有沟通困难的人提供护理。医院护照是加强安全和以患者为中心的护理的一种方式,需要作为护理计划的基础来查阅和使用。然而,格式的差异可能会限制其有效性,护士应与其他人合作,制定一种更标准化的方法,以更好地满足所有利益相关者的需求。