Sosebee Tonya, Potter Robert, Gilbert Valarie, Newcomb Patricia, Hampton Michelle
Author Affiliations: Assistant Chief Nursing Officer (Ms Sosebee) All Nursing Services, Texas Health Azle Hospital; Director (Mr Potter), Nursing Emergency Services; and Chief Nursing Officer (Ms Gilbert), all Nursing Services, Texas Health Methodist Hospital Azle; Nurse Scientist (Dr Newcomb), Nursing Operations, Texas Health Resources, Arlington; and Director (Dr Hampton), Nursing Operations, Texas Health Methodist Hospital, Fort Worth.
J Nurs Adm. 2017 Nov;47(11):565-570. doi: 10.1097/NNA.0000000000000544.
The objective of this study is to assess benefits of the acuity-adaptable (AA) care model in rural hospitals.
The AA model aims to provide care in the same space from admission to discharge regardless of acuity. Evidence is lacking to support claims that AA care will improve patient safety, increase nurse productivity, and improve patient/staff satisfaction in rural hospitals.
Patients admitted to a rural intensive care unit (ICU) were allocated to an AA group or an ICU group. Patients in the AA group remained in the ICU room through discharge. Patients in the ICU group transferred out of ICU when acuity permitted. Patient anxiety, depression, and perception of emotional care were measured. Staff responses were assessed qualitatively.
Acuity-adaptable patients reported significantly more anxiety and less perceived emotional care than ICU patients. Intensive care unit nurses resisted caring for less acute patients.
Disadvantages may outweigh benefits of AA care delivery in the rural ICU.
本研究的目的是评估农村医院中急性病适应性（AA）护理模式的益处。
AA模式旨在无论病情严重程度如何，在同一空间内为患者提供从入院到出院的护理。缺乏证据支持AA护理能提高农村医院患者安全、提高护士工作效率以及改善患者/工作人员满意度的说法。
入住农村重症监护病房（ICU）的患者被分配到AA组或ICU组。AA组患者直至出院都留在ICU病房。ICU组患者在病情允许时转出ICU。测量患者的焦虑、抑郁以及对情感护理的感受。对工作人员的反应进行定性评估。
与ICU患者相比，急性病适应性患者报告的焦虑明显更多，且对情感护理的感受更少。重症监护病房护士抵制护理病情较轻的患者。
在农村ICU中，AA护理模式的弊端可能超过益处。
