Müller Christiane A, Fleischmann Nina, Cavazzini Christoph, Heim Susanne, Seide Svenja, Geister Christina, Tetzlaff Britta, Hoell Andreas, Werle Jochen, Weyerer Siegfried, Scherer Martin, Hummers Eva
Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany.
Faculty V - Health, Religious Education and Social Affairs, University of Applied Sciences and Arts, Blumhardtstraße 2, 30625, Hannover, Germany.
BMC Fam Pract. 2018 Jan 11;19(1):14. doi: 10.1186/s12875-017-0678-1.
Given both the increase of nursing home residents forecast and challenges of current interprofessional interactions, we developed and tested measures to improve collaboration and communication between nurses and general practitioners (GPs) in this setting. Our multicentre study has been funded by the German Federal Ministry of Education and Research (FK 01GY1124).
The measures were developed iteratively in a continuous process, which is the focus of this article. In part 1 "exploration of the situation", interviews were conducted with GPs, nurses, nursing home residents and their relatives focusing on interprofessional interactions and medical care. They were analysed qualitatively. Based on these results, in part 2 "development of measures to improve collaboration", ideas for improvement were developed in nine focus groups with GPs and nurses. These ideas were revisited in a final expert workshop. We analysed the focus groups and expert workshop using mind mapping methods, and finally drew up the compilation of measures. In an exploratory pilot study "study part 3" four nursing homes chose the measures they wanted to adopt. These were tested for three months. Feasibility and acceptance of the measures were evaluated via guideline interviews with the stakeholders which were analysed by content analyses.
Six measures were generated: meetings to establish common goals, main contact person, standardised pro re nata medication, introduction of name badges, improved availability of nurse/GP and standardised scheduling/ procedure for nursing home visits. In the pilot study, the measures were implemented in four nursing homes. GPs and nurses reviewed five measures as feasible and acceptable, only the designation of a "main contact person" was not considered as an improvement.
Six measures to improve collaboration and communication could be compiled in a multistep qualitative process respecting the perspectives of involved stakeholders. Five of the six measures were positively assessed in an exploratory pilot study. They could easily be transferred into the daily routine of other nursing homes, as no special models have to exist in advance. Impact of the measures on patient oriented outcomes should be examined in further research.
Not applicable.
鉴于预测的养老院居民数量增加以及当前跨专业互动面临的挑战，我们制定并测试了相关措施，以改善养老院环境中护士与全科医生（GP）之间的协作与沟通。我们的多中心研究由德国联邦教育与研究部资助（项目编号：01GY1124）。
这些措施是在一个持续的过程中反复制定的，这也是本文的重点。在第1部分“情况探索”中，对全科医生、护士、养老院居民及其亲属进行了访谈，重点关注跨专业互动和医疗护理。对访谈结果进行了定性分析。基于这些结果，在第2部分“改善协作措施的制定”中，与全科医生和护士组成的九个焦点小组提出了改进想法。这些想法在最后的专家研讨会上进行了重新审视。我们使用思维导图方法对焦点小组和专家研讨会进行了分析，最终制定了措施汇编。在探索性试点研究“第3部分研究”中，四家养老院选择了他们想要采用的措施。这些措施进行了为期三个月的测试。通过与利益相关者进行的指导性访谈评估措施的可行性和可接受性，并通过内容分析进行分析。
产生了六项措施：建立共同目标的会议、主要联系人、标准化按需用药、佩戴姓名徽章、提高护士/全科医生的可及性以及标准化养老院探访的日程安排/程序。在试点研究中，这些措施在四家养老院实施。全科医生和护士认为五项措施可行且可接受，只有指定“主要联系人”未被视为一项改进。
通过尊重相关利益者的观点，在一个多步骤的定性过程中可以制定出六项改善协作与沟通的措施。六项措施中的五项在探索性试点研究中得到了积极评价。它们可以很容易地应用到其他养老院的日常工作中，因为无需预先存在特殊模式。这些措施对以患者为导向的结果的影响应在进一步研究中进行考察。
不适用。
