Deakin University, Burwood, Vic., Australia.
Caulfield Hospital, Caulfield, Vic., Australia.
J Clin Nurs. 2018 Nov;27(21-22):4089-4099. doi: 10.1111/jocn.14553. Epub 2018 Jul 23.
To explore allied health staff perceptions on the role of nurses in subacute care wards.
A consequence of earlier discharge from acute hospitals is higher acuity of patients in subacute care. The impact on nurses' roles and required skill mix remains unknown. In the same way, nurses' integration into the rehabilitation team is ambiguous.
Descriptive qualitative inquiry.
Semistructured interviews conducted with 14 allied health staff from one subacute care facility in Melbourne, Australia. Interviews were audio-recorded and transcribed verbatim. Analysis using the framework approach.
Three main themes were evident: (a) the changing context of care: patient acuity, rapid patient discharge and out-dated buildings influenced care; (b) generalist as opposed to specialist rehabilitation nurses: a divide between traditional nursing roles of clinical and personal care and a specialist rehabilitation role; and (c) interdisciplinary relations and communication demonstrated lack of respect for nurses and integrating holistic care into everyday routines.
Allied health staff had limited understanding of nurses' role in subacute care, and expectations varied. Power relationships appeared to hamper teamwork. Failure to include nurses in team discussions and decision-making could hinder patient outcomes. Progressing patients to levels of independence involves both integrating rehabilitation into activities of daily living with nurses and therapy-based sessions. Promotion of the incorporation of nursing input into patient rehabilitation is needed with both nurses and allied health staff.
Lack of understanding of the nurses' role contributes to lack of respect for the nursing contribution to rehabilitation. Nurses have a key role in rehabilitation sometimes impeded by poor teamwork with allied health staff. Processes in subacute care wards need examination to facilitate more effective team practices inclusive of nurses. Progressing patients' independence in rehabilitation units involves activities of daily living with nurses as much as therapy-based sessions.
探索辅助医疗人员对护士在亚急性护理病房中角色的看法。
从急性医院更早出院的结果是亚急性护理中患者的病情更严重。对护士角色和所需技能组合的影响尚不清楚。同样，护士融入康复团队的情况也不明确。
描述性定性研究。
对澳大利亚墨尔本一家亚急性护理机构的 14 名辅助医疗人员进行半结构化访谈。访谈进行了录音，并逐字记录下来。使用框架方法进行分析。
有三个主要主题：（a）护理环境的变化：患者的病情严重程度、快速出院和陈旧的建筑影响了护理；（b）通才与专科康复护士：传统护理角色的临床和个人护理与专科康复角色之间的分歧；（c）跨学科关系和沟通表明对护士缺乏尊重，以及将整体护理纳入日常工作中。
辅助医疗人员对护士在亚急性护理中的角色的理解有限，期望也各不相同。权力关系似乎阻碍了团队合作。未能让护士参与团队讨论和决策可能会影响患者的康复结果。将患者推进到独立水平需要将康复融入护士和治疗师的日常生活活动中。需要促进将护理投入纳入患者康复，包括护士和辅助医疗人员。
对护士角色的理解不足导致对护士对康复的贡献缺乏尊重。护士在康复方面发挥着关键作用，但有时会因与辅助医疗人员的团队合作不佳而受到阻碍。亚急性护理病房的流程需要进行审查，以促进更有效的团队实践，包括护士。在康复病房中提高患者的独立性需要护士参与日常生活活动，以及治疗性的课程。
