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提升长期护理能力:支持机构提供静脉治疗服务

Building Capacity in Long-Term Care: Supporting Homes to Provide Intravenous Therapy.

作者信息

Papaioannou Alexandra, Hazzan Afeez Abiola, Ioannidis George, O'Donnell Denis, Broadhurst Daphne, Navare Hrishikesh, Hillier Loretta M, Simpson Diane, Loeb Mark

机构信息

Department of Medicine, Division of Geriatric Medicine, McMaster University, Hamilton, ON, Canada.

Geriatric Education and Research in Aging Sciences (GERAS) Centre, St. Peter's Hospital, Hamilton, ON, Canada.

出版信息

Can Geriatr J. 2018 Dec 30;21(4):310-319. doi: 10.5770/cgj.21.327. eCollection 2018 Dec.

Abstract

BACKGROUND

Typically, long-term care home (LTCH) residents are transferred to hospital to access intravenous (IV) therapy. The aim of this study was to pilot-test an in-home IV therapy service, and to describe outcomes and key informants' perceptions of this service.

METHOD

This service was pilot-tested in four LTCH in the Hamilton-Niagara region, Ontario. Interviews were conducted with six caregivers of residents who received IV therapy and ten key informants representing LTC home staff and service partners to assess their perceptions of the service. A chart review was conducted to describe the resident population served and service implementation.

RESULTS

Twelve residents received IV therapy. This service potentially avoided nine emergency department visits and reduced hospital lengths of stay for three residents whose IV therapy was initiated in hospital. There were no adverse events. The service was well received by caregivers and key informants, as it provided care in a familiar environment and was perceived to be less stressful and better quality care than when provided in hospital.

CONCLUSION

IV therapy is feasible to implement in LTCHs, particularly when there are supportive resources available and clinical pathways to support decision-making. This service has the potential to increase capacity in LTCHs to provide medical care.

摘要

背景

通常情况下,长期护理院(LTCH)的居民会被转至医院接受静脉输液治疗。本研究的目的是对一项居家静脉输液治疗服务进行试点测试,并描述该服务的结果以及关键信息提供者对其的看法。

方法

该服务在安大略省汉密尔顿 - 尼亚加拉地区的四家长期护理院进行了试点测试。对接受静脉输液治疗的居民的六位护理人员以及代表长期护理院工作人员和服务合作伙伴的十位关键信息提供者进行了访谈,以评估他们对该服务的看法。进行了一项图表审查,以描述所服务的居民群体和服务实施情况。

结果

十二名居民接受了静脉输液治疗。该服务可能避免了九次急诊就诊,并缩短了三名在医院开始接受静脉输液治疗的居民的住院时间。没有出现不良事件。护理人员和关键信息提供者对该服务评价良好,因为它在熟悉的环境中提供护理,并且被认为比在医院提供护理时压力更小、质量更高。

结论

在长期护理院中实施静脉输液治疗是可行的,特别是当有支持性资源可用且有临床路径支持决策时。这项服务有可能提高长期护理院提供医疗护理的能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee0e/6281378/004d374279c5/cgj-21-310f1.jpg

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