Zeffiro Valentina, Sanson Gianfranco, Carboni Luigia, Malatesta Anna, Vellone Ercole, Alvaro Rosaria, D'Agostino Fabio
Dottoranda di ricerca in Scienze infermieristiche e sanità pubblica, Dipartimento di Biomedicina e Prevenzione, Università degli studi di Roma Tor Vergata, Italia.
Tutor didattico, Università di Trieste, Italia.
Ig Sanita Pubbl. 2018 Jul-Aug;74(4):359-376.
Chronic diseases require continuous healthcare that is not fully guaranteed by the Italian Health System which is more oriented towards acute care. In the Lazio region (city of Palombara Sabina), a Nursing-Led in-patient unit is present with the aim to care for patients affected by chronic diseases. The aim of this study was to describe the type of healthcare delivered by this unit. A descriptive-comparative design was used. All 290 patients admitted to the Nursing-Led Unit, during 2014 and 2015 participated in the study. The following variables were analyzed: socio-demographic characteristics of patients, reasons for admission, nursing diagnoses and interventions, medical diagnoses and interventions, Barthel index, length of stay, mortality rate, and discharge rate to acute care hospitals. The mean age of participants was 78 years old (SD 11,4) and the most frequent reason for admission was the need to receive a medium-high intensity nursing care (14,5%). The most frequent nursing diagnoses were bathing/hygiene self-care deficit (78,3%) and impaired physical mobility (74,8%). Hypertensive heart disease was the most frequent medical diagnosis (32,4%). The mean length of stay was 19 days, the mortality rate was 2,1% and the discharge rate to an acute care hospital was 9%. Significant improvements in patient dependency levels, as measured by the Barthel index, were observed at discharge with respect to admission (p < 0,001). The NursingLed Unit seems to be strategic in the delivery of care to older adults affected by multiple chronic diseases, in some phases of their condition. The results of this study indicate that the Palombara Sabina's nursing-led unit may contribute in reducing hospital admissions and achieving favorable patient outcomes when additional nursing interventions are needed.
慢性病需要持续的医疗保健，但意大利医疗系统更侧重于急性病护理，无法充分保障这一点。在拉齐奥地区（帕隆巴拉·萨比纳市），有一个由护士主导的住院单元，旨在照顾慢性病患者。本研究的目的是描述该单元提供的医疗保健类型。采用了描述性比较设计。2014年和2015年期间入住该护士主导单元的所有290名患者参与了研究。分析了以下变量：患者的社会人口学特征、入院原因、护理诊断和干预措施、医疗诊断和干预措施、巴氏指数、住院时间、死亡率以及转至急性病医院的出院率。参与者的平均年龄为78岁（标准差11.4），最常见的入院原因是需要接受中高强度护理（14.5%）。最常见的护理诊断是洗澡/卫生自理缺陷（78.3%）和身体活动能力受损（74.8%）。高血压性心脏病是最常见的医疗诊断（32.4%）。平均住院时间为19天，死亡率为2.1%，转至急性病医院的出院率为9%。出院时，通过巴氏指数衡量的患者依赖程度与入院时相比有显著改善（p<0.001）。在某些病情阶段，护士主导单元在为患有多种慢性病的老年人提供护理方面似乎具有战略意义。本研究结果表明，当需要额外的护理干预措施时，帕隆巴拉·萨比纳的护士主导单元可能有助于减少住院次数并取得良好的患者治疗效果。
